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HA Exam 3 - Wk 9-12 > Neuro - Bates > Flashcards

Neuro - Bates Flashcards

1
Q

What 4 regions make up the brain?

A

cerebrum, diencephalon, brainstem, cerebellum

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2
Q

A vast network of interconnecting nerve cells in the brain are known as ___.

A

neurons

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3
Q

___ are single long fibers that conduct impulses to other parts of the nervous system.

A

Axons

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4
Q

___ matter consists of aggregations of neuronal cell bodies. Rims the surfaces of the cerebral hemispheres, forming the cerebral cortex.

A

Grey

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5
Q

___ matter consists of neuronal axons that are coated w/myelin. The myelin sheaths allow nerve impulses to travel more rapidly.

A

White

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6
Q

The ___ ___ affects movement.

A

basal ganglia

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7
Q

The ___ maintain homeostasis and regulates temp, HR, and B/P, as well as emotional behaviors such as anger and sexual drive.

A

hypothalamus

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8
Q

Hormones secretes in the hypothalamus act directly on the ___ ___.

A

pituitary gland

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9
Q

The ___ lies at the base of the brain and coordinates all movement and helps maintain the body upright in space.

A

cerebellum

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10
Q 
The spinal cord is divided into segments:
C1-C8 = \_\_\_
T1-T12 = \_\_\_
L1-L5 = \_\_\_
S1-S5 = \_\_\_
and coccygeal
A

cervical
thoracic
lumbar
sacral

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11
Q

The ___ nervous system regulates muscle movements and response to the sensations of touch and pain.

A

somatic

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12
Q

The ___ nervous system connects to internal organs and generates autonomic reflex responses.

A

autonomic

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13
Q

The ___ nervous system, mobilized organs and their functions during times of stress and arousal.

A

sympathetic

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14
Q

The ___ nervous system conserves energy and resources during times of rest and relaxation.

A

parasympathetic

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15
Q

CN I is known as ___. Its function is ?

A

olfactory, sense of smell

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16
Q

CN II is known as ___. Its function is ?

A

optic, vision and visual acuity

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17
Q

CN III is ___. Its function is ?

A

oculomotor, pupillary constriction, pupillary reaction to light, opening the eye, accommodation and convergence, and most extraocular movements

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18
Q

CN IV is ___. Its function is ?

A

trochlear, downward, internal rotation of the eye

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19
Q

CN V is ___. It’s function is ?

A

trigeminal, jaw clenching and lateral jaw movement, cottonball to forehead, cheeks, and chin, difference between sharp or dull touch

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20
Q

CN VI is ___. Its function is ?

A

abducens, lateral deviation of the eye

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21
Q

CN VII is ___. Its function is ?

A

facial, facial expression, raising eyebrows, puff out cheeks, smile, frown, whistle

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22
Q

CN VIII is ___. Its function is ?

A

acoustic, hearing and balance

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23
Q

CN IX is ___. Its function is ?

A

glossopharyngeal, swallowing and gag reflex (pharynx)

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24
Q

CN X is ___. Its function is ?

A

vagus, raises palate by saying “ahhh” (pharynx and larynx)

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25
Q

CN XI is ___. Its function is ?

A

spinal accessory, shoulder and neck movement (sternomastoid and upper portion of trapezius)

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26
Q

CN XII is ___. Its function is ?

A

hypoglossal, extend tongue and push tongue against cheeks

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27
Q 
Sensory = \_\_\_ fibers
Motor = \_\_\_ fibers
A

afferent

efferent

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28
Q

What 3 motor pathways impinge on the anterior horn cells? A lesion in any of these areas will affect ___ or reflex activity

A

the corticospinal tract, basal ganglia system, and the cerebellar system, movement

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29
Q

The ___ tract aka ___, mediates voluntary movement and integrate skills, complicated, or delicate movements by stimulating selected muscular actions and inhibiting others. Carry impulses that inhibit muscle tone. Fibers cross to the ___/contralateral side.

A

corticospinal, pyramidal, opposite

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30
Q

The ___ ___ system includes motor pathways that help to maintain muscle tone and to control body movements, especially gross automatic movements such as walking.

A

basal ganglia

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31
Q

The ___ system receives both sensory and motor input and coordinates motor activity, maintains equilibrium, and helps to control posture.

