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V Med > Neuro (lecture/trans) > Flashcards

Neuro (lecture/trans) Flashcards

1
Q

Abnormal perception of pain from a normally nonpainful mechanical or thermal stimulus. Delay in perception and of after sensation

A

Allodynia

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2
Q

Mainly spontaneous abnormal sensation that is mot unpleasant; usually described as “pins and needles”

A

Paresthesia

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3
Q

It is measured through position sense and vibration sense

A

Proprioception

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4
Q

In patients with immature brain or deep coma, meningeal signs are all positive. True or False

A

False. We will not be able to elicit the meningeal irritation signs

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5
Q

If the patient cannot raise his hand but cam do side to side movement of the extremities

A
  1. Active movement with gravity eliminated
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6
Q

Character of the alteration of muscle tone in extra pyramidal syndromes

A

Plastic, equal throughout passive movement (rigidity) or intermittent (cogwheel)

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7
Q

Superficial abdominal reflex direction of the stimuli

A

Towards the umbilicus

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8
Q

Seen in loss of position sense in the legs from polyneuropathy or posterior column damage.

A

Sensory ataxia

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9
Q

Gait is staggering and unsteady,
with feet wide apart and
exaggerated difficulty on turns. Patients cannot stand steadily with feet together, whether eyes
are open or closed.
Other signs are
present such as dysmetria,
nystagmus, and intention
tremor.

A

Cerebellar ataxia

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10
Q

Modulates equilibration and the orientation of head and eyes
• Has connections with Vestibular Nuclei located in the Pons and Medulla

A

Flocculonodular lobe

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11
Q

Left Frontal Lesion
• Instruction:
1. Verbally instruct the patient to do the different
tongue movements 2. Ask the patient to act as if blowing out a match or
sucking a straw 3. If verbal instruction fails, try miming
• If the person cannot do the action even if you already
showed him how

A

BUCCO-FACIAL APRAXIA

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12
Q

Left Parietal Lesion
• Instruction:
1. Ask the patient to demonstrate sequential acts → Example: illustrate how to cook rice

A

Ideomotor apraxia

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13
Q

Right Parietal Lesions
• Instruction: 1. Draw geometric figures

A

Constructional apraxia

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14
Q

Dysfunction of the Medial Frontal Cortex
• One reason why a patient with no hemiparesis will still
stay bed-bound → patient’s brain forgot how to walk

A

Gait apraxia

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15
Q

Perception of odor in absence
• Example:
HALLUCINATORY EXPERIENCE
• Causes:
a. Medial Temporal Lobe Seizure →
Uncinate Fit – abnormal neuronal discharge is coming from the Uncus of the Temporal Lobe

A

Phantosmia

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16
Q

The preferential gaze and the hemiparesis will both be contralateral to the lesion
True or False

A

True

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17
Q

Pontine gaze center, ipsilateral or contralateral

A

Ipsilateral

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18
Q

If you have an infarct on the Right Pons, the
Preferential Gaze is on the

A

Left

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19
Q

Ask the patient to say “ah” or to yawn as you watch the movements of the soft palate and the pharynx. What CN test?

A

CN IX, GLOSSOPHARYNGEAL NERVE

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20
Q

In a patient experiencing weakness on the right face, right arm, and right leg, lesion will be on the

A

Left corticospinal tract

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21
Q

Lesion is below the brainstem, weakness is what side

A

Ipsilateral to the lesion

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22
Q

Manifest as the lower motor neuron type of lesion

A

Lesions at Ventral Gray Horn, Ventral Root, Spinal Nerves, Plexuses, Peripheral Nerves, NMJ, Muscle (if it is already involving the parts of the PNS + the Gray Matter of the Spinal Cord)

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23
Q

will manifest as the UPPER MOTOR NEURON type of weakness

A

If the lesion is located anywhere between the
Cerebral Hemispheres to the Lateral White Matter of the Spinal Cord

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24
Q

increased muscle tone, hyperreflexia

A

upper motor neuron signs

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25
Q

decreased muscle tone, hyporeflexia, fasciculations and atrophy

A

lower motor neuron signs

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26
Q

mediate voluntary movement and integrate skilled, complicated, or delicate movements by stimulating selected muscular actions and inhibiting others.

