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Q2 Physical Diag card, ab, LE, neuro, privates > Neuro > Flashcards

Neuro Flashcards

1
Q

Frontal Lobe for?

A

behavior, judgement

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2
Q

Parietal Lobe for?

A

sensory processing

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3
Q

Temporal Lobe for?

A

auditory processing, memory

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4
Q

Occipital Lobe for?

A

visual/spatial processing

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5
Q

Thalamus for?

A

relay visual, sound, sensation

NOT motor

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6
Q

Basal Ganglia for?

A

automated movements

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7
Q

Brainstem contains?

A

CNs, arousal, descending motor tracts, ascend sensory, respiratory

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8
Q

Cerebellum does?

A

coordinates voluntary movement, balance

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9
Q

Spinal cord ends where?

A

T12-L1

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10
Q

Cord injury above C5 =

A

death

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11
Q

Myelopathies are?

A

diseases of spinal cord

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12
Q

Corticospinal Tract carries?

A

voluntary motor movement,

nerves from motor cortex CROSS to contra-lateral side of medulla

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13
Q

Spinothalamic Tract carries?

A

carries light touch,
pain,
temp,
pressure

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14
Q

Posterior Columns carry?

A

carry vibration,
proprioception,
discriminative touch

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15
Q

Exam for CNS includes (4)?

A

1) gait
2) romberg
3) reflex
4) tone

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16
Q

Myopathies are?

A

disease of mm

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17
Q

PNS muscle exam includes? (3)

A

1) bulk
2) strength
3) tone

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18
Q

Neuromuscular jxn diseases characterized by?

A

proximal weakness and fatigue,

improves w/ rest

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19
Q

Neuromuscular jxn exam includes? (2)

A

1) strength

2) fatigue

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20
Q

Peripheral neuropathies are?

A

diseases of peripheral nerves

(U) diffuse

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21
Q

PNS nerve exam includes?

A

1) sharp/dull
2) vibration
3) proprioception
4) mm strength

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22
Q

Brachial plexus located?

A

C5-C8

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23
Q

Lumbosacral plexus located?

A

L3-S1

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24
Q

Plexopathies characterized by? (3)

A

1) loss of reflex
2) widely distributed weakness
3) multifocal numbness (w/ or w/o pain)

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25
Q

Most plexopathies caused by?

A

compression or infiltration

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26
Q

PNS plexus exam includes? (3)

A

1) strength
2) motor
3) reflex

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27
Q

Radiculopathies are?

A

diseases of nerve root

(U) localized

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28
Q

Radiculopathies U from?

A

compression or other mechanical

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29
Q

Cervical roots for UE located?

A

C5-8

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30
Q

Injury to roots causes?

A

1) lancinating dysesthetic pain (stabbing pain when touched)
2) focal weakness
3) reflex loss

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31
Q

Lumbsacral roots to LE located?

A

L3-S1

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32
Q

of spinal nerve pairs?

A 
31
C=8
T=12
L=5
S=5
Coc=1
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33
Q

Location of reflex:

Biceps
Triceps
Patellar
Achilles

A 
B = C5,6
T = C7,8
P = L3,4
A = S1,2

"reflex dance" to help remember:
1,2 achilles
3,4 patellar
5,6 biceps
7,8 triceps
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34
Q

Integrity of reflex dependent on what 3 things?

A

Afferent
Synaptic
Efferent neurons

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35
Q

Syncope?

A

brief LOC

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36
Q

JOMAC is?

A 
mental status exam:
Judgement
Orientation
Memory
Affect
Cognitive
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37
Q

Pronator Drift tests for?

A

contralateral upper motor neuron lesion

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38
Q

Romberg test for?

A

balance

eyes closed, feet tog

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39
Q

Thumb dermatome?

A

C6

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40
Q

Middle finger dermatome?

A

C7

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41
Q

5th digit dermatome?

A

C8

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42
Q

Nipple line dermatome?

A

T4

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43
Q

Umbilicus dermatome?

A

T10

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44
Q

Anterior thigh dermatome?

A

L3

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45
Q

Anterior shin dermatome?

A

L4

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46
Q

Top of foot dermatome?

A

L5

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47
Q

Bottom of foot dermatome?

A

S1

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48
Q

2 Point Test?

A

(cortical sensory)

fingertips: 2mm
toes: 3-8mm
palms: 8-12mm
back: 40-6o-mm

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49
Q

Stereognosis test?

A

(cortical sensory)

identify object

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50
Q

Graphesthesia test?

A

(cortical sensory)

draw letter in palm

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51
Q

Tactile Location test?

A

(cortical sensory)

touch pt in two separate places, opp side of body

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52
Q

Finger-to-Nose exam for?

