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Neuro Flashcards

1
Q

Stages of ALS

Stage III

A
  • Severe weakness of specific muscles
  • Increasing fatigue
  • Mild to moderate functional limitations
  • Ambulatory
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2
Q

Neurotmesis

A
  • Class 3
  • Cutting of the nerve w/ severance of all structures and complete loss of function
  • Reinnervation typically fails w/o surgical intervention because of aberrant regeneration
  • Failure of regenerating axon to find its terminal end
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3
Q

LE Extension Synergy Components

A

Strong Components:

  • Hip Abduction
  • Knee Extension
  • Ankle Plantarflexion

Other Components:

  • Hip extension
  • IR
  • Ankle Inversion
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4
Q

Temororal Lobe Area

A
  • Contains:
    • Primary Auditory Cortex
    • Associative Auditory Cortex
    • Wernicke’s Area
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5
Q

Patients w/ T12-L3 Lesions

A
  • Can be independent ambulator on all surfaces/stairs
  • Swing-Through/Four-Point Gait
  • Bilateral KAFOs/Crutches
  • Household Ambulators
  • WC Community Ambulator
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6
Q

Fibrillation

A
  • Spontaneous independent contractions of individual muscle fibers
  • Evident w/ denervation for 1-3 weeks after losing nerve
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7
Q

Anterior Cord Syndrome: UMN Lesion

A

Loss of anterior cord:

  • Loss of Lateral Corticospinal Tracts
    • Bilateral loss of motor function, spastic paralysis below level of lesion
  • Loss of Spinothalamic Tracts
    • Bilateral loss of pain and temperature
  • Preservation of Dorsal Columns
    • Proprioception, kinesthesia, and vibratory sense
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8
Q

Glasgow Coma Scale

Score 13-15

A

Minor Brain Injury

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9
Q

Hoehn and Yahr Classification

Stage II

A
  • Minimal bilateral or midline involvement
  • No balance involvement
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10
Q

Stages of AD

Moderate AD

A
  • Noticable memory, thinking, and behavioral symptoms that impair a person’s ability to function in daily life
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11
Q

Spinothalamic Tracts

A
  • Lateral
    • Sensations of Pain and Temperature
  • Anterior
    • Crude Touch
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12
Q

Occipital Lobe Area

A
  • Primary Visual Cortex
  • Visual Association Cortex
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13
Q

Most Common Lumbar SCI Injury

A

Flexion

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14
Q

ACA Blood Supply

A

Anterior two-thirds of the medial cerebral cortex

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15
Q

Functional Balance Grade: Fair

A
  • Patient is able to maintain steady balance with hand-hold support; may require occasional minimal assistance (static).
  • Patient accepts minimal challenge; able to maintain balance while turning head/trunk (dynamic).
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16
Q

Stages of ALS

Stage II

A
  • Moderate weakness in groups of muscles
  • Some wasting (atrophy) of muscles
  • Modified independence w/ assistive devices
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17
Q

Fasciculations

A
  • Spontaneous contractions of all or most of the fiber in a motor unit
    • Muscle twitches that can be observed or palpated
  • Present w/ LMN disorders and denervation
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18
Q

Posterior Cord Syndrome: UMN Lesion

A

Loss of dorsal columns:

  • Bilateral Loss of Proprioception, Vibration, Pressure,
  • Epicritic Sensation (Stereognosis/Point Discrimination)
  • Preservation of Motor Function, Pain, and Light Touch
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19
Q

Reticulospinal System

A

Modifies Transmission of Sensation, Especially Pain

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20
Q

Brudzinski’s Sign

A
  • Patient is positioned in supine; flex neck to chest
  • Positive sign: causes flexion of hips and knees
    • Suggests meningeal irritation
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21
Q

Patients w/ C5 Lesions

A
  • Have Shoulder/Elbow Function
  • Can use manual chair w/ propulsion aids
    • Independent for short distances on smooth/flat surfaces
    • May choose electric WC for distances/energy conservation
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22
Q

Figure-Ground Discrimination

A

Ability to pick out an object from an array of objects

Ex: brakes from a WC

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23
Q

Typical Neurological Gait Deficits

Ankle

A
  • Equinus Gait
  • Varus Foot
  • Equinovarus Position
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24
Q

Medial Medullary Syndrome

A

Ipsilateral to lesion:

  • Paralysis of Half of Tongue

Contralateral to lesion:

  • Hemiplegia UE/LE
  • Impaired Sensation
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25
Q

