Neuro Block 1 Flashcards
Define Dysarthric
Define Photophobia
D/o or articulation, stammering or stuttering due to a nerve defect
Eye discomfort from brith lights
Define Phonophobia
What is the criteria for alcohol abuse?
Fear of own voice or sounds
1-2 drinks at a time
1-2 drinks a month
Never more the 5 drinks at a time
Define Diplopia
Define Dysphagia
Double vision
Difficulty swallowing
Define Paresthesia
Define Radiculopathy
Define Dyskinesia
Burning, tingling, prickling
Nerves not working (neuropathy) at or near the root
Involuntary movements
What are the red flags of neuro that can’t be missed?
Worst HA of life/thunder clap (hemorrhage/aneurysm)
Sudden blindness (Amaurosis fugax/hypoperfusion of retina)
Back pain worse at night (CA)
Bowel/bladder incontinence (Cauda equine)
SI w/ plans
Define Level of Consciousness
How is Orientation tested for
Awareness of self and environment and rages from awake to comatose
PT states name, location, time of day (day of week and date)
What part of a PTs orientation is FIRST to deteriorate
How is speech assessed?
Time, date, week
Articulation, rate, rhythm and prosody- change in pitch/accentuation of syllables and words
How is language assessed?
What is a typical testing sequence for assessing speech and language
Content of PTs verbal and written output, response to commands and ability to read
Name parts of clothing, watch and pen Repeat “no ifs, ands, or buts” Follow 3 step verbal command Write sentence Read and respond to written command
How are abnormalities of insight or judgement detected during an interview?
What is an example question?
PT describes how they’d respond to situations that have a variety of outcomes
“What would you do if you found a wallet on the ground?”
Types of memory categories and how the info is extracted
Fund of info- history/current events
Insight/judgement- found wallet
Abstract thought- describe similarities
Calculation- subtract by 7s
Define the mini-mental status exam?
What type of score is concerning?
Formal eval tool w/ max of 30pts total
<24/30= suggestive of cognitive d/o
How reliable is a MMSE?
What is it one of the best tests for?
85% and 85% for dementia Dx that is moderate to severe in educated PTs
Mental status of PT, especially as a baseline for future scores
When conducting HEENT exam, testing for other modalities such as corneal reflex and motor part of CN5 is needed when?
What are the 5 movements tested when assessing CN7?
Hx suggests need
Eye brow elevation Forehead wrinkling Eye closure Smiling Cheek puff
Paralysis of the lower half of the face suggests ?
Paralysis of the entire half of the face suggests?
UMN lesion
LMN lesion
What size tuning fork is used to assess CN8?
When/why is the Rinne and Weber tests conducted?
512Hz
Abnormality is detected by Hx or exam
What are the three parts of a motor exam?
The decrease of one of these is indicative of ?
Strength, Tone, Appearance
Dec tone- LMN or peripheral nerve d/o
Pronator drift test is extremely useful for screening for ?
A finding of side, up, searching of withering during this test is indicative of ?
Upper limb weakness- flexion of elbows/fingers, pronation of forearm, especially asymmetrical
Loss of position sense
Define Jendrassik maneuver
What types of movements does this maneuver include?
PT contracts other/distant muscle groups to enhance reflexes during DTR assessment
Inc upper limb reflexes by clenching jaw
Inc Achilles reflex by flexing fingers and pulling them apart
Motor, reflex and sensation of C5
What nerves control the biceps AND brachioradialis reflex?
Deltoid, Bicep tendon, Outter upper arm
C5 and C6
Motor reflex and sensation of C6
Motor, reflex and sensation of C7
Wrist extension, Brachioradialis reflex, lateral forearm (“6-shooter”)
Wrist flexion, tricep tendon, middle finger
Motor, reflex and sensation of C8
What nerves don’t have reflexes associated with them?
Intrinsic hand muscles, no reflex, medial forearm
C8, L5
Motor, reflex and sensation of L4
Motor, reflex and sensation of L5
Tibialis anterior for foot inversion, patellar tendon, medial foot sensation
Extensor digital rum longus, no reflex, middle toes sensation
What nerves in never ate ankle dorsiflexion
Why is this one important to know?
L4 and L5 via peroneal nerve
Crosses head of fibula below the knee and if injured, causes Foot Drop- inability to dorsiflex the foot
Motor, reflex, and sensation of S1
Define the Plantar Reflex
Peroneus longus and brevis muscles, Achilles’ tendon reflex, lateral foot sensation
Normal= plantar flexion of toes Babinski= extensor plantar response from UMN lesion above S1