A

cerebellar

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32
Q

When upper motor neuron systems are damaged ABOVE the crossover of its tracts in the medulla, motor impairment develops on the ___ side. When there is damage BELOW the crossover, motor impairment occurs on the ___ side.

A

opposite/contralateral, same/ipsilateral

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33
Q

Damage to the basal ganglia system produces changes in what?

A

muscle tone and disturbances in posture and gait, a slowness or lack of spontaneois and automatic movements and various involuntary movements.

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34
Q

Cerebellar damage impairs what?

A

coordination, gait, and equilibrium, and decreases muscle tone as well

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35
Q

The ___ tract arises in free nerve endings in the skin that register pain, temp, and crude touch.

A

spinothalamic

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36
Q

The ___ ___ system transmit the sensations of vibration, proprioception, kinesthesia, pressure, and fine touch.

A

posterior column

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37
Q

At the ___ level, general quality of sensation is perceived (pain, cold, pleasant, unpleasant), but fine distinctions are not made.

A

thalamic

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38
Q

A lesion in the ___ ___ may not impair the perception of pain, touch, and position, but does impair finer discrimination.

A

sensory cortex

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39
Q

___ and ___ ___ are often preserved despite partial damage to the cord.

A

crude, light touch

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40
Q

Loss of position and vibration sense, w/preservation of other sensations, points to disease of the ___ ___.

A

posterior column

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41
Q

Loss of all sensations from the waist down, together w/paralysis and hyperactive reflexes in the legs, indicates transection of the ___ ___.

A

spinal cord

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42
Q

A ___ is the band of skin innervated by the sensory root of a single spinal nerve.

A

dermatome

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43
Q

A ___ is an involuntary stereotypical response.

A

reflex

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44
Q

2 of the most common symptoms in neuro disorders include ___ and ___.

A

h/a and dizziness

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45
Q

___ always warrant careful assessment.

A

H/A

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46
Q

Migraine, tension, cluster, and chronic dly headaches are known as ___ headaches.

A

primary

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47
Q

___ headaches arise from underlying structural, systemic, or infectious causes and my be life-threatening

A

Secondary

48
Q

What type of h/a often presents as “the worse h/a of my life”?

A

subarachnoid hemorrhage

49
Q

Severe h/a and stiff neck accompany ___.

A

meningitis

50
Q

Dull h/a, increased by coughing and sneezing, esp in same location, occurs in ___ ___.

A

mass lesions

51
Q

___ h/a is often preceded by an aura.

A

Migraine

52
Q

What does POUND stand for?

A 
Pulsatile or throbbing
One-day duration
Unilateral
Nausea/vomiting
Disabling or intensity causing interruption of dly activity
53
Q

Feeling light-headed, weak in the legs, or about to faint points to ___.

A

syncope

54
Q

___ is unsteady and off-balance.

A

disequilibrium

55
Q

___ is a spinning sensation w/in the pt or of the surroundings.

A

Vertigo

56
Q

double vision = ___
difficulty forming words = ___
problems w/gait or balance = ___
These 3 are suspicious for ___ or ___.

A

diplopia
dysarthria
ataxia
TIA, stroke

57
Q

___ weakness occurs in the shoulder or hip girdle and effects movements like combing hair, reaching up to a shelf, getting up out of a chair, or climbing a high step.

A

Proximal

58
Q

___ weakness occurs in the hands or feet and effects opening a jar or using scissors or a screwdriver

A

Distal

59
Q

Burning pain in the hands/feet like pins and needles occurs in ___ ___.

A

diabetic neuropathy

60
Q

Common causes of acute symptomatic seizures include ?

A

head trauma, alcohol, cocaine, withdrawal from alcohol, benzo’s, and barbiturates, metabolic insults from low or high glucose, calcium, or sodium, acute stroke, meningitis, or enchephalitis

61
Q

A ___ is a rhythmic oscillatory movement of a body part resulting from the contraction of opposing muscle groups and is the most common movement disorder.

A

tremor

62
Q

Low-freq unilateral resting tremor, rigidity, and bradykinesia typify what disorder?

A

Parkinson’s

63
Q

An unpleasant sensation in the legs, esp at night, that gets worse during rest and improves w/activity is known as what?

