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NPTE > Neuro > Flashcards

Neuro Flashcards

1
Q

What is the function of the frontal lobe?

A

voluntary muscle activation
emotions and judgements
Broca’s area = motor aspects of speech

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2
Q

What is the function of the parital lobe?

A

integration of sensatinon

touch, proprioception, pain and temp from opposite side of body

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3
Q

What is the function of the temporal lobe?

A

primary auditory cortex = receives/processes auditory stimuli
associative auditory = processes auditory stimuli
Wernicke’s = language comprehension

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4
Q

What is the function of the occipital lobe?

A

primary visual cortex = receives/processes visual stimuli

visual association = processes visual stimuli

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5
Q

What is the function of the hypothalamus?

A

integrates and controls functions of the autonomic NS and neuroendocrine system
**maintains body homeostasis

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6
Q

What is the function of the thalamus?

A

Aside from sense of smell, all other sensory processes involve a thalamic nucleus receiving a sensory signal which is then directed to the relevant cortical area.
The thalamus plays a role in controlling the motor systems of the brain which are responsible for voluntary bodily movement and coordination.

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7
Q

What does the sympathetic NS do?

A

prepares body for fight or flight, emergency responses; increases HR and BP, constricts peripheral blood vessels, and redistributes blood; inhibits peristalsis
Thoracolumbar division T1-L2

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8
Q

What does the parasympathetic NS do?

A

conserves and restores homeostasis; rest and digest; slows HR and reduces BP; increases peristalsis and glandular activity
Craniosacral division CN 3, 7, 10; S2-4

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9
Q

What signs/tests do you use for examination of CNS infection or meningeal irritation?

A

signs of global, not focal

  • neck mobility
  • Kernig’s sign - 90/90 HS, bilat pain suggests meninitis
  • Brudzinski’s sign - flex neck causes flexion of hips/knees
  • irritability
  • slowed mental function
  • altered vital signs
  • generalised weakness
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10
Q

What do you examine for increased intracranial pressure secondary to cranial edema and brain herniation?

A 
Altered level of consciousness
Altered vital signs
Headache
Vomiting
Pupillary changes
Papilledema at entrance to eye
Progressive impairment of motor function
Seizure activity
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11
Q

What is homonymous hemianopsia?

A

loss of half of visual field in each eye, contralateral to cerebral lesion

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12
Q

What is somatognosia?

A

patient can’t identify body parts

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13
Q

What is visual spatial neglect?

A

unilateral neglect, ignores one side of body

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14
Q

What is anosognosia?

A

severe denial, neglect of lack of awareness of severity of conditions

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15
Q

What is agnosia?

A

inability to recognise familiar object with one sensory modality (ie sight), but can recognise same object with other sensory modality (ie. hearing)

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16
Q

What is apraxia?

A

inability to perform voluntary, learned movements in absence of loss of sensation, strength, coordination, attention or comprehension

Ideomotor - can’t perform on command, but can do task on their own
Ideational - cannot perform task on command or on their own

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17
Q

What is aphasia? Types?

A

communication disorder

Nonfluent / expressive aphasia
Fluent / receptive aphasia

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18
Q

What is meningitis? And how do you treat it?

A

inflammation of membranes of the spinal cord or brain.
bacterial or viral
PT - supportive symptomatic Rx, bed positioning, PROM, skin care to prevent complications of immobility, safety measures if confusion present

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19
Q

What is encephalitis?

A

severe infection and inlammation of the brain

PT - supportive symptomatic therapy

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20
Q

What is a brain abcess?

A

infectious process in which there is a collection of pyogenic material in brain parenchyma.
PT - supportive symptomatic therapy

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21
Q

What is AIDS? S&S?

