Neuro Review Final Flashcards
facial droop:
if can’t close eye all the way?
cn 7 (if weak eye closing, it could be UMN)
facial droop. Location? Anything else involved like ____ or ____?
hyperacusis (this would be 7 right at nucleus on ipsilateral side) or taste? (this would be 12)
Bell’s Palsey could result in:
Blinking reflex abnormal, earache, lacrimation problems, loss of taste in tongue, and seventh cn
a cause of Bell’s Palsey could caused by:
HSV, diabetes infarction, etc, treat with steroids and antivirals
if Bell’s palsey with lesions around the ears:
hsv reactivation causing bell’s palsey, use avalcyclovir of steroids (they help all inflammation)
don’t give steroids to a diabetis:
it’ll raise their blood sugar
palate elevation:
cn9 and 10
pupillary response:
cn 2 and 3
dystarthia:
10 or 9 and 10
Tongue and palate 9, 10, 12 always trip you up because they travel on the same side down the _____ until:
cortico bulbar tracts from the motor cortex in the brain until they get to the level they want to be and then they cross over (this is why they will show opposite facial side findings from the other problems)
if you have a pontine lesion, you will have a bell’s palsey on the ipsi side, and then possibly a:
palate elevation on the other side, tongue deviation, hemiparesis, etc on the other side
hoarsness:
vegal fibers
all one side sensory loss, face and body:
brain
what parts of the brain can only be responsible for sensory loss?
thalamus
if cortex can be responsible for sensory loss, why can’t a storke in the cortex give you all one sided sensory loss?
the motor and sensory cortex share the same blood supply
all sensory information (other than smell) has to go through the____
thalamus
can sensory loss be from cerebellum lesion?
no!
Note that complete loss of all sensory everything on face and body means a ______ lesion on the _______ side
thalamus, opposite side from the loss
T12 loss of all pain and temp as well as motor, but still has vibration and sensation:
anterior cord syndrome, bilateral at level of t12, and this was caused by a rupture of the anterior spinal artery infarct
if hands are weaker than shoulders, it must be:
nerve
if muscles are weaker than hands:
muscle
if spinal cord, there can’t be problems:
above and below the paralesis
distal weakness, areflexia, all points to:
nerve problem
gradually weaker (subacute) , ascending weakness, areflexia, no sensory loss, POSSIBLY BIFACIAL WEAKNESS:`
guillain-Barre
acute right-sided weakness, dyarthric but not aphasic, right facial droop that spares the forehead, right side hemiparesis, no sensory loss
everything on one side: brain!
does not have to be umn or lmn, etc.
if nothing in the differential says anything about distal here, proximal there, and everything is affected on one side, it’s:
brain, regardless of things like aphasia, reflexes, etc, opposite side internal capsule
if you have all sensory loss on one side, it is most always ___ but occasionally it can be a _____
internal capsule stroke (2/3), ventral pontine stroke getting the coricospinal tract above where the facial nucleus is located (1/3)
if someone has a stroke that effects the thalamus, they may not be _______ right away
hyperreflexic, espeically diabetics
unconscious man with small pupils, minimally reactive, eyes don’t move horizontally but intermittently spontaneously deflect downward and come back, no movement horizontally to cold calorics, blink to corneal reflex, no facial grimace to pain, slight gag, no motor movement to pain, increased tone, reflexes are hyperactive and both toes go up, bilateral clonus
unconscious must be brainstem!
no eye movement
if you have no eye movement on exam, the lesion must be:
in the brainstem
if eyes don’t move horizontally and don’t move to cold water it is a problem with :
pprf!