Neuro

Question 1

Cheyne-stokes respiration

Answer 1

Period of apnea lasting 10-60sec followed by gradually increasing depth and frequency of respiration a (from frontal lobe and diencephalic dysfunction)

Question 2

Hyperventilation :

Answer 2

Increased rate and depth, from lower midbrain and pons dysfunction

Question 3

Apneustic breathing

Answer 3

Abnormal respiration marked by prolonged inspiration due to damage of upper pons

Question 4

Kernig sign

Answer 4

Supine , flex hip and knee fully to chest then extend knee

Positive: pain and increased resistance to extending knee due to spasm of hamstring( if bilateral meningeal irritation )

Question 5

Brudzinski sign

Answer 5

Supine flex neck to chest

Positive: causes Flexion of hips and knees (drawing up) suggests meningeal irritation

Question 6

Anosognosia

Answer 6

Severe denial, neglect or lack of awareness of severity of condition

Question 7

Mini mental scores

Answer 7

21-24 mild impairment
16-20 moderate
Less than 15 severe
Max score is 30

Question 8

Opisthotonos

Answer 8

Prolonged severe spasm of muscles causing head back and heels to arch backward with arms/hands in rigid Flexion

Seen in severe meningitis, tetanus, epilepsy and strychnine poisoning

Question 9

Flexion synergy pattern upper extremity

Answer 9

Scapular retraction/elevation, shoulder subduction and external rotation, elbow Flexion and forearm Supination, wrist and finger Flexion

Question 10

Extension synergy pattern upper extremity

Answer 10

Scapular protraction, shoulder adduction and internal rotation, elbow extension and forearm pronation, wrist and finger Flexion

Question 11

Flexion synergy pattern lower extremity

Answer 11

Hip Flexion and abduction, external rotation, knee Flexion, ankle dorsiflexion and inversion

Question 12

Extension synergy lower extremity

Answer 12

Hip extension and adduction and internal rotation, knee extension and ankle plantarflexion/inversion

Question 13

Pre central gyrus

Answer 13

Primary motor cortex for voluntary muscle action

Post central gyrus is primary sensory cortex for integration of sensation

Question 14

Metabolic syndrome

Answer 14

Need three to diagnose:
1. Waist circumference >40”men, 35”women

2. > = 150 triglycerides
3. = 130/and or diastolic 85
4. Fasting plasma glucose level of > 100

Question 15

Performance oriented mobility assessment (poma, tinetti)

Answer 15

Balance: sitting, sit to stand, standing feet together, turn 360, sternal nudge, stand on one leg, tandem stand, reaching up, bending over, stand to sit, timed rising) and walking (gait initiation, path, turning times walk, step over obstacles)

Max score: 28
19-24 moderate fall risk

Question 16

Berg balance

Answer 16

Max score 56

Question 17

TUG

Answer 17

3 meters.
Normal intact adult: 20 sec
High fall risk: >30 sec

Question 18

Functional reach

Answer 18

Forward only.

Above average >12.2 inches

Question 19

Short physical performance battery (sppb)

Answer 19

Repeated 5 times sit to stands, semi tandem, tandem, side by side stands and timed 8 ft walk

Ordinal scale (0 worst performance to 12 best performance)

Question 20

DGI

Answer 20

Changes in gait speed, head turns, pivot turns l, obstacles, stairs

Normal adults 21
Hx of fall: 11

Question 21

Balance efficacy scale

Answer 21

Total score divided by 18 to yield mean bes score

Question 22

cerebellum

Answer 22

regulates movement, postural control and muscle tone

if damaged = produces ataxia (difficulty initating movement), errors in rate/rhythm/timing of motor responses, also get dysarthria, disdiadochokinesia and nystagmus

Question 23

basal ganglia

Answer 23

function - controls procedural learning, voluntary motor, routines

if damaged = produces hemiballismus, choreathetosis, hyperkinesis, rigidity, and bradykinesia

Question 24

external intercostals

Answer 24

lit ribs up in deep inspiration

internal intercostals = pull ribs downward during forced expiration

Question 25

Emg fibrillation

Answer 25

Spontaneous independent contraction of individual muscle fibers, evident with denervation for 1-3 weeks after losing nerve

