Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clin Med III Exam 3 (🐈, 👵🏼, 🌭) > Neuro A&P (Lauren's Part slide 68-132 🌭) > Flashcards

Neuro A&P (Lauren's Part slide 68-132 🌭) Flashcards

1
Q

Where is the lesion:
aphasia

Neglect (can’t attend to one side of body)

Hemianopia

UMN hemiparesis

Hemisensory of face and arm vs the leg

A

Cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Where is the lesion:

Dense hemiplegia (face, arm, and leg all equally affected)

Abnormal movements (chorea, ball is, tremor, cogwheeling)

A

Subcortical structures: Internal Capsule and Basal Ganglia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Where is the lesion:

Truncal ataxia and dysmetria

A

Midline cerebellum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Where is the lesion:

Limb ataxia and dysmetria

A

Hemisphere of cerebellum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Where is the lesion:

Ipsilateral CN palsies

Contralateral body deficits

“Crossed signs”

A

Brainstem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Where is the lesion:

Paraparesis

Bowel and Bladder involvement (rectal tone)**

Sensory level

Saddle anesthesia

A

spinal cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Your patient has bilateral lower extremity weakness and bowel and bladder tone loss. What do you need to do immediately?

A

Give dexamethasone.

Cauda equina syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

If the test question says “Fasciculations” what is the answer

A

Lower motor neuron

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Do lower motor neurons have any sensory function?

A

NO. Motor control only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Where is the lesion:

Fasciculation

No sensory involvement

A

Lower motor neuron

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are fasciculations?

A

Wiggly tongue

Wiggly things under the skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Do peripheral nerves have motor and sensory?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Where is the lesion:

Stocking glove weakness and sensory loss

Diminished reflexes

A

Peripheral nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is fatigability ?

A

Your muscles perform the task at first just fine, but they get tired right away if you keep doing it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

If you start brushing your teeth but you cant finish because your muscles are too tired, what is that called?

A

Fatigability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

If you see “Fatigability” in a test quesstion, what is the answer?

A

NMJ (neuromuscular junction)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Where is the lesion:

Fatigability

No sensory involvement

Normal DTRs

A

NMJ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Where is the lesion:

Proximal weakness

Symmetric

No sensory involvemnt

A

Muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the “setting” of a patient’s presentation?

A

Patient’s age and race

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the “time course” of a patient’s presentation?

A

The onset and course

Ex: acute, subacute, chronic, progressive, stepwise, stable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Once you localize the lesion, you need to do VITAMIN CDE to come up with a list of differentials for what could have caused the lesion.

What does VITAMIN CDE stand for?

A

Vascular

Inflammatory

Trauma

Autoimmune

Metabolic

Infectious

Neoplastic

Congenital

Drugs

Epilepsy/seizures

(You would come up with Vascular things that could have caused a lesion. Then come up with Inflammatory things that could have caused it, etc)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the steps of a neurological examination?

A

Mental status (alert, coma, etc)

Neck/spine

Cranial nerves

Motor exam

Sensory exam

Reflexes

Coordination

Station and gait

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Instead of describing your patient’s level of arousal as “stuporous” or “obtunded” etc, what should you do instead?

A

Just describe them.

“The patient opens eyes and turns to voice but is mute and obeys no verbal commands”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are you looking for on the neck/spine part of the neuro exam?

A

Inspection

Auscultation

Nuchal rigidity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are all the cranial nerves in order?

I forgot too

A

I. Olfactory

II. Optic

III. Oculomotor

IV. Trochlear

V. Trigeminal

VI. Abducens

VII. Facial

VIII. Vestibulocochlear

IX. Glossopharyngeal

X. Vagus

XI. Spinal accessory

XII. Hypoglossal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is your favorite mnemonic to remember the cranial nerves in order. Here is mine

A

Oh Oh Oh To Touch And Feel Virgin Girls’ Vaginas And Hymens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What do you do to test cranial nerve II (Optic)

A

Visual acuity (just ask them to look at the clock or a Kleenex box)

Color vision (especially RED DESATURATION)

Visual fields

Fundoscopic exam

Pupils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is red desaturation?

