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NPTE > Neuro > Flashcards

Neuro Flashcards

1
Q

in an action potential, which ion flows in and which flows out of the cell?

A

Na+ in; K+ out

Na+ perm inc, repolarization by activation of K+ chan

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2
Q

resting membrane potential of a nerve cell

A

-70mV

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3
Q

CN I and test

A

Olfactory, Sensory, smell!

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4
Q

CN II and test

A

Optic, Sensory
visual acuity
visual fields
pupil light reflex

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5
Q

CN III and test

A

Oculomotor, motor/parasymp
eye mvt: up, down, in
pupil light reflex

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6
Q

CN IV and test

A 
Trochlear, motor
eye mvt (down & in)
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7
Q

CN V and test

A

Trigeminal, both
Sensory: face and cornea
Motor: temporal and masseter
corneal reflex ipsi

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8
Q

CN VI and test

A 
Abducens, motor
eye mvt (out)
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9
Q

CN VII and test

A

Facial, both/parasymp

facial expression

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10
Q

CN VIII and test

A

Vestibular, sensory

finger rub, weber fork on head, rinne on bone & front of ear

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11
Q

CN IX and test

A

Glossopharyngeal, both/parasymp
voice quality, uvula deviation
gag reflex

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12
Q

CN X and test

A

Vagus, both/parasymp
Palate and pharynx control
gag reflex

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13
Q

Arthrogryposis

A

nonprogressive, nongenetic, congenital disorder; rigid joints of extremities, weak/nonfunctioning mm

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14
Q

Gout has elevated serum levels of:

deposits crystals where?

A

Uric Acid;

deposits urate crystals in joints, soft tissue, kidney

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15
Q

symptoms of gout (location, pain, etc)

A

feet: toe, ankle, midfoot

night pain, warmth, erythema, tenderness

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16
Q

Tx for gout

A

anti inflam, colchicine, diet, allopurinol

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17
Q

ITB syndrome associated with hip IR or ER in stance

A

IR

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18
Q

Pivot shift test

A

ACL integrity
Valgus F and IR tibia, slowly flex knee, (+) is when tibia starts in anterior subluxed pos’n and returns to neutral around 30 deg

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19
Q

noble compression test

A

ITB friction synd: press prox to lat fem condyle, extend knee, pain before 30 deg (+)

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20
Q

myositis ossificans Tx

A

AROM and AAROM, no passive stretching

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21
Q

anosmia - what is it?

A

inability to detect smells CN I

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22
Q

Myopia - what?

A

impaired far vision

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23
Q

presbyopia - what?

A

impaired near vision

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24
Q

Homonymous Hemianopsia

A

CN II half of vision is impaired in ea eye, contra to lesion

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25
Q

anisocoria

A

unequal pupils

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26
Q

Strabismus

A

eye deviates from normal position

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27
Q

esotropia

A

eye pulled in, CN VI

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28
Q

Bell’s Palsy - CN?

A

VII

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29
Q

Dysphonia - what is it?

A

hoarseness, vocal cord paralysis

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30
Q

dysphagia - what is it? CN?

A

difficulty swallowing, CN IX, X

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31
Q

Dysarthria - what? CN?

A

articulation, CN X, XII

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32
Q

Broca’s aphasia aka & where?

A

nonfluent, expressive, L frontal lobe

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33
Q

Wernicke’s aphasia aka & where?

A

fluent, receptive, L temporal lobe

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34
Q

Cheyne-stokes respiration - what and where?

A

10-60s apnea then increasing depth & freq of breaths; frontal & diencephalic

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35
Q

hyperventilation - where in the brain?

A

midbrain and pons

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36
Q

temperature is controlled in

A

hypothalamus

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37
Q

Kernig’s sign

A

90-90 test, if B cause pain= meningeal irritation

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38
Q

brudzinski’s sign

A

flex neck, hips & knees flex

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39
Q

Which is faster and worse: bacterial or viral meningitis?

