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E&M > Neuro > Flashcards

Neuro Flashcards

1
Q

3 parts of cognition

A
  1. Memory
  2. Judgement
  3. Attention span
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2
Q

3 parts of mental status

A
  1. Orientation
  2. Attention
  3. State of consciousness
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3
Q

2 screenings for mental status

A

MiniMental State Exam

Mini-cog

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4
Q

What does the mini-cog include?

A

Have pt repeat 3 items, clock drawing, recall 3 items

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5
Q

Which is a better mental status exam - MMSE or minicog?

A

Minicog

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6
Q

What does the MoCA screen for?

A

Mild cognitive impairment (MCI)

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7
Q

7 components of MoCA

A
  1. Attention and concentration
  2. Executive function
  3. Language
  4. Visio-constructional skills
  5. Conceptual thinking
  6. Calculations
  7. Orientation
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8
Q

What disorder is the MoCA very sensitive for?

A

Alzheimers

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9
Q

What is the MMSE very specific for?

A

Normals

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10
Q

4 reasons to sensory test

A
  1. Directed by recommended interventions
  2. Safety
  3. Baseline
  4. Determine need to educate pt in compensatory techniques
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11
Q

5 tests for protective sensation

A
  1. Pain via sharp/dull
  2. Light touch
  3. Deep pressure
  4. Temp
  5. Monofilaments
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12
Q

3 tests for deep sensation

A
  1. Vibration
  2. Kinesthesia
  3. Proprioception
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13
Q

What is the only test that we test on the affected side first?

A

Vibration

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14
Q

7 cortical sensation tests

A
  1. Tactile localization
  2. Stereognosis
  3. 2 pt discrimination
  4. Double simultaneous touch
  5. Barognosis
  6. Graphesthesia
  7. Texture
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15
Q

Test for regrowth of peripheral nerve?

A

Tinel’s sign

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16
Q

Functional test for assessing sensation

A

Modified Moberg’s pick up test

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17
Q

8 types of neuro lesions

A
  1. Peripheral nerve
  2. Nerve root
  3. Spinal cord
  4. Diabetic peripheral neuropathy
  5. Anterior cord syndrome
  6. Posterior cord syndrome
  7. Brain stem
  8. Cerebral cortex
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18
Q

Tingling signifies that nerve has been _________

A

Bumped

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19
Q

Loss of sensation signifies that nerve has been _____________

A

Severed

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20
Q

Type of neuro lesion that will present with bilateral sensation loss

A

Diabetic peripheral neuropathy

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21
Q

Progression of sensation loss in peripheral neuropathy

A 
Early = loss of vibration/temp
Prolonged = loss of protective sensation
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22
Q

If there is an injury to the brainstem, there will be sensory loss on the __________ side of the body. What is an exception to this?

A

Contralateral

Cranial nerve deficits will occur on ipsilateral side

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23
Q

This part of the brain is injured during a stroke

A

Cerebral cortex

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24
Q

2 ways sensation is lost from a lesion to cerebral cortex

A
  1. Atopognosia - ability to localize stimulation site

2. Parietal lobe - loss of discriminative sensation

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25
Q

If your pt has a lesion in their cerebral cortex, which side of the body will experience sensory loss?

A

Contralateral

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26
Q

When there is pressure on a nerve, do you lose sensory or motor first?

A

Sensory —– then both if prolonged

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27
Q

If an injury caused denervation there will be a loss of ______________

A

Sensibility

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28
Q

How many mm can a nerve grow a day?

A

1-2 mm

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29
Q

When nerves are regrowing, they may be ___________

A

Hypersensitive

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30
Q

_______ fibers are more susceptible to a compression injury

A

Sensory

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31
Q

In a compression injury, these two things happen sequentially:

A
  1. Diminished vibratory perception

2. Intermittent numbness and paresthesia

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32
Q

What is the intervention for a moderate-severe nerve injury?

A

Surgery

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33
Q

5 general principles of sensory testing

A
  1. Pt positioned comfortably
  2. Explain procedure
  3. Establish area of normal sensation
  4. Vision obscured
  5. Distal –> proximal
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34
Q

5 variables of sensory testing

A
  1. Environment
  2. Pt emotions
  3. Callus vs non callus
  4. Instrumental related variables
  5. Method related variables
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35
Q

4 variables to document after sensation testing

A
  1. Status
  2. Type
  3. Location of testing
  4. Sensory mapping
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36
Q

6 conditions for foam and dome test

A
  1. Eyes open, stable surface
  2. Eyes closed, stable surface
  3. Visual conflict w moving surround/dome, stable surface
  4. Eyes open, foam
  5. Eyes closed, foam
  6. Foam and dome
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37
Q

3 systems tested in foam and dome

A
  1. Vision
  2. Somatosensory
  3. Vestibular
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38
Q

Describe flexion synergy of LE

A

Hip flexion, abduction, ER; knee flexion; ankle DF

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39
Q

3 things to observe in the appearance of tone

A
  1. Atrophy
  2. Pseudohypertrophy
  3. Fasciculations
40
Q

4 ways to test muscle tone

A
  1. Passive movement
  2. Pendulum test
  3. Drop arm test
  4. DTRs
41
Q

Pendulum test is used to assess…

A

Spasticity

42
Q

Drop arm test is used to test integrity of….

