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Neurologic System PE > Neuro > Flashcards

Neuro Flashcards

1
Q

division of ANS that prods the body into action during times pf physiologic and psychologic stress

A

sympathetic division

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2
Q

division of ANS that functions in a complementary and a counterbalancing manner to conserve body resources and maintain day to day body functions such as digestion and elimination

A

parasympathetic division

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3
Q

Where does the brain receive 20% of total cardiac output from?

A

2 internal carotid arteries

2 vertebral arteries

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4
Q

Blood drains from the brain through ____ ___ and ___ ___ that empty in to the ___ ____ veins.

A

venous plexuses
dural sinuses
internal jugular

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5
Q

What are the 3 main units of the brain?

A

cerebrum
cerebellum
brainstem

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6
Q

Two ____ ____, each divided into lobes form the cerebrum.

A

cerebral hemispheres

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7
Q

The ____ outer layer, the ____ ____, houses the higher mental functions and is responsible for general movement, visceral functions, behavior and integration of these functions.

A

gray

cerebral cortex

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8
Q

____ _____ (corpus callousum) interconnect the counterpart areas in each hemisphere, permitting the coordination of activities between the hemispheres.

A

commissural fibers

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9
Q

What lobe contains the motor cortex associated with voluntary skeletal movement and fine repetitive motor movements, as well as the control of eye movements.

A

frontal lobe

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10
Q

What are the specific areas in the motor area associated with?

A

movement of specific parts of the body

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11
Q

What extends from the primary motor area into the spinal cord?

A

corticospinal tracts

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12
Q

What lobe is primarily responsible for processing sensory data as it is received.

A

parietal lobe

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13
Q

What lobe assists with the interpretation of tactile sensations (temp, pressure, pain, size, shape, texture, and two point discrimination) as well as visual, gustatory, olfactory, and auditory sensations?

A

parietal lobe

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14
Q

What lobe is responsible for recognition of body parts and awareness of body position (proprioception)?

A

pariteal lobe

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15
Q

What lobe has association fibers that provide communication between the sensory and motor area of the brain?

A

pariteal lobe

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16
Q

What lobe contains the primary vision center and provides interpretation of visual data?

A

occipital lobe

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17
Q

What lobe is responsible for the perception and interpretation of sounds and determination of their source?

A

temporal lobe

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18
Q

What lobe is also involved in the integration of taste, smell and balance?

A

temporal lobe

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19
Q

What is Wernicke’s areas for in the temporal lobe?

A

the reception of speech and interpretation of speech

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20
Q

What functions as the extrapyramidal pathway and processing station between the cerebral motor cortex and the upper brainstem?

A

basal ganglia system

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21
Q

What are the interconnections of the basal ganglia system (extrapyramidal pathway and processing station between cerebral motor cortex and upper brainstem) that refine motor movements?

A

within the thalamus, motor cortex, reticular formation and spinal cord

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22
Q

What part of the brain aids the motor cortex of the cerebrum in the integration of voluntary movement?

A

cerebellum

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23
Q

What part of the brain processes sensory information from the eyes, ears, touch receptors, and MSK?

A

cerebellum

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24
Q

What part of the brain is integrated with the vestibular system?

A

cerebellum

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25
Q

What does the vestibular system in the cerebellum do?

A

uses the sensory data for reflexive control of muscle tone, balance and posture to produce steady and precise movements

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26
Q

What part of the brain is the pathway between the cerebral cortex and the spinal cord that controls many involuntary functions?

A

brainstem

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27
Q

What part of the brain includes structures such as the medulla oblongata, pons, midbrain, diencephalon? ( the nuclei of the 12 cranial nerves arise from these structures)

A

brainstem

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28
Q

What is the major integrating center for perception of various sensations such as pain and temperature

A

thalamus

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29
Q

What structure also relays sensory aspects of motor information between the basal ganglia and cerebellum?

A

thalamus

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30
Q

What structure transmits information between the brainstem and the cerebellum, relaying motor information from the cerebral cortex to the contralateral cerebellar hemisphere?

A

pons

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31
Q

What is the site where the descending corticospinal tracts decussate?

A

medulla oblongata

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32
Q

How long is the spinal cord?