A

bacterial

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40
Q

increased intracranial pressure effect on BP, HR, temp

A

inc BP, dec HR, inc temp

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41
Q

intracranial pressure signs

A

HA, vomit (CNX) pupil change (CNIII), papilledema

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42
Q

spmatognosia

A

body scheme disorder

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43
Q

anosognosia

A

denial/unaware of issue

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44
Q

agnosia

A

inability to recognize objects c one sense, can recognize c another sense

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45
Q

apraxia

A

inability to perform voluntary, learned mvts

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46
Q

Modified ashworth scale

A 
spasticity
0
1: end ROM
1+: <1/2 ROM
2
3
4: rigid
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47
Q

decerebrate rigidity - what and where

A

rigid extension, lesion bet sup colic & vestib nuc

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48
Q

decorticate rigidity - what and where

A

UE flexion, LE ext

lesion above sup colic

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49
Q

opisthotonos

A

head back, arch back

meningitis, tetanus, strychnine, epilepsy

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50
Q

chorea

A

relatively quick twitches/dance

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51
Q

athetosis

A

slow, irreg twisting sinuous

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52
Q

cerebellar disorder - what kind of tremor?

A

intention tremor

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53
Q

CTSIB - dependent on vision is unstable in

A

EC, Stable surface
visual conflict, stable surf
EC, moving surf
VC, moving surf

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54
Q

CTSIB - dependent on somaotsens is unstable in

A

EO, moving surf
EC, moving surf
VC, moving surf

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55
Q

CTSIB - vestib loss is unstable in

A

EC, moving surf

visual conflict, moving surf

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56
Q

CTSIB - sensory selection problems unstable in

A

visual conflict, stable surf
EO, moving surf
EC, moving surf
VC, moving surf

57
Q

LP normal csf amount, pressure, protein

A

90-150mL
90-180 mm H2O
15-45 mg/dL

58
Q

fibrillation is? means?

A

spontaneous contraction of individ mm fiber,

denervation for 1-3 wks

59
Q

fasciculation is? means?

A

spontaneous contraction of all/most fibers in motor unit,

LMN disorders & denervation

60
Q

complete LMN lesion will show fib or fascic?

A

fibrillation only

61
Q

Partial LMN lesion will show fib or fascic?

A

Both

62
Q

akinesia

A

inability to initiate mvt

63
Q

Broca’s aphasia accompanied by

A

object naming, writing, R hemiplegia usu

64
Q

Wernicke’s aphasia accompanied by

A

auditory comprehension, reading, writing, word recognition

65
Q

ideational apraxia

A

person doesn’t get the idea of how to do a task

66
Q

idomotor apraxia

A

person can’t do task on command, but can do spontaneously

67
Q

steriognosis

A

recognize object by touch

68
Q

ataxia

A

uncoordinated mvt - esp gait

69
Q

morton’s neuroma

A

excessive pronation causes compression bet 3rd & 4th toes, metatarsalgia, enlarged n

70
Q

somatognosia

A

lack of awareness of relationship of own body parts or other’s body parts

71
Q

apneustic breathing

A

prolonged inspiration, damage to upper pons

72
Q

jaw reflex - what n?

A

CN V - trigeminal

73
Q

Hamstrings DTR - what n?

A

L5-S3?

74
Q

abdominal reflex

A

stroke lateral to medial toward umbilicus in 4 quadrants, should deviate toward stimulus; T6-L1

75
Q

Cremasteric reflex

A

L1-L2; stroke skin prox and medial thigh = elevation of testicle

76
Q

ATNR

A

rotation of head = flexion of back limbs and ext of front limbs

77
Q

STNR

A

flexion of head = flexion of UE/ext LE

ext of head = ext of UE/ Flex LE

78
Q

positive supporting reflex

A

contact to ball of foot in stancing = rigid ext of LE

79
Q

associated reactions

A

strong voluntary mvt = involuntary mvt of another extremity

80
Q

DMD weakness progresses in what direction?

A

prox to distal

81
Q

DMD posture, issues in what mm?

A

heel cord contracture, TFL, lumbar lordosis, kyphoscoliosis

82
Q

peds: fwd walker encourages what posture

A

forward leaning of trunk

83
Q

peds: posterior walker encourages what posture/mm activation

A

trunk extension, sh depression, elb ext, neutral wrist, dec scissoring in LE

84
Q

Tonic Labyrinthine reflex

A

The tonic labyrinthine reflex is stimulated through the labyrinth in the inner ear. If the infant is in a supine position, the body and extremities are held in extension; in a prone position, the body and extremities are held in flexion. This reflex not only interferes with the ability to roll, but also the ability to prop on elbows, balance in sitting, and attain an upright posture from a supine position. Integration of the reflex is often associated with the ability to roll from supine to prone.