A

viral syndrome and severe depression of cell-mediated immunity
S&S:
dementia complex
motor deficits - ataxia, weakness, tremor, loss of fine motor
peripheral neuropathy

22
Q

List the types of spinal cord lesions and their characteristics

A

complete: bilat motor, bilat sensory loss
central: bilat motor, bilat pain and temp

Brown-sequard: ipsilat motor, ipsilat proprioception, contralat loss pain and temp

anterior: bilat motor loss, bilat pain/temp
posterior: bilat loss of proprioception, vibration, pressure

cauda equina

23
Q

What types of nerve fibers are there? And what are the functions of each?

A

A fibers: large, myelinated, fast conducting

  • Alpha proprioception, somatic motor
  • Beta touch, pressure
  • Gamma motor to motor spindles
  • Delta pain temp touch

B fibers: small, myelinated, conduct less rapidly

C fibers: smallest, slowest, unmyelinated

24
Q

What are levels of conciousness?

A

Alterness - appropriate response
Lethargy - appears drowsy, falls asleep quickly
Obtundation - can open eyes, responds slowly and confused, decreased interest in environment
Stupor - aroused from sleep from painful stimuli, verbal response slow/absent, minimal awareness
Coma - cannot be aroused, no response to stimuli
Unresponsive/vegetative

25
Q

What is the Glasgow Coma Scale and how is it scored?

A

measures 3 elements of response - eye opening, motor response, verbal response

Severe scores 1-8
moderate 9-12
minor 13-15

26
Q

What are the levels of Rancho Los Amigos?

A 
1 - unresponsive
2- general
3 - local
4 - confused agitated
5 - confused inapp
6 - confused app
7 - auto inapp
8 - auto app, purposful
9 - assistance
10 - ind
27
Q

What are the cranial nerves and what are their functions?

A

Olfactory - smell
Optic - vision
Oculomotor - move eyes, raise eyelids, regulate pupils
Trochlear - eye movements, proprioception
Trigeminal - sensations of head and face, chewing, muscle sense
Abducens - lateral eye movements
Facial - facial expressions, taste, secretion of saliva
Vestibulochochlear - balance, equilibrium, hearing
Glossopharyngeal - tast and other sensations of tongue, swallowing, saliva
Vagus - muscles for speech, swallowing, smooth muclse of viscera in abdo
Accessory - turning head, movement of shoulders, voice production
Hypoglossal - tongue movements

28
Q

What is dyssenergia?

A

impaired ability to associate muscles together for complex movement

29
Q

What is dysmetria?

A

impaired ability to judge the distance of range of movement

30
Q

What is dysdiadochokiesia?

A

impaired ability to perform rapid alternating movements

31
Q

What are the types of involuntary movements?

A

Tics - spasmodic contraction common in face, neck, shoulders

Chorea - quick twitches or dancing movements

athetosis - slow, irregular, twisting, writhing

tremor - continuous quivering movements, rhythmic oscillatory movement obs at rest

myoclonus - single, quick jerk

32
Q

What are the sensory elements of balance?

A

visual - acuity, depth perception
somatosensory - proprioception, cutaneous sensation, trunk, feet, ankles
vestibular - changes in head position

33
Q

What are the 6 recovery stages of a CVA?

A

1 - initial flaccidity, no voluntary movement
2 - emergence of spasticity, hyperreflexia, synergies
3 - voluntary movement possible, only in synergies, strong spasticity
4 - voluntary control in isolated joint movement
5 - increased voluntary control out of synergy, coordination deficits
6 - control and coordination near normal

34
Q

What are characteristics of a left and right CVA lesion?

A

Left:
slow, cautious, hesitant, insecure
use words, gestures
do not underestimate ability to learn

Right:
impulsive, quick, indifferent, poor judgement
use verbal cues
visusospatial deficits, avoid clutter
focus on safety
do not overestimate ability
35
Q

What is primary and secondary damage regarding a TBI?