A

cerebellar disease

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53
Q

Finger-to-Nose exam for?

A

cerebellar disease

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54
Q

Heel-to-shin exam for?

A

cerebellar disease

55
Q

Rapid alternating movement test?

A

pronate/supinate forearms

for cerebellar disease

56
Q

Dysdiadochokinesia is?

A

inability to do rapid alternating movements

57
Q

Gait exams test for?

A

cerebellar disease

58
Q

Kernig’s Sign?

A

for meningeal irritation
pt supine, flex hip/knee, straighten leg
+ if low back pain

59
Q

Dysphoric is?

60
Q

Obtundation is?

A

hard to arouse
slow/confused responses
decreased interest in surroundings

61
Q

Stupor is?

A

unresponsiveness w/o painful stimuli

62
Q

Dysarthria is?

A

problem w/ motor speech/articulation

63
Q

Dysphonia is?

A

weak, breathy voice

64
Q

Aphasia is?

A

impaired ability to speak, write

65
Q

Expressive (Broca’s) Aphasia?

A

comprehension intact

speech disability

66
Q

Receptive (Wernicke’s) Aphasia?

A

comprehension not intact

fluent, nonsensical speech

67
Q

Global Aphasia?

A

combo of Expres/Recept

68
Q

Apraxia is?

A 
inability to perform a learned motor act:
don't understand command
don't remember command
motor ability is intact
(U) parietal lobe lesion
69
Q

Agnosia is?

A

inability to recognize sensory (any kind) stimuli

(U) large parieto-occipital-post temporal lesion

70
Q

Accelerating levels of awareness? (4)

A

Alert ->
Vigilant ->
Hypomaniac ->
Manic

71
Q

Decelerating levels of awareness? (8)

A 
Alert ->
Relaxed ->
Lethargic ->
Somnolent ->
Obtunded ->
Stuporous ->
Comatose ->
Death
72
Q

Coma is?

Localized to?

A

sustained LOC doesn’t reverse w/ internal or external stim

impaired bilat thalamus
bilat hemispheric injury
midbrain or below injury

73
Q

Lethargy (somnolence) is?

A

aroused w/ light stim

74
Q

Delirum is?

A

hypervigilant w/ agitation and impaired attention

75
Q

Confused is?

A

impaired attn, incoherent thougnt

76
Q

Fugue is?

A

sudden abandonment of life to start new life w/o later memory of the fugue

77
Q

Catatonia is?

A

psychomotor disturb in schizophrenia

78
Q

Coma glasgow score of < 8 for >72 hrs means?

A

very poor prognosis

79
Q

Coma Vigil/Alpha Coma?

A

Pt appears awake but still brain dead:
open eyes
cough, yawn
move extremities

80
Q

Decorticate posturing?

A

extended legs, plantarflex
arms tight against chest w/ flexed wrists

from lesion in corticospinal tract: cortex to up midbrain

81
Q

Decerebrate posturing?

A

legs and arms out straight, flexed feet/hands and neck

from damage to cortispinal tract at pons or upper medulla

82
Q

Brain herniation etiology?

A

2º to ↑ ICP from trauma, lesions

83
Q

Brain herniates where?

A

under falx

thru tentorium or foramen mag

84
Q

3rd Nerve Palsy presents?

A

unilateral, fixed, dilated pupil

ptosis

85
Q

3rd Nerve Palsy etiology?

A

uncal brain herniation,

aneurysm compressing CN III

86
Q

L 4th nerve Paralysis (paralytic strabismus) presents?

A

L eye can’t look down while looking medially

87
Q

L 6th nerve Paralysis (paralytic strabismus) presents?

A

looking forward, L eye esotropic (looks medially)

looking L, L eye look straight ahead

88
Q

Pupils fixed at midposition (2-5mm) from?

A

midbrain lesion

89
Q

Pinpoint and reactive pupils from?

A

pontine lesion

90
Q

Unilateral fixed pupil dilation from?

A

CN III lesion

uncal herniation

91
Q

Bilateral fixed pupil dilation from?

A

central hernia

hypoxia

92
Q

Oculocephalic Reflex (Doll’s Eyes) presents?

A

eyes open, rotate head side-side

eyes roll same direction as head instead of opp direction

93
Q

Oculocephalic Reflex from?

A

midbrain or pons lesion

CN III - VIII lesion

94
Q

Vestibulocochlear Reflex presents?

A

head at 30º
cold water in ear causes fast nystagmus away from ear

normal response would be slow turn toward ear

95
Q

Vestibulocochlear Reflex from?

A

brainstem lesion

CN III - CN VI

96
Q

Cheyne-Stoke respiration in coma?