A

40-50 cm

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33
Q

The spinal cord begins at the ___ _____ as a continuation of the ___ ___ and terminates at __ and ___ of the vertebral column.

A

foramen magnum
medulla oblongata
L1, L2

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34
Q

What part of the spinal cord is arranged in a butterfly shape with anterior and posterior horns, contains the nerve cell bodies associated with sensory pathways and the autonomic nervous system?

A

gray matter

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35
Q

What part of the spinal cord contains the ascending and descending spinal tracts?

A

white matter

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36
Q

What structure of the brainstem’s function is respiratory, circulatory and vasomotor activities?

A

Medulla Oblongata

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37
Q

What structure of the brainstem’s function has reflexes of swallowing, coughing, vomiting, sneezing and hiccuping?

A

Medulla Oblongata

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38
Q

What structure of the brainstem’s function is the relay center for major ascending and descending spinal tracts that decussate at the pyramid?

A

Medulla Oblongata

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39
Q

What structure of the brainstem’s function has reflexes of pupillary action and eye movement?

A

Pons

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40
Q

What structure of the brainstem’s function is to control voluntary muscle action with corticospinal tract pathway

A

Pons

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41
Q

What structure of the brainstem’s function is the reflex center for the eye and head movement

A

Midbrain

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42
Q

What structure of the brainstem’s function is the auditory relay pathway?

A

Midbrain

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43
Q

What structure of the brainstem’s function relays impulses between cerebrum, cerebellum, pons and medulla?

A

Diencephalon

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44
Q

What structure of the brainstem’s converts all sensory impulses (except olfaction) to and from cerebrum

A

thalamus

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45
Q

What structure of the brainstem’s controls state of consciousness, conscious perception of sensations and abstract feelings?

A

thalamus

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46
Q

What structure of the brainstem houses the pineal body and functions for sexual development and behavior?

A

epithalamus

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47
Q

What structure of the brainstem’s is the major processing center of internal stimulation for autonomic nervous system

A

Hypothalamus

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48
Q

What structure of the brainstem maintains temp control, water metabolism, osmolarity, feeding behavior and neuroendocrine activity?

A

Hypothalamus

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49
Q

What structure of the brainstem controls hormonal growth lactation, vasoconstriction and metabolism?

A

pituitary gland

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50
Q

The ______ tract permits skilled, delicate, and purposeful movements.

A

corticospinal (pyramidal)

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51
Q

The _____ tract causes the extensor muscles of the body to suddenly contract when an individual starts to fall.

A

vestibulospinal

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52
Q

The ____ tract arises from the brainstem and innervates motor functions of the cranial nerves.

A

corticobulbar

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53
Q

nerve cell bodies within the CNS that comprise the descending pathways from brain to spinal cord to influence, direct and modify reflex arc and circuits.

A

Upper motor neurons

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54
Q

cranial and spinal neurons that originate in the anterior horn of spinal cord that extend into peripheral nervous system to signal directly to muscles to permit movement

A

Lower motor neurons

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55
Q

Injury to which motor neuron results in initial paralysis followed by partial recovery over an extended period?

A

Upper motor neurons

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56
Q

Injury to which motor neurons results in permanent paralysis?

A

Lower motor neurons

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57
Q

How many pairs of spinal nerve are there?

A

31 pairs

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58
Q

What happens to the number of cerebral neurons with age?

A

They decrease but no clinical signs because vast number of reserve neurons inhibit the appearance of signs however the velocity of conduction declines so responses take longer

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59
Q

HPI for seizures or convulsions? (10)

A 
sequence of events
character of symptoms
aura
level of consciousness
automatism (eye fluttering, lip smacking, chewing)
muscle tone
postical behavior
relationship of seizure (time of day, meals, stress, environment)
frequency of seizures
medications
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60
Q

HPI for pain (6)

A 
onset
quality and intensity
location or radiation
associated manifestations (crying, tremor)
efforts to treat; impact on life
medications
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61
Q

What are the risk factors for a stroke? (10)

A 
HTN
obesity
sedentary lifestyle
smoking
stress
increased cholesterol 
oral contraceptives
sickle cell
Family h/o
congenital
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62
Q

what is anosmia? What causes it?