85
Q

Signs and symptoms of unilateral vestibular dysfunction

A

Abnormal VOR produces nystagmus, loss of gaze stabilization during head movements, oscillopsia. Veering to one side when walking shows abnormal vestibulospinal function

86
Q

BPPV signs and symptoms

A

episodic vertigo, nausea, blurred vision and autonomic changes that occur with head movement and usually stop after 30 seconds of static head position

87
Q

Acoustic Neuroma

A

benign tumor affecting CN 8. Progressive hearing loss, tinnitus, and disequilibrium.

88
Q

Meniere’s disease signs and symptoms

A

nausea, vomiting, episodic vertigo, and fullness in the ear with low-frequency hearing loss

89
Q

CN XI and test

A

Spinal accessory, motor
Trap and SCM muscles
shrug shoulders or turn head against resistance

90
Q

CN XII and test

A

Hypoglossal, motor

tongue movements

91
Q

Posterior cord syndrome

A

A relatively rare syndrome that is caused by compression of the posterior spinal artery and is characterized by loss of pain perception, proprioception, two-point discrimination, and stereognosis. Motor function is preserved.

92
Q

Brown-Sequard’s Syndrome

A

An incomplete lesion usually caused by a stab wound, which produces hemisection of the spinal cord. There is paralysis and loss of vibratory and position sense on the same side as the lesion due to the damage to the corticospinal tract and dorsal columns. There is a loss of pain and temperature sense on the opposite side of the lesion from damage to the lateral spinothalamic tract.

93
Q

Cauda equina syndrome

A

An injury that occurs below the L1 spinal level where the long nerve roots transcend. Cauda equina injuries can be complete, however, they are frequently incomplete due to the large number of nerve roots in the area. A cauda equina injury is considered a peripheral nerve injury. Characteristics include flaccidity, areflexia, and impairment of bowel and bladder function. Full recovery is not typical due to the distance needed for axonal regeneration.

94
Q

Central cord syndrome

A

An incomplete lesion that results from compression and damage to the central portion of the spinal cord. The mechanism of injury is usually cervical hyperextension that damages the spinothalamic tract, corticospinal tract, and dorsal columns. The upper extremities present with greater involvement than the lower extremities and greater motor deficits exist as compared to sensory deficits.

95
Q

Anterior cord syndrome

A

An incomplete lesion that results from compression and damage to the anterior part of the spinal cord or anterior spinal artery. The mechanism of injury is usually cervical flexion. There is loss of motor function and pain and temperature sense below the lesion due to damage of the corticospinal and spinothalamic tracts.

96
Q

Frontal lobe

A

Function

voluntary movement, intellect, orientation
Brocaʼs area (typically located in the left hemisphere): speech, concentration
personality, temper, judgment, executive functions

Impairment

contralateral weakness
perseveration, inattention
personality changes, antisocial behavior
Brocaʼs aphasia (expressive deficits)
delayed or poor initiation; emotional lability
97
Q

Parietal lobe

A

Function

associated with sensation of touch, kinesthesia, perception of vibration, and temperature
receives information from other areas of the brain regarding hearing, vision, motor, sensory, and memory
interprets language and words
spatial and visual perception

Impairment

dominant hemisphere (typically located in the left hemisphere): agraphia, alexia, agnosia
non-dominant hemisphere (typically located in the right hemisphere): dressing apraxia, anosognosia
contralateral sensory deficits
impaired language comprehension

98
Q

Temporal lobe

A

Function

primary auditory processing and olfaction
Wernickeʼs area (typically located in the left hemisphere): ability to understand and produce meaningful speech, verbal and general memory, assists with understanding language
the rear of the temporal lobe enables humans to interpret other peoplesʼ emotions and reactions

Impairment

learning deficits
Wernickeʼs aphasia (receptive deficits)
antisocial, aggressive behaviors
difficulty with facial recognition
difficulty with memory, memory loss
inability to categorize objects
99
Q

Occipital lobe

A

Function

main processing center for visual information
processes visual information regarding colors, light, and shapes
judgment of distance, seeing in three dimensions

