Neuro Flashcards
1
Q
Loss of voice that accompanies disease affecting the larynx or its nerve supply
A
Aphonia
2
Q
Impairment in the volume, quality or pitch of the voice. Example- hoarse or only speak in a whisper. Caused by laryngitis, tumors, unilateral cord paralysis (CN X)
A
Dysphonia
3
Q
Defect in the muscular control of the speech apparatus (lips,, tongue, palate, pharynx). Worse may be nasal, slurred, or indistinct but central symbolic aspect of language remains intact. Causes include motor lesions of CNS or PNS, parkinsonism, cerebellar disease.
A
Dysarthria
4
Q
Disorder in producing or understanding language. Often caused by lesion in the dominant cerebral hemisphere (left)
A
Aphasia
5
Q
In which type of aphasia is speech fluent, rapid, effortless but sentences lack meaning and words are malformed or inverted.
A
Wernicke’s Aphasia
6
Q
In which type of aphasia is word comprehension good, and reading comprehension fair to good?
A
Broca’s aphasia
7
Q
In which type of aphasia are word and reading comprehension, repetition, naming, and writing all impaired?
A
Wernicke’s aphasia
8
Q
IN which type of aphasia is speech nonfluent, slow and laborious. Words are meaningful with nouns and transitive verbs with important adverbs.
A
Broca’s aphasia
9
Q
What type aphasia is there a lesion in the posterior superior temporal lobe?
A
Wernicke’s
10
Q
In which type aphasia is there a lesion in the posterior inferior frontal lobe?
A
Broca’s
11
Q
This type of disorder is characterized by distrust and suspiciousness.
A
Paranoid
12
Q
Characterized by Detachment from social relations with a restricted emotional range
A
Schizoid
13
Q
Eccentricities in behavior and cognitive distortions; acute discomfort in close relationships
A
Schizotypal
14
Q
Disregard for the law and rights of others; a defect in the experience of compunction or remorse for harming others
A
Antisocial
15
Q
Instability in interpersonal relationships, self-image and affective regulation; impulsivity
A
Borderline
16
Q
Emotional overreactivity, theatrical behavior, and seductiveness; attention-seeking behavior
A
HIstrionic
17
Q
Persisting grandiosity, need for admiration and lack of empathy for others
A
Narcissistic
18
Q
Social inhibition, feelings of inadequacy and hypersensitivity to negative evaluation
A
Avoidant
19
Q
Submissive and clinging behavior; psychological dependence on others
A
Dependent
20
Q
Rigid, detail-oriented behavior, often associated w/ compulsions to perform tasks repetitively and unnecessarily and rigid conformity to rules
A
Obsessive-compulsive
21
Q
Speech characterized by indirection and delay in reaching the point because of unnecessary detail. Occurs in people with obsessions.
A
Circumstantiality
22
Q
Speech in which a person shifts from one subject to others w/o realizing the subjects aren’t meaningfully connects. Seen in schizophrenia, manic episodes,
A
Derailment (loosening of associations)
23
Q
An almost continuous flow of accelerated speech in which a person changes abruptly from topic to topic. Changes are usually based on understandable associations and play on words but ideas don’t produce a sensible conversations. Most often seen in manic episodes
A
Flight of ideas
24
Q
Invented or distorted words, or words w/ new and highly idiosyncratic meanings. Often seen in schizophrenia, psychotic disorders, aphasia
A
Neologisms
25
Speech that is largely incomprehensible because of illogic, lack of meaningful connections, abrupt changes in topic, disordered grammar or word use. Seen in severe psychotic disturbances (usually schizophrenia)
Incoherence
26
Sudden interruption of speech in mid sentence or before completion of an idea. Person attributes this to losing the though. Also occurs in normal people, but may be striking in schizophrenia.
Blocking
27
Fabrication of facts or events in response to questions to fill in the gaps of invalid memory. Often seen in Korsakoff's syndrome from alcoholism.