A

Corticospinal (pyramidal) tract.

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27
Q

synapse on lower motor neurons in the spinal cord which directly mediate movement. Damage causes weakness.

A

the corticospinal tract system

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28
Q

helps to maintain normal muscle tone and to control body movements, especially gross automatic movements such as walking.

A

Basal ganglia system.

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29
Q

Damage can cause rigidity, slowness of movement (bradykinesia), involuntary movements, and/or disturbances in posture and gait.

A

to the basal ganglia

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30
Q

receives both sensory and motor input and coordinates motor activity, maintains equilibrium, and helps to control posture.

A

Cerebellar system.

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31
Q

also helps coordinate eye movements and speech, so other signs like nystagmus or dysarthria may be seen.

A

cerebellum

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32
Q

Damage can impair coordination (called ataxia), gait, equilibrium, and decrease muscle tone

A

cerebellum

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33
Q

True or False

Disease of the basal ganglia system or cerebellar system cause paralysis

A

False. does not cause paralysis but can be disabling.

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34
Q

Origin area of corticospinal tract

A

Frontal Lobe / Area 4 /
Prefrontal Gryus

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35
Q

MOST COMMON SITE of
INTRACRANIAL HEMORRHAGES secondary to
Hypertension

A

Basal ganglia

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36
Q

Atrophy slight and due to disuse
• Comes AFTER the
weakness

A

UMN (Supranuclear) paralysis

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37
Q

Atrophy pronounced; up to 70% of total bulk
• May be present BEFORE
the weakness

A

LMN (Nuclear- Infranuclear) Paralysis

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38
Q

Hallmark of LMN (Nuclear- Infranuclear) Paralysis

A

Fasciculations / Rippling of Muscles

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39
Q

Spasticity
hyperactivity of the tendon reflexes and extensor plantar reflex (Babinski Sign)

A

UMN (Supranuclear) paralysis

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40
Q

Flaccidity and hypotonia of affected muscles with loss of tendon reflexes.
Plantar reflex, if present, is of normal flexor type

A

LMN (Nuclear- Infranuclear) Paralysis

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41
Q

Individual muscles may be
affected

A

LMN (Nuclear- Infranuclear) Paralysis

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42
Q

Pathognomonic Sign for a lesion anywhere in the Corticospinal Tract

A

+) Babinski Sign

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43
Q

Active movement done to evaluate the
strength of proximal leg muscles

A

Hopping in place, rising from sitting position, or
stepping up on stool

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44
Q

Excessive flexion of hips and knee with every step

A

Steppage Gait

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45
Q

Weakness of hip muscles cause drop of hip and
trunk tilting to the side OPPOSITE foot placement

A

Waddling Gait

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46
Q

fall to SIDE OF LESION
o Poor balance
o Ask which side the patient is veering too → that side is IPSILATERAL to the lesion

A

Vestibular ataxia

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47
Q

Small, shuffling steps or festinating
→ strides become quicker and
shorter than normal (hurrying)

A

Parkinsonian gait

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48
Q

If the Hemiplegia weakness of the face is on the SAME SIDE of the arm and leg weakness → lesion can be localized to

A

CEREBRAL
HEMISPHERE

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49
Q

If the hemiplegia weakness of the face is
opposite to the Hemiparesis → lesion can be localized to

A

Brainstem

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50
Q

A special form of Quadriplegia in
which the legs are affected more than the arms

A

Diplegia

51
Q

Occurs more often as a
transitional condition in the development of or partial recovery from Tetraplegia

A

Triplegia

52
Q

If the tone is spastic, it is an evidence of

A

Corticospinal Tract injury

53
Q

There is resistance
you start from the beginning
the until the end of ROM

A

RIGIDITY

54
Q

When you are about to
finish the ROM, that is
when you start encountering
resistance

