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Clin Med III Exam 3 > Neuro Diagnostics > Flashcards

Neuro Diagnostics Flashcards

1
Q

EEG

A

painless recording of cortical electrical activity;

8-16 electrodes applied to scalp and readings are taken

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2
Q

Stressors for EEG

A

sleep deprivation

hyperventilation

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3
Q

Indications for EEG

A

Seizure disorders (may be normal since seizures are episodic)
Metabolic encephalopathy (focal vs. generalized slowing)
Cortical vs. subcortical
Tumors

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4
Q

Cortical issues

A

neglect
aphasia
hemianopia

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5
Q

Sub cortical issue

A

motor hemiparesis

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6
Q

Tumors on EEG

A

focal slowing/spike discharges

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7
Q

EEG rhythms for normal awake adult

A 
Alpha= 8-12 Hz
Beta = >12 Hz
Theta = 4-8 Hz
Delta = 0-4 Hz
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8
Q

Focal changes on EEG

A

tumor, infarct, scar tissue

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9
Q

generalized EEG changes

A

encephalopathy anoxia

metabolic disorders

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10
Q

EMG

A

exam of electrical activity of muscle fibers/motor unit

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11
Q

Goal of EMG

A
  • define locations of problems in peripheral nerves

- differentiate primary muscle conditions from muscle weakness caused by neurologic disorders

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12
Q

Technique for EMG

A

needle electrodes inserted into skeletal muscle – look for abnormal activity

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13
Q

When is activity evaluated for EMG

A
  • during need insertion
  • spontaneous activity at rest
  • slight muscle contraction
  • full muscle contraction
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14
Q

Indications for EMG

A 
LMN disease: ALS
NMJ disease: Myasthenia gravis (fatigability)
Muscle disease: Myopathy
Peripheral nerve disorders: carpal tunnel, peripheral neuropathies
• Alcoholic neuropathy 
• Amyotrophic lateral
sclerosis (ALS)
• Brachial plexopathy
• Carpal tunnel syndrome 
• Cervical spondylosis
• Denervation
• Guillain-Barre
• Muscular dystrophy
• Myasthenia gravis
• Myopathy
• Nerve dysfunction
• Peripheral neuropathy 
• Polymyositis
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15
Q

EMG w/ myasthenia gravis

A

fatigability

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16
Q

EMG w/ myopathy

A

decreased amplitude of motor response

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17
Q

Nerve conduction study

A

used to assess rate of conduction & amplitude of response of peripheral nerves (how well and how fast nerves can transmit signal)

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18
Q

Done together

A

EMG + nerve conduction study

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19
Q

Indications for nerve conduction studies

A

differentiate b/w nerve and muscle disorder
differential LMN from peripheral neuropathy
Detect abnormalities in sensory nerves
Axonopathy (decreased amplitude)
Demyelinating process (decreased conduction rate)

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20
Q

Decreased conduction rate on NCV

A

demyelinating process

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21
Q

Decreased amplitude on NCV

A

axonopathy

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22
Q

NCV for carpal tunnel syndrome

A

determine integrity of sensory/motor pathway

- help determine when surgery is needed

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23
Q

Types of neuroimaging

A
  • Plain films
  • CT scan
  • MRI
  • Ultrasound
  • Angiography/MRA
  • Myelography
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24
Q

Indication for plain films

A
  • Degenerative disease (osteophytes, decreased disk space, alignment- kypohsis, scoliosis)
  • Trauma (Fx/dislocation)
  • malignancy
25
Q

Contraindications of EEG

A

None.

26
Q

Spondylolithesis imaging and views

A

lumbar spine plain film; get flexion & extension views to show degree of instability

27
Q

Dx of spinal fx

A

1st line: plain film! (compression fx)

Follow w/ CT or MRI to define presence of associated soft tissue imaging

28
Q

EMG measures what

A

ability of muscle to respond to stimulation

29
Q

Indications for plain skull films

A

Trauma
Metabolic disease
Malignancy

30
Q

CT scan indications

A 
• Trauma 
• Stroke
- Ischemic v. hemorrhagic
• Hydrocephalus
• Suspicious headaches
• Altered mental status
• For spine: 
- Trauma
- Degenerative
• LOC
• Persistent neurologic dysfunction 
• Persistent vomiting
• GCS < 8 or deteriorating
• Retrograde or antegrade amnesia 
• Post-traumatic seizures
31
Q

Epidural hematoma

A

between dura and skull

lens-shaped

32
Q

Subdural hematoma

A

B/w dura and arachnoid

Crescent-shaped

33
Q

Dx of stroke

A

Non-constrast head CT!!!!

34
Q

Why do you need a non-contrast CT for stroke?

A

r/o hemorrhagic stroke prior to administration of thrombolytic meds

35
Q

Indications for MRI

A 
Tumors
Vascular disease
Inflammation/infection
MS
Degenerative disease (Spine)
36
Q

Types of MRI

A

T1: fat lights up
T2: water flights up

37
Q

T1 MRI

A

reflects uptake of magnetic energy

better for normal anatomy

38
Q

T2 MRI

A

reflects release of magnetic energy better for pathology

39
Q

TOC for tumors

A

MRI w/ gadolinium

40
Q

Diffusion MR

A

measures microscopic motion of water

41
Q

Most sensitive test for suspected acute ischmic stroke of brain/spinal cord

A

Diffusion MR

42
Q

MR use

A

ischemic stroke
encephalitis
abscess

43
Q

Dx of MS

A

MRI showing periventricular plaques

44
Q

Indications for new deficit (CT/MRI)

A 
Acute onset of:
•New vision loss
• Aphasia
•AMS
•Sensory abnormalities •Motor paralysis
•Vertigo w/HA, diplopia, focal deficit, ataxia, or dsyarthria
45
Q

When to get imaging for HA

A

“worst HA of my life” - subarachnoid hemorrhage
new h/a in pts w/ CA or HIV
HA w/ papilledema
HA w/ neuro deficit
HA/ w/ AMS
HA that worsens w/ exertion, positionally related, awakens from sleep, changes over tim

46
Q

TOC for head trauma

A

CT

47
Q

TOC for onset sz

A

CT (MRI if CT neg and pt has neuro deficit)

48
Q

TOC for brain tumor

A

MRI

49
Q

TOC for hydrocephalus

A

CT

50
Q

Indications for MRI spine

A
  • Radiculopathy – persistent/progressive
  • High impact trauma
  • New or progressive deficit
  • Suspected tumor or infection
  • Neurogenic claudication
  • New onset of back pain in a patient with cancer
51
Q

Carotid US

A

used to determine degree of stenosis; measure velocity through blood vessel

52
Q

Angiography: what is it?

A

IV injection of contrast;

Tradition vs CTA vs MRA

53
Q

where is access for angiography

A

femoral vessels

54
Q

Indications for angiography

A

pre-operative (CEA, aneurysm repair)

55
Q

Goal of myelography

A

detect spinal cord pathology/compression (herniated discs, spinal stenosis)

56
Q

MOA of myelography

A

radiopague dye injected into thecal space; patient tilted for images (XR or CT), Replaced by MRI

57
Q

LP use

A

meningitis

58
Q

Contraindication of LP

A

Papilledema

Increased ICP

Clin Med III Exam 3 (3 decks)

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