Confabulation
28
Persistent repetition or words or ideas. Seen in schizophrenia and other psychotic disorders
Preseveration
29
Repetition of the words and phrases of others. Occurs in manic episodes and schizophrenia
Echolalia
30
Speech in which a person chooses a word on the basis of sound rather than meaning, as in rhyming and punning speech. Seen in schizophrenia and manic episodes
Clanging
31
Repetitive behaviors or mental acts that a person feels driven to perform in order to produce or prevent some future state of affairs, although such expectations are unrealistic.
Compulsions
32
Recurrent, uncontrollable thoughts, images, or impulses that a person considers unacceptable and alien. Intrusive thoughts.
Obsessions
33
Persistent, irrational fears, accompanied by a compelling desire to avoid that stimulus.
Phobias
34
Apprehensions, fears, tensions or uneasiness that may be focused (phobia) or free-floating ( a general sense of ill-defined dread or impending doom)
Anxieties
35
A sense that one's self is different, changed or unreal or has lost identity or become detached from one's mind or body.
Feelings of Depersonalization
36
False, fixed personal beliefs that are not shared by other members of the person's culture.
Delusions
37
Misinterpretations of a real external stimuli. Seen in greif, PTSD< schizophrenia, delirium
Illusions
38
Subjective sensory perceptions in the absence of relevant external stimuli.
Hallucinations
39
3 tests for attention
Digit Span
Serial 7s
Spelling Backwards
40
Memory about birthdays, anniversaries, social security number, names of schools attended, historical events.
Remote Memory
41
Events of the day (weather, appointment time, medications)
Recent memory
42
A delusion where people are getting thoughts from other sources- television, PC, etc.
Delusions of reference
43
People keep adding on symptoms and have a very elaborate amount of symptoms.
systematized delusions
44
What are the 3 "d's" to screen for?
Delirium
Depression
Dementia
45
Cranial Never for lateral deviation of the eye.
CN VI Abducens
46
CN for downward, internal rotation of the eye.
Trochlear, IV
47
CN for facial movements and taste on anterior 2/3 of tongue.
Facial VII
48
CN for temporal, masseter, lateral pterygoids movements and sensory from face.
Trigeminal, V
49
CN for hearing and balance
VIII, Acoustic (vestibulocochlear)
50
CN for motor of parynx, sensory from posterior parts of earn and ear drum, pharynx, posterior taste of tongue
IX, Glossopharyngeal
51
CN for motor of the palate, pharynx, larynx. Sensory from pharynx and larynx
X, Vagus
52
CN for movement of SCM, upper part of trapezius
XI, Spinal accessory
53
CN for movement of the tongue
XII, Hypoglossal
54
CN for vision, ocular fundi
II, Optic
55
CN for pupillary constriction, opening of the eye, EOM
III, Oculomotor
56
CN for sense of smell
I, Olfactory
57
What cranial nerves are involved in pupillary reactions?
II, III (optic, oculomotor)
58
WHat CN are involved in EOMs?
III, IV, VI (Oculomotor, trochlear, abducens)
59
What CN are involved in voice and speech?
V, VII, X, XII (Trigeminal, Facial, Vagus, Hypoglossal)
60
What CN are involved in swallowing and risk of the palate, gag reflex
CN IX, X (glossopharyngeal, Vagus)
61
In what condition will the eyes not close and forehead not wrinkle on the affected side.
Peripheral lesion of facial nerve i.e. Bell's Palsy
62
In what condition will the forehead wrinkle but there is paralysis of the lower face?
Central lesion involving UPN between cortex and pons
63
What is the rhythmic oscillation of the eyes, analogous to a tremor ins other parts of the body?
Nystagmus
64
What are some causes of nystagmus?
Impairment of vision early in life
Disorders of the labyrinth and cerebellar system
Drug toxicity
65
When does nystagmus occur normally?
When a person watching a rapidly moving object (ex- passing train)
66
What tract mediates voluntary movement, and integrates skilled, complicated or delicate movements. Also carry impulses that inhibit muscle tone.
Corticospinal (pyramidal) tract
67
What are tracts that synapse in the brainstem with motor nuclei of the cranial nerves called?
Corticobulbar
68
What is a system that helps maintain muscle tone and control body movements, especially gross automatic movements such as walking?
