Brainscape's Knowledge GenomeTM

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


See full index

Clin Skills > neuro- intro > Flashcards

neuro- intro Flashcards

1
Q

white matter is what? grey matter is what?

A

neuronal cell bodies
PNS- ganglia
CNS- nuclei (except basal ganglia)

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

4 regions of the brain

A

cerebrum
diencephalon
cerebellum
brain stem

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

what does the cerebrum include? 7 parts

A 
*2 hemispheres- 2 parts to each lobe
frontal lobe
occipital lobe
parietal lobe
temporal lobe
basal ganglia
limbic system
ventricles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

frontal lobe is responsible for….

A

reasoning, planning, parts of speech, movement, emotions, problem solving

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

parietal lobe is responsible for….

A

movement, orientation, recognition, perception of stimuli

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

occipital lobe is responsible for….

A

visual processing

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

temporal lobe is responsible for….

A

auditory recognition and perception

memory, and speech

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

the diencephalon includes what 2 parts of the brain? what does each part do?

A

thalamus - takes in all sensory and sends it where it needs to be processed
hypothalamus - homeostasis

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

what does the cerebellum do? what three types of information does it receive and from where does it receive it?

A

the coordinator of movement, planning, execution of movement, posture, and head and eye movements,

  • Sensory information from spinal cord
  • Motor information from the cerebral cortex
  • Balance information from the inner ear
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what does the brainstem include? what are its 3 parts ?

A

10/12 cranial nerves, LOTS of nuclei and relay centers, control of autonomic action, reticular activating system
Midbrain
Pons
Medulla

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

where doe the spinal cord start and end?

A

Starts at medulla and ends at the 2 or 3rd lumbar vertebra

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

how many cranial nerves? how many peripheral nerves?

A

cranial- 12

peripheral- 31 pairs

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

CN 1 and 2 come from where?

A

fiber tracts from the brain

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

CN 3 and 7 come from where?

A

arise from brain stem

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

what are the 3 functions of cranial nerves?

A

general motor
sensory
special sensory

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

what are the 2 types of peripheral nerves? how are they formed?

A

Spinal nerve- motor and sensory roots merge to form spinal nerve
Peripheral nerve- spinal nerves merge together to form plexuses to form peripheral nerves

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

what are the 4 motor pathways?

A

Corticospinal tract (pyrimidal)
Basal ganglia system
Cerebellar system
Extrapyramidal pathways

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

upper motor neurons : where are their cell bodies located and where do they synapse?

A

have cell body in the gray matter of the brain

Axons synapse with cell body in brain stem (for CN) and in spinal cord (for peripheral nerves)

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

lower motor neurons: where are their cell bodies located and where do they synapse?

A

Cell body in the spinal cord (peripheral) called anterior horn cells
Anterior horn cell body has axon that travels through anterior root&raquo_space; spinal nerve&raquo_space; peripheral nerve» neuromuscular junction
Called the “final common pathway”

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

where do all motor pathways converge to control muscle activity?

A

the anterior horn

-lots of activity here

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

UMN damage vs LMN damage?

A

UMN – weakness or paralysis; poor skilled movement; increased muscle tone, hyperreflexive DTRs
LMN – ipsilateral weakness or paralysis, decreased muscle tone, hyporeflexive or absent DTRs

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

corticospinal tract (pyrimidal) is responsible for?

A

Voluntary movement

“Integrate skilled, complicated, or delicate movements by stimulating selected muscular actions and inhibiting others.”

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

where doe the corticospinal tract originate?

A

Origination – brain motor cortex

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

where does corticospinal tract go? (pathway)

A

Path – form pyramid-like structure in lower medulla where most fibers cross to contralateral medulla
Synapse with anterior horn cells or intermediate neurons

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

what is the corticobulbar part of the corticospinal path?

A

Corticobulbar – tracts that synapse in brainstem with CN motor nuclei

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

what does the basal ganglia do?

A

Maintenance of muscle tone
Body movement control – especially gross movement
i.e. walking

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

what is the basal ganglia complex (aka what pathway and parts of the brain is it associated with ?

A

Complex – “motor pathways between cerebral cortex, basal ganglia, brainstem, and spinal cord”

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

what does damage to the BG cause?

A

Damage = muscle tone changes (usually increases tone), may have abnormal posture or bradykinesia

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

what do the sensory pathways of the Corticospinal tract contribute to? (5 parts)

A 
Reflex Activity
Conscious sensation
Body position calibration
Regulation of autonomic functions
BP, pulse, resp
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what is the spinothalamic tract?

A

Pain and temperature or crude touch from nerve endings in skin within 1-2 spinal segments from cord entry

  • Pass to posterior horn and synapse with secondary sensory neurons
  • Cross to contralateral side and travel upward to thalamus
  • Consists of smaller unmyelinated or thinly myelinated axons
31
Q

what are the posterior columns of the sensory pathways? what passes through them and where do these go after?

