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Phys Assess Final > Neuro > Flashcards

Neuro Flashcards

1
Q

CN I - Olfactory

A

patient to discriminate between odors

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2
Q

CN II - Optic

A

visual acuity either wall chart (Snellen) or pocket chart (Rosenberg) either one

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3
Q

CN III - Oculomotor

A

eyelids for drooping- close eyes tight

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4
Q

CN IV - Trochlear

A

PERRLA and consensual reflex

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5
Q

CN V – Trigeminal

A

clench teeth and palpate masseter muscle-check muscle tone

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6
Q

CN VI – Abducens

A

six extraocular muscles six fields of gaze

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7
Q

CN VII – Facial

A

wrinkle forehead, squeeze eyes shut, smile, frown, puff out cheeks

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8
Q

CN VIII – Acoustic

A

Hearing tests Rinne, Weber, whisper etc. Vestibular fx: Romberg test

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9
Q

CN IX- Glossopharyngeal

A

gag or swallowing tested along with CN X

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10
Q

CN X – Vagus

A

“AH” – rise and fall of the palate uvula symmetry and rise and fall assessed together with IX

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11
Q

CN XI– Spinal Accessory

A

shrug shoulders

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12
Q

CN XII – Hypoglossal

A

tongue protrudes and side to side

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13
Q

Proprioception & Cerebellar function (3)

A
  • Balance – Equilibrium and Gait- heal-to-toe walking, ROMBERG, can have them close eye and stand on one foot
  • Coordination of fine motor – look for tremors or tics etc.
  • Rhythmic alternating movements and accuracy- flip ands over and back, finger to nose and back
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14
Q

Sensory function (3)

A

ALL TESTED WITH EYES CLOSED
Primary sensory function:
- superficial touch- cotton ball
- superficial pain- alternate sharp and smooth edges (paper clip)
- Vibration- LARGER tuning fork with lower Hz on bony prominences (great toe, elbow, sternum ankle etc.)

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15
Q

Cortical sensory function (3)

A
  • Two-point discrimination
  • Stereognosis
  • Extinction phenomenon
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16
Q

Plantar Reflex in adults

A

in adults, all toes should plantar flex (negative babinski)

Babinski sign should be NEGATIVE on anyone > 2 years old

superficial

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17
Q

Cremasteric

A

stroke inner thigh- testicle (s) and scrotum should rise on affected side

superficial

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18
Q

Rooting

A

starts when the corner of the baby’s mouth is stroked or touched. The baby will turn his or her head and open his or her mouth to follow and root in the direction of the stroking.

This reflex lasts about 4 months.

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19
Q

Moro

A

a normal reflex for an infant when he or she is startled or feels like they are falling. The infant will have a startled look and the arms will fling out sideways with the palms up and the thumbs flexed.

Absence of the Moro reflex in newborn infants is abnormal and may indicate an injury or disease.

20
Q

Palmar grasp

A

Infant grabs finger

disappears at 4-6 mo

21
Q

Plantar grasp

A

toes curl around finger

disappears 9mo-1yr

22
Q

Meningitis

A

Fevers, headache and POSITIVE:

  • Brudzinski sign- supine, flex neck and hips and knees involuntarily fledx
  • Kernig sign- supine, flex knee to 90 degrees and will meet resistance to straightening that leg
23
Q

Guillain-Barre syndrome

A

common post-infection AUTOIMMUNE

  • typically starts in lower extremities, paresthesia, diminished reflexes, possible respiratory distress.
24
Q

Bell palsy

A

CN VII (facial nerve) affected. Acute paralysis one one side of the face. Rapid onset, eyelid will not close

25
Q

Difference between bells palsy and CVA

A

Bells Balsy CANNOT move anything like eyebrow

CVA- eyebrow able to move

26
Q

Parkinson Classic Sign

A

Classic sign is resting tremors and DISAPPEAR with intended movement. Typically, slow progression, degenerative disorder

27
Q

MS classic signs

A

Inflammation and degeneration of the myelin in the brain and spinal cord

Muscle weakness, HYPERactive DTRs.