Stages of ALS

Stage IV

A
  • Severe weakness and wasting of LEs
  • Mild weakness of UEs
  • Moderate assistance and assistive devices required
  • Uses WC
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26
Q

Segmental Demyelination

A
  • Axons are preserved (no wallerian degeneration)
  • Remyelination restores function
    • ex: Guillain-Barre
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27
Q

Cheyne-Stoke Respiration

A
  • A period of apnea lasting 10-60 seconds
  • Gradually increasing depth/frequency of respirations
  • Accompanies depression of frontal lobe/diencephalic dysfunction
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28
Q

Depth and Distance Imperceptions

A

Determine whether a patient can judge depth and distance

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29
Q

Stages of ALS

Stage V

A
  • Progressive weakness w/ deterioration of mobility/endurance
  • Increased fatigue
  • Moderate to severe weakness of whole limbs/trunk
  • Spasticity
  • Hyperreflexia
  • Loss of head control
  • Max assist
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30
Q

Opisthotonos

A
  • Prolonged, severe spasm of muscles, causing head, back, andheels to arch backward
    • Arms and hands are held regidly flexed
  • Seen in severe meningitis, tetanus, epilepsy, and strychnine poisoning
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31
Q

Patients w/ C8-T1 Lesions

A
  • Have Hand Function
  • Manual WC w/ standard hand rims
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32
Q

Midbrain Lesion

A
  • Contralateral Hemiplegia
  • Contralateral CN III palsy
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33
Q

Stages of AD

Mild AD

A
  • Mild by measurable changes in cofnitive abilities noticeable to person affected and family members
  • Able to carry out everyday activities
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34
Q

Spinoreticular Tracts

A

Convey Deep and Chronic Pain

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35
Q

Stages of AD

Preclincal AD

A
  • Individuals have measureable changes in brain CSF/blood biomarkers w/out noticeable symptoms
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36
Q

Axonal Degeneration

A
  • Degeneration of axon cylinder and myelin
  • Progressing from distal to proximal
  • Dying back of nerves
    • ex: peripheral neuropathy
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37
Q

Typical Neurological Gait Deficits

Hip

A
  • Retracted/Flexed
  • Trendeleburg Limp (Weak Abductors)
  • Scisoring (Spastic Adductors)
  • Insufficient Pelvic Rotation during Swing
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38
Q

Lesions of Neocerebellum (Hemisphere, Posterior Lobe)

A
  • Intention Tremor
    • Irregular/Oscillatory Voluntary Movements
  • Dysdiadochokinesia
  • Dysmetria
    • Hypermetria
    • Errors or Force, Direction, Amplitude, Rebound Phenonmenon
  • Dyssynergia
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39
Q

Rancho Los Amigos Levels of Cognitive Function

Level IV, V, and VI

A

Confused

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40
Q

Parietal Lobe Area

A
  • Contains:
    • Postcentral Gyrus (Primary Sensory Cortex)
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41
Q

Neck Mobility Test for Meningeal Irritation

A
  • Patient is positioned in supine, flex neck to check
  • Positive sign: neck pain w/ limitation/guarding of head flexion due to spasm of posterior neck muscles
    • Can result from meningeal inflammation, arthritis, or neck injury
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42
Q

Guidelines to Promote Learning

W/ Right Hemisphere Lesions

A
  • Use verbal cues
    • Demonstrations or gestures may confuse patients w/ visuospatial deficits
  • Give frequent feedback
    • focus on slowing down and controlling movement
  • Focus on safety
  • Avoid environmental (spatial) clutter
  • Do not overestimate ability to learn
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43
Q

MCA Bloody Supply

A

Lateral cerebral cortex, basal ganglia, and large portions of the internal capsule

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44
Q

UE Extension Synergy Components

A

Strong Components:

  • Shoulder Adduction

Other Components:

  • Scapular Protraction
  • IR,
  • Elbow Extension,
  • Forearm Pronation
  • Wrist and Finger Flexion
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45
Q

Gross Motor Classification for CP

Level II

A
  • Walks w/o assistive devices
  • Limitations walking outdoors/community
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46
Q

Dorsal Columns/Medial Lemniscal System

A
  • Convey sensations of:
    • Proprioception
    • Vibration
    • Tactile Discrimination
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47
Q

Functional Balance Grade: Poor

A
  • Patient requires hand-hold support and moder to maximal assistance to maintain position (static).
  • Patient unable to accept challenge or move without loss of balance (dynamic).
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48
Q

