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NPTE Prep > Neuro > Flashcards

Neuro Flashcards

1
Q

Frontal lobe lesions would result in what deficits?

A

Aphasia: Broca’s
Controls plan, programming, movements
Emotions, behavior control, personality
Olfaction

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2
Q

Temporal lobe lesions would result in what deficits?

A

Aphasia: Wernicke’s
Hearing
Language comprehension

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3
Q

Parietal lobe would result in what deficits?

A

Perceptual disorders: unilateral neglect
Sensory loss

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4
Q

Occipital lobe would result in what deficits?

A

Visual loss

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5
Q

Where do the cranial nerves approximately come out of?

A

CN 1 and 2 from cerebrum
CN 3 and 4 from midbrain
CN 5, 6, 7, 8 from pons
CN 9, 10, 11, and 12 from medulla

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6
Q

What CNs are involved with the pupillary light reflex?

A

CN 2 (afferent)
CN 3 (efferent)

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7
Q

Myopia vs presbyopia

A

Myopia: short-sighted
Presbyopia: far-sighted

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8
Q

What is a normal pupillary response if you shine light into the R eye?

A

Both pupils should constrict. The R CN 2 takes in the light, sends a message to R and L CN 3 to constrict both pupils.

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9
Q

What is affected if you shine light into the R eye and only the R eye pupil constricts?

A

L CN 3 is affected

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10
Q

What is affected if you shine light into the R eye and only the L eye pupil constricts?

A

R CN 3 is affected

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11
Q

What is affected if you shine light into the R eye and both eyes stay dilated?

A

R CN 2

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12
Q

What is strabismus?

A

Resting position of the eye

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13
Q

What is ptosis?

A

Drooping of the eyelid

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14
Q

Which CN provides sensation for the face?

A

CN 5

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15
Q

Which CN innervates majority of the facial muscles besides muscles of mastication and opening of the eye?

A

CN 7 innervates facial muscles
CN 5 innervates muscles of mastication
CN 3 innervates the muscles that lift the eye lid

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16
Q

What CN are involved with the corneal reflex?

A

CN 5 afferent
CN 7 efferent

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17
Q

What CN provides taste to the anterior 2/3rd of the tongue? What CN provides sensation to the anterior 2/3rd of the tongue? What CN provides sensation for the posterior 1/3 of the tongue? What CN provides taste for the posterior 1/3rd of the tongue?

A

Taste for anterior 2/3rd: CN 7
Sensation for anterior 2/3rd: CN 5
Taste and sensation for posterior 1/3rd: CN 9

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18
Q

What CN helps to dampen sound vs which one amplifies it?

A

CN 5 and 7 dampen the sound
CN 8 amplify the sound

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19
Q

What is the difference between conductive vs sensorineural hearing loss?

A

Conductive hearing loss involves the outer and middle ear structures.
Sensorineural hearing has to do with the inner ear (more commonly what is thought of with older people and hearing loss).

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20
Q

What are the steps for determining if someone has conductive vs sensorineural hearing loss?

A

Step 1 is to perform Rinne’s test. This will tell you what type the person has.
Step 2 is to perform Weber’s test. This will tell you what side is affected.

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21
Q

What is a normal response for the Rinne’s test?

A

Air conduction > bone conduction

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22
Q

What is the response for the Rinne’s test if someone has sensorineural hearing loss?

A

Air conduction > bone conduction

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23
Q

What is the response for the Rinne’s test if someone has conductive hearing loss?

A

Bone conduction > air conduction

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24
Q

What is the difference in responses for the Weber’s test if someone has sensorineural hearing loss vs conductive hearing loss?

A

If conductive hearing loss, the patient should report that the sound is amplified on the affected side. If sensorineural hearing loss, the patient should report that the sound is amplified on the unaffected side.

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25
Q

What CN are involved with the gag reflex?

A

CN 9 afferent
CN 10 efferent

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26
Q

What CN is involved with the resting position of the uvula? Which CN (L or R) would be affected if the uvula was pulled to the L when viewing it?

A

CN 10
It would be the R side affected

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27
Q

What CN (number and side) is affected if the tongue deviates to the R when the patient protrudes their tongue?

A

R CN 12

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28
Q

What are the cardinal symptoms of Parkinson’s Disease?

