Neuro Flashcards
Middle Cerebral:
-Main deficits: UE>LE contralateral hemiplegia, loss sensation in arm/face
-Possible: homonymous hemianopsia (R or L half of contralt visual field)
-Infarct in dominant L hemisphere: aphasia and apraxia
-Infarct in main step: global aphasia
Anterior Cerebral:
- Rarely involved
- Main deficits: LE>UE resulting in contralateral hemiplegia and sensory loss
- Infarct extensive on dominant side can cause mental confusion, aphasia, and contralat neglect
Posterior Cerebral:
-Main deficits: persistent pain syndrome, contralateral pain and temperature sensory loss
-If occluded: homonymous hemianopsia, aphasia, and thalamic pain syndrome
Vertebral-Basilar:
-Main deficits: death from edema associated
-If survives and had pons involvement: quadriparesis, bulbar palsy; locked in state with only blinking to communicate
-Possible: vertigo, coma, diplopia, nausea, dysphagia, and ataxia
Anterior Inferior Cerebellar:
-Main deficits: unilateral deafness, loss of pain/temp on contralateral side, paresis of lateral gaze, unilateral Horner’s
-Possible: ataxia, vertigo, nystagmus
Superior Cerebellar:
-Main deficits: severe ataxia, dysarthria, dysmetria, and contralateral pain/temp
Posterior Inferior Cerebellar:
- Main deficits: Wallenberg’s syndrome- vertigo, nausea, hoarseness, dysphagia, ptosis, and decreased sensation in IPS face and CONT torso/limbs
- Possible: Horner’s syndrome
Rancho Levels of Cognitive Functioning
I: No response: completely unresponsive to stimuli
II: Generalized response: inconsistent reaction to nonspecific stimuli
III: Localized response: inconsistent response to specific stimuli
IV: Confused/Agitated: heightened state of activity; bizarre, non-purposeful behavior non-relative to immediate environment. Recall/retention span is poor.
V: Confused-inappropriate: responds to simple commands but unable to do complex tasks. Memory impaired and verbalization inappropriate.
VI: Confused-appropriate: dependent upon external input but unable to perform consistently. Memory improved.
VII: Automatic-appropriate: automatically and appropriately response in structured environments. Judgement is impaired.
VIII: Purposeful-appropriate: acts appropriately though not perfectly. Problems in stressful or unusual circumstances.
Asymmetrical Tonic Neck
-0-4/6 months
-Rotation of head causes flexion of skull limbs, extension of jaw limbs (fencing) in supine/sitting
-Prolonged: scoliosis, hip sublux/dislocation
-Severe reflex: grasping with extended arm only when head turned away from object
Crossed Extension
- 28wks gestation- 1/2 months
- Noxious stimuli to ball of foot results in opposite LE flexes, adducts, then extends
- Hemiplegia: lifting uninvolved leg off of ground while walking results in increased extensor tone in involved leg
- Reflex with supporting reaction results in hyperextension of knee
Equilibrium Reactions
-6 (prone), 7 (supine), 8 (sitting), kneeling (9-12), standing (12-21) months to forever
-Displaced/moving surface results in curvature of trunk toward upward side with extension and abd of extremities on that side; protective extension on opposite side
-Absent if marked spasticity
Grasp
-0 to 4/6 months for palmar; 28wks hesitation to 9 months for plantar
-Pressure to palm of hand or ball of foot results in maintain flexion of fingers/toes
Landau’s
-3 mo to 2 years
-Lifting from thorax in prone results in head then back/leg extension; if head is pushed into flexion then extensor tone disappears
-Absent if strong flexor spasticity
Moro
-28wks gestation to 5-6 mo
-Sudden change in position of head in relation to trunk results in extension/abd of UE with hand opening and crying then flexion/add/arms across chest
Optical and Labyrinthe Rightning
-0/2mo to forever
-Altered body position via tipping (with eyes closed=labyrinthe) results in head orientation to vertical with mouth horizontal
