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Oral Surgery > Nervous System > Flashcards

Nervous System Flashcards

1
Q

upper motor neurons vs lower in cell bodies

A

upper – cerebral cortex

lower – spinal corn in ANTERIOR HORN

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2
Q

corticospinal tract

A

mediate voluntary movement, also integrate skilled, complicated movements

carry impulses that INHIBIT muscle tone

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3
Q

spinothalamic tract

A

SENSORY pathway

pain temperature and touch

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4
Q

posterior column

A

SENSORY pathway

position, propioception, vibrationo, pressure and fine touch

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5
Q

mental status

A

A + O X 3

  • awake and oriented THREE TIMES
  • say is patient awake and oriented

self – know their name

place

time

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6
Q

mental status

A

A + O X 3
- awake and oriented THREE TIMES

self – know their name
place
time

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7
Q

ankle reflex

A

sacral 1 primarily

ankle rested and hit from behind

example of deep tendon reflex

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8
Q

knee reflex

A

deep tendon reflex

lumbar 2,3,4

extremity must be hanging

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9
Q

biceps reflex

A

C 5 and 6

example of deep tendon reflex

patient can be sitting or lying down

finger over the brachial tendon

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10
Q

trriceps reflex

A

C 6 and 7

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11
Q

crnaial nerves to check

A

I, II (visual acuity check) , III, IV (superior oblique movement) ,V

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12
Q

light reflex

A

CN III - do you get constriction of pupil with light reflex?

keeps it open
- if harmed then get ptosis – drooping of eyelid

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13
Q

physical exam standpoint with eye

A

III, IV, or VI

patient cant do something - that nerve is effected - then do more tests to determine if muscle or nerve

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14
Q

CN VI

A

ABDUCENS
lateral rectus

EOM - how can check this

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15
Q

muscle activation determined on level of

A

0-5

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16
Q

deep tendon relfexes

A

ankle, biceps, knee

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17
Q

deep tendon relfexes

A

ankle, biceps, knee

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18
Q

biceps reflex gets

A

C5 and 6

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19
Q

deep tendon relfexes graded on scale of

A

0-4+

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20
Q

4+ with deep tendon

A

very brisk hyperactive with clonus

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21
Q

3+ with deep tendon reflexes

A

brisker than average

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22
Q

2+?

A

average response with deep tendon reflex

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23
Q

1+

A

somewhat diminshed with deep tendon relfexes

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24
Q

1+

A

somewhat diminshed with deep tendon relfexes

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25
Q

glasgow coma scale

A

used to evaluate the level of consciousess following a traumatic brain injury

score is based on:
eye opening (4 points )

verbal response (5 points)

motor response (6 points)

three things examines

best score = 15
worst score = 3
=<8 = coma

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26
Q

glasgow coma scale lowest score

A

3 (1 of each)

best score = 15

8 or below = coma status

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27
Q

eye opening in terms of glasgow coma scale

A

4 points response

4 – spontaneous (best)

3 = to voice

2 = to pain

1 = none

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28
Q

verbal with glasgow coma scale worth

A

5 points

5 = normal conversatino (best)

4 = disoriented conversation

3 = words but not coherent

2 = NO words only SOUNDS

1 = none

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29
Q

motor response in terms of glasgow coma scale

A

6 points total

6= obeys commands

5= localizes to pain

4= withdraws to pain

3= FLEXION to pain

2= EXTENSION to pain

1= no motor response

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30
Q

sucking and snout reflexes

A

special techniques / specific signs

more utalized in infants

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31
Q

sucking reflex

A

suckin movement of an infant’s lips elicited by touching them or adjacent skin

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32
Q

snout reflex

A

a pouting or pursing of the lips that is caused by light tapping of the closed lip near the midline

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33
Q

gray matter

A

consists of aggregations of neuronal cell bodies

rims surfaces of cerebral hemispheres - forming cerebral cortex

deep in brain

  • basal ganglia
  • thalamus
  • hypothalamus
34
Q

basal ganglia - general

A

deeper cluster of gray matter and effects movement

35
Q

thalamus - general

A

deeper cluster of gray matter and processes sensory impulses and relays to the cerebral cortex

36
Q

hypothalamus - general

A

deeper cluster of gray matter and maintains homeostasis and regulates temperature, HR, BP,
-releasing factors at directly on the pituitary gland

37
Q

white matter - basic

A

neuronal AXONS that are coated with myelin - give the color

38
Q

cerebellum basic function and locatrion

A

lies at the base of the brain and coordinates all movement and helps maintain the body upright in space