A

Automatic proprioceptive reactions

43
Q

DTR corresponding nerve:

Jaw

A

Trigeminal nerve

44
Q

DTR corresponding nerve:

Biceps

A

C5

45
Q

DTR corresponding nerve:

Brachioradialis

A

C6

46
Q

DTR corresponding nerve:

Triceps

A

C7, 8

47
Q

DTR corresponding nerve:

Patellar

A

L2-4

48
Q

DTR corresponding nerve:

Ankle

A

S1-2

49
Q

Define muscle tone

A

Resistance of muscle to passive stretch

50
Q

3 causes for muscle tone

A
  1. Physical inertia
  2. Intrinsic stiffness of muscle/CT
  3. Reflex muscle contraction
51
Q

3 ways to categorize muscle tone

A
  1. Hypertonia
  2. Hypotonia
  3. Dystonia
52
Q

4 components of hypertonia

A
  1. Spasticity
  2. Clasp-knife reflex
  3. Clonus
  4. Rigidity
53
Q

If a pt has hypertonia, the spasticity will ____________ at increased speeds

A

Increase

54
Q

In hypertonia, rigidity is ___________

A

Similar at all speeds

55
Q

Decerebrate rigidity

A

Extension of all exremities

56
Q

Decorticate rigidity

A

UE flexed, LE extended

57
Q

Sustained muscle contractions that result in twisted and abnormal posture

A

Dystonic posturing

58
Q

Tonal grading scale

A 
0 = no response
1 = decreased response (hypo)
2 = normal response 
3 = exaggerated response (mild-mod hyper)
4 = sustained response (severe hyper)
59
Q

MAS scale for spasticity

A

0 = no increase in tone
1 = slight increase (catch and release)
1+ =slight increase (initial catch followed by min resistance thru partial range)
2 = increased tone thru most of range
3 = increased tone, passive mvmt difficult
4 = rigid in ext/flx

60
Q

Scale for spasticity tested at three speeds

A

Tardieu scale

61
Q

Three speeds of tardieu scale

A
  1. Slow
  2. Speed at which gravity would drop the limb
  3. Fast
62
Q

2 factors graded on tardieu scale

A 
X = quality
Y = angle of catch
63
Q

How many levels in the Barry Albright Dystonic Scale?

A

5

64
Q

BADS measures ______________

A

% of time that dystonia is occuring

65
Q

Scoring for DTRs

A 
0 = no response 
1+ = decreased response
2+ = normal response 
3+ = exaggerated response
4+ = clonus (1-3 beats)
5+ = sustained clonus
66
Q

7 factors that influence tone

A
  1. Position and interaction w tonic reflexes
  2. Stress/anxiety
  3. Volitional effort/movement
  4. Meds
  5. State of CNS arousal
  6. Temperature of environment
  7. General health
67
Q

Ability to execute smooth, accurate, controlled movements

A

Coordination

68
Q

Deficits in coordination are often related to…

A

CNS disorders of cerebellum, basal ganglia, dorsal

69
Q

Inability to make smooth, accurate movements

A

Ataxia

70
Q

Disturbance in distance or ROM

A

Dysmetria

71
Q

Involuntary slow, twisting, writhing continuous movements esp seen in distal parts of extremities and perioral area

A

Athetosis

72
Q

Involuntary abrupt, rapid, brief, unsustained, arrhythmical, random mvmts

A

Chorea

73
Q

Chorea is seen most often at ________ joints

A

Proximal

74
Q

Chorea is worse at _______ and sometimes improved by ________

A

Rest; movement

75
Q

Rhythmical oscillating movements

A

Tremor

76
Q

3 types of tremors and what they indicate

A

Intention - cerebellar diseases
Resting - parkinsons (disappears or slows w movement)
Postural - seen when body part is held against gravity

77
Q

Repetitive, stereotyped, involuntary movements

A

Tics

78
Q

Slowness of movement

A

Bradykinesia

79
Q

Inability to perform rapidly alternating movements

A

Dysdiadochokinesis

80
Q

5 main areas of coordination assessment

A
  1. Alternate or reciprocal movement
  2. Movement synergy
  3. Movement accuracy
  4. Fixation or limb holding
  5. Equilibrium or posture holding
81
Q

Defined as the stability produced on each side of the vertical axis

A

Balance

82
Q

How is balance achieved?

A

Via multiple CNS inputs/outputs

83
Q

How is balance assessed?

A

Standardized tools OR observation of functional activities

84
Q

3 types of reactions

A
  1. Righting
  2. Protective
  3. Equilibrium
85
Q

Serve to maintain body alignment and/or orientation to the environment

A

Righting reactions

86
Q

When COM moves too far beyond BOS

A

Protective reactions

87
Q

Attempt to maintain COM over BOS

A

Equilibrium reactions

88
Q

6 things to note when recording results for equilibrium testing

A
  1. Number of extremities involved
  2. Distribution
  3. Situations that alter coordination/balance
  4. Amount of time to perform
  5. Level of safety
  6. History of falls
89
Q

Community balance and mobility scale is for ________________

A

Higher level pts

90
Q

2 types of reflexes

A
  1. Superficial cutaneous reflexes

2. Primitive reflexes

91
Q

Dermatomes tested for abdominal reflexes

A

T7-T12

92
Q

Normal response of abdominal reflexes

A

Contractions of abs w umbilical deviation toward the stimulus

93
Q

Another name for plantar reflex

A

Babinski reflex

94
Q

Normal response of plantar reflex

A

Flexion and adduction of toes

95
Q

Abnormal response (babinski sign)

A

Extension of great toe along with abduction or fanning of lateral four toes

96
Q

2 developmental reflexes

A

Tonic labyrinthine

Tonic neck

E&M (24 decks)

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