Functional Balance Grade: Good

A
  • Patient is able to maintain steady balance without hand-hold support, limited postural sway (static).
  • Patient accepts moderate challenge; able to maintain balance while picking object off floor (dynamic).
49
Q

Tectospinal Tract

A

Assists in Head-Turning Responses to Visual Stimuli

50
Q

LE Flexion Synergy Components

A
  • Hip flexion
  • Abduction
  • ER
  • Knee Flexion
  • Ankle Dorsiflexion/Inversion
51
Q

Agnosia

A
  • Inability to recognize familar objects w/ one sensory modality
  • Retain ability to recognize same object w/ other sensory modalities
  • Ex: Subject doesn’t recognize a clock by sight but can recognize by ticking
52
Q

Vertebrobasilar Artery Blood Supply

A

Ventral surface of the medulla and the posterior inferior aspect of the cerebellum

53
Q

Rancho Los Amigos Levels of Cognitive Function

Level II-III

A

Decreased Response

54
Q

Vertical Disorientation

A

Determine whether patient can accurately identify when something is upright

55
Q

Patients w/ L4-L5 Lesions

A
  • Bilateral AFOs w/ Crutches or Canes
  • Independent Community Ambulators
  • May still use WC for high-endurance activities
56
Q

Lateral Inferior Pontine Syndrome

A

Ipsilateral to lesion:

  • Cerebellar: Ataxia, Nystagmus, Vertigo
  • Facial Paralysis/Impaired Facial Sensation
  • Paralysis of Conjugate Gaze
  • Deafness
  • Tinnitus

Contralateral to lesion:

  • Impaired Pain and Temperature Sensation
57
Q

Vestibulospinal Tracts

A

Controls:

  • Muscle Tone
  • Antigravity Muscles
  • Postural Reflexes
58
Q

Spatial Relations

A

Ability to duplicate a pattern of two or three blocks

59
Q

Patients w/ T6-T9 Lesions

A
  • Require KAFOs, Crutches, Swing-to Gait Pattern
  • Supervised ambulation for short distances
  • May prefer standing devices/standing WC
60
Q

Lesions of Paleocerebellum (Spinocerebellum; Rostral Cerebellum/Anterior Lobe)

A
  • Hypotonia
  • Truncal Ataxia
    • Dysequilibruim
    • Static Postural Tremor
    • Increased Sway
    • Wide BOS
    • High Guard Arm Position
    • Posture worse w/ EO
  • Ataxic Gait
    • Unsteady/Increased Falls
    • Uneven/Decreased Step Length
    • Increased Step Width
61
Q

CRPS: Dystrophic or Middle Stage

A
  • Think/Pale/Cynotic Skin
  • Cessation of Hair/Nail Growth
  • Hyperhidrosis
  • Muscle Astrophy
  • Osteoporosis
62
Q

Most Common Cervical SCI Injuries

A

Flexion-Rotation

63
Q

CRPS: Acute or Early Stage

A
  • Diffuse/Severe Burning/Aching Pain
    • Increases w/ Emotional Stress
  • Allodynia
  • Hyperpathia
    • Increased sensitivity to normal stimuli
  • Vasomotor Instability
  • Dusky Molting/Cool Sking
  • Swelling
  • Edema
64
Q

CATSIB

Patients Unstable in Conditions 4, 5, and 6

A

Dependent on Surface/Somatosensory Inputs

65
Q

Anterior Cerebral Artery (ACA) Syndrome

A
  • UE more spared
  • Apraxia
  • Akinetic Mutism
66
Q

Basilar Artery Blood Supply

A

Ventral portion of the pons

67
Q

Gross Motor Classification for CP

Level III

A
  • Walks w/ assistive mobility device
  • Limitations walking outdoors/community
68
Q

CATSIB

Patients Unstable in Conditions 3, 4, 5, and 6

A

Patients with Sensory Selection Problems

69
Q

Lateral Medullary (Wallenberg’s) Syndrome

A

Ipsilateral to lesion:

  • Cerebellar: Ataxia, Nystagmus, Vertigo
  • Loss of Pain and Temperature to Face
  • Sensory Loss UE, Trunk, or LE

Contralateral to lesion:

  • Impaired Pain and Temperature Sensation to Body/Face
  • Horner’s Syndrome (Miosis, Ptosis, Decreased Sweating)
  • Dysphagia
  • Impaired Speech
70
Q