28
Q

CVA stats

A

Ischemic – most common

Hemorrhagic - about 15%

29
Q

Resting tremor

A

Parkinson disease or drug-induced Parkinsonian tremor (neuroleptics)

Pill rolling, resting tremor, reduced with intentional movement

30
Q

Essential Tremor

A

Most common. Hands, head, and voice

  • Slow to progress
  • Worse with intentional movement (like writing)
31
Q

Physiologic Tremor

A

Withdrawal, drug-induced, medications , Wilson disease, caffeine, stress, fatigue

  • Occurs while holding a position against gravity-arms extended
32
Q

Intentional tremor

A

MS, CVA, Wilson, lithium, tumor, trauma

  • Coarse hand tremor, worse with movement, maybe abnormal gait
33
Q

Tension Headache

A
  • Most common form of headache

Characteristics include

  • Dull pressure, band-like, heavy feeling to head or shoulders
  • Bilateral
  • Mild to moderate pain
  • Not aggravate by physical activity
  • May be chronic 15 days more a month, frequent 1-14 days per month, or infrequent or episodic
34
Q

Cluster Headache

A
  • Trigeminal pathway activated
  • Unilateral and severe
  • At least 5 attacks
  • Typically, orbital or supraorbital
  • Ptosis, facial swelling or nasal congestion may be seen
  • Usually last 15 minutes to several hours
  • May occur daily for weeks then periods of remission (several months to years)
  • Episodic cluster headaches
    –criteria above and at least 2 cluster periods lasting one week to one year followed by a remission period 3 months or longer

Chronic- criteria above without a remission period (or remission less than 3 months)

35
Q

Migraines

A

Migraine with or without an aura

Characteristics

  • Unilateral
  • Pulsating or throbbing
  • Moderate to severe pain
  • Aggravated by physical activity
  • N/V photo or phonophobia

Four phases
The prodrome- irritability neck stiffness and others 24-48 hours before migraine

The aura-visual, auditory, sensory, language, motor

The headache- USUALLY unilateral, throbbing or pulsatile
One to several hours, may have nausea or vomiting, photo or phonophobia

The postdrome- patients drained or exhausted
Precipitating factors- one questionnaire is over 100 questions to determine triggers (menstrual, lack of sleep, odors, foods, weather, you name it!)

36
Q

When assessing the plantar reflex in adults, the practitioner uses the end of a reflex hammer and strokes the lateral side of the foot. With a normal finding:

A

NEGATIVE BABINSKI - which is plantar flexion
(negative over age of 2yo)

dorsiflexion over 2yo is abnormal and therefore positive babinski sign

37
Q

A post infectious disorder following a nonspecific gastrointestinal or respiratory infection that causes an acute neuromuscular (typically starting in the lower extremities) paralysis is:

A

Guillian Barre Syndrome

38
Q

A classic sign of parkinson’s tremor is:

A

tremor that present at rest and disappears with intentional movement (like writing)

39
Q

You have asked a patient to close his eyes and identify an objected place in his hand. You are evaluating

A

stereogenesis

40
Q

If a patient cannot shrug the shoulders against resistance, which cranial nerve requires further eval?

A

spinal accessory

41
Q

How is primary sensory function tested?

A

with a cotton ball or large tuning fork

42
Q

When the provider asks the patient to smile and raise his eyebrows, the provider is testing what cranial nerve?

and how can you differentiate between CVA and bells palsy

A

CN VII facial

bells palsy cannot raise eyebrows

43
Q

a positive brudinski’s sign is:

what is it indicative of?

A

patient supine, flex neck and watch for involuntary flexion of the knees

meningeal irritation

44
Q

symmetric abduction and extension of the infant’s arms and legs then adduction of the extremities is known as what reflex

A

moro reflex

45
Q

when assessing gait/balance and using the assessment technique of rapid rhythmic movements, you are testing:

A

proprioception and cerebellar function

Phys Assess Final (7 decks)

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