A

Spasticity

55
Q

Clasp-knife effect

A

Spastic

56
Q

Presence of tremor, chorea,
athetosis, dystonia (Involuntary movements

A

Extrapyramidal syndromes

57
Q

Presence of Babinski sign and paralysis of voluntary movement

A

Corticospinal syndrome

58
Q

BICEPS REFLEX
Subserved by what Segment

A

C5-C6

59
Q

TRICEPS REFLEX
Subserved by

A

C6, C7, C8

60
Q

PATELLAR REFLEX
Subserved by

A

L2, L3, L4

61
Q

Achilles Reflex, what segment

A

S1 primarily

62
Q

Abdominal Reflexes

A

Upper: T8, T9, T10
Lower: T10, T11, T12

63
Q

True or False

Movement of the Umbilicus should move
towards the direction of the stimuli

A

True. If you are from the right going medially, the
Umbilicus should move towards the stimuli → will meet the stimuli midway

64
Q

Increased in:
a. Parkinsonism
b. Patients who are emotionally tense
Absence in adults indicates abnormality in the Spinal Arc or
Cortex

A

Abdominal Reflexes

65
Q

Abdominal Reflexes
Normally Absent in:

A

Infants less than 1 y/o
And
Patients in Deep Sleep (Anesthesia, Comatose)

66
Q

weakness is
usually on the proximal limb of the UE and there is also weakness on the muscles innervated by the Cranial Nerves

A

Myasthenia Gravis

67
Q

sensory
deficit will only appear if the problem
is in the

A

Peripheral Nerves / Spinal
Nerves

68
Q

If you have a Cerebellar Lesion, the motor findings will be

A

IPSILATERAL to the lesion

69
Q

middle part of the Cerebellum is known as

A

Vermis

70
Q

jerky movement of the eye)

A

Nystagmus

71
Q

True or False
To test truncal ataxia, you will not ask the patient to walk

A

True

72
Q

Concerned with posture gait and truncal tone

A

Anterior lobe of the cerebellum aka Rostral Vermis

73
Q

• Lesions:
1. Unsteady Walking
2. Gait Ataxia
3. Hypotonia

Caused by:

A

Alcoholism and Nutritional
o Most common cause is
Malnutrition
o Chronic Alcoholism can cause
the cells of the Cerebellum to
die → imbalance even if the
Anterior Lobe
patient is not drunk

74
Q

will manifest or amplify the Gait Ataxia of the patient

A

Tandem Gait (walking)

75
Q

consists of slowness, slurring of words, and Scanning Speech
• Voice varies from a low volume to a high volume
o Due to failure to meter and modulate the strength
of the muscular contraction that produce the speech sounds

A

Dysarthria

76
Q

Coordination of skilled action • Lesions:
1. Limb Ataxia
2. Dysmetria
3. Dysdiadochokinesia
4. Tremor
5. Dyssynergia

A

Posterior Lobe of the cerebellum

77
Q

Finger-to-Nose Test tests for

A

Dysmetria

78
Q

CLINICAL TESTS FOR LEG DYSTAXIA

A

Heel-to-Shin/Knee Test
Heel-tapping test

79
Q

the inability to control the distance, speed, and range of motion necessary to perform smoothly coordinated movements.

A

Dysmetria

80
Q

lack of muscular coordination resulting in shaky limb movements and unsteady gait.

A

Dystaxia

81
Q

OTHER MANIFESTATIONS OF CEREBELLAR DYSFUNCTION

A

Decomposition of Movement
Hypotonia
Mild Asthenia

82
Q

Patients with Cerebellar Dysfunction do not
experience any weakness o However, generally, they complain of weakness o There is some form of generalize muscle
weakness

A

Mild Asthenia

83
Q

Floppy posture
Rag Doll Gait
Pendulous MSRs
Manifests what cerebellar abnormality

A

Hypotonia

84
Q

Classical Pathology of Unilateral Anosmia

A

OLFACTORY GROOVE
MENINGIOMA

85
Q

Distortion of sense of smell
Causes:
a. Recovery from Head Injury
b. Psychiatric Disorders

A

Parosmia

86
Q

Decreased sense of smell due to AGING

A

Presbyosmia

87
Q

Triad of Parkinson’s Dss

A

Bradykinesia, Rigidity, and Resting Tremors

88
Q

DEFICITS ASSOCIATED WITH LEFT HEMISPHERE DAMAGE

A

Aphasia
2. Right Left Disorientation
3. Finger Agnosia → Temporal Lobe
4. Constructional Apraxia
5. Limb Apraxia

89
Q

DEFICITS ASSOCIATED WITH right HEMISPHERE DAMAGE

A
  • Anosognosia
    -Visuospatially-oriented perception and behavior
  • musicality
  • verbal inflections, aand voice tone
  • dressing apraxia
  • prosopagnosia
90
Q

Inability to understand or express words as symbols
for communication even though the PRIMARY SENSORIMOTOR PATHWAYS to RECEIVE and EXPRESS LANGUAGE and mental status are RELATIVELY INTACT

A

Aphasia

91
Q

difficulty in the production of the word and sound due to a defect in the muscular control of the muscles used for speech.
The central symbolic aspect of language remains intact.

