Neuro Flashcards
Brain functions to assess
Sensation
Vision, hearing
Language comprehension
Damage to brain can cause?
Loss of function (dependent on area affected
Motor weakness
Paralysis
Loss of sensation (paresthesia)
Impaired ability to understand and process language
Stroke Prevention nemonic
F- face drooping
A- Arm weakness
S- Speech difficulty
T- Time to call 911
Sensory conduction transmits?
Pain Temperature Light touch Crude touch Position Vibration Vaguely localized touch
Pyramidal tract
skilled and purposeful movement
Extrapyramidal tract
more primitive motor system—maintains muscle tone, controls body movement such as walking
Cerebellar system
coordinates movement
maintains posture
maintains equilibrium
Upper motor neuron disease
Within CNS
Stroke
Cerebral palsy
Multiple Sclerosis
Lower motor neuron disease
Located within periphery (cranial nerves, spinal nerves)
spinal cord lesions
Poliomyelitis
Amyotrophic lateral sclerosis
Reflexes are mediated by?
spinal nerve fibers
Spinal nerve number
- 31 pairs arise from spinal cord; 8 cervical, 12 thoracic, 5 lumbar, 2 sacral, 1 coccygeal
Contain both sensory and motor fibers
Nerves exit through roots
Sensory through posterior (dorsal) roots
Motor through anterior (ventral) roots
Dermatomes
circumscribed skin area supplied from the spinal cord segment through particular spinal nerve
Infants
movement directed primarily by primitive reflexes; these disappear with age
Increased process of myelination results in increased motor control
Sensation rudimentary at birth—need strong stimulation to create response in an infant
Aging adult Subjective
Steady loss of neuron structure in brain and spinal cord General loss of muscle bulk; loss of muscle tone in face, neck, around spine Decreased muscle strength Impaired fine coordination and agility Loss of sensation Pupillary changes Reaction time slows Touch, pain, taste, smell may diminish
Decreased cerebral blood flow and oxygen consumption may cause dizziness, loss of balance with position changes
Stroke belt
Southeast-Georgia, costal regions of North and South Carolina
40% higher than rest of US
Dysarthria
difficulty forming words d/t motor function loss
Dysphagia
difficulty swallowing
Dysphasia
Can be receptive or expressive; difficulty with language comprehension or expression
Environmental hazards
Insecticides
Organic solvents
Lead
Mercury
Aging adult objective
Assess fall risk--> increased with diagnosis of stroke or dementia gait balance disorders use of assistive devices history of recent falls
Flaccidity of muscles occurs with what type of neuron injury?
LMN lesion/injury
Peripheral
Spasticity and rigidly of muscles occur with what type of neuron injury?
UMN (brain and spinal cord)
Central
Paresis
Weakness , diminished strength
Involuntary movements
Tics, tremors, fasciculation, myoclonus, chorea, and athetosis
What to assess during muscle inspection and palpation?
Size
Strength
Tone
Involuntary movements
Cerebellar function assessment
Coordination RAM Finger-finger test Finger-to-nose test Heel-to-shin test Balance tests Gait Romberg
Dysdiadochokinesia
Slow, clumsy, sloppy responses during cerebellar assessment
Dysmetria
Clumsy movement with overshooting the mark during finger-to-finger test
Ataxia
Unsteady uncoordinated gait
Positive rohmberg test
Loss of balance that occurs when closing the yes during standing.
Occurs with cerebellar ataxia
Tone
muscle resistance in passive movement
Strength
Ability of muscle during contraction
Spinothalamic tract tests
Pain–> alternate b/n pinprick and lounge blade and have pt describe as “sharp or dull”
Light touch–> whip of cotton on arms, forearms, hands, chest, thighs, and legs
Posterior (dorsal) column tract tests
Position (kinesthesia) Vibration Finely localized touch (stereogeneis) Tactile discrimination Stereognosis Graphesthesia Two-point discrimination Extinction Point location
Stereognosis
Being able to identify object without looking
Deep tendon reflex
4+ very brisk hyperactive w/ clonus
3+ Brisker than average, may indicate disease
2+ Average, normal
1+ Diminished, low normal, only occurs with reinforcement
0 no response
Biceps reflex
C5-C6
Triceps reflex
C7-C8
Brachioradialis reflex
C5-C6
Quadriceps reflex
Knee Jerk
L2 to L4
Achilles reflex
L5 to S2