A

the loss of sense of smell or an inability to discriminate odors, can be causes by trauma to the cribriform plate or by an olfactory lesion

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63
Q

What cranial nerves are BOTH sensory and motor? (4)

A

CN V Trigeminal
CN VII Facial
CN IX Glossopharyngeal
CN X Vagus

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64
Q

What cranial nerves are sensory only? (3)

A

CN I Olfactory
CN II Optic
CN VIII Acoustic

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65
Q

What cranial nerves are Motor only? (5)

A 
CN III Oculomotor
CN IV Trochlear
CN VI Abducens
CN XI Spinal Acessory
CN XII Hypoglossal
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66
Q

What does a positive Romberg indicate?

A

cerebellar ataxia, vestibular dysfunction or sensory loss

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67
Q

the expected leg is stiff and extended with plantar flexion of the foot; movement of the foot results from pelvic tilting upward on the involved side; the foot is dragged often scraping the the toe or circumducted; the affected arm remains flexed and adducted and does not swing

A

spastic hemiparesis

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68
Q

the patient uses short steps, dragging the ball of the foot across the floor, the legs are extended and the thighs tend to cross forward on each other at each step, due to injury of the pyramidal system

A

Spastic diplegia (scissoring)

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69
Q

the hip and knee are elevated excessively high to lift the plantar flexed foot off the ground the foot is brought down to the floor with a slap; pt is unable to walk on heels

A

steppage

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70
Q

The legs are kept apart and weight is shifted from side to side in a waddling motion due to weak hip aBductor muscles, the abdomen often protrudes and lordosis is common

A

Dystrophic (waddling)

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71
Q

The legs are positioned far apart, lifted high and forcibly brought down with each step; the heel stamps on the ground

A

Tabetic

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72
Q

The patients feet are wide-based; staggering and lurching from side to side is often accompanied by swaying of the trunk

A

Cerebellar gait (cerebellar ataxia)

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73
Q

The patients gait is wide based; the feet are thrown forward and outward, bringing them down first on heels, then on toes; the pt watched the ground to guide his or her steps; a positive Romberg sign is present

A

Sensory ataxia

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74
Q

The patient’s posture is stopped and the body is held rigid; steps are short and shuffling, with hesitate on starting and difficulty stopping

A

Parkinsonian gait

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75
Q

Jerky, dancing movements appear nondirectional

A

Dystonia

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76
Q

Uncontrolled falling occurs

A

Ataxia

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77
Q

The patient limits the time of weight bearing on the affected leg to limit pain

A

Antalgic limp

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78
Q

What is the inability to recognize objects by touch, what does it suggest?

A

tactile agnosia

parietal lobe lesion

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79
Q

the area of sensory loss is generally less than the anatomic distribution of nerve; lost sensation is greatest in the central portion of nerve distribution with surrounding zone of partial loss due to adjacent nerve overlap. may lose all or selected modalities of sensation

A

loss of single peripheral nerve

80
Q

the sensory loss is most severe over legs and feet or over hands (glove and stocking distribution); the change from expected to impaired sensation is gradual; usually involved all modalities of sensation

A

loss of multiple peripheral nerves (polyneuropathy)

81
Q

incomplete loss of sensation in any area of the skin usually occurs when one nerve root is affected; when two or more nerve roots are completely divided, a zone of sensory loss is surrounded by partial loss; tendon reflexes may also be lost

A

loss of multiple spinal nerve roots

82
Q

all forms of sensation are lost below the level of the lesion; pain, temperature, and touch sensations are lost one to two dermatomes below the lesion

A

complete transverse lesion of the spinal cord

83
Q

pain and temperature sensation are lost one to two dermatomes below the lesion on the opposite side of the body from the lesion; proprioceptive loss and motor paralysis occur on the lesion side of the body

A

Partial spinal sensory syndrome (Brown-Sequard Syndrome)

84
Q

hand a patient a familiar object to identify by touch and manipulation

A

Stereognosis

85
Q

What are the primary sensory functions? (5)

A 
superficial touch
superficial pain
temperature and deep pressure
vibration
position of joints
86
Q

What are the cortical sensory functions? (5)

A 
Stereognosis
two point discrimination
extinction phenomenon
Graphesthesia
Point location
87
Q

If unable to perform the cortical sensory functions what can you suspect?