A

If someone is going to lose their color vision, red is going to be the color that usually is lost first.

She suggests you carry around a pen with a red cap and ask them if it looks more red in one eye vs the other

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the fancy name for tunnel vision (losing peripheral vision)

A

Bitemporal hemianopia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What causes bitemporal hemianopia?

A

Pituitary adenoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

If someone has increased ICP, what will you see when you do a fundoscopic exam?

A

Papilledema

Emergency! Their brainstem could herniate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

When you are doing the pupillary reflex, which cranial nerve receives the info from the light, and which one constricts the pupils?

A

Sees the light: CN II

Constricts the pupil: CN III

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

If you shine a light in someone’s left eye, and both pupils constrict, what can you assume about their cranial nerves?

A

Left CN II is intact

Right AND Left CN III are intact

(Normal response)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

If you shine a light in someone’s Right eye, and neither pupil constricts, what can you assume about their cranial nerves?

A

Right CN II doesnt work

can’t say anything about CN III on either side

(In on II, out on III)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

If someone has complete paralysis of their eyes and numbness on the top and middle part of their face, what is the problem

A

Something is wrong in the CAVERNOUS SINUS ***

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What does CN V do?

A

Sensation to face

Muscles of mastication

Sensory limb of the corneal reflex (feeling the Q tip on the cornea)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

When you do the corneal reflex test (touching their eyeball with a Q tip to see if they blink), which cranial nerves are you testing?

A

CN V: detects the Q tip

CN VII: blinks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Which cranial nerve closes your eyes

A

CN VII

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What cranial nerve keeps the eyelids open

A

CN III

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Which cranial nerve is damaged if you have PTOSIS (lack of eyelid opening)

A

CN III

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What cranial nerve is damaged if you can not close your eyelids

A

CN VII

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is the vestibulo-ocular reflex?

A

Head rotates to right, eyes move to the left

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Which cranial nerves are tested in the vestibulo-ocular reflex?

A

CN VIII (detects the Head movement)

CN VI and III move the eyes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What cranial nerves are tested with the gag reflex?

A

CN IX

CN X

(In on 9 out on 10)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

You’re doing the vestibulo-ocular reflex test and you turn the patients head to the right, and his eyes follow.

Abnormal or normal?

A

Abnormal

BRAINSTEM DAMAGE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

How do you test CN XI?

A

Sternocleidomastoid (head turning)

Trapezius (shoulder shrug)

47
Q

If CN XII is damaged on the RIGHT, which side will your tongue deviate towards when you stick out your tongues

A

To the RIGHT

“LICK YOUR WOUNDS”

48
Q

Which one is velocity dependent:

spasticity or rigidity

A

Spasticity

49
Q

If someone has spasticity, where is the lesion?

A

UMN lesion

50
Q

If someone has rigidity, where is the lesion?

A

Basal ganglia

I think thats what slide 95 means

51
Q

When doing strength testing, do you start distally or proximally

A

Proximal

52
Q

Which nerve roots:

Biceps reflex

A

C5, C6

53
Q

Which nerve root:

Brachioradialis reflex

A

C6

54
Q

Which nerve root:

Triceps reflex

A

C7

55
Q

Which nerve root:

Patellar reflex

A

L4

56
Q

Which nerve root:

Achilles’ tendon reflex

A

S1

57
Q

Where is the lesion:

POSITIVE babinski sign

A

UMN

58
Q

What is a positive babinski sign?

A

When you stroke the bottom of their foot their big toe point up

59
Q

When you do the sensory exam, do you start distally or proximally?

A

Distal to proximal

60
Q

What is dysmetria?

A

Inability to judge distance. Causes you to overshoot/undershoot when you do finger to nose test

61
Q

What tests can you do to test coordination?