Impairment

homonymous hemianopsia
impaired extraocular muscle movement and visual deficits
reading and writing impairment
cortical blindness with bilateral lobe involvement

100
Q

Fasciculus Cuneatus (posterior or dorsal column)

A

Ascending

Sensory tract for trunk, neck, and upper extremity proprioception, vibration, two-point discrimination, and graphesthesia

101
Q

Fasciculus Gracilis (posterior or dorsal column)

A

Ascending

Sensory tract for trunk and lower extremity proprioception, two-point discrimination, vibration, and graphesthesia

102
Q

Spinocerebellar Tract (dorsal)

A

Ascending

Sensory tract that ascends to the cerebellum for ipsilateral subconscious proprioception, tension in muscles, joint sense, and posture of the trunk and lower extremities

103
Q

Spinocerebellar Tract (ventral)

A

Ascending

Spinocerebellar Tract (ventral)
Sensory tract that ascends to the cerebellum, some fibers crossing with subsequent recrossing at the level of the pons for ipsilateral subconscious proprioception, tension in muscles, joint sense, and posture of the trunk, upper extremities, and lower extremities
104
Q

Spino-olivary Tract

A

Spino-olivary Tract

Ascends to the cerebellum and relays information from cutaneous and proprioceptive organs

105
Q

Spinoreticular Tract

A

Spinoreticular Tract

The afferent pathway for the reticular formation that influences levels of consciousness

106
Q

Spinotectal tract

A

Spinotectal Tract
Sensory tract providing afferent information for spinovisual reflexes and assists with movement of eyes and head towards a stimulus

107
Q

Spinothalmic tracts

A 
Spinothalamic Tract (anterior)
Sensory tract for light touch and pressure
Spinothalamic Tract (lateral)
Sensory tract for pain and temperature sensation
108
Q

Cortiospinal tracts

A 
Corticospinal Tract (anterior) 
Pyramidal motor tract responsible for ipsilateral voluntary, discrete, and skilled movements
Corticospinal Tract (lateral)
Pyramidal motor tract responsible for contralateral voluntary fine movement. Damage to the corticospinal (pyramidal) tracts results in a positive Babinski sign, absent superficial abdominal reflexes and cremasteric reflex, and the loss of fine motor or skilled voluntary movement
109
Q

Reticulospinal tract

A

Reticulospinal Tract
Extrapyramidal motor tract responsible for facilitation or inhibition of voluntary and reflex activity through the influence on alpha and gamma motor neurons

110
Q

Rubrospinal tract

A

Rubrospinal Tract
Extrapyramidal motor tract responsible for motor input of gross postural tone, facilitating activity of flexor muscles, and inhibiting the activity of extensor muscles

111
Q

Tectospinal Tract

A

Tectospinal Tract

Extrapyramidal motor tract responsible for contralateral postural muscle tone associated with auditory/visual stimuli

112
Q

Vestibulospinal tract

A

Vestibulospinal Tract
Extrapyramidal motor tract responsible for ipsilateral gross postural adjustments subsequent to head movements; facilitating activity of the extensor muscles and inhibiting activity of the flexor muscles

113
Q

C4 SCI functional outcomes

A

capable of respiration and scapular elevation

key muscles: diaphragm and traps

dependent bed mobility, transfers, positioning, wc management

Wheelchair Mobility: supervision to modified independent with power wheelchair. chin control

114
Q

C5 fnx outcomes

A

capable of elbow flexion and supination, shoulder external rotation, abd to 90 degrees and limited shoulder flexion

key muscles: biceps, brachialis, brachioradialis, deltoid, infraspinatus, rhomboids, supinator

Bed Mobility: moderate to maximal assist

Transfers: dep- maximal assist with sliding board

needs assistance for caughing

power chair with hand controls for community and manual with rim projectors for home

115
Q

C6 fnx outcomes

A

capable of shld flexion, ext, IR and ADD
scapular ADD and UR
forearm pronation
wrist extension (tenodesis grip)

key muscles: ECR, infra, lats, pec major, SA, teres minor

can become ind with self care equip and slide board transfers

LTG: ind with rolling and supported sitting

can drive car with hand controls

116
Q

C7 fnx outcomes

A

capable of elbow extension, wrist flexion, finger extension

ind with LE self ROM exercises

can use manual WC with friction rims for community integration with some difficulty on rough terrain

able to get wc in/out of car

117
Q

Closed skill

A

 Performer initiates the action

 Environmental context is stable (does not change from trial to trial)

