Neuro Flashcards
Sylvian Fissure
Separates T lobe from F/P
Longitudinal Fissure
Separates 2 hemis
Central Sulcus
Seps F lobe from P
Symptoms of an LMN (peripheral) lesion
Flaccidity, decreased or absent deep tendon reflexes & atrophy
Symptoms of UMN lesion
Increased deep tendon reflexes, spasticity, clonus (mus spasm), emergence of prim reflexes: Babinski’s, exaggerated cutaneous reflexes, autonomic dysreflexia; flaccidity may occur at lesion level
LMN Structures
Cell bodies in ant horn of SC, spinal nerves, CN fibers that travel to target muscles
UMN Structures
Any nerve cell body or fiber in SC except ant horn cells; all superior structures (gray/white matter affected motor fx and descending nerve tracts; CN nuclei
Alpha, Beta, Gamma & Delta fibers
A= proprioception/somatic motor; B= touch/pressure; G= motor to muscle spindles; D= pain/temp/touch
*All A fibers - Fast conducting, large & myelinated
Transient ischemic attack (TIA)
Transitory stroke that usually lasts a few minutes; occurs when blood flow to part of brain is briefly interrupted. Most disappear w/in an hour.
TIA symptoms
Numbness/weakness of face, arm or leg esp on one side of the body; confusion or difficulty talking/understanding speech; vision difficulties; difficulty w walking, dizziness, and/or loss of balance/coordination - often warning sign (1/3 have stroke)
Cerebral Infarction
d/t either an embolism or thrombosis of the intra or extra cranial arteries
Cerebral Hemorhrage
Bleed secondary to HTN or aneurysm
Cerebral Arteriovenous Malformaton (AVM)
Abnorm, tangled collections of dialated blood vessels that result from congenitally malformed structures
CVA general symptoms
Abrupt onset of usually unilat neurolog signs like weakness, vision probs & sensory changes; progress over several hours to 2 days; specific symptoms are dependent on site
Middle Cerebral Artery (MCA) Stroke
Contralat hemi, hemianesthesia, homonymous hemipanosa, aphasia (usually left MCA) and/or apraxia (usually left MCA), unilat neglect (usually right MCA), spatial dysfunction (usually right MCA)
Internal Carotid Artery (ICA) Stroke
Contralat hemi, hemianesthesia, homonymous hemipanosa, aphasia (usually left ICA) and/or apraxia (usually left ICA), unilat neglect (usually right ICA), spatial dysfunction (usually right ICA) - Similar to MCA
Ant Cerebral Artery (ACA) Stroke
Contralat hemi, grasp reflex, incontinence, confusion, apathy and/or mutism
Post Cerebral Artery (PCA) Stroke
Homonymous hemipanosa, thalamic pain, hemi-sensory loss and/or alexia (in ability to see/read words)
Verterbrobasilar system stroke
Pseudobulbar signs (dysarthria {unclear speech}, dysphasia, emo instability) & tetraplegia
Left Hemi
Mvmt of right side of the body, processing sensory info from right side, visual reception from right field, visual verbal processing, bilat motor praxis, verbal mem, bilat auditory reception, speech, processing of verbal auditory info
Right Hemi
Mvmt of left side of body, processing sensory info from left side, visual reception from left field, visual spatial processing, left motor praxis, nonverb mem, atten to incoming stim, emotion, processing of nonverb auditory info, interp of abstract info, interp of tonal inflections
Stroke Risk Factors
HTN, cardiac disease, Afib, DB, smoking, alcohol abuse, HLD, age, gender (males), race (AA & latinos) & heredity
Medical Mngt of Stroke
Airway maintenance, adequate oxygeniation, nutritional intervention, decubiti prevention, tx of underlying cardiac dysfunction, pharmacological therapies
TBI occurs & impact/opp pole
From penetration of the skull (open TBI), rapid acceleration or deceleration of brain (closed) or blunt ex force (closed) & Impact = coup & opp pole = countercoup
TBI symptoms
Post traumatic LOC/concussion, cerebral contusion/laceration/edema accompanied by surface wounds/skull fx’s, plegia, abnorm reflexes, decorticate/ decerebrate rigidity, fixed pupils, coma or changes in vital signs
Glascow Coma Scale
Used for initial eval and cont assessment of persons level of consciousness; 3 tests: eye, verbal & motor responses. A fully conscious person is a 15 while lowest is 3 (deep coma/death) > individual test scores and total recorded
Levels of Glascow Coma Scale
Severe= 13
GCS: Best Eye Response (E)
Eyes open spontaneously: 4; eyes open to speech: 3; eyes open to pain: 2 & no eyes opening: 1
GCS: Best Verbal Response (V)
Orientate: 5; Confused (responds coherently but some disorientation): 4; Inappropriate (random/exclamatory speech): 3; Incomprehensible sounds (moans): 2 & none: 1
GCS: Best Motor Response (M)
Obeys commands: 6; Localizes to pain: 5; W/d from pain: 4; Flex in response to pain (decorticare response): 3; Exten to pain (decerebrate response): 2 & none: 1
Medical Mngt of TBI
Resuscitation; mngt of resp dysfunction; cardiovas monitoring; surg/pharmacological/mechanical means to decrease intracranial pressure; neurosurgery to manage lacerated vessels/depressed skull fx’s & pharmacological intervention
ASIA Scale
Scale used to grade degree of SCI impairment & severity of injury; ASIA Scale E is normal!
ASIA Scale: A
Complete, no sensory/motor function is preserved in sacral segs S4-S5
ASIA Scale: B
Incomp, sensory but no motor function is preserved below neurolog level & extends thru sacral segs
ASIA Scale: C
Incomp, motor function preserved below neurolog level & majority of key muscle groups below neurolog level have muscle grade less than 3/5
ASIA Scale: D
Incomp, motor function is preserved below neurolog level & majority of key muscle groups below neurolog level have muscle grade greater than 3/5
SCI Symptoms
Spinal shock (4-8wks) - all reflex below injury is obliterated; partial or complete sensory deficits, loss of bowel/bladder control, loss of temp control below injury. decreased resp fx, sexual dysfunction, changes in muscles tone (flaccidty or spasticity) & loss of motor fx