A 
primary:
diffuse axonal
focal injury
coup-contracoup
closed/open injury

secondary:
hypoxic ischemic injury
swelling edema
electrolyte imbalance

36
Q

Describe each ASIA scale level

A

A - complete, no motor or sensory function
B - incomplete, sensory but no motor
C - incomplete, motor preserved with > MMT 3
D - incomplete, motor >3 MMT
E - normal, motor and sensory normal

37
Q

What is MS?

A

chrnoic progressive demyelinating disease of CNS
worsening symptoms with heat, hyperventilation, dehydration, fatigue
S&S = ataxic, spasticity, hyperreflexia, dysarthria, paraesthesia, vestibular involvement, fatigue

38
Q

What is Parkinson’s disease?

A

chronic progressive disease of CNS with degeneration of basal ganglia
S&S: rigidity, bradykinesia, resting tremor, impaired postrual reflexes

39
Q

What is myasthenia gravis?

A

neuromuscular junction disorder, progressive muscular weakness and fatiguability on exertion
muscular strength worsens with continued contraction, improved with rest

40
Q

What is epilepsy?

A

recurrent seizures

41
Q

What are the types of peripheral nerve diseases?

Poly? Mono? Radic?

A

polyneuropathy - bilat symmetrical involvement

mononeuropathy - single nerve involvement

radiculopathy - involvement of nerve roots

clinical symptoms of LMN

42
Q

What is trigeminal neuralgia?

A

CN V neuralgia

stabbing shooting pain following mandibular and maxillary divisions, one side of the face
exacerbated by stress, cold

43
Q

What is Bell’s palsy?

A

LMN lesion to CN VII (facial nerve)
unilateral paralysis
loss of control of salivation
acute onset, max severity in hours-days

44
Q

What is Bulbar palsy?

A

weakness or paralysis of muscles innervaated by motor nuclei of lower brainstem (face, tongue, larynx, pharynx)

45
Q

What is Guillain-Barre syndrome?

A

polyneuritis with progressive muscular weakness that develops rapidly
demyelination of cranial or peripheral nerves; LMN disease
sensory loss, paresthesia, pain, sensory loss less than motor loss
symmetrical distribution of motor loss
progresses from LE to UE, distal to proximal

46
Q

What is ALS?

A

Degenerative disease affecting UMN and LMN
muscular weakness, early onset involves limbs progressing to whole body; atrophy, cramping, muscle fasiculations, twitching (LMN)
spasticity, hyperreflexia (UMN)
pain, cramping, postural stress syndrome, joint hypomobility

47
Q

What is postpolio syndrome?

A

slowly progressive muscel weakness in patients with history of polio
abnormal fatigue
pain, myalgia
weakness and atrophy, asymmetrical

48
Q

What are the anterior and posterior neurons of central gray matter?

A

anterior/ventral - efferent motor neurons

posterior/dorsal - afferent sensory neurons

49
Q

What are the ascending and descending systems of the white matter in the spinal cord?

A

ascending (sensory)

  • dorsal - proprioception, vibration, tactile
  • spinothalamic - pain and temp, crude touch
  • spinocerebellar - proprioception, voluntary movement control from touch and pressure receptors
  • spinoreticular - deep and chronic pain

descending (motor)

  • corticospinal - voluntary movement
  • vestibulospinal - muscle tone, postural reflex
  • rubrospinal - motor function
  • reticulospinal - modifies transmission of sensation, pain
50
Q

How do you measure spasticity with the Modified Ashworth Scale?

A

0 - no increase in muscle tone
1 - slight increase, minimal resistance at end ROM
1+ - slight increase in tone, minimal resistance through less than half of ROM
2 - more marked increase in tone, through most ROM, affected part easily moved
3 - considerable increased tone, passive movement difficult
4 - affected part rigid in flexion and extension

51
Q

What is the differential diagnosis of UMN and LMN lesions?

A

UMN - hypertonia, spasticity, hyperreflexia, clonus, disuse atrohpy, impaired voluntary movement

LMN - hypotonia, hyporeflexia, neurogenic atrophy, strength altered along myotome

NPTE (13 decks)

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