A

lesion in the sensory cortex or the posterior columns of the spinal cord.

88
Q

What are the superficial tendon reflexes?

A

upper abdominal
lower abdominal
cremasteric
plantar

89
Q

What are the deep tendon reflexes?

A 
biceps
brachioradial
triceps
patellar
achilles
90
Q

What spine segment is tested with upper abdominal reflex?

A

T8, T9, T10

91
Q

What spine segment is tested with lower abdominal reflex?

A

T10, T11, T12

92
Q

What spine segment is tested with cremasteric reflex?

A

T12, L1, L2

93
Q

What spine segment is tested with plantar reflex?

A

L5, S1, S2

94
Q

What spine segment is tested with biceps tendon reflex?

A

C5 and C6

95
Q

What spine segment is tested with brachioradial tendon reflex?

A

C5 and C6

96
Q

What spine segment is tested with triceps tendon reflex?

A

C6, C7, C8

97
Q

What spine segment is tested with patellar reflex?

A

L2, L3, L4

98
Q

What spine segment is tested with Achilles reflex?

A

S1 and S2

99
Q

When might there be a diminished abdominal reflex?

A

obesity or stretched abdominal muscles after pregnancy or on the side of a corticospinal tract lesion BUT HAS LITTLE CLINICAL SIGNIFICANCE

100
Q

What SHOULD BE the response of the plantar reflex?

A

plantar flexion of all toes

101
Q

When is the Babinski sign present? What does it indicate?

A

when there is dorsiflexion of the great toe without without fanning of the other toes. Indicates pyramidal tract disease

102
Q

When testing deep tendon reflexes what might absent reflexes indicate?

A

neuropathy or lower motor neuron disorder

103
Q

When testing deep tendon reflexes what might hyperactive reflexes indicate?

A

upper motor neuron disorder

104
Q

What is the scoring of deep tendon reflexes?

A 
Grade:
0: no response
1+ : sluggish or diminished
2+ active or expected
3+ more brisk than expected
4+ brisk, hyperactive, with intermittent or transient clonus
105
Q

Which motor neuron disorder results in fasciculation’s?

A

lower motor neuron

106
Q

Which motor neuron results in paralysis of voluntary movements?

A

upper motor neuron

107
Q

Which motor neuron results in paralysis of muscles?

A

lower motor neuron

108
Q

Which motor neuron results in damage that affects muscles on the ipsilateral side of body?

A

lower motor neuron

109
Q

What motor neuron has damage above the level of brainstem affects contralateral side of body, damage below the brainstem affects the ipsilateral side of the body?

A

upper motor neuron

110
Q

Sustained (mayo)clonus is indicative of what?

A

upper motor neuron disease

111
Q

What should be used in all patents with DM and peripheral neuropathy? Why?

A

5.07 monofilament or Waardenberg wheel to test for several protective sensations on several sites of the foot

112
Q

What is a stiff neck or nuchal rigidity associated with?

A

meningitis or intracranial hemorrhage

113
Q

What are the important signs for meningitis?

A

Fever
stiff neck
altered mental status

114
Q

What is the leading cause of death and adult disability in older adults?

A

stroke

115
Q

What are lifestyle modifications that can reduce the risk for stroke?

A 
weight reduction
low fat diet
low sodium
rich in fruits and veggies
30 mins aerobic exercise
116
Q

What diminished smell and taste sensation if affected first in older adults?

A

bitter and sour taste

117
Q

How might medications impair CNS function in older adults?

A

slower reaction time
tremors(rhythmic, oscillating involuntary purposeless movements)
anxiety

118
Q

What are other common cranial nerve changes in older adults? (6)

A 
reduced ability to differentiate colors
reduced upward gaze
slower adjustment to lighting changes
decreased corneal reflex
middle to high frequency hearing loss
reduced gag reflex
119
Q

What gait changes are expected with older adults due to decrease in proprioception, speed balance?

A

shorter steps with less lifting of the feet
shuffling
arms more flexed, flexion at hips and knees

120
Q

What test can be sued for any adult thought to be at risk for falls or for people who have difficulty performing daily activities?