Question 26

Emg fasiculation

Answer 26

Spontaneous contraction of all or most of fibers in motor unit, muscle twitches that can be observed or palpated. Present in LMN disorders and denervation
**complete LMN lesion= fibrillation only
Partial= fibrillation and fasiculation

Question 27

Ramiste phenomena

Answer 27

Involved lower extremity will abduct/adduct with applied resistance to uninvolved extremity in same direction

Question 28

Souques phenomena

Answer 28

Raising involved upper extremity above 100 degrees with elbow extension will produce extension and abduction of fingers

Question 29

Absolute contraindications for exercise testing in sci

Answer 29

Autonomic dysreflexia, severe or infected skin on weight hearing surfaces, symptomatic hypotension, uti, unstable fx, uncontrolled hot humid environment, insufficient rom to perform exercise task

Question 30

Relapsing- remitting MS

Answer 30

Relapses with full recovery, lack of disease progression

Question 31

Primary progressive MS

Answer 31

Disease progression from onset, without plateau or remission, or with occasional plateau and temporary minor improvements

Question 32

Secondary progressive MS

Answer 32

Initial relapsing remitting course then progression at variable rate

Question 33

Progressive relapsing MS

Answer 33

Progressive disease from onset but without clear acute relapse that may have Recovery or remission. Seen in those who develop after 40 years of age

Question 34

Hohen and yahr classification for Parkinson’s

Answer 34

Stage 1 minimal or absent disability, unilateral symptoms

Stage 2 minimal bilateral or midline involvement, no balance involvement

Stage 3 impaired balance with some restriction to activity

Stage 4 all symptoms present and severe, stands and walks only with assistance

Stage 5 confinement to bed or wheelchair

Question 35

Bradyphrenia

Answer 35

Slowing of thought processes

Question 36

Neuropraxia

Answer 36

Class 1 injury to nerve causing conduction block ischemia, nerve dysfunction will readily reverse after few weeks ex compression

Question 37

Axonotmesis

Answer 37

Class 2 injury to nerve interrupting axon and causing wallerian degeneration distal to lesion. No disruption to endoneurium, regeneration possible ex crush injury

Question 38

Neurotmesis

Answer 38

Class 3 injury severance of all nerve structures, complete loss of function, axon cannot regenerate

Question 39

Emg evidence of reinnervation

Answer 39

Low amplitude short duration polyphasic motor unit potentials

Question 40

Vestibulospinal tract

Answer 40

Gross postural adjustments and subsequent head movements and acceleration

Question 41

Recto spinal tract

Answer 41

Visual info related to spatial awareness, ends at cervical spine and controls musculature of neck and head position

Question 42

Rubrospinal tract

Answer 42

Communicates with thalamus and cerebellum and plays important role in coordination of movement

Question 43

Polyneuropathy

Answer 43

Bilateral symmetrical involvement of peripheral nerves, legs more than arms, distal earlier and more involved than proximal

Question 44

Bulbar palsy

Answer 44

Weakness or paralysis of muscles innervated by motor nuclei of Lower brain stem of face tongue larynx pharynx

Question 45

Stages of ALS (umn/LMN)

Answer 45

Stage 1 early disease, mild focal weakness, asymmetrical distribution , hand cramping and fasiculation man

Stage 2 moderate weakness, some atrophy of muscles, mod I c assistive device

Stage 3 severe weakness, increasing fatigue, mild to moderate functional limitations but still ambulatory

Stage 4 severe weakness and wasting of BLE, mild weakness of UEs, mod A, wheelchair user

Stage 5 progressive severe weakness of limbs and trunk, spasticity And hyperteflxia, loss of head control and max A

Stage 6 bedridden, dependent ADLs, progressive respiratory distress

Question 46

Symmetrical tonic labyrinthine reflex

Answer 46

Occurs at birth, integrates by 6 months.

When in prone = body and extremities held in increased flexor tone (Flexion)

When in supine = body and extremities held in increased extensor tone (extension)

Question 47

Crossed extension reflex

Answer 47

Occurs at 28 weeks gestation and integrates by 1-2 months

Noxious stimulation to ball of foot when lower extremity is fixed in extension causes other lower extremity to flex, adduct and then extend