A

Position/proprioception and vibration, kinesthesia, pressure, and fine touch
These sensations pass to posterior columns of cord and pass upward to medulla
Fibers synapse with secondary sensory neurons in the medulla then cross to opposite side and cont to thalamus

32
Q

what is the site of the general quality of sensation?

A

thalamus

33
Q

what does a lesion in the sensory cortex cause?

A

impaired fine discrimination but intact pain, touch, and position sense

34
Q

what does a lesion in the posterior columns cause?

A

position and vibration loss

35
Q

what does a lesion of the spinal cord transection cause?

A

loss of all sensation below transection, paralysis, exaggerated reflexes

36
Q

what will still be intact even with partial cord damage?

A

crude and light touch intact (impulses on one side travel both sides of cord)

37
Q

what are the dermatomes

A

Bands of skin
Innervation of sensory root of single spinal nerve
Can localize to specific spinal segment

38
Q

definition of a reflex?

A

deep tenton reflex (DTR) : “involuntary stereotypical response that may involve as few as two neurons, one afferent (sensory) and one efferent (motor), across a single synapse”

39
Q

____ reflexes are monosynaptic

A

DTRs in arms and legs

brisk tap on tendon of partially stretched muscle

40
Q

good reflex test means what?

A

all are Intact – sensory nerve fibers, spinal cord synapse, motor nerve fibers, neuromuscular junction, and muscle fibers

41
Q

what are the DTR segmental levels?

A 
Ankle – S1 primarily
Knee – L2, 3, 4
Supinator (brachioradialis) – C5, 6
Biceps – C5, 6
Triceps – C6, 7
42
Q

what are the sections of the cutaneous stimulation ?

A 
Abdomen
Upper – T8, 9, 10
Lower – T10, 11, 12
Plantar
L5, S1
Anal
S2, 3, 4
43
Q

5 parts of neuro exam

A 
Mental Status
Cranial Nerves
Motor System
Sensory System
Reflexes
44
Q

6 parts of mental status to evaluate?

A
  1. appearance and behavior
  2. speech/language
  3. mood (not being tested on)
  4. thoughts/perceptions (not being tested on)
  5. cognition/function
  6. higher cognitive function
45
Q

what 5 parts of speech and language do we evaluate?

A
  1. quantity : talkative or silent?
  2. rate : fast or slow talking?
  3. volume (loudness)
  4. articulation of words
  5. fluency of speech (involves rate, flow , melody of speech)
46
Q

4 fluency abnormalities

A
  1. Hesitancies in speech (as seen in patients with aphasia from strokes)
  2. Monotone inflections (schizophrenia or severe depression)
  3. Circumlocutions: words or phrases are substituted for the word a person cannot remember; e.g., “the thing you block out your writing with” for an eraser
  4. Paraphasias: words are malformed (“I write with a den”), wrong (“I write with a branch”), or invented (“I write with a dar”)
47
Q

aphasia is usually caused by _____

A

dominant hemisphere problem

48
Q

what is cognition testing?

A

Assess orientation to person, place, and time
assess attention, remote memory (further history), recent memory, new learning ability (tell 4 words and ask them to repeat in 5 min)

49
Q

3 parts to assess attention

A

Digital span: give the patient a string of numbers to recite back to you
Serial 7s: ask the patient to subtract serial “7s” from 100
Spelling backward: ask the patient to spell W-O-R-L-D backwards

50
Q

three parts to check higher cognitive function? how do you check?

A

Calculating ability: difficult calculations such as making change
Abstract thinking:
-Interpreting proverbs: “A stitch in time saves nine”
-Similarity exercises: What do a ball and an orange have in common?
Constructional abilty: drawing complex shape or clock

51
Q

5 parts of neuro screening

A
  1. Mental Status: Level of Alertness, Appropriateness of Response, Orientation
  2. Cranial Nerves: Visual acuity, Pupillary light reflex, Eye movement, Hearing, Facial strength
  3. Motor System: Strength, Gait, Coordination
  4. Sensory System: Toes – light touch or pain/temperature or proprioception
    5: Reflexes: DTR – biceps, patellar, Achilles
    Plantar response
52
Q

CN1

A 
– Olfactory
Test nasal patency
Close eyes
Occlude one nostril
Test smell
Ask patient if can smell and what smell is
Test bilaterally
53
Q

CN2

A 
Optic
Visual acuity
Inspect optic fundi
Visual fields by confrontation
May need to isolate eyes for this test if patient is suspected to have a deficit
54
Q

CN3

A

Oculomotor
Test with CN II: Inspect size and shape of pupils – compare bilaterally
Pupillary reaction to light
Near response: Pupillary constriction, Convergence,
Accommodation

55
Q

what is aniscoria?