A

Tinetti balance and Gait Assessment Tool

Useful to monitor change over time

121
Q

a progressive disorder characterized by a combination of inflammation and degeneration of the myelin of the brains white matter leading to decreased brain mass and obstructed transmission of neural impulses.

A

Multiple Sclerosis

122
Q

____ ___ are believed to play a role in triggering MS in susceptible individuals.

A

infectious agents

123
Q

MS is ____ but unpredictable progression with or without remission. onset between _______ years of age and women affected twice as often as men

A

gradual; 20-40

124
Q

What are some of the objective findings of MS? (6)

A 
muscle weakness, ataxia
hyperactive deep tendon reflexes
paresthesias (loss of vibration sense)
intention tremor
optic neuritis
cognitive changes
125
Q

What is shown on MRI of the brain with MS?

A

brain lesions that are periventricular, ovoid and perpendicular to the ventricles; spinal cord lesions may also be found

126
Q

epilepsy is a chronic disorder characterized by recurrent, unprovoked generalized seizures secondary to underlying brain abnormality

A

seizure disorder

127
Q

The episodic abnormal electrical discharges of cerebral neurons in seizure disorder may be caused by CNS disorder, CNS structural defect or disorder that affects functions of the CNS such as…. (4)

A

Brain injury
stroke
brain tumor
hypoxic syndromes

128
Q

What is the subjective data found in seizure disorder? (6)

A 
h/o prior seizure
premonition or aura
body is stiff and rigid followed by rhythmic jerky movements
eyes roll upward
drooling
loss of bladder or bowel control
129
Q

What is the objective data found in seizure disorder?

A

tonic phase, clonic and postictal stage

130
Q

What is the tonic phase of seizure disorder?

A

brief flexion and characteristic cry with contraction of abdominal muscles followed by generalized extension for 10-15 minutes; loss of consciousness for 1-2 minutes, eyes deviated upwards with dilated pupils

131
Q

What is the clonic phase of seizure disordeR?

A

contractions alternate with muscle relaxation

132
Q

What is the postictal state of seizure disorder?

A

coma followed by confusion and lethargy

133
Q

acute inflammation of the brain and spinal cord, involving the meninges often due to a virus such as herpes simplex.

A

encephalitis

134
Q

IN encephalitis how can the virus be transmitted?

A

the bite of an arthropod or mosquito

135
Q

What is the subjective data for encephalitis?

A

mild viral illness with fever, quiet stage, followed by onset of lethargy, restlessness and mental confusion

136
Q

What is the objective data of encephalitis? (4)

A

altered mental status, confusion, stupor
photophobia
stuff neck
muscle weakness, paralysis or ataxia

137
Q

An inflammatory process in the meninges, the membrane around the brain and spinal cord

A

Meningitis

138
Q

The pathophysiology: the bacterial viral or fungal organisms colonizes int he upper respiratory tract and invades the bloodstream, crosses BBB to infect the CSF and meninges

A

Meningitis

139
Q

What is the subjective data for meningitis? (6)

A 
fever chills
headache/ stiff neck
lethargy/ malaise
vomiting
irritability
seizures
140
Q

What are the objective findings with meningitis?

A

altered mental status
nuchal rigidity
fever
brudzinski & kerning sign may be positive
petechiae and purpura with meningococcal meningitis

141
Q

What confirms the diagnosis of meningitis?

A

lumbar puncture and CSF culture

142
Q

An abnormal growth of neural or non neural tissue within the cranial cavity that may be a primary or metastatic cancer

A

intracranial tumor

143
Q

What is the pathophysiology of an intracranial tumor?

A

lesion causes displacement of tissue and pressure on CSF in circulation; function is threatened through compression and destruction of tissues

144
Q

What are the objective findings of intracranial tumors depending on the location?

A 
altered consciousness or confusion
papilledema
cranial nerve impairment
aphasia- language disorder
vision loss
gait disturbance
145
Q

What confirms the dx of intracranial tumors?

A

CT scan or MRI of brain

146
Q

the sudden interruption of blood supply to part of the brain or rupture of a blood vessel, spilling blood into spaces

A

stroke (brain attack or CVA)

147
Q

What is the most common cause of strokes?