A

Finger to nose

Heel-knee-heel

Thumb tapping/ Toe tapping

Rapid alternating movements

62
Q

Upper Motor Neuron or Lower motor neuron:

Spastic weakness

A

Upper motor neuron

63
Q

Upper Motor Neuron or Lower motor neuron:

Hyper-reflexia

A

Upper motor neuron

64
Q

Upper Motor Neuron or Lower motor neuron:

(+) Babinski

A

Upper Motor Neuron

65
Q

Upper Motor Neuron or Lower motor neuron:

Flaccid weakness

A

Lower

66
Q

Upper Motor Neuron or Lower motor neuron:

Hypo-reflexia

A

Lower

67
Q

Upper Motor Neuron or Lower motor neuron:

Atrophy

A

Lower

68
Q

Upper Motor Neuron or Lower motor neuron:

Fasciculations

A

Lower

69
Q

Where is the lesion:

Face and arm are affected more than the leg

A

In the cortex, supplied by the Middle Cerebral Artery

70
Q

Where is the lesion:

Leg is affected more than arm/face

A

In the cortex, supplied by the anterior cerebral artery

71
Q

Where is the lesion:

Aphasia (cant talk)

A

Cortex

72
Q

Where is the lesion:

Apraxia (can’t plan movements. Putting on a jacket or using scissors is hard)

A

Cortex

73
Q

Where is the lesion:

Agnosia (unaware of deficits, unable to process sensory information)

A

Cortex

74
Q

Where is the lesion:

DENSE unilateral motor or sensory deficit

A

Subcortical

75
Q

Where is the lesion:

Face/arm and leg are equally affected

A

Subcortical

76
Q

Where is the lesion:

Movement disorders

A

Subcortical

77
Q

Aphasia

A

Cortex

⭐️⭐️⭐️⭐️

78
Q

Neglect

A

Cortex

⭐️⭐️⭐️⭐️

79
Q

Dense hemiplegia

A

Subcortical structures: internal capsule and basal ganglia

80
Q

Chorea, Ballism, Tremor, Cogwheeling

A

Subcortical structures: Internal capsule and basal ganglia

81
Q

Face/arm affected separately from leg

A

Cortex

82
Q

Face/arm and leg equally affected

A

Subcortical structures: internal capsule and basal ganglia

83
Q

Truncal vs limb ataxia and dysmetria

A

Cerebellum

⭐️⭐️⭐️⭐️

84
Q

Cranial nerve palsies

A

Brainstem

85
Q

“Crossed signs”

A

Brainstem

86
Q

Bilateral leg involvement

A

Spinal cord

87
Q

Bladder and bowel involvement

A

Spinal cord

88
Q

Saddle anesthesia

A

Spinal cord

89
Q

Sensory level

A

Spinal cord

90
Q

Fasciculations

A

Motor neuron

⭐️⭐️⭐️⭐️

91
Q

Distal weakness and sensory involvement in a stocking glove distribution

A

peripheral nerve

92
Q

Areflexia or hyporeflexia

A

Peripheral nerve

93
Q

Fatigability

A

NMJ

⭐️⭐️⭐️⭐️

94
Q

Proximal weakness

A

Muscle

95
Q

74 yr old male with vascular risk factors was brought into the ED with a sudden inability to speak and right sided weakness.

where is the lesion?

What is the setting?

What is the pathologic course?

A

Where: Left cortex (aphasia)

Setting: 74 yr old adult with vascular risk factors

Pathologic course: sudden

96
Q

If you have a lesion in the RIGHT FRONTAL eye field, which way will your eyes look?

A

RIGHT

“Look at your lesion”

97
Q

A 74 yr old male rolls in with sudden onset left sided weakness involving the face and arm. Language is preserved. He has a right gaze preference, and left sided neglect.

Where is the lesion

A

Right sided cortex in the MCA distribution

MCA does face and arm, ACA does leg

98
Q

How would you figure out if a cortical lesion is in the ACA distribution or the MCA distribution.

A

ACA: leg is affected

MCA: face and arm are affected

99
Q

Its probably a good idea to kind of look at homunculus man and get a general idea of where the body parts are

A

OK

100
Q

What is left homonymous hemianopia?