A

RLS

64
Q

___ is a neurologic deficit caused by cerebrovascular ischemia (87%) or hemorrhage (13%).

A

Stroke

65
Q

___ ___ is an infarction of CNS tissue that may be symptomatic or silent.

A

Ischemic stroke

66
Q

A ___ is a transient episode of neurological dysfunction caused by focal, brain, spinal cord, or retinal ischemia, w/out acute infarction.

A

TIA

67
Q

ABCDD is used as a scoring system for stroke and stands for ?

A 
Age > 60 yrs
B/P > 140/90
Clinical features of focal weakness or impaired speech
Duration up to or more than 60 mins
Diabetes
68
Q

Stroke prevalence is highest in what ethnic group?

A

African American

69
Q

Midlife risk factors for stoke include ?

A

autoimmune collagen vascular dis, hx of preeclampsia, gest diabetes, PIH

70
Q

Stroke outcomes markedly improve if therapy is given w/in ___ hrs of onset of sympt.

A

3

71
Q

Most common cause of ischemic sympt is occlusion of what artery, which causes field cuts and contralateral hemiparesis and sensory deficits.

A

middle cerebral artery

72
Q

Occlusion of what artery often produces aphasia?

A

left middle cerebral artery

73
Q

Occlusion of what artery produces neglect or inattention to the opposite side of the body.

A

right middle cerebral artery

74
Q

What are the stroke attack warning signs?

A

sudden numbness or weakness of the face, arm, or leg
sudden confusion, trouble speaking or understanding
sudden trouble seeing in one or both eyes
sudden trouble walking, dizziness, or loss of balance or coordination
sudden severe h/a

75
Q

Modifiable risk factors for ischemic stroke are ?

A

HTN, smoking, hyperlipidemia, diab, excess wt, lack of exercise, heavy alcohol use

76
Q

For prevention of hemorrhagic stroke, optimal control of what is essential?

A

B/P

77
Q

The most common type of peripheral diabetic neuropathy is what? It is slowly progressive and asympt in up to 50% of pts, increasing risk of foot injury and amputation. Maintaing HgA1C at or below ___ reduces the odds of onset of neuropathy by 60%.

A

distal symmetric sensorimotor polyneuropathy. 7.4%

78
Q

___ is an acute confusional state marked by sudden onset, fluctuating course, inattention, and at times, changes in LOC.

A

Delirium

79
Q

___ involves age-related changes in cognition from mild cognitive impairment and Alzheimer disease. The MMSE is the best test for this.

A

Dementia

80
Q

___ is more common in ind w/significant medical conditions and involves screening w/2 questions: “Have you been feeling down, depress, or hopeless?” and “Have you felt litter interest or pleasure in doing things?”

A

Depression

81
Q

What are the 5 things you want to assess for neuro function?

A 
mental status, speech, and language
cranial nerves
the motor system
the sensory system
reflexes
82
Q

___ is known as a difference of > 0.4mm in the diameter of one pupil.

A

Aniscoria

83
Q

What 3 CN test the 6 cardinal directions of gaze w/either the star or an H?

A

III, IV, and VI

84
Q

___ is an involuntary jerking movement of the eyes w/quick and slow components.

A

Nystagmus

85
Q

___ is drooping of the upper eyelids

A

Ptosis

86
Q

The palate fails to rise w/a bilat lesion of CN ___.

A

X

87
Q

In a ___ ___ ___, the protruded tongue deviates transiently in a direction away from the side of the cortical lesion, toward the side of weakness.

A

unilateral cortical lesion

88
Q

___ ___ refers to a loss of muscle bulk or wasting. When looking for this, pay particular attn to the hands, shoulder, and thighs.

A

Muscle atrophy

89
Q

___ is an increase in bulk w/proportionate strength.

A

Hypertrophy

90
Q

When a normal muscle w/an intact nerve supply is relaxed voluntarily, it maintains a slight residual tension known as ___ __. This can be assessed best by feeling the muscle’s resistance to passive stretch.

A

muscle tone

91
Q 
Impaired strength = \_\_\_
Absence of strength = \_\_\_
Weakness of one-half of body = \_\_\_
Paralysis of one-half of body = \_\_\_
Paralysis of the legs = \_\_\_
Paralysis of all 4 limbs = \_\_\_
A 
paresis (weakness)
plegia (paralysis)
hemiparesis
hemiplegia
paraplegia
quadriplegia
92
Q

A muscle is strongest when ___ and weakest when ___.

