neuro

Question 1

cauda equina characteristics

Answer 1

flacid paralysis, no spinal reflex, flacid bladder and bowel

potential for nerve regeneration, which slows and stops after 1 year

Question 2

SCI posterior cord syndrome

Answer 2

loss of dorsal columns (proprioception, vibration light touch)

motor, pain, temp preserved

Question 3

SCI anterior cord syndrome

Answer 3

bilateral loss of motor function (corticospinal tract)

bilateral loss of pain and temp (spinothalamic)

dorsal column preserved (proprioception, kinesthesia, vibration, light touch)

Question 4

Brown-Sequard syndrome

Answer 4

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

Question 5

SCI complete cord lesion

Answer 5

complete loss of sensory and motor function

spastic paralysis below lesion, including spastic bowel and bladder

Question 6

SCI central cord lesion

Answer 6

bilat loss spinothalamic (pain and temp)

loss of ventral horn, bilateral loss of motor function, UE loss>LE loss

Question 7

ASIA levels

Answer 7

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

Question 8

stroke recovery stages

Answer 8

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

Question 9

pontine stroke symptoms

Answer 9

symptoms variable, locked in syndrome possible

Question 10

midbrain lesion stroke symptoms

Answer 10

contralateral hemiplegia

Question 11

internal capsule lesion (posterior limb stroke)

Answer 11

lacunar (pure motor) stroke, contralateral hemiplegia

no aphasia, visual field deficits rare

Question 12

middle cerebral artery stroke

Answer 12

UE affected > LE

dominant hemisphere: non-fluent aphasia
non-dominant: perceptual deficit

Question 13

anterior cerebral artery stroke

Answer 13

LE affected > US

Question 14

posterior cerebral artery stroke

Answer 14

contralateral vision loss
involuntary movements

central pos-stroke pain
possible contralateral hemiplegia

Question 15

right hemisphere lesion behaviors

Answer 15

impulsive, quick, indifferent
poor judgement and safety
often overestimate their abilities

more visiospatial deficits compared to left lesion

Question 16

autonomic dysreflexia

Answer 16

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

Question 17

FIM scores

Answer 17

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%)

Question 18

CN responsible for smell

Answer 18

CN I: Olfactory

test: smell

Question 19

CN responsible for Vision

Answer 19

CN II: Optic

test: visual acuity; central (Snellen chart), peripheral

Question 20

CN responsible for pupillary reflexes

Answer 20

CN II and III: Optic and Oculomotor

test: pupilary reflexes

Question 21

CN responsible for extraocular movements

Answer 21

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

Question 22

CN responsible for sensory to face and cornea, motor for chewing

Answer 22

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)

Question 23

CN responsible for facial expression

Answer 23

CN VII: Facial

test motor function of face (raise eyebrows, frown, show teeth, smile, close eyes tightly, puff cheeks)

Question 24

CN responsible for vestibular and hearing

Answer 24

CN VIII: Vestibulocochlear (Acoustic)

test: balance, gaze stability, auditory acuity

Question 25

Weber’s test

Answer 25

vibrating tuning fork on top of head

conductive loss will hear louder in impaired ear

sensorineural loss will only hear sound in good ear

Question 26

Rinne’s test

Answer 26

vibrating tuning fork to mastoid process, then close to ear canal

conductive loss: sound heard through bone is equal or longer compared to air

sensorineural loss: sound heard longer in air

Question 27

CN responsible for phonation (speaking)

Answer 27

IX and X: Glossopharyngeal and Vagus

test: voice quality

Question 28

CN responsible for swallowing

Answer 28

IX and X: Glossopharyngeal and Vagus

test: swallow function

Question 29

CN responsible for palate and pharynx control

Answer 29

IX and X: Glossopharyngeal and Vagus

test: have pt say “ah”, observe motion of soft palate (should elevate) and uvula (should remain midline)

Question 30

CN responsible for gag reflex

Answer 30

IX and X: Glossopharyngeal (mostly) and Vagus

test: stimulate back of throat lightly on each side

Question 31

CN responsible for trapezius and SCM motor function

Answer 31

CN XI: Accessory

test: MMT

Question 32

CN responsible for tongue movement

Answer 32

CN XII: Hypoglossal

test: will deviate to weak side