CATSIB

Patients Unstable in Conditions 2, 3, 5, and 6

A

Dependent on Vision

71
Q

Ideomotor Apraxia

A

Patient cannot perform task on command but can do task when left alone

72
Q

Lacunar (pure motor) Stroke

A
  • Contralateral Hemiplegia
  • UE/LE
  • No Aphasia
  • Visual Field Deficit Rare
73
Q

Hoehn and Yahr Classification

Stage V

A
  • Confined to bed or WC
74
Q

Rancho Los Amigos Levels of Cognitive Function

Level VII and VIII

A

Appropriate (Automatic and Purposeful)

75
Q

Stages of ALS

Stage I

A
  • Early disease
  • Mild focal weakness
  • Asymmetrical distribution
  • Symptoms of hand cramping and fasciculations
76
Q

Medial Inferior Pontine Syndrome

A

Ipsilateral to lesion:

  • Cerebellar Ataxia
  • Nystagmus
  • Paralysis of Conjugate Gaze
  • Diplopia

Contralateral to lesion:

  • UE/LE Hemiparesis
  • Impaired Sensation
77
Q

Glasgow Coma Scale

Score 1-8

A

Severe Brain Injury

78
Q

Topographical Disorientation

A

Determine whether patient can navigate a familiar route on their own

Ex: travel from room to clinic

79
Q

Middle Cerebral Artery (MCA) Syndrome

A
  • LE more spared
  • Nonfluent Aphasia
  • Perceptual Deficit
  • Loss of Conjugate Gaze to Opposite Side
  • Sensory Ataxia
80
Q

Hoehn and Yahr Classification

Stage III

A
  • Impaired Balance
  • Some restrictions in activities
81
Q

Apraxia

A

Inability to perform voluntary, learned movements in the absence of loss of sensation, strength, coordination, attention, or comprehension

82
Q

Stages of ALS

Stage VI

A
  • Bedridden
  • Dependent ADS/FMS
  • Progressive respiratory distress
83
Q

Locked-in Syndrome

A
  • Tetraplegia
  • Lower Bulbar Paralysis (CN V-XII)
  • Mutism (Anarthria)
  • Preserved Consciousness
  • Preserved Vertical Eye Movements/Blinking
84
Q

Glasgow Coma Scale

Score 9-12

A

Moderate Brain Injury

85
Q

Ideational Apraxia

A

Patient cannot perform the task at all

86
Q

Functional Balance Grade: Absent

A
  • Patient unable to maintain balance.
87
Q

CATSIB

Patients Unstable in Conditions 5 and 6

A

Patients with Vestibular Loss

88
Q

Hoehn and Yahr Classification

Stage IV

A
  • All symptoms present and severe
  • Stand and walks only w/ assistance
89
Q

Guidelines to Promote Learning

W/ Left Hemisphere Lesions

A
  • Develop an appropriate communication base
    • Words, Gestures, Pantomimes
    • Assess Level of Understanding
  • Give frequent feedback and support
  • Do not underestimate ability to learn
90
Q

Gross Motor Classification for CP

Level V

A
  • Self-mobility is severely limited, even w/ assistive technology
91
Q

Typical Neurological Gait Deficits

Knee

A
  • Weak Knee Extensors
    • Knee Flexes during Stance
    • Compensatory Locking of Knee in Hyperextension
  • Spastic Quadriceps
    • May Also Hyperextend Knee
92
Q

Patients w/ Left Hemisphere Lesions

A

Typically slow, cautious, hesitant, and insecure

93
Q

Cauda Equina Injury: LMN Lesion

A
  • Loss of long nerve roots at or below L1
  • Variable nerve root damage (motor and sensory signs)
    • Incomplete lesions common
  • Flaccid paralysis with no spinal reflex activitiy
  • Flaccid paralysis of bladder and bowel
  • Potential for nerve regeneration
    • Regeneration often incomplete, slows and stops after about 1 year
94
Q

Neurapraxia

A
  • Class 1
  • Injury to nerve that causes transient loss of function (conduction block ischemia)
  • Nerve dysfunction may be rapidly reserves or persist a few weeks
    • ex: compression
95
Q

Wallerian Degeneration

A
  • Transection (neurotmesis) results in degeneration of the axon/myelin sheath distal to site of axonal interuption
96
Q

Posterior Cerebral Artery (PCA) Syndrome

A
  • Contralateral Sensory Loss
  • Choreoathetosis, Tremor, Hemiballismus
  • Transient Contralateral Hemiparesis
  • Homonymous Hemianopsia
  • Visual Agnosia
  • Memory Defect
  • Dyslexia
  • Central Pain
  • Weber’s Syndrome
  • Oculomotor N. palsy
97
Q