A

Dysarthria

92
Q

disorder in producing or understanding language.

A

Aphasia

93
Q

True or False

Aphasics retain Exclamatory Speech and also
singing and humming

A

True

94
Q

Associated Speech Area

A

Supramarginal Gyrus o Angular Gyrus

95
Q

Wernicke’s Area

A

Superior Temporal Lobe

96
Q

Inferior Frontal Lobe

A

Broca’s Area

97
Q

Conduction aphasia lesion

A

Arcuate fasiculus

98
Q

Arcuate Fasciculus is a

A

Band of White Matter connecting the Broca’s and Wernicke’s Area

99
Q

Aka motor aphasia

A

Broca’s aphasia,

100
Q

Fluent speech but cannot understand

A

Receptive Aphasia /
Wernicke’s Aphasia

101
Q

the problem is in naming
and repetition

A

Conduction aphasia

102
Q

Problem is only in naming

A

Anomic

103
Q

Global aphasia lesion area

A

Perisylvian region

104
Q

Posterior border zone lesion produces transcortical motor aphasia
True or False

A

False. produces transcortical sensory aphasia

Motor - anterior border zone

105
Q

Inability to perform a voluntary act even though the
motor system, sensory system, and mental status are intact

A

Apraxia

106
Q

Right parietal lesions

A

Constructional apraxia
Dressing apraxia

107
Q

Gait apraxia lesion

A

Medial frontal cortex

108
Q

Inability to demonstrate sequential acts
Left parietal lesion

A

Ideomotor apraxia

109
Q

Bucco-facial apraxia lesion area

A

Left frontal lesion

110
Q

if the sensory problem is in the Cord or CNS, the numbness will be

A

Contralateral to the lesion

111
Q

If the numbness is in the PNS → abnormal sensation
will be felt

A

IPSILATERAL to the lesion

112
Q

True or False
Proprioceptive Pathways alone should be the
one maintaining the verticality

A

True

113
Q

inability to understand the meaning, import, or
symbolic significance of ordinary sensory stimuli

A

AGNOSIA

114
Q

Ability to identify numbers written in hand

A

Graphesthesia

115
Q

Graphesthesia Lesion

A

CONTRALATERAL PARIETAL

116
Q

Prosopagnosia lesion

A

RIGHT or BILATERAL INFEROMEDIAL Lesion TEMPORO-OCCIPITAL region

117
Q

Inability to locate, identify, and orient one’s body
parts
And what lesion area

A

Asomatognosia
LEFT ANGULAR GYRUS

118
Q

Inability to be aware of his own bodily defect

Lesion area?

A

Anosognosia

RIGHT PARIETAL (Classic)

119
Q

Astereognosia lesion

A

Same with Agraphesthesia
CONTRALATERAL PARIETAL

120
Q

Seen with RIGHT PARIETAL LESION • Unilateral Neglect

A

LEFT-SIDE HEMISPATIAL INATTENTION
demonstrate that there is intact sensation on both sides; when tested SEPARATELY but when tested SIMULTANEOUSLY, the patient was able to perceive only one side

121
Q

True or False
CN are already a part of PERIPHERAL NERVOUS SYSTEM

A

True

122
Q

Lesion in the PRETECTAL NUCLEUS (Midbrain) o Seen in NEUROSYPHILIS

A

ARGYL ROBERTSON PUPIL

123
Q

Horner’s Syndrome is a GOOD LATERALIZING sign → If
miosis is on the Right, then the lesion is

A

also on the
Right

124
Q

Causes of 3rd Nerve Palsy

A

Uncal Herniation
2. Posterior Communicating Artery Aneurysm
3. Cavernous Sinus Thrombosis
4. Tolosa-Hunt Syndrome

V Med (6 decks)

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