A

pupil size: >0.4mm difference in diameter comparatively seen in up to 38% of people

56
Q

CN 3, 4 and 6: what are these called, how do you test them?

A

Oculomotor, Trochlear, and Abducens

  1. EOM in 6 cardinal directions of gaze: Determine if monocular or binocular
  2. Cover-uncover test
  3. Convergence
  4. ID Nystagmus: Increase or decrease when fixed on far object?
  5. ID Ptosis
57
Q

what causes diplopia?

A

disconjugate extraocular eye movement

58
Q

what is CN5 and what are it’s 3 components?

A

trigeminal nerve: 3 parts
Ophthalmic, Maxillary, Mandibular
(motor and sensory parts )

59
Q

testing CN5 motor

A

Patient clenches teeth while palpating temporal then masseter muscles noting strength
Move jaw side-to-side

60
Q

testing CN 5 sensory

A

Pain sensation at forehead, cheeks, and jaw bilaterally
Sharp object with blunt end (safety pin)
“Do you feel anything? Where? Does it feel sharp or dull?”
Abnormal? - Temperature sensation
Light touch – wisp of cotton
“Tell me when you feel something touch your skin.”

61
Q

corneal reflex tests what 2 CNs?

A

sensory CN V and motor CN VII
“Look up and away from me with your eyes.”
Touch CORNEA with cotton, avoiding eyelashes.
Normal Response = Blink
Contact Lenses – diminish or delete reflex

62
Q

CN 7

A

Inspect at rest and during conversation: Asymmetry? Tics? Abnormal Movements?
Observe in Response to Requests (raising eyebrows, frowning, etc)

63
Q

CN 8

A 
Acoustic
Whispered voice test
Conductive vs Sensorineural
--Rinne – air vs. bone conduction
--Weber – lateralization
Vestibular function – rarely need to test in usual Neuro Exam
64
Q

sensory info from the vestibular system is used to…?

A

Provides a stable visual image for the retina while the head moves
Make adjustments in posture necessary to maintain balance

65
Q

3 semicircular canals test what? 2 otolith organs test what?

A

angular acceleration ; linear acceleration

66
Q

how do the otolith organs detect linear acceleration ?

A

When the head is moved linearly the otolith mass slides along the hair cells either depolarizing (stimulating) or hyperpolarizing (inhibiting) them detecting a change in position.

67
Q

afferent nerves from vestibular hair cells terminate in one of ____ vestibular nuclei in the ____. these 4 are…

A

Afferent nerves from vestibular hair cells terminate in one of four vestibular nuclei in the medulla; Superior, Medial, Lateral, Inferior

68
Q

vestibular ocular reflex (VOR)- what does this allow you to do?

A

allows you to focus on a point when your head is moving (small movements of the eyes)
test as a reflex to make sure peoples’ brainstems are functioning

69
Q

“the brain looks at the lesion” - what does this mean?

A

“the brain looks at the lesion” - if you have some sort of degenerative lesion (something decreasing the output) on left side of head (stroke, tumor)- then you get right of the left side function- eyes will only be able to look “towards” the lesion- cause you have knocked out the side pushing the opposite way

70
Q

what is a normal reflex that you can get from stimulating the semiC canals?

A

Nystagmus is a normal reflex. You get it from stimulating the semicircular canals. (dix hallpike test to mimic irritating the semicircular canals- test for pathologic nystagmus)

71
Q

CN 9 and 10

A

Glossopharyngeal and Vagus
-Voice
Hoarse? (Vocal Cord Paralysis) Nasal quality? (Paralysis of the Palate)
-Difficulty swallowing: Pharyngeal or palatal weakness
-Normal symmetrical rise of the soft palate (X) – “Say ah”
-Gag Reflex – elevation of the tongue and soft palate and constriction of the pharyngeal muscles

72
Q

dolls eyes maneuver

A

vestibular pathway maintains ability to focus central vision even with head moving- roll head back and forth- eyes should look to the opposite side of where you roll it

73
Q

CN 11

A

Spinal Accessory
Atrophy or fasciculation in trapezius?
“Shrug both shoulders upward against my hands.”
Strength? Contraction?
“Turn your head to each side against my hand.”
sternocleidomastoid contraction

74
Q

CN 12

A

Hypoglossal
Listen to articulation
(CN V, VII, X, XII)
Inspect for atrophy or fasciculation
Tongue protrusion: Asymmetry? Atrophy? Deviation?
“Move your tongue side to side.”: Symmetrical motion?
Not sure?: Ask patient to push tongue against cheek while you palpate externally to assess strength

Clin Skills (25 decks)

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