Stages of AD

Severe AD

A
  • Loss of ability to communicate, recognize others, and complete dependence
98
Q

Position in Space

A

Have patient demonstrate different limb positions

99
Q

Spinocerebellar Tracts

A

Convey proprioception information from:

  • Muscle Spindles
  • Golgi Tendon Organs
  • Touch/Pressure Receptors
100
Q

Frontal Lobe Area

A
  • Contains:
    • Precentral Gyrus
    • Prefrontal Cortex
    • Broca’s Area
101
Q

Rubrospinal Tracts

A

Assists Motor Function

102
Q

Gross Motor Classification for CP

Level I

A
  • Walks w/o restrictions
  • Limitations in more advanced gross motor skills
103
Q

Kernig’s Sign

A
  • Patient is positioned in supine, flex hip and knee fully to chest, and then extend knee.
  • Positive sign: causes pain and increased resistance to extending the knee due to spasm of hamstring
    • When bilateral, suggests meningeal irritation
104
Q

Corticospinal Tracts

A

Arise from Primary Motor Cortex

105
Q

Hoehn and Yahr Classification

Stage I

A
  • Minimal or absent disability
  • Unilateral symptoms
106
Q

Brown-Sequard Syndrome: UMN Lesion

A

Hemisection of Spinal Cord:

  • Ipsilateral Loss of Dorsal Columns
    • Loss of tactile discrimination, pressure, vibration, and proprioception
  • Ipsilateral Loss of Corticospinal Tracts
    • Loss of motor function and spastic paralysis below lesion
  • Contralateral Loss of Spinothalamic Tract
    • Loss of pain and temperature below level of lesion
    • Bilateral loss of pain and temperature at level of lesion
107
Q

Patients w/ C7 Lesions

A
  • Have Triceps Function
  • Same as C6 but w/ increased propulsion
108
Q

Patients w/ C6 Lesions

A
  • Have Radial Wrist Extensors
  • Manual WC w/ friction surface hand rims
  • Independent
109
Q

Patients w/ Right Hemisphere Lesions

A
  • Typically impulsive, quick, indefferent
  • Often exhibit poor judgement/safety
  • Overestimate their abilities while underestimating their problems
110
Q

UE Flexion Synergy Components

A

Strong Components:

  • Elbow, Wrist, Finger Flexion

Other Components:

  • Scapular Retraction/Elevation
  • Shoulder Abduction, ER,
  • Supination
111
Q

Form Constancy

A

Ability to pick out an object from an array of similarly shaped but different sized objects

112
Q

Axonotmesis

A
  • Class 2
  • Injury to nerve interrupting the axon and causing loss of function and wallerian degeneration distal to lesion
  • No disruption of the endoneurium
  • Regeneration is possible
    • ex: crush injury
113
Q

Gross Motor Classification for CP

Level IV

A
  • Self-mobility w/ limitations
  • Children are transported or use power mobility outdoors/community
114
Q

Most Common SCI Injury Levels

A
  • C5
  • C7
  • T12
  • L1
115
Q

Lisions of the Archicerebellum (Flocculonodular Lobe)

A
  • Central vestibular symptoms
    • Ocular Dysmetria
    • Poor Eye Pursuit
    • Dysfunctional VOR
    • Impaired Hand-Eye
  • Gait/Trunk Ataxia
    • Poor Postural Control/Orientation
    • Wide-Based Gait
  • Little change in tone or dyssenergia of extremities
116
Q

Rancho Los Amigos Levels of Cognitive Function

Level I

A

No Response

117
Q

Functional Balance Grade: Normal

A
  • Patient is able to maintain steady balance without hand-hold support (static).
  • Patient accepts maximal challenge and can shift weight easily at full range in all directions (dynamic).
118
Q

CRPS: Atrophic or Late Stage

A
  • Decreased Hypersensitivity
  • Normal Blood Flow/Temperature
  • Smooth/Glossy Skin
  • Severe Muscle Atrophy
  • Periscapular Fibrosis
  • Diffuse Osteoporosis
  • Development of Claw Hand
119
Q

Central Cord Lesion: UMN Lesion

A

Cavitation of central cord in cervical section:

  • Loss of Spinothalamic Tracts
    • Bilateral loss of pain/temperature
  • Loss of Ventral Horn
    • Bilateral loss of motor function: primarily UE
  • Preservation of proprioception and discriminatory sensation

NPTE (19 decks)

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