A

shortest, longest

93
Q

Muscle strength is graded on a 0-5 scales w/0 being what and 5 being what?

A 
0 = no muscular contraction detected
5 = active movement against full resistance w/out evident fatigue (normal muscle strength)
94
Q

Look for weak opposition of the thumb in median nerve disorders such as what?

A

carpal tunnel syndrome

95
Q

The motor system tests for ?
Cerebellar system tests for ?
Vestibular system tests for ?
Sensory system tests for ?

A

muscle strength
rhythmic movement and steady posture
balance and coordination of eye, head, and body
position sense

96
Q

When assessing the gait, what 6 things should you have the pt do?

A

walk across the room
walk heel-to-toe in a straight line
walk on the toes, then the heels for balance (plantar flexion and dorsiflexion)
hop in place
do a shallow knee bend on one leg, then the other
rise from a sitting position and step up on a sturdy stool

97
Q

What test is used as a test of position sense? Have the pt stand w/feet together and eyes open and then close both eyes for 30-60 secs w/out support. Normally only minimal swaying occurs.

A

The Romberg test

98
Q

When testing for ___ ___, have the pt stand for 20-30 secs w/both arms straight forward, palms up, and eyes closed.

A

pronator drift

99
Q

What 4 things do you test to evaluate the sensory system?

A

pain and temp
position and vibration
light touch
discriminative sensations

100
Q

Absence of touch = ___
Decreased sensitivity = ___
Increased sensitivity = ___

A

anesthesia
hypesthesia
hyperesthesa

101
Q

___ refers to the ability to identify an object by feeling it. Place a familiar object (coin, pencil, cottonball) in pt’s hand and ask them to tell you what it is.

A

Sterognosis

102
Q

When motor impairment, arthritis, or other conditions prevent the pt from manipulating an object well enough to identify it, test the ability to identify numbers w/what test?

A

Number identification/Graphesthesia

103
Q

Using the 2 ends of an opened paper clip, touch a finger pad in 2 places simultaneously and alternate between 1 and 2. This is known as what?

A

Two-point discrimination

104
Q

___ ___ is where you touch a point on the patient’s skin, then ask the pt to open both eyes and point to the place touched.

A

Point localization

105
Q

Test for ___ by simultaneously stimulate corresponding areas on both sides of the body. Ask where the pt feels your touch.

A

extinction

106
Q

Scale for grading reflexes ranges from 0-4+, w/0 being what? 4+ being what? and 2+ being what?

A

no response
very brisk, hyperactive, w/clonus
average, normal

107
Q

Tests for meningeal inflam or subarachnoid hemorrhage include ?

A

neck mobility/nuchal rigidity (have pt touch chin to chest)
brudzinski’s (flex the neck, watch the hips and knees in reaction - normally should remain relaxed and motionless)
Kernig’s (flex pt’s leg at both hip and knee, then straighten the knee - pain behind knee during full extension is +)

108
Q

Dorsiflexion of the big toe from a stroke on the lateral aspect of the sole from the heel to the ball of the foot is known as a + ___ and indicates a NSC lesion in the corticospinal tract.

A

Babinski

109
Q

Pain radiating into the ipsilateral leg upon a straight raise of the leg is known as a + ___-___ test and is usually caused from what 2 things?

A

straight-leg, sciatica, herniated disc

110
Q

What are the 2 cardinal “Don’ts” if you have a stuporous or comatose pt?

A

Don’t dilate the pupils

Don’t flex the neck if there is any question of trauma to the head or neck.

111
Q

In the level of ___, the pt opens the eyes, looks at you, and responds fully and appropriately to stimuli.

A

alertness

112
Q

A ___ pt appears drowsy but opens the eyes and looks at you, responds to questions, and then falls asleep.

A

lethargic

113
Q

A pt in an ___ state opens the eyes and looks at you but responds slowly and is somewhat confused.

A

obtunded

114
Q

A ___ pt arouses from sleep only after painful stimuli. Verbal responses are slow or even absent.

A

stuporous

115
Q

A ___ pt remains unarousable w/eyes closed, even upon repeated painful stimuli.

A

comatose

HA Exam 3 - Wk 9-12 (10 decks)

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