A

ischemic strokes- when a thrombus or embolism interrupts blood supply

148
Q

What causes 15% of hemorrhagic strokes?

A

intracerebral or subarachnoid bleeding, often thin the distribution of the brain- brain cells die

149
Q

What is the subjective data associated with stroke? (5)

A

sudden numbness or weakness( mostly one side of body)
sudden confusion or trouble speaking or understanding speech
sudden trouble seeing
sudden trouble with walking, dizzy
sudden severe headache

150
Q

What is the objective data with stroke that vary based on location?

A 
elevated BP
altered level of consciousness
difficulty managing secretions
weakness or paralysis of extremities or face
aphasia- repetitive or expressive
articulation impairment
impaired horizontal gaze of hemianopia
151
Q

an autoimmune disorder of neuromuscular transmission involving the production of autoantibodies directed against the nicotinic acetylcholine receptor, leading to the destruction and inflammatory changes in the postsynaptic membranes

A

myasthenia gravis

152
Q

In Myasthenia Gravis the ______ receptor sites stop transmitting nerve impulses across the ________ junction to direct muscle contraction.

A

acetylcholine;neuromuscular

153
Q

What is the subjective data of Myasthenia gravis?

A

drooping eyelids
double vision
difficulty swallowing or speaking
fatigue worse with exercise and improves with rest
inability to work with arms raised above head
difficulty walking
symptoms worse later in the day

154
Q

What are the objective findings with myasthenia gravis?

A

ptosis that develops within 2 minutes of upward gaze
facial weakness when puffing out cheeks
hypophonia
difficulty managing secretions
respiratory compromise or failure
weakness of skeletal muscles WITHOUT reflex, sensory or coordination abnormalities

155
Q

An autoimmune mediated destruction of peripheral nerve myelin sheaths and inflammation of nerve roots that occurs following a nonspecific GI or URI infection 1-3 weeks earlier or following an immunization

A

Guillain-Barre Syndrome

156
Q

Pathophysiology: results in impaired conduction of nerve impulses between then odes of Ranvier

A

Guillain-Barre syndrome

157
Q

What is the subjective data associated with GBS?

A 
h/o of recent illness and recovery
progressive weakness-mostly legs
paresthesia
pain in the shoulder back or posterior thigh
double vision
158
Q

What are the objective findings with GBS?

A 
distal weakness usually bilateral and symmetric, and diminished reflexes in ASCENDING pattern
ataxia progressing to flaccid paralysis
bell palsy
dysphagia
respiratory distress
159
Q

Recurrent paroxysmal sharp pain that radiates into one of more branches of the fifth cranial nerve

A

Trigeminal neuralgia

160
Q

a slowly progressive, degenerative disorder in which deficiency of the dopamine neurotransmitter results in poor communication between parts of the brain that coordinate and control movement and balance

A

Parkinson Disease

161
Q

What are the factors associated with disease onset of Parkinson’s?

A 
h/o encephalitis
drug use
cerebrovascular disease
genetic
environmental
viral
vascular
162
Q

Parkinson Disease occurs most often in what patient population?

A

older than 50

163
Q

What are the subjective findings in Parkinson Disease?

A

tremors (sometimes unilateral) occur at rest and fatigue but disappear with intended movement and sleep
progressing to pill-rolling movement of fingers bilaterally and tremor of the hand
slowing of voluntary and automatic movements
numbness, aching, tingling and muscle soreness occur in many patients

164
Q

What are the objective findings in pts with Parkinson Disease?

A 
tremors
muscle rigidity
stooped posture, and instability
short steps, shuffling and freezing gait
difficulty swallowing, drooling and voice softening
slow, slurred monotonous speech
impaired cognition, dementia
165
Q

A syndrome stimulating degenerative diseases that is caused by noncommunicating hydrocephalus (dilated ventricles with intracranial pressure within expected ranged)

A

Normal Pressure Hydrocephalus

166
Q

May be due to a slightly elevated baseline CSF and intermittent increased CSF pressure waves

A

Normal Pressure Hydrocephalus

167
Q

What leads to symptoms in Normal Pressure Hydrocephalus?

A

compression of brain tissue and decreased cerebral blood flow

168
Q

What is the first symptom of Normal Pressure Hydrocephalus ?