Basal ganglia system
69
This system maintains equilibrium, helps to control posture.
Cerebellar system
70
Ankle reflex stimulates what?
Sacral 1
71
Knee reflex stimulates...
Lumbar 2,3,4
72
Supinator (brachioradialis) reflex stimulates
Cervical 5,6
73
Biceps reflex stimulates
cervical 5,6
74
Triceps reflex stimulates
cervical 6,7
75
What is the rhythmic oscillations b/w flexion and extension . Is normal if there is less than 5.
Clonus
76
What is a DTR classified as very brisk, hyperactive with clonus.
4+
77
What is the DTR classified as average, normal?
2+
78
What is a DTR that is somewhat diminished, a low normal?
1+
79
What is a DTR that is brisker than average. Possibly indicative of disease.
3+
80
What are fine flickering irregular movements in small groups of muscle fibers?
Fasciculations
81
Muscle strength is graded on a ___ to ___ scale.
0 to 5
82
What is the grade for an active movement of the body part with gravity eliminated?
2
83
What is the grade for a barely detectable flicker or trace of contraction?
1
84
What is the grade for active movement against full resistance without evident fatigue. Normal
5
85
What is the rating for active movement against gravity.
3
86
What is the rating for active movement against gravity and some resistance.
4
87
What type lesion is spasticity associated with?
Upper motor neuron or corticospinal tract system
88
With spasticity there is _______ that is rate dependent.
Hypertonia
89
With spasticity during rapid passive movement, initial hypertonia may give way suddenly as the limb relaxes. This catch and relaxation is know as....
Clasp-knife resistance
90
Rigidity is due to a lesion where?
Basal ganglia system
91
WIth rigidity there is increased resistance that persists throughout the movement arch, independent of rate of movement. This is know as what?
Lead- pipe rigidity
92
With rigidity there is a superimposed racketlike jerkiness with flexion and extension called....
Cogwheel rigidity
93
What is a common cause of rigidity?
Parkinsonism
94
Flaccidity is associated with a lesion where?
Lowe motor neuron system. ANy point from the anterior horn cell to the peripheral nerves
95
Flacidity is associated with loss of muscle tone causing the limb to be loose or floppy. This is called....
hypotonia
96
In flacidity, the limbs affected may be _____ or ever flail-like.
hyperextensible
97
What is a common cause of flacidity?
Guillain-Barre syndrome. Initial phase of spinal cord injury
98
With paratonia, where is the lesion?
Both hemispheres, usually frontal lobes
99
What is associated with sudden change in tone with passive range of motion?
Paratonia
100
What is a sudden loss of tone that increases the ease of motion in paratonia?
Mitgehen
101
In paratonia, a sudden increase in tone making motion more difficult is called what?
Gegenhalten (holding against)
102
What is a common cause of paratonia?
Dementia
103
This gait abnormality is seen in corticospinal tract lesion and causes the affected arm to be flexed, immobile and held to the side. The affected leg extensors are spastic. Patient may drag toe, circle leg stiffly outward and forward or lean towards contralateral side during walk.
Spastic hemiparesis
104
This gait abnormality is seen in spinal cord disease and causes bilateral lower extremity spasticity. Gait is stiff, steps are short. Thighs tend to cross forward on each other. Often with cerebral palsy.
Scissors Gait
105
This gait abnormality is usually secondary to peripheral motor disease. Seen in foot drop- patients drag their feet or lift them high with knees flexed and bring them down with a thud.
Steppage Gait
106
This gait abnormality is seen in basal-ganglia defects. Posture is stooped with flexion fo heads, arm, hips knees. Patients are slow initiating movement, there is festination and retropulsion.
Parkinsonian gait
107
In this abnormality, gait is staggering, unsteady, wide based. Patients can't stand steadily with feet together. There is also dysmetria, nystagmus, intention tremor.
Cerebellar ataxia
108
This abnormality is seen in loss of position sense in the legs, gait is unsteady and wide based, patients throw their feet forward and outward then bring them down with a double tapping sound. Watch ground for guidance when walking. Positive Rhomberg.
