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Year 2 PCM IV final > Neuro, Cohen 10Q > Flashcards

Neuro, Cohen 10Q Flashcards

1
Q

Neuro exam overview

A 
mental status
cranial nerves
cerebellum
strengths
DTRs
Sensory testing
gait
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2
Q

Neuro exam overview

A 
mental status
cranial nerves
cerebellum
strengths
DTRs
Sensory testing
gait
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3
Q

mental status exam

A 
level of consciousness
orientation
language
attention
memory
executive/intellectual function
non dominant hemisphere
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4
Q

lethargic patient

A

prefers to sleep but stays awake with minimal verbal or physical stimulation

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5
Q

stuporous

A

repeated physical stimulation to stay awake

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6
Q

somatose

A

sleep like state

cannot be awaken

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7
Q

sudden decline in sconsciousness

A 
bad
new problem like decline in funciton of organ
new medication with adverse effect
sepsis
O2 decline or CO2 increase
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8
Q

orientation

A

person place and time

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9
Q

aphasia

A

indicaiton that dominant hemisphere is impaired, stroke hemorrhage, seizure or trauma

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10
Q

brocas aphasia

A

frontal lobe

usually have hemiplegia, retained understanding and brief telegraphic output

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11
Q

brocas aphasia

A

frontal lobe

usually have hemiplegia, retained understanding and brief telegraphic output

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12
Q

wernickes aphasia

A

superior temporal lobe, fluent, poor understanding

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13
Q

anomia

A

inability to nameobjects

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14
Q

agraphia

A

limited writing

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15
Q

dysarthria

A

slurred or thick speech
disease of either hemisphere
sometimes brainstem or could even me a medication effect

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16
Q

testing language function

A 
listen
have patients repeat words or simple phrases
read a paragraph
write a sentence
name simple objects
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17
Q

apraxia

A

loss of complex tasks

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18
Q

example of apraxia

A

can;t comb the hair or brush teeth

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19
Q

Gerstmann Syndrome lesion location

A

lesion in dominant parietal lobe

damage of angular gyrus

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20
Q

Sx of gerstmann syndrome

A

acalculia
agraphia
inability to distinguish the L and R sides of patient
inability to distinguish individual fingers

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21
Q

testing attention

A

digit repitition 7 forward 5 backwards
serial sevens
reading series of letters
spell world forward and backwards

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22
Q

testing attention

A

digit repitition 7 forward 5 backwards
serial sevens
reading series of letters
spell world forward and backwards

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23
Q

patient who cannot stick to the subject at hand, fails to do serial sevens or cannot spell a word forwards or backwards

A

may have delirium

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24
Q

deliurium

A

acute confusional state or encephalopathy
may be agitation, sometimes hallucinations, tremors wide fluctuations in blood P and rate
hyper-reactive to stimulation

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25
Q

delirium often due to

A

serious infections like sepsis, new medications, impairment of respiration, hepatic or renal function or widespread stroke
infections within the pain or alcohol and narcotic withdrawal

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26
Q

MSE in a patient with delirium

A

cannot be reliably tested beyond attention
definitely not beyond language
too inattentive to understand memory testing
poor executive functions

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27
Q

location causing abnormal memory

A

bilateral medial temporal lobe damage
hippocampus
sign or Sx of brain disease
alzheimers

28
Q

anterograde

A

loss or recent memory

ability to store new information

29
Q

retrograde

A

distant memories like dates of graduation etc.

30
Q

retrograde

A

distant memories like dates of graduation etc.

31
Q

questions for anterograde memory

A

give 3 words

32
Q

questions for retrograde memory

A

ask about past graduation or history etc

33
Q

how to check verbal fluency

how frontal lobes retriever information from temporal

A

as to name as many things in a category
most can name 20+
dementia

34
Q

indicators of dementia

A

abnormal executive function, judgement, abnormalities in nondominant hemisphere

35
Q

what functions localized to right parietal lobe

A

visual spatial skills
construcitons
awareness

36
Q

abnormalities in non-dominant hermisphere

A

new tumor, stroke or trauma or part of dementia

37
Q

right temporal lobe

A

loss of musical abilities and tendency to psychiatric disturbances like psychosis, depression and bipolar disorder, anxiety

38
Q

right occipital lobe

A

left homonymous hemianopia and prosopagnosia, inability to recognize faces

39
Q

right occipital lobe

A

left homonymous hemianopia and prosopagnosia, inability to recognize faces

40
Q

hemispatial neglect

A

not seeing people or objects in L side of room or on L side of drawing

41
Q

anosognosia

A

inability to recognize weakness in a patients L arm or L leg

42
Q

dressing agnosia

A

inability to button clothes or put an arm in sleeve on L side

43
Q

lack of constructional skills is sign of damage where (drawing clock)

A

nondominant (right) parietal lobe damage

very much impaired in alzheimers

44
Q

abnormal CN II

A

loss of vision
bitemporal hemianopia means around pituitary or chiasm
check acuity and pupillary reactivity

45
Q

loss of pupillary reflex

A

problem with II or III

46
Q

abnormal CN III

A

pupil usually spared

if not have large dilated pupil

47
Q

causes of abnormal CN III

A

strokes, DM, migraine sometimes
if outside midbrain like a herniation, pupil not spared
also aneurysm of PCA

48
Q

Ptosis

A

droopiness of upper eye lid from CNIII lesion

also in horners

49
Q

Abnormal IV and VI

A

IV- patient cannot look down and in

CI- patient cannot look laterally

50
Q

abnormal VI lesion would be

A

pons or skull

like increased ICP

51
Q

how to test VII

A

closing eyes, raising eyebrowns

smiling pursing lips

52
Q

Peripheral VII palsy

A

once left pons if damaged both upper and lower facial mm ipsi are impaired
idiopathic- bells palsy

53
Q

central VII palsy

A

lesion in brain stem, contralateral

only lower facial mm impaired

54
Q

central VII palsy

A

lesion in brain stem, contralateral

only lower facial mm impaired

55
Q

cerebellum function

A

coordination of movements on ipsi side because crosses midline twice

56
Q

what can cause b/l cerebellar damage

A

familial cerebellar degeneration, alcoholism, certain meds, mercury, MS

57
Q

what can cause b/l cerebellar damage

A

familial cerebellar degeneration, alcoholism, certain meds, mercury, MS

58
Q

rhomberg tests

A

posterior columns, gracile and cuneate fasciculi

requires vison, cerebellum and posterior columns for upright posture

59
Q

2/5 strengthe

A

no movement against gravity

60
Q

3/5

A

movement against gravity

no resistance

61
Q

quadriplegia

A

disease of upper or mid cervical spine or both corticospinal tracts of brain stem

62
Q

hemiplegia

A

disease of one cerebral hemisphere or one side brainstem along corticospinal tract

63
Q

paraplegia

A

disease of spinal cord in thoracic or high lumbar regions

64
Q

paraplegia

A

disease of spinal cord in thoracic or high lumbar regions

65
Q

causes of dec DTR

A 
DM
hypothyroidism
vit B12 def
exposure heavy metals
inc production Ig
auto immune disease
66
Q

causes of inc DTR

A

lesion of corticospinal tracts, UMN weakness, spinal cord or brain stem
hyperthyroidism
normal pregnancy

67
Q

dermatomal abnormal sensory

A

peripheral nerves or roots affected

Year 2 PCM IV final (6 decks)

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