Neuro Flashcards
Most common neuro disease
stroke
who gets stroke?
people with HTN and diabetics are at the highest risk
how many pairs of cranial nerves do we have?
12
how many pairs of spinal nerves do we have?
31
important info to gather about headache location
- frontal: could be sinus-related
- occipital: tension or migraine
- temporal: brain freeze
what types of headache onset are concerning?
- if it wakes them up in the middle of the night
- if there is no onset, and it has not gone away in three or more weeks
when should you go to the ER for a headache?
if it is the worst you’ve ever had- could be aneurysm
what pattern of headaches is not concerning?
every 4 weeks or in sync with menstrual cycle
What associated symptoms with headaches are concerning?
vision problems, N/V
What do we need to know about seizures?
what happened before, during and after
- before: aura, involuntary articulations like screaming?
- during: tonic clonic movements, pass out, awake and alert, hit their head, lose bladder function?
what is the biggest concern about seizing?
muscle contractions over and over → acidosis builds up in the muscles
Most concerning type of memory loss
long term
Cranial nerve mnemonic
On Old Olympus Towering Top, A Fin and German Viewed Some Hopps
Sensory or motor mnemonic
Some Say Marry Money, But My Brother Says Big Boobs Matter More
CN I
- olfactory
- sensory
CN I test
smell two scents
CN II
- optic
- sensory
CN II test
- Snellen (20/20 normal, 20/200 blind)
- Rosenbaum: 14 in away from face
CN III
- oculomotor
- sensory
CN IV
- trochlear
- sensory
CN VI
- abducens
- sensory
CN III, IV, VI function and test
- work together to innervate the eyes and eyelids
- test extraocular movements: follow finger as it moves
- test PEARL (pupils eaqual and reactive to light): both eyes constrict when either is stimulated with light
Where should eyelids be when eyes are open?
about 2 mm over the iris
If iris is greater than 3mm
exopthalmos
CN V
- trigeminal
- sensory and motor
CN V test
temporal and masseter muscles: clench jaw while feeling those muscles- should be equal in strength on both sides
CN VII
- facial
- sensory and motor
CN VII test
test by smiling, frowning, puffing cheeks, gritting teeth, closing eyes against resistance
-should be equal on both sides
CN VIII
- acoustic/ vestibulocochlear
- sensory
CN VIII test
- cold water test if you’re mean
- hearing: whisper test
- Weber: tuning fork on top of head, should hear in both ears
- Rinne: should hear in front of ear twice as long as behind ear
CN IX
- glossopharyngeal
- sensory and motor
CN X
- vagus
- sensory and motor
CN IX and X test
- uvula and soft palate rise evenly when pt says “ah”
- gag reflex
- swallowing symmetrically
- hoarseness is a bad finding
CN XI
- spinal accessory
- motor
CN XI test
- shrug shoulders against resistance (tests trapezius)
- turn head against resistance (tests sternocleidomastoid)
CN XII
- hypoglossal
- motor
CN XII test
-tongue strength
How to evaluate balance
- heel to shin
- stand on one foot and hop
- gait: opposite arms swings
Romberg test
eyes closed, watch for swaying… test cerebellum function
Tests for meningitis
- Brudzinski’s sign: severe neck stiffness causes a patient’s hips and knees to flex when the neck is flexed
- Kernig’s sign: inability to straighten the leg when the hip is flexed to 90 degrees
Brown-Sequard syndrome
when half the brain (hemisphere) has an injury and you get ipsilateral weakness and loss of proprioception
central cord syndrome
- sacral sparing: lose control of bowels and bladder
- mostly upper etremity
anterior cord syndrome
problem with anterior corf artery (compression, tumor, or lytic problem), causes loss of pain and temperature
posterior cord syndrome
- posterior artery issue
- loss of proprioception and variable loss of motor function (upper and lower)
atrophy and fasciculations of the tongue
fasciculations- twitching/ rapid, uncontrolled movements
-seen a lot in ALS and parkinsons
Tics
- involuntary muscle contractions, often in face and upper extremities
- tourettes, drugs like phenethylamines and amphetamines
postural tremors
- activity generated tremors
- usually benign
- fatigue, hyperthyroidism
intention tremors
- may or may not go away and the intensity is steady
- absent at rest
- when you go to grab something you get a tremor or movement gets bigger
- MS and parkinsons
congenital unilateral athetosis
- twisting and writhing movements
- cerebral palsy
cerebellar ataxia
- ataxia: irregular movement
- how you walk when you’re drunk
- often seen in intoxication
parkinsonian gait
- shuffling, stooped, and cogwheel (moves fast, then stops, fast, then stops)
- Parkinsons… clearly.
scissors gait
- thighs are overlapping
- partial paralysis
spastic hemiparesis
- hand is flexed very close to them and drag same sided toe or swing it around when they walk
- stroke
food drop
- also called slap foot
- pull knee up really high and slap it down
- cannot land on their heel
- lower motor neuron diseases
paralysis
loss of movement
paresis
weakness
plegia
stroke or paralysis
mono
one limb
hemi
both limbs on one side
di- or para-
both upper limbs or both lower limbs (divided at the waist)