Sensory ataxia
109
This is an abnormal posture seen in comatose patients. Upper arms are flexed tight to the sides with joints flexed. Legs are extended and internally rotated. Feet are plant flexed. Implies a destructive lesion of the corticospinal tracts within or near cerebral hemispheres.
Decorticate rigidity (abnormal flexor response)
110
In this abnormal posture seen in comatose patients, jaw is clenched, neck is extended. Arms are adducted and stiffly extended at the elbows. Forearms pronated, wrists and fingers flexed. Legs are extended, feet are planter flexed. Caused by a lesion in the midbrain, pons, or metabolic disorder.
Decerebrate rigidity (abnormal extensor resposne)
111
What is the tests where the patient stands for 30 sec with both arms extended forward with palms up and eyes closed. The examiner taps the arms briskly.
Pronator Drift
112
This type of vertigo is sudden, on rolling onto affected side or tilting head up. and lasts a few second to less than a minute. Sometimes naseau, vomiting, nystagmus accompany it.
Benign positional vertigo
113
This type of vertigo is sudden and can lasts hours up to 2 weeks. Also have N/V, nystagmus
Vestibular neuronitis (acute labyrinthitis)
114
This type of vertigo has a sudden onset and can last several hours or equal to one day. There is sensorineural hearing loss, loss recurs and eventually progresses. Tinnitus is present and there may be pressure or fullness in the affected ear along with N/V, nystagmus.
Meniere's Disease
115
This type of vertigo is insidious from CN VIII compression of the vestibular branch. Variable course, hear is impaired on one side. May also involve CN V and VII.
Acoustic Neuroma
116
If an individual can't feel light touch, what 2 locations could the lesion be?
Spinothalamic tracts and posterior columns
117
If an individual can't feel pain, where is the lesion?
Spinothalamic tracts
118
If a person can't determine vibration and proprioception, where is the lesion?
Posterior columns
119
If a person can't determine the where one or two points is touching their skin (discrimination) where is the lesion?
Spinothalamic tracts
Posterior columns
Cortex
120
What are two signs that can determine meningeal irritation?
Brudzinski's
| Kernig's
121
If this sign is positive, when the neck is flexed the hips and knees will also flex.
Brudzinski's Sign
122
If this sign is positive, when the patient's leg is flexed at both the hip and the knee, when extended there is pain and increased resistance.
Kernig's Sign
123
In this test, the patient is supine and the leg is lifted and ankle is flipped. If the person has radiculopathy this will reproduce the pain.
Straight leg raise
124
In this test, when the opposite leg is raised the pain on the affected side is reproduced.
Crossed straight leg raise
125
This helps to identify metabolic encephalopathy. When patient puts their hand up as if to signal "stop" there is sudden, brief, nonrhythmic flexion of the hands and fingers. This is seen in liver disease, uremia, and hypercapnia.
Asterixis
126
This is caused by weakened shoulder muscles (especially serratus anterior) and is seen in muscular dystrophy or injury to the long thoracic nerve.
Winging of the scapula
127
For this LOC you apply repeated painful stimuli to wake the patient.
Coma
128
In this LOC you apply a painful stimulus (ex- pinch a tendon, rub the sternum) to wake the patient.
Stupor
129
In this LOC you shake the patient gently as if awakening a sleeper to have the patient come to.
Obtundation
130
In this LOC you speak to the patient in a loud voice to awake the patient.
Lethargy
131
In this LOC you speak to the patient in a normal tone of voice and the patient will respond.
Arousal
132
This type patient appears drowsy but opens their eyes to respond then falls back asleep.
Lethargic patient
133
This type patient opens their eyes and looks at you but responds slowly and is somewhat confused. Alertness and interest in the environment are decreased.
Obtunded patient
134
This patient arouses from sleep only after painful stimuli. Verbal responses are slow or even absent. When stimuli ceases, the patient lapses into an unresponsive sate.
Stuporous patient
135
This patient remains unarousable with eyes closed. No evident response to inner need or external stimuli.
Comatose patient.