A

gait impairment- unsteadiness and difficulty turning

169
Q

What are the other subjective findings in Normal Pressure Hydrocephalus besides gait impairment?

A

cognitive impairment

urgency frequency that progresses to incontinence over time

170
Q

What are the objective findings in Normal Pressure Hydrocephalus ?

A

wide-based stance, short, small steps and reduced floor clearance
no tremor
no sensory impairment
cognitive impairment, executive function impaired

171
Q

During recovery, damaged neurons sent out axonal links to activate fibers that has been killed by the virus; the remaining motor neurons activated way more muscle fibers than they were expected to handle, over time, the overloaded damaged neurons died causing symptoms to reoccur

A

Postpolio syndrome

172
Q

What are the objective findings in post polio syndrome?

A 
weakness
dysphagia
sleep apnea
reduced muscle strength with aging
assistive devices
173
Q

Type of tremor that is seen with arms held extended, disappears when limb is at rest, small amplitude

A

enhanced physiologic tremor

174
Q

What are possible causes of enhanced physiologic tremor?

A

drug or alcohol withdrawal
hyperthyroidism, hypoglycemia
toxicity associated with medication (TCAs, lithium, valproate)

175
Q

Type of tremor that is bilateral, symmetrical primarily seen in hands or outstretched arms; may be seen in head, trunk, voice and tongue; may worsen with stress or fatigue and improve with alcohol; progressive; no other signs and lower limbs rarely affected.

A

essential tremor

176
Q

What are the potential causes of essential tremor?

A

no consistent cerebral pathology

autosomal dominant inheritance pattern

177
Q

What tremor is seen during intentional movements (writing, finger to nose test). DO NOT occur at rest

A

intention tremor

178
Q

What are the potential causes of an essential tremor?

A

cerebellar disorders such as MS or alcohol abuse

179
Q

what type of tremor is seen when limb is at rest; slow supination and pronation (pill rolling) movements

A

resting tremor

180
Q

What Is the potential cause of resting tremor?

A

Parkinson disease

181
Q

What cranial nerves arise from the medulla oblongata?

A

CN IX, X, XI and XII

182
Q

What cranial nerves arise from the pons?

A

CN V, VI, VII, VIII

183
Q

What cranial nerves arise from the midbrain?

A

CN III and CN IV

184
Q

What cranial nerves arise from the diencephalon?

A

CN I and II

185
Q

What artery is affected in stroke with:
unilateral blindness
severe contralateral hemiplegia and hemianesthesia
profound aphasia

A

internal carotid artery

186
Q

What artery is affected in stoke with:
alternation in communication, cognition mobility and sensation
contralateral hemiplegia and hemiparesis, motor and sensory loss GREATER IN FACE AND ARM

A

middle cerebral artery

187
Q

What artery is affected with stroke with:
emotional lability
confusion, amnesia, personality changes
urinary incontinence
contralateral hemiplegia or hemiparesis in LOWER EXTREMITIES

A

Anterior cerebral artery

188
Q

What artery is affected with stroke with:
VISUAL LOSS
memory deficits
receptive aphasia

A

Posterior Cerebral Artery

189
Q

What artery is affected with stroke with:
“locked in”
SYNCOPE

A

vertebral or basilar artery

190
Q

What procedures are used for testing the lateral spinothalmic tract? (2) (lower motor)

A

superficial pain

temperature

191
Q

What procedures are used for testing the anterior spinothalmic tract? (2) (lower motor)

A

superficial touch

deep pressure

192
Q

What procedures are used for testing the posterior column of ascending tracts? (lower motor)

A 
vibration
deep pressure
position sense
stereognosis
point location
two point discrimination
193
Q

What procedure is used to test anterior and dorsal spinocerebellar? (lower motor)

A

proprioception

194
Q

What procedure is used to test the lateral and anterior corticospinal tracts? (upper motor)

A

rapid alternating movements
voluntary movement
deep tendon reflexes
plantar reflex

195
Q

What procedure is used to test medial and lateral reticulospinal tracts? (upper motor)

A

posture and Romberg
gait
instinctual motor reactions

Neurologic System PE (2 decks)

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