A

Left half of visual field is lost in both eyes

101
Q

75 yr old male rolls into the ED with sudden onset of right sided weakness.

On exam, language is normal, and he has a dense hemiparesis and hemisensory loss of the Face, arm, and leg.

Where is the lesion

A

Subcortical

LEFT side

102
Q

68 yr old male with shaky hands and trouble walking that has worsened slowly over 4 years.

On exam, masked fancies, reduced eye blink, problems with smooth pursuit of eye movements, left greater than right hand tremor at rest, and shuffling gait.

What is the setting and pathologic course?

Where is the lesion?

A

Setting- 68yr old male

Course- progressive

Where: subcortical (Basal ganglia)

103
Q

22 yr old male playing racquetball suddenly developed right neck pain, trouble swallowing (CN IX and X), right facial numbness and left body numbness.

Where is the lesion

A

Right brainstem

“Crossed signs”- left facial numbness and right body numbness

(Probably caused by a right vertebral artery dissection around the medulla)

104
Q

Are all cranial nerve deficits an emergency?

A

Yes

105
Q

65 yr old male with facial droop that has progressed over the last 2 days. He is unable to close his right eye, and has flattening of the nasolabial folds on the right side.

What’s wrong?

A

CN VII on the RIght

106
Q

55 yr old ex-alcoholic present with progressive unsteady gait x 2 years. “My family still thinks I drink because I walk funny, but ive been sober for 5 years now”

On exam, he has spastic weakness, hyper-reflexia, absent proprioception and vibration up to the knees, a positive Romberg, and an ataxic gait.

Where is the lesion?

A

Dorsal column

(This is called subacute combined degeneration of the dorsal columns and lateral corticospinal tracts due to B12 deficiency)

107
Q

Truncal ataxia and an ataxic gait

A

Central cerebellum

108
Q

Bilateral leg weakness, sensory loss, and urinary retention and fecal incontinence. Absent rectal tone.

A

Spinal cord

109
Q

Upper and lower motor neuron signs with diffuse Fasciculations is pathognomic for:

A

ALS

110
Q

Mild spastic quadriparesis, quadriparesis, diffuse fasciculations, hyper-reflexia, and upgoing toes on plantar stimulation. No sensory loss.

What are the UMN signs:

What are the LMN signs:

What is this

A

UMN: spastic, hyperreflexia, babinski

LMN: fasciculations

This is pathognomic for ALS

111
Q

39 year old male presents with 5 days of progressive bilateral buttock pain . The pain started suddenly after a coughing fit. Today he has developed numbness of his genitals, unable to urinate and constipation. On exam, saddle anesthesia and absent rectal tone.

Is this an emergency?

What do you need to do?

Where is the lesion?

A

This is a neurologic emergency

Give IV dexamathasone

Lesion is at end of spinal cord, either at conus medularis or cauda equina.

(Cough probably popped out a disc)

112
Q

46 yr old female with Raynauds presents with worsening double vision, droopy eyelids and exercise intolerance over 6 months.

On exam, bilateral ptosis, unable to maintain sustained upgaze, develops double vision, and fatigable weakness.

Where is the lesion

A

NMJ.

This is myasthenia Travis

113
Q

65 yr old diabetic with a hx of lung cancer and chemo has had numbness and tingling in bilateral feet that has worsened over 5 years.

On exam he has distal weakness in the legs, decreased reflexes, decreased sensation distally in both hands and feet, with downgoing toes to plantar stimulation 🧦🧤

Where is the lesion

A

Peripheral nerve

This is diabetic peripheral neuropathy

114
Q

5 year old adopted boy just started school and he is having a lot of difficulty in PE class.

On exam, he has delayed speech, very large calves, proximal weakness, no sensory loss, waddling gait, and when you ask him to get up off the floor, he has to use his arms (Gower’s Sign)

Where is the lesion?

A

Muscle (“Proximal weakness”= muscle problem)

This is duchennes muscular dystrophy

Clin Med III Exam 3 (🐈, 👵🏼, 🌭) (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions