neuro Flashcards
cauda equina characteristics
flacid paralysis, no spinal reflex, flacid bladder and bowel
potential for nerve regeneration, which slows and stops after 1 year
SCI posterior cord syndrome
loss of dorsal columns (proprioception, vibration light touch)
motor, pain, temp preserved
SCI anterior cord syndrome
bilateral loss of motor function (corticospinal tract)
bilateral loss of pain and temp (spinothalamic)
dorsal column preserved (proprioception, kinesthesia, vibration, light touch)
Brown-Sequard syndrome
hemisection of spinal cord
Ipsilateral loss of dorsal column and corticospinal tracts
Contralateral loss of pain and temp 2 levels below
Bilateral loss of pain and temp at lesion level
SCI complete cord lesion
complete loss of sensory and motor function
spastic paralysis below lesion, including spastic bowel and bladder
SCI central cord lesion
bilat loss spinothalamic (pain and temp)
loss of ventral horn, bilateral loss of motor function, UE loss>LE loss
ASIA levels
A - complete loss, no motor or sensory below lesion, no sacral sparing
B - sensory preserved, no motor function
C - motor preserved, but weak, most muscles <3
D - motor preserved, but strong, most muscles >3
E - normal
stroke recovery stages
1 - initial flaccidity, no voluntary movement
2 - emergence of spasticity, hyperreflexia
3 - voluntary movement, possible only in synergy patterns
4 - voluntary control in isolated joint movements, decreasing spasticity and synergy
5 - increasing voluntary control out of synergy, coordination deficits
6 - control and coordination near normal
pontine stroke symptoms
symptoms variable, locked in syndrome possible
midbrain lesion stroke symptoms
contralateral hemiplegia
internal capsule lesion (posterior limb stroke)
lacunar (pure motor) stroke, contralateral hemiplegia
no aphasia, visual field deficits rare
middle cerebral artery stroke
UE affected > LE
dominant hemisphere: non-fluent aphasia
non-dominant: perceptual deficit
anterior cerebral artery stroke
LE affected > US
posterior cerebral artery stroke
contralateral vision loss
involuntary movements
central pos-stroke pain
possible contralateral hemiplegia
right hemisphere lesion behaviors
impulsive, quick, indifferent
poor judgement and safety
often overestimate their abilities
more visiospatial deficits compared to left lesion
autonomic dysreflexia
Lesions above T6
sxs: increased BP, bradycardia, sweating, headache, flushing, anxiety
most commonly bladder distension, but find cause
have them sit up/not lie down - OPP of orthostatic hypotension
FIM scores
7 - total independence 6 - mod I with a device, but no help 5 - supervision 4 - minimal to CGA (pt can do at least 75%) 3 - mod assist (pt can do 50-75%) 2 - max assist (pt can do 25-50%) 1 - total assist (pt can do <25%)
CN responsible for smell
CN I: Olfactory
test: smell
CN responsible for Vision
CN II: Optic
test: visual acuity; central (Snellen chart), peripheral
CN responsible for pupillary reflexes
CN II and III: Optic and Oculomotor
test: pupilary reflexes
CN responsible for extraocular movements
CN III, Oculomotor, turns eye up, down in, elevates eyelid
CN IV, Trochlear, turns adduced eye down
CN VI, Abducens, turns eye down
test: pursuit
CN responsible for sensory to face and cornea, motor for chewing
CN V: Trigeminal
Test: pain and light touch over face (all three branches), palpate muscles, clench teeth, hold against resistance (if impaired, jaw will deviate to ipsilateral side when opened)
CN responsible for facial expression
CN VII: Facial
test motor function of face (raise eyebrows, frown, show teeth, smile, close eyes tightly, puff cheeks)
CN responsible for vestibular and hearing
CN VIII: Vestibulocochlear (Acoustic)
test: balance, gaze stability, auditory acuity
