Neuro 4/7

Question 1

Broca’s aphasia

Answer 1

.

Question 2

Wernicke’s aphasia

Answer 2

.

Question 3

Global aphasia

Answer 3

.

Question 4

Dysarthria

Answer 4

Motor speech disorder

Question 5

Dysphagia

Answer 5

Difficulty swallowing, prone to chocking, poor nutritional status, Modified barium swallow test can determine areas most dysfunctional in the swallowing mechanism

Question 6

Contraversive pushing

Answer 6

Patient pushes toward paretic side, Often involves lesion in thalamus and/or right sided cortical lesions causing neglect
Can resolve in 6 months.

Question 7

Perseveration

Answer 7

Continuous repetition of words, lesion of the premotor and prefrontal cortex

Question 8

Left CVA Behavioral Differences

Answer 8

Right hemiparesis - Difficulties in communication and processing information in a sequential manner. Cautious, anxious and disorganized. Hesitant to try new tasks. Realistic regarding their dysfunctions

Question 9

Right CVA Behavioral Differences

Answer 9

Left hemiparesis - Difficulty grasping the whole idea of a task, Quick and impulsive, Overestimate their abilities, Safety of more concern with these patients

Question 10

Early warning signs of CVA

Answer 10

Sudden N/T in face and/or extremities
Sudden confusion and trouble speaking
Sudden difficulty seeing out of one eye
Sudden dizziness and LOB
Sudden severe headache
 F.A.S.T (face, arm, speech, time)

Question 11

Ischemic umbra (shadow)

Answer 11

Core area of irreversible neuronal damage

Question 12

Ischemic penumbra

Answer 12

Peripheral area of “damaged” neurons, neurons are vulnerable for expansion of stroke. First 3-4 hours

Question 13

Lacunar strokes

Answer 13

Can affect neuronal cell bodies in the cerebrum, can affect the internal capsule (capsular stroke)

Question 14

CVA pure motor symptoms

Answer 14

posterior limb of internal capsule, basal pons, pyramids

Question 15

CVA pure sensory symptoms

Answer 15

thalamus, thalamocortical fibers

Question 16

Stage 1 CVA recovery

Answer 16

Initial flaccidity; no voluntary movement

Question 17

Stage 2 CVA recovery

Answer 17

Emergence of spasticity, hyperreflexia and synergies

Question 18

Stage 3 CVA recovery

Answer 18

Strong spasticity; voluntary movement possible, but only in synergistic patterns

Question 19

Stage 4 CVA recovery

Answer 19

Decline in spasticity and synergies; voluntary control in isolated joint movements emerging

Question 20

Stage 5 CVA recovery

Answer 20

Increased voluntary control out-of-synergies; coordination deficits present

Question 21

Stage 6 CVA recovery

Answer 21

Control and coordination near normal

Question 22

Multiple Sclerosis

Answer 22

• De-myelination of axons in CNS between ages 15-50
• (?) d/t immune reaction triggered by viral infection (possibly a form of Epstein-Barr)
• Vitamin D deficiency could be a factor
• Women 3x more affected

Question 23

Sensory impairments of MS

Answer 23

parasthesias, decreased position sense, decreased pallesthesia, dysesthesias, allodynia, trigeminal neuralgia, pain, lhermitte’s sign

Question 24

Visual impairments of MS

Answer 24

.

Question 25

Motor impairments of MS

Answer 25

Fatigue, paresis, ataxia, dysmetria, dysdiadochokinesia, dysphagia, dysarthria, dysphonia, UMN signs (spasticity, hyperreflexia, (+) Babinski)

Question 26

Cognitive/Behavioral impairments of MS

Answer 26

mild to moderate cognitive deficits, bowel/bladder dysfunction, sexual dysfunction

Question 27

Relapsing/Remitting MS

Answer 27

85% initially this Dx. Onset of sxs with either full or partial recovery followed by periods of no progression of the disease.
When deficits always resolve between episodes = benign MS

Question 28

Secondary Progressive MS

Answer 28

initial relapsing/remitting course followed by progressive course
50% will develop this form by 10 years; 90% within 25 years
May include minor remissions

Question 29

Primary Progressive

Answer 29

Disease progresses consistently from initial onset

May have occasional plateaus & minor improvements

Question 30

Progressive relapsing

Answer 30

Progressive decline with episodes of increased symptoms

Least common form; occurs in those that are > 40 y/o

Question 31

Clinically isolated syndrome (CIS)

Answer 31

Person has an attack suggestive of demyelination but does not fulfill the criteria for MS
30%-70% will later develop MS
Should be started on immune-modulating drugs immediately

Question 32

MS signs/Sx exacerbated by

Answer 32

Heat (Uhthoff’s Phenomenon - itcreased body temperature worsens Sxs), stress, viral or bacterial infections

Question 33

Diagnosis of MS

Answer 33

• Evidence of plaques in at least 2 distinct areas which occurred at different points in time
  

Question 34

Amyotrophic Lateral Scerosis

Answer 34

Muscles w/o innervation, lateral gray horn in spinal cord affected, degenerated neurons become sclerosed.
Degeneration and loss of motor neurons in the spinal cord, brainstem and cortex (results in UMN &LMN signs/sx)

Question 35

Stages of ALS

Answer 35

I) mild focal asymmetric weakness; hand cramping
II) moderate weakness in groups of muscles
III) severe weakness, but ambulatory
IV) severe weakness; predominately uses
w/c
V) severe weakness with loss of head control; spasticity noted
VI) bedridden with progressive respiratory distress

Question 36

slide 151

Answer 36

still need to go back and fill out some info