118
Q

open skill

A

 Performer must act according to the actions of skill

 Performer must act according to the actions of the changing environment

119
Q

left hemisphere

A 
language
sequence and perform movements
understand language
produce written and spoken language
analytical
controlled
logical
rational
mathematical calculations
express positive emotions such as love and happiness
process verbally coded info in an organized, logical, and sequential manner
120
Q

right hemisphere

A 
non-verbal processing
process info in holistic manner
artistic 
general concept comprehension 
hand-eye coordination
spatial relationships
kinesthetic awareness
understand music
understand nonverbal communication
mathematical reasoning 
express negative emotions
body image awareness
121
Q

C1-C3 SCI outcomes

A

capable of talking, blowing, sipping, mastication

key muscles: face and neck

dependent self care

ventilator/phrenic nerve stimulator

WC ind on smooth level surfaces (power tilt in space with mouth control and seatbelt)

122
Q

C8 SCI functional outcomes

A

capable of full use of UE except for hand intrinsics

ind living at home

may be able to do curbs in wc

123
Q

T1-5 functional outcomes

A

capable of full UE use, increased respiratory reserve, and improved trunk control

can participate in wc sports

124
Q

T6-T8 fnx

A

improved trunk control, increased respiratory reserve

ind in swing-to gait in parallel bars with B KAFOs for short distances

125
Q

T9-T12 fnx

A

increased endurance and improved trunk control

lower abs and intercostals

ind swing to or swing through on level surfaces with walker/forearm crutches and B KAFOs

ind floor to wc and tub transfers

may be ind household ambulators

126
Q

T12-L3 fnx

A

capable of hip flexion, add, knee extension

B KAFOs and forearm crutches in home

may use wc for energy conservation or connivence

can be community ambulatory

127
Q

L4-L5 fnx

A

capable of strong hip flexion and knee extension, weak knee flexion, impv trunk control

ind home ambulators

can use wc for community/energy conservation

128
Q

perception problems of R vs L CVA

A

R hemisphere effected (L hemi)

  • problems with spacial relationships and hand eye coordination
  • irritability, short attn span
  • cannot retain info, difficulty leaning individual steps
  • poor judgement affecting personal safety
  • diminished body image with left-sided neglect
  • quick and impulsive

L CVA

  • apraxia
  • difficulty starting and sequencing tasks
  • perseveration
  • easily frustrated with high levels of anxiety
  • inability to communicate verbally
  • cautious and slow
129
Q

rinne vs weber

A

rinne: positive if normal. AC>BC. IF BC > air conduction = abnormal
weber: negative if normal.

in an affected person:
if normal side hears better= Sensorineural hearing loss in other ear

if affected side hears better= conductive loss in that ear

130
Q

wallenberg syndrome (lateral medullary syndrome)

A

Occlusion of PICA

vertigo, nausea, etc etc.... but main feature=
ips face (loss of pain and temp, horners)
contr body (loss of pain and temp)
131
Q

vestibulocerebellum

A

responsible for adjustments in muscle tone in response to vestibular stimuli

132
Q

spinocerebellum

A

controls muscle tone and synergistic movements on the same side of body in the extremities

133
Q

APGAR scale

A

Appearance (skin color), Pulse (heart rate), Grimace (reflex irritability), Activity (muscle tone), and Respiration

134
Q 
norms of 
BERG
TUG
TINETTI
FR
A

TINETTI: max score=28… 20 seconds is increased risk of falls… >30 is high risk of falls
FR:<10 inches is increased risk of falls
DGI: normal = 21, falls=11

135
Q

flexion synergy components

A

scapular retraction/elevation, shoulder abduction, ER, elbow flexion, forearm sup, wrist and finger flexion

hip flexion, abd, er. knee flexion. ankle DF and eversion

136
Q

ptosis can be caused by damage to which CN?

A

3, oculomotor

137
Q

inability to close eye fully could be caused by damage to which CN

A

7, facial

138
Q

medial strabismus can be caused by damage to which CN?

A

6, abducent (innervated lateral rectus)

139
Q

difficulty looking inferior medially can be caused by damage to which CN?

A

4, trochlear

NPTE (4 decks)

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