A

Tremor (resting)
Rigidity
Akinesia
Postural instability

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29
Q

Are males or females more typically affected for Parkinson’s Disease?

A

Males

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30
Q

What is used to classify Parkinson’s Disease?

A

Hoehn and Yahr

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31
Q

What stage of Hoehn and Yahr will someone have bilateral involvement but no balance deficits?

A

2

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32
Q

What stage of Hoehn and Yahr will someone require and assistive device for standing and walking?

A

4

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33
Q

What stage of Hoehn and Yahr will someone have bilateral involvement with balance deficits, but can live independently and walk?

A

3

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34
Q

What stage of Hoehn and Yahr will someone be confined to a bed or wheelchair?

A

5

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35
Q

Besides the cardinal signs of Parkinson’s Disease, what other s/s may be present?

A

Loss of smell
Constipation
Sleep disorders
Orthostatic hypotension
Restrictive lung disease
Difficulty with dual tasking

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36
Q

What is something that can be added or adjusted to a patients shoe if they have a festinating gait?

A

Add a toe wedge or declined heel to move COM posterior

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37
Q

What exercises do we want to address posture in someone with Parkinson’s Disease?

A

Rotation exercise and crossing midline
Can also have them go into prone to help with thoracic kyphosis

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38
Q

What medication is taken by patients with Parkinson’s Disease? What is the On/Off phenomenon? When do you want the patient to take their medication in regard to treatment with you?

A

Levodopa/Carbidopa
During the On-stage of the medication, the patient experiences dyskinesia. During the Off-stage of the medication (when it no longer works), the patient experiences dystonia. You want the patient to take their medication one hour before treatment with you.

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39
Q

What is a dietary concern we want to be aware of in regard to patients who take Levodopa/Carbidopa?

A

High protein diet can block medication effectiveness

40
Q

What are the typical s/s of a patient with Multiple Sclerosis?

A

Lhermitte’s Sign
Uhthoff’s phenomenon
Charcot’s triad
Cranial nerve 2

41
Q

What is Charcot’s triad?

A

Scanning speech, intention tremor, nystagmus

42
Q

How will a patient with MS react to the pupillary light reflex? What is it called?

A

A patient will respond with pupil dilation rather than constriction which is called Marcus Gunn Pupil

43
Q

What is the most common type of MS?

A

Relapsing remitting

44
Q

What MS type starts off as relapsing remitting and then goes into primary progressive?

A

Secondary progressive

45
Q

What type of neurons die with ALS?

A

Motor neurons

46
Q

Will sensation be affected with MS?

A

Yes, glove and stocking distribution

47
Q

Will sensation be affected with ALS?

A

No it will not be affected

48
Q

What are we concerned for a patients neck with ALS? What can we recommend for the patient?

A

They have weak cervical extensors, placing them in increased in neck flexion. We can recommend a soft neck collar.

49
Q

Which type of orthosis do we not want to recommend for patients with ALS who are looking to ambulate?

A

HKAFO because it requires a lot of energy

50
Q

Guillain-Barre Syndrome is typically precipitated by what?

A

An infection

51
Q

Does Guillain-Barre affect proximal to distal or distal to proximal?

A

Distal to proximal

52
Q

How will a patient with Guillain-Barre present when testing reflexes?

A

Decreased or absent

53
Q

What is one major concern we have for patients after Guillain-Barre?

A

Respiratory depression

54
Q

How long does recovery take for a patient with Guillain-Barre?

A

6-12 months

55
Q

What type of imaging would you want to use for seeing an acute brain hemorrhage?

A

CT scan

56
Q

What type of imaging would you want to use for seeing vascular occlusion or an infarct within a few hours post-stroke?

A

MRI

57
Q

What type of strokes are CT scans not helpful in observing?

A

Ischemic/small lesions because they are better at visualizing larger cortical lesions

58
Q

Within how many days post-stroke will an infarction show up on a CT scan?

A

3-5 days post-stroke

59
Q

If you wanted to detect cerebral edema shortly post-stroke, would you want to use a CT scan or MRI?

A

MRI because it allows visualization 30 minutes post-stoke and CT scan is within 3 days post-stroke

60
Q

Where is a Lumbar Puncture typically performed?

A

Spinal needle is inserted BELOW the level of L1-L2

61
Q

Are ischemic or hemorrhagic strokes more common?

A

Ischemic

62
Q

What are the risk factors for a CVA?

A

Atherosclerosis
HTN
Diabetes, metabolic disorder
TIA
Cardiac disease

63
Q

Irreversible anoxic damage to the brain begins after how long?

A

4-6 minutes!!

64
Q

Stages of Recovery Post-Stroke

A
  1. Flaccidity
  2. Increase in spasticity, hyperreflexia, synnergies emerge.
  3. Voluntary movements but only within synergy; spasticity peaks.
  4. Voluntary control in isolated joint movements due to decreased spasticity and synergy.
  5. Increased voluntary control out of synergy.
  6. Coordination and control of movements are almost normal.
65
Q

Difference in behaviors between a right vs left hemisphere stroke.

A

Left: slow, cautious, anxious. They understand their impairments and that frustrates them.
Right: impulsive, quick, and indifferent. They have poor judgement and overestimate their abilities.

66
Q

Which outcome measure has the best evidence and ability to assess a post-stroke patient who has impaired sitting balance?

A

TIS

67
Q

Which stroke outcome measure is a self-report that evaluates biopsychosocial health and participation after stroke?

A

Stroke Impact Scale

68
Q

Which side hemispheric stroke will benefit more greatly from gestures with communication?

A

Left rather than the right because it may confuse a patient with a right hemispheric stroke due to visuospatial deficits

69
Q

What should you think about when trying to remember what UE spasticity looks like in a patient post-stroke?

A

The chicken dance

70
Q

What should you think about when trying to remember what LE spasticity looks like in a patient post-stroke?

A

Ballerina

71
Q

Difference between spasticity vs synergy post-stroke.

A

Spasticity occurs at rest vs synergy occurs with movement

72
Q

Autonomic dysreflexia occurs above what spinal level?

A

T6

73
Q

What do you not want to do with a patient who has heterotopic ossification?

A

Aggressive stretching

74
Q

What muscles do we need to keep tight for a patient with a SCI?

A

Finger flexors
Lumbar extensors
Hamstrings only 100-110

75
Q

Which level is MOST associated with gaining independence in many of the areas of living/activities?

A

C6

76
Q

What kind of control can someone with a C1-C3 SCI use for their WC?

A

Mouth control

77
Q

What kind of control can someone with a C4 SCI use for their WC?

A

Chin control

78
Q

What kind of control can someone with a C5 SCI use for their WC?

A

Joystick

79
Q

Which is the most caudal level that a SCI patient can drive a van with adaptive controls?

A

C5

80
Q

Transfers with a slide board require what to happen at the wrist?

A

Finger flexion or wrist in neutral

81
Q

Which SCI level requires assistance for a manual cough technique?

A

C5

82
Q

Which is the most cranial level for a SCI patient to use a manual WC with friction hand rims for community mobility?

A

C7

83
Q

Which is the most cranial level for a SCI patient to be an independent home ambulator?

A

T12-L3

84
Q

How often should a patient with a reflexive or flaccid bladder use an IC?

A

Every 3-6 hours

85
Q

Should a reflexive or flaccid bowel use suppositories and digital stimulation?

A

Reflexive

86
Q

Should a reflexive or flaccid bowel use manual evacuation techniques and the Valsalva maneuver to empty?

A

Flaccid

87
Q

Down-beating nystagmus or direction-changing gaze evoked nystagmus =

A

CNS dysfunction which is a red flag

88
Q

Do you want to increase duration or intensity first for a patient who fatigues easily?

A

Duration

89
Q

Generalized seizure is also known as what?

A

Grand mal

90
Q

Absence seizure is also known as what?

A

Petit mal

91
Q

What seizure involves posture being maintained, person repetitively blinks or has other small movements, and happens several times/day?

A

Absence

92
Q

Which seizure is involved with a loss of urine?

A

Generalized or grand mal

93
Q

What is status epilepticus?

A

Prolonged seizure or series of seizures (> 30 minutes) with no relief in between episodes. MEDICAL EMERGENCY!

94
Q

Partial or focal seizure can be classified as what two seizures?

A

Complex partial
Temporal lobe seizure

95
Q

What electrolyte imbalance can increase the risk of seizures?

A

Hyponatremia, hypernatremia, hypoglycemia, hypomagnesmia

NPTE Prep (5 decks)

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