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PT 521 Patient Management > Neuro Lecture > Flashcards

Neuro Lecture Flashcards

1
Q

CNS

A

Brain, brainstem
Cerebellum
Spinal Cord

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2
Q

PNS

A

Motor & Sensory
CN & ganglia
Spinal nerves & dorsal root ganglia
Peripheral nerves

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3
Q

ANS

A

Sympathetic & Parasympathetic nerves & ganglia

Enteric System

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4
Q

UMN

A 
Brain to anterior horn of SC
Hyperreflexia
Clonus - rapid DF/PF
Abnormal reflexes
Muscle weakness
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5
Q

LMN

A

Anterior horn of SC via nerve roots to peripheral nerves
Hyporeflexia/Areflexia
Fasciculations - involuntary contractions
Atrophy
Muscle weakness

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6
Q

ALS/Lou Gerhig’s is involvement of UMN or LMN?

A

BOTH

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7
Q

Hallmark sign of ALS?

A

Hyperreflexia: Clonus in legs

Hyporeflexia/Areflexia reflexes in arms

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8
Q

If it’s in the brain, is it only effecting the Upper?

A

NO

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9
Q

ANS functions can happen when…

A

Nervous patients or other…

PNS/SNS

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10
Q

ANS Presentations

A 
Ringing in the ears
Dizziness
Blurred vision
Photophobia (light sensitivity)
Rhinorrhea (runny nose)
Sweating
Lacimation (tearing)
Generalized loss of muscle strength
Increased HR
Flushing (vasodilation)
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11
Q

ANS Signs for Peripheral nerve lesions: SNS changes

A

Loss of sweat glands (dryness)

Loss of pilomotor response (no goosebumbs)

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12
Q

ANS Signs for Peripheral nerve lesions: Sensory Changes

A

Loss of sensation
Loss of vasomotor tone
Skin may be scaly or smooth & shiny
Nail changes (brittle, no luster, irregular)

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13
Q

Peripheral injuries in LE

A

Patients will say numbness/tingling in a certain body part

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14
Q

Peripheral injuries in UE

A

Dropping things, b/c they can’t feel

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15
Q

If patient has double vision… what nerves are involved?

A

Cranial nerves

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16
Q

Coordination involvement is an involvement of what nerves?

A

CNS
Falling, LOB
Stiffness, difficulty moving quickly

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17
Q

Mental status Changes involvement is an involvement of what nerves?

A 
CNS
Confusion
Memory Loss
Attention
Behavior
Speech
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18
Q

What are some red flags?

A

ANS signs
bowel/bladder dysfunction and/or sexual dysfunction
Onset of peripheral symptoms w/ acute neck/back pain
Severe headache w/ other near signs (subarachnoid hemorrhage)
Neck stiffness w/ fever (meningeal irritation)

19
Q

Red flags: Emergency Situations

A 
Loss of speech
LOC
Sudden change in vision/tingling
Uncontrolled seizures
Sudden acute
No known dx
20
Q

Red flags: Non-emergency Situations

A

Known dx, but some changes

21
Q

Which test will help us understand upper vs lower motor neuron?

A

Reflexes
Deep Tendon
Pathologic: Babinksi

22
Q

Which regulates activity? UMN/LMN?

A

UPN

if this is involved, it gets our control

23
Q

If reflex is gone, which is involved?

A

LMN

24
Q

How to test for reflex?

A

Let the patient know that we are testing for the reflex… then distract them to relax them!

25
Q

How is reflex graded?

A 
0 - Absent
1+ - Diminished
2+ - Average
3+ - Brisk
Clonus

(Grade what you see!)

26
Q

What is hyperreflexia?

A

3+/Clonus, but could be normal, further testing required.

27
Q

What is a second test to determine UMN?

A

Babinski, positive if toes extends up

28
Q

What are the steps to screen for LMN?

A

LSensation (Check bilaterally)

1) Light touch (yes/no)
2) Pin prick (dull/sharp)
3) Vibration (start/stop)
* Determine patten of loss
- Dermatome or Peripheral

29
Q

What are the two main pathways?

A

Light Touch, Vibration, Proprioception

Nociception, Temperature

30
Q

Dermatome:

A

Sensory region of skin innervated by nerve root

31
Q

Myotome:

A

ALL muscles innervated by nerve root

  • Each nerve root innervates more than one muscle; therefore each muscle is innervated by more than one nerve root
  • One nerve root will be involved, but you won’t lose all movements (that muscle has other nerves running to it)
32
Q

After knowing the areas of involvement, how do you r/o spinal root or peripheral?

A

MMT

33
Q

Spinal nerve root is likely involved when…

A

There’s muscles in two spinal nerve areas with MMT
2 peripheral nerves involvement is not likely
*Look at myotome patterns & MOI…

34
Q

What MMT is considered a significant weakness with quads?

A

4/5

35
Q

Peripheral muscles: Femoral involvement:

A

Quads

36
Q

Peripheral muscles: Obturator involvement:

A

Adductors

37
Q

Peripheral muscles: Sciatic involvement:

A

HS

38
Q

Peripheral muscles: Tibial involvement:

A

HS

Gastroc/Soleus

39
Q

Peripheral muscles: Superficial Peroneal involvement:

A

PB/PL

40
Q

Peripheral muscles: Deep Peroneal involvement:

A

Gastroc/Soleus

41
Q

If peripheral is involved should you test all muscles in that area?

A

YES!

42
Q

What dx involved multiple peripheral nerve involvement?

A

Polyneuropathy (usually bilateral)
Common: Diabetes, stock-glove pattern
starts distal and comes proximally
*B12 deficiency as well

43
Q

Romberg Test

A

Positive is when patient closes eyes and falls over…
Has to be a profound loss to be considered -
When patient can’t feel the ground
Must be absent not diminished (sensory)

PT 521 Patient Management (25 decks)

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