39
Q

axons in upper vs lower motor neuron

A

upper
- synapse in brain (CN), spinal tract (PN)

lower
- terminate at NMJ

40
Q

lesions in upper motor neuron

A
  • spasticity and rigidity
  • increase deep tendon reflexes
  • extensor plantar response
41
Q

lesions in lower motor neuron

A

weaness, loss of reflexes, muscle wasting

42
Q

tract that can carry impusles that inhibit muscle tone

A

corticospinal tract

43
Q

corticobulbar associated with

A

CN - motor pathway

44
Q

extrapyrimadal system

A

maintains muscle tone and control body movement - like walking

45
Q

basal ganglia pathway responsible for

A

automatic movements

46
Q

cerebellar system - general

A

coordinates muscle activity, equilibrium, control posture

47
Q

one to note if basal ganglia pathway affected

A

parkinsonism

48
Q

one eto note if cerebellar system affected

A

nystagmus

49
Q

upper motor neuron systems are damaged ABOVE THE CROSSOVER OF ITS TRACT IN MEDULLA (still in brain) ….

A

motor impairment develops on the OPPOSITE / CONTRALATERAL SIDE

50
Q

upper motor neuron systems are damaged BELOW THE CROSSOVER, …

A

motor impairment occurs on the SAME SIDE / IPSILATERAL side of the body

51
Q

two main sensory pathways

A

spinothalamic and posterior column

52
Q

reflex - basic

A

affarent sensory — posterior root ganglion — anterior horn cell — anterior root – efferent motor fiber

53
Q

chec CN V

A

trigeminal

since it controls muscles of mastication and sensation to face and oral cavity we can test stregth of muscles of mastication and sensation and corneal relfex

54
Q

corneal reflex

A

associated with CN V

- have to touch the cornea NOT the sclera

55
Q

CN III palsy

A

patient cannot move eye up and in
- controls the inferior oblique

so patient looing STRAIGHT ahead – unable to move eye in that direction hence the CN III palsy

56
Q

CN VI

A

abducent – lateral recture

do an EOM

57
Q

Cn VII

A

function - facial movement, taste of anterior 2/3

examine in 5 dimensions

58
Q

VIII

A

vestibulo-cochlear –> hearing and balance

gross hearing test

59
Q

CN IX

A

glossopharyngeal
- sensory to pharynx and posterior 1/3 of tongue and tympanic membrane

secretory to parotid

gag reflex - say ‘AH’

60
Q

examine CN IX by

also examines?

A

gag relfex - say ‘AH’

CN X - vagus

61
Q

test ___ with head rotation against resistance , shoulder elevation

A

CN XI – spinal accessory as it innervates SCM and trapezius

62
Q

CN XII

A

hypoglossal – motor to tongue

examine by midline protrusion

63
Q

midline protruion examines

A

hypoglossal nerve – CN XII

64
Q

motor system exam numbers

A

0-5

graded based on a five , 5/5 or 3/5

65
Q

motor test of 3

A

active movement against gravity

BUT CAN NOT resist additional pressure

66
Q

motor test of 5

A

active movement against gravity with FULL RESISTANCE to normal motor strength

67
Q

motor test of 4

A

movement against gravity with resistance

68
Q

motor test 2

A

active movement of the body with GRAVITY ELIMINATED

69
Q

motor test 1

A

barely detectable flicer or contraction

70
Q

motor test 0

A

no muscular contractino detected

71
Q

sucking and snout reflex normal in?

A

infants – NOT in adults

72
Q

bell’s palsy

A

lower portion of face recieves from opposite side

peripheral lesion
- takes out that whole one side
CN VII –> takes it ALL out on that side

  • lower portion is only from opposite side

central lesion

  • still have some from the ipsilateral side
  • maintain some of the UPPER portion
  • still have connection of ipsilateral side not beig knocked out
73
Q

meningeal signs

A

brudzinski sign

kernig’s sign

74
Q

brudzinski sign

A

flexion of the neck toward the chest causes the patient to flex his hips and knee

seen in patients with meningitits

75
Q

what is seen in patients with meningitis

A

brudzinski signs

  • flexion of the neck toward the chest causes patient to flex hips and knees
76
Q

kernig’s sign

A

seen in patients with meningitis

inability to straighten the leg when the hip is flexed to 90 degrees

77
Q

plantar response

A

stimulation of the outside of the sole, results in plantar flexion of the big toe

so like points toes downwards – normal response

78
Q

babinski reflex

A

abnormal plantar response

stimulation of outside of the sole results in dorsi-flexion (flexes toward TOP of the foot) of the big toe

79
Q

babinki reflex can be normal in?

A

children younger than 2

80
Q

babinski reflex implication

A

abnormal
POSITIVE = abnormal = babinski

plantar reflex response AFTER the age of 2

  • indicated a CNS lesion in the CORTICOSPINAL TRACT

Oral Surgery (26 decks)

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