A

apnea lasting 10 to 60 sec, followed by gradually increasing depth and frequency of respirations

from bihemispheric lesion
metabolic encephalopathy

97
Q

Hyperventilation (Kussmaul’s) respiration in coma?

A

metabolic acidosis

herniation

98
Q

Apneustic respiration in coma?

A

prolonged inspiration unrelieved by attempts to exhale

Pontine damage

99
Q

Cluster respiration in coma?

A

early medullary damage

100
Q

Ataxic (Biot’s) respiration in coma?

A

quick, shallow inspirations followed by apnea

medullary damage

101
Q

CN I deficit

A

hyposmia (decreased)
anosmia (absent)

olfactory groove meningioma

102
Q

Pituitary Adenoma presents?

A

visual field defect and HA

103
Q

Signs of pituitary hypersecretion?

A

↑ growth hormone ->acromegaly
↑ prolactin -> infertility
↑ ACTH -> cushings

104
Q

CN VII: central lesion presents?

A

Contralateral paralysis of low face,

spares forehead

105
Q

CN VII: peripheral lesion presents?

A

Ipsilateral paralysis of entire side of face

106
Q

Bell’s palsy from?

A

low motor neuron lesion

107
Q

Acoustic Neuroma?

A

benign growth on CN VIII ->

sensory neural hearing loss

108
Q

Glossopharyngeal Lesion?

A

CN IX lesion ->
deviation of palate AWAY from side of lesion
loss of gag reflex

109
Q

Hypoglossal Lesion?

A

CN XII lesion ->

tongue deviation TOWARD lesion

110
Q

Cerebrovascular Accident (CVA) sxs? (5)

A 
Acute weak/numb
Abrupt impaired consciousness
Worst HA of life
Aphasia (can't speak)
Dysarthria (slurred speech)
111
Q

Upper Motor Neuron impairment sxs? (5)

A

1) Weakness in affected distribution
2) Spasticity
3) Hyperactive DTRs
4) Clonus
5) Babinski sign +

112
Q

Lower Motor Neuron impariment sxs? (5)

A

1) Weakness in segmental distribution
2) Muscle atrophy
3) Flaccidity
4) Fasciculations (mm twitching w/o moving joint)
5) Reduced/absent DTRs

113
Q

Up MN weakness present where?

A

below level of lesion

114
Q

Unilat lesions above medulla present?

A

contralateral weakness

115
Q

Unilat lesions below medulla present?

A

ipsilateral weakness

116
Q

Up MN disease may result in damage to?

A

corticospinal tracts

117
Q

Carpal tunnel synd what kind of MN defect?

118
Q

Ulnar Entrapment is?

3 sxs?

A

Ulnar nerve compression (low MN):

1) sensory loss 4th/5th digits
2) motor loss hypothenar (abd digiti minimi, 1st dorsal ineross)
3) pain 4th/5th digits and elbow

119
Q

Resting Tremor?

A

prominent at rest
gone w/ movement
(Parkinson’s)

120
Q

Postural Tremor?

A

seen in head or extrem while maintaining posture

hypothyroidism

121
Q

Intention Tremor?

A

seen when reaching for target

cerebellar dx, MS, old

122
Q

Oral-Facial Dyskinesias

A

tics of face, jaw, tongue

123
Q

Athetosis?

A

writhing, twisting mvmts

slower than chorea

124
Q

Myoclonus?

A

sudden, rapid jerks

infections, stroke, anoxia

125
Q

Spastic Hemiparesis?

A

a/w corticospinal disease: ONE SIDE
UE flexed
LE extended
drag foot around

126
Q

Steppage Gait (foot drop)?

A

LMN disease:
drag foot,
high knee lift,
foot slap

127
Q

Sensory ataxia (poor coordination)?

A

a/w loss of proprioception in legs and + Romberg:
unsteady, wide-based gait,
watch ground

128
Q

Cerebellar ataxia?

A

a/w cerebellar dx:
staggering, wide-based gait,
turn difficulty,
can’t stand w/ eyes closed

129
Q

Parkinson’s etiology?

A

degeneration of dopaminergic neurons in substantia nigra

130
Q

Parkinson’s sxs?

A 
cog-wheel rigidity
pill-rolling resting tremor
masked facial expression
bradykinesia
30% dementia
131
Q

Reflex scale?

A 
0 = no response
\+1 = diminished
\+2 = normal
\+3 = increased
\+4 = hyperactive
132
Q

Reinforcement techniques for obtaining reflexes?

Jendrassik

A 
UE = grit teeth
LE = grab fingers and pull in opp direction
133
Q

Affect:
Blunted?
Flat?
Labile?

A

blunt = reduced

flat = absent

labile = abrupt ∆s

Q2 Physical Diag card, ab, LE, neuro, privates (6 decks)

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