136
This reflex helps to asses brainstem function in a comatose patient.
Oculocephalic reflex (doll's eye movements)
137
If there is contralateral leg weakness, where is the stroke?
Anterior circulation (Anterior cerebral artery)
138
If there is contralateral face, arm > leg weakness, sensory loss, field cut, aphasia where is the stroke?
Anterior circulation- middle cerebral artery (MCA)
139
If there is contralateral motor or sensory deficit without cortical signs where is the stroke?
Subcortical circulation- lenticulostriate deep penetrating branches of MCA
140
If there is a contralateral field cut where is the stroke?
Posterior circulation- posterior cerebral artery (PCA)
141
If there is dysphagia, dysarthria, tongue/palate deviation and/or with crossed sensory/motor defects where is the stroke?
Posterior circulation- brainstem, vertebral, basilar artery branches
142
If there are oculomotor deficit and/or ataxia with crossed sensory/motor defects where is the stroke?
Posterior circulation- basilar artery
143
If an individual has "locked-in" syndrome with intact consciousness but with inability to speak and quadriplegia where is the stroke?
Complete basilar artery occlusion
144
Define the vertigo: Sudden onset; lasts a few weeks and may recur, hearing is not affected, tinnitus is absent, possible N/V and nystagmus
Vestibular neuronitis (acute labyrinth itis)
145
Define the vertigo: insidious onset due to compression of CN VIII; variable duration; hearing is impaired on one side; tinnitus is present; involves CN V and VII
Acoustic Neuroma
146
Define the vertigo: Sudden onset, recurrent course, sensorineural hearing loss; tinnitus is present and fluctuating, pressure or fullness of affected ear; N/V, nystagmus
Meniere's Disease
147
Define the syncope: Stressful situation, symbolic expression of an unacceptable idea through body language, hysterical personality traits, slump to the floor
hysterical fainting from conversion reaction
148
Define the syncope: sudden peripheral vasodilation w/o compensatory rise in CO; strong emotion; standing; fatigue/hunger, prompt return of consciousness
vasodepressor or vasovagal syncope
149
Define the syncope: constriction of cerebral blood vessels; hyperventilation; anxiety; dyspnea, palpitation, numbness of hands; slow improvement; any position
hypocapnia due to hyperventilation
150
Define the syncope: insufficient glucose; insulin therapy or metabolic disorders; tremor, hunger, HA, confusion, abnormal behavior; any position
Hypoglycemia
151
Define the seizure: tonic/clonic movements; start unilaterally in hand/foot/face, spread to other body parts on same side; normal consciousness in postictal state
Jacksonian
152
Define the seizure: brief lapse in consciousness with blinking, staring, or lip/hand movements; Postictal- no aura
absence seizure
153
What is the time frame in a typical absence seizure?
< 10 seconds
154
What is the time frame in an atypical absence seizure?
>10 seconds
155
What is the difference between petit mal absence and atypical absence?
petit mal= prompt return to normal consciousness
| atypical= some postictal confusion
156
Define the seizure: sudden loss of consciousness; body stiffens; breathing stops (cyanosis); rhythmic muscle contractions follow; injury, tongue biting, and urinary incontinence occur; following seizure: confusion/drowsiness/fatigue/HA; amnesia and no aura
Tonic Clonic seizure
157
Define the tremor:
absent at rest
appear with movement
Intention Tremors
158
What diseases intention tremors associated with?
disorders of cerebellar pathways (Multiple Sclerosis)
159
Define tremor:
| occur when actively maintaining a posture
Postural tremor
160
What diseases Postural tremor associated with?
hyperthyroidism
anxiety, fatigue
benign essential tremor
161
Define tremor:
at rest
decrease/disappear with voluntary movement
Resting (Static) tremor
162
What is the main disease associated with Resting tremor?
Parkinson's
163
T/F: In oral-facial dysinesias, the limbs and trunk are involved.
False
164
What is a common cause of athetosis?
cerebral palsy
165
What are 2 common causes of chorea?
Sydenham's chorea (with rheumatic fever)
| Huntington's disease
