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NUNP 540 (Kelly's flashcards) > Neuro > Flashcards

Neuro Flashcards

1
Q

MSE (4) (ORAL)

A

Orientation
Recall
Attention
Language

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2
Q

UMN S/S

A 
Atrophy of disuse, arms flexed, legs extended.  
Stronger flexors > extensors upper 
Stronger extensors > flexors lower 
Increased/spastic tone
Coordination limited 
Reflexes 
Plantar: up (dorsi flex)
Deep: increased clonus
Superficial: absent
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3
Q

LMN S/S

A

Atrophy, fasciculations

Weak
Decreased tone
Coordination limited
Reflexes
Plantar: down (plantar flex)
Deep: decreased
Superficial: absent
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4
Q

asterixis

A

brief jerky downward mvts of the wrist when patient extends both arms with wrist dorsiflexed, palms forwards, eyes closed

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5
Q

Tics

A

non-voluntary contractions of single muscles or groups of muscles, suppressive, associated with a sense of relief

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6
Q

Myoclonus

A

sudden rapid muscle jerk, may be focal

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7
Q

athetosis

A

repetitive, involuntary, slow, sinuous, writhing, especially severe in hands

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8
Q

dystonia

A

prolonged/sustained muscle contraction

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9
Q

Tremor

A

rhythmic semi-rhythmic oscillating movements, can be fast or slow. Both against and antagonist muscles simultaneously activated. Coarse = insignificant (cold/fatigue). Fine = UMN lesion, or other

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10
Q

Chorea

A

“Dance” = fleeting random involuntary movements that affect multiple joints may be fluid or jerky and carrying in quality

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11
Q

Hemiballismus

A

Violent flinging movement of half the body

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12
Q

seizure automatisms

A

stereotyped semi-purposeful movements, repeated eye blinking, tonic or clonic motor activity

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13
Q

Location of lesion for:
Spasticity
Flaccidity
Rigidity

A 
Spasticity = UMN 
Flaccidity = LMN 
Rigidity = extrapyramidal
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14
Q

Rhyme song to recall myotomes… ‘___ pick up sticks…’

A

C5, C6 pick up sticks (biceps)
C6, 7, 8, lay them straight (triceps)
L3, L4, kick the door (quad)
S1, S2, buckle my shoe (ankle plantar flexion)

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15
Q

What are the 4 lobes of the cerebral cortex and what do they control

A 
•	Frontal 
Personality, behaviour, emotion 
Broca’s – motor speech 
Precentral gyrus 
(primary motor)

• Parietal
Sensation
Postcentral gyrus (primary sensory)

• Temporal
Hearing taste smell
Wernicke’s

• Occipital
Visual

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16
Q

Function of cerebellum

A
  • Motor coordination
  • Equilibrium
  • Balance
  • Voluntary movement and muscle tone
  • Does not initiate movement, but coordinates and smooths it
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17
Q

What does the extrapyramidal system control? What are the structures (general)?

A
  • Basal ganglia
  • Subcortical motor system
  • Brain stem and spinal cord
  • All movement outside of pyramids
  • Gross automatic movements like: arm swinging, walking
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18
Q

What does the thalamus do?

A

relay station

19
Q

Hypothalamus neuro function?

A
  • Temperature, HR, BP, sleep
  • Pituitary gland
  • Coordinates ANS and emotional status
20
Q

What are the components of the brainstem?

A
  • Midbrain: most anterior of the brain stem, merges into thalamus hypothalamus
  • Pons: enlarged area containing ascending and descending fibre tracts
  • Medulla: continuation of spinal cord. CN XIII to XII. Pyramidal decussation.
21
Q

What does the posterior (dorsal) column transmit?

A

vibration
fine touch (stereognosis)
proprioception (position)

22
Q

What does the spinothalamic tract do? lateral vs anterior

A
  • Pain and temperature – lateral thalamic tract

* Crude touch – anterior spinothalamic tract

23
Q

What are the UMN?

A

corticospinal, corticobulbar, extra pyramidal tracts. (MS, CVA)

24
Q

What are the LMN?

A

PNS, cell body in grey matter of spinal cord then extends to muscle (ALS, polio)

25
Q

DTR has 5 components to function. What are they?

A 
Afferent limb
Efferent limb
Synapse in the cord
Neuromuscular junction
Competent muscle
26
Q

Where do CN I and II originate form?

A

cerebrum

27
Q

Where do CN III to XII originate from?

A

diencephalon and brainstem

28
Q

Movement disorders (8)

A
  • Paralysis
  • Fasciculations
  • Tic
  • Myoclonus
  • Intention tremor
  • Rest tremor
  • Chorea: sudden, rapid, jerky, purposeless
  • Athetosis: slow, twisting, writhing, continuous movement resembling a snake
29
Q

Spastic hemiparesis gait

A

o arm stuck, leg extended, circumducts to walk

o UML, CVA, trauma

30
Q

cerebellar ataxia gait

A

o Wide-based gait, staggering.
o Positive Romberg sign
o ETOH, cerebellar tumour, MS

31
Q

parkinsonian (festinating) gait

A

o Stooped posture, trunk pitched forwards
o Short shuffling steps
o Hesitates to initiate walking and has difficulty stopping

32
Q

scissors gait

A

o Knees crossed, or are in contact

o MS

33
Q

steppage or foot drop

A

o Slapping quality
o Weakness of tibia, LMN lesions
o Charcot, Polio

34
Q

waddling gait

A

o Weak hips

o Muscular dystrophy, hip dislocation

35
Q

short leg gait

A

o Discrepancy > 2.5 cm

o Congenital dislocated hip

36
Q

What is cerebral palsy?

A
  • Mixed group of neuromotor disorders of infancy and childhood
  • Results from damage to cerebral cortex caused by a developmental defect
37
Q

What is muscular dystrophy?

A
  • Chronic progressive wasting of skeletal musculature

* Duchenne’s

38
Q

What is hemiplegia?

A
  • Damage to corticospinal tract, above pyramids, UML, contralateral
  • CVA
39
Q

Parkinsonism

A
  • EPS tract defect in the Basal Ganglia
  • Loss of dopamine
  • Triad: tremor, rigidity, akinesia
  • Slow monotonous speech, diminutive writing, flat affect, excessive saliva, less eyelid blinking
40
Q

Paraplegia

A
  • LMN damage

* First DTR absent, then reappear gradually, then spastic  prevailing extensor tone

41
Q

What sensory loss does spinal cord hemisection (brown squared) result in?

A
  • Loss of pain and temperature sensation on the contralateral side, starting one to two segments below the level of the lesion
  • Loss of vibration sensation and positive discrimination on the ipsilateral side below the level of the lesion
  • Meningioma, neurofibroma, MS, cervical spondylitis
42
Q

What loss of function does thalamus or cortex lesion result in?

A
  • ALL modalities, contralateral side, head to toe
  • Vascular occlusion
  • Cortex: also loss of graphesthesia, stereognosis, recognition of shapes and weights, finger finding…
43
Q

Speech disorders:
Dysphonia
Dysarthria
Aphasia

A

Dysphonia – hoarse/whisper
Dysarthria – distorted, poor articulation
Aphasia – defect in comprehension
- Global – spontaneous speech absent or reduced to stereotypical words
- Broca’s – expressive – speech mostly nouns and verbs – word searching. Auditory and reading intact.
- Wernicke’s – receptive aphasia

NUNP 540 (Kelly's flashcards) (10 decks)

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