Neuro Flashcards
Three guiding questions for neuro exam?
- Is the mental status intact?
- Are your findings symmetrical?
- Where is the lesion?
Grey Matter
Exterior layer and deep in brain
White matter
Myelinated so electrical impulses can travel fast
Frontal lobe control what?
Voluntary motor functions, planning, mood, smell, and social judgment
Parietal lobe controls what?
Somatosensory reception, taste and integration of sensory information
Occipital lobe controls what/
Visual cener
Temporal lobe controls what?
hearing, smell, learning, memory, emotions
Cerebellum controls what?
Motor coordination
For spinal nerves, dorsal root carries what info. and ventral root carries what info?
dorsal-sensory info
ventral- motor info
CNS consists of what?
brain, midbrain, spinal cord
PNS consists of what?
CN 1-12 and peripheral nerves
Motor pathways are?
Upper motor neurons
Lower motor neurons- final common pathway (movement only affected by signals from lower motor neurons)
Diabetic patients with small fiber neuropathy report what type of pain? Large fiber neuropathy?
Small fiber neuropathy- sharp, burning, shooting foot pain
Large fiber neuropathy- numbness and tingling or no sensation
What does stroke spare the forehead?
Upper face is controlled by pathways from both sides of the cortex and although the upper motor neurons on one side may be destroyed, neurons on the other side will remain
Things for stroke prevention
- control HTN
- control lipids
- control DM
- quit smoking
- maintain healthy weight
- exercise
Red flags for Headache
- Age>50
- stiff neck
- new, sudden onset of symptoms
- thunderclap
- diplopia, photophobia, orbital pain
- vomiting w/o nausea
Red flags for infants
- floppy baby
- increased spasticity and tone
- reappearance/persistent primitive reflexes
- fisting after 3 months of age
- slow appearance of postural reflexes
- no social smile, no stranger anxiety/poor attachments
- poor sleep and persistent crying
Infant exam includes?
- measure head circumference
- early or delayed closure of fontanels
- listen for bruits over cranium
- opthalmoscopy for red reflex
- EOMS
Preschooler Red flags
- Neurocutaneous syndromes- tuberous sclerosis, neurofibromatosis, sturge-weber disease
- dominant handedness before 18 months
- pes cavus- highly arched feet
- increased irritability or lethargy
- aggressive behavior, impaired comprehension, memory loss
- inability to perform series of steps to complete task
Preschooler exam includes what?
- red reflex
- corneal light reflex
- EOM
- motor strength
- vision
- hearing
Cerebellar function does what?
- coordinates muscular activity, maintains equilibrium, and controls posture
- coordination- finger to nose, rapid alternating movements, heel to shin, toe tapping
- romberg/gait
- shallow knee bend
2 sensory pathways are?
Spinothalamic tract- pain, temp, crude touch
Posterior column- position, vibration, fine touch
What are the spinal reflexes?
- DTRs
2. cutaneous reflexes- bulbocavernous, anal wink, cremastic
DTR grading
0- no response
1- low normal, slightly diminished
2- normal
3- more brisk than normal, not necessarily indicative of disease
4- brisk, hyperactive, clonus of tendon associated with disease
CN 1
olfactory- sense of smell, sensory
CN 2
optic nerve- visual acuity (central vision), gross visual fields (peripheral vision)- sensory
CN 3
oculmotor- PERRL; EOM- motor
CN 4
trochlear- PERL; EOM- motor
CN5
trigeminal- clench teeth- both sensory and motor
CN 6
Abducens- PERL; EOM- motor
CN 7
facial- 7 facial movements- both sensory and motor
CN 8
acoustic- hearing, whisper test- sensory
CN 9
glossopharyngeal- say AH- both sensory and motor
CN 10
vagus- say AH- both sensory and motor
CN 11
spinal accessory- shoulder shrug and head movement against resistance- motor
CN 12
hypoglossal- stick out tongue, lingual speech: round the rugged rock the fascal ran- motor
