NEUROLOGIC Flashcards
What is the dermatome of the tip of the thumb?
C6 dermatome
What type of neurologic condition is from anterior horn cell above?
UMNL
Does Parkinson’s Disease have UMNL signs?
No
In the Hoehn and Yahr Classification, what stage is “All sx present and severe. Standing and walking possible with assistance”?
Stage 4
In the Hoehn and Yahr Classification, what stage is “Minimal bilateral or midline movement. Balance is not impaired.”
Stage 2
What neurotransmitter is lacking in PD?
Dopamine
What are the 4 cardinal features of Parkinson’s Disease?
rigidity, bradykinesia, tremor, and postural instability
What term refers to end-of-dose deterioration, a worsening of symptoms toward the end of the expected timeframe of medication effectiveness?
Wearing-off
Is there a single definitive test or group of tests used to diagnose PD?
No
What term refers to “masked” facial expression, a reduction in facial expressiveness?
Hypomimia
What is the triad of Bacterial Meningits?
Headache, fever and neck stiffness
What is the most specific part affected in PD?
Pars compacta in Substancia Nigra (Basal Ganglia)
Which Broddman’s area is in the precentral gyrus?
3, 1, 2
What is the most common site of occlusion in stroke?
MCA
__________ lobe ischemia results in amnesia (memory loss).
Temporal lobe ischemia results in amnesia (memory loss).
A pt c myelomeningocele aims to become a community ambulator. What are the 4 criterias for potential community amb?
- 1000 yards non-stop amb
- Don and doff orthosis indep
- All ADLs c braces on all day
- Can do stair negotiation
What muscles are intact with mid lumbar level Myelomeningocele?
L3 = Knee extensors
How many months in gross milestones can a child amb?
10-18 mos.
How many months in gross milestones can a child stand?
7-9 mos.
What is the usual pre amb orthosis used fro pt’s c thoracic level and upper lumbar level myelomeningocele?
Reciprocating gait orthosis RGO
What muscles to be tested for L4 myotome?
Ankle dorsiflexors
What myotome is the muscle for ankle plantarflexion?
S1
What muscles to be tested for S2 myotome?
Knee flexors
What type of ambulators are pt’s c Myelomeningocele T12-L2?
Household ambulators; difficulty in stair negotiations
Parasympathetic nervous system arises from what spinal division?
Parasympathetic nervous system arises from Craniosacral division
What are the cholinergic receptors of the parasympathetic nervous system?
Muscarinic and Nicotinic receptors
Among the cranial nerves related in parasympathetic nervous system which does not have a cranial nerve ganglia and why?
CN X is the longest CN based on extracranial course; does not need ganglia since it is already long
What are the cranial nerves related in parasympathetic nervous system?
CN III, CN VII, CN IX, CN X
What are the ganglias related with CN VII?
Pterygopalatine, submandibular and sublingual ganglia
What is the sympathetic effect on the detrusor muscle and sphincter?
Detrusor muscle is relaxed while sphincter is contracted
What is the parasympathetic effect on the lungs?
Bronchoconstriction
What is the parasympathetic effect and sympathetic effect on the genitalia of the male and female?
Ejaculation in males and Emission in females (Sympa)
Erection in males and Lubrication in females (Para)
If a pt has a long thoracic nerve palsy what direction of scapular winging does the pt have?
Medial scapular winging (Serratus ant. palsy)
How many extensors tunnels are there?
Enumerate the extensors mm per tunnel.
1 = APL, EPB 2 = ECRL, ECRB 3 = EPL 4 = EDC, EIP 5 = EDM 6 = ECU
What is the “mobile wad of 3” in Lateral epicondylitis?
Brachioradialis, ECRL and ECRB
What is the last mm innervated by the radial nerve?
EIP
What is the innervation of Teres Major and Subscapularis
Lower subscapular nerve
What is the innervation of Deltoids and Teres Minor?
Axillary nerve
What are the muscles innervated by Posterior Interosseus nerve?
APL, EPB, EPL, EIP
What is the innervation of ECRL, ECRB?
Radial nerve
What medical condition do you call when there is unequal pupil size?
Anisocoria
What cranial nerve is affected c Anisocoria?
CN III
What cranial nerve is affected in a pt c (+) Vertical diplopia?
CN IV
What are the muscles being innervated by the CN V?
Tensor tympani, Temporalis, Internal/ Medial pterygoid, Masseter, External/Lateral pterygoid
What quadrant/s of the face have dual innervations?
2nd and 3rd quadrant
What quadrant of the face are affected with R CVA?
4th quadrant (L Lower quadrant)
What quadrant/s of the face are affected with Myasthenia Gravis?
1, 2, 3, 4
What is most likely the case of a pt. who has Bifacial Palsy with Internal Strabismus?
Mobius Syndrome
What are the related sensation functions of CN IX?
Sensation of the external ear, post. 1/3 of the tongue, uvula (gag reflex)
What are the related motor functions of CN IX?
Muscles of the pharynx and larynx, stylopharyngeus mm (swallowing), Salivation
What are the parasympathetic functions of the CN X?
Cardiac inhibition (vasovagal reflex), Bronchoconstriction, Inc. GIT motility
What are the related motor functions and muscle innervations of CN X?
Tensor veli palatini (uvula mm.), palatoglossus (tongue mm.), swallowing
Case: If the pt. has R CVA, what uvular side will be paralyzed?
L side of the uvula is paralyzed; uvula would deviate towards the R lesion away from the hemiplegic side
Case: if the pt. has L vagal palsy, what uvular side will be paralyzed?
L side of the uvula is paralyzed; uvula would deviate away from the lesion (R)
What are the muscles innervated by the CN XI?
Innervates the SCM and the trapezius mm
If there is a lateral winging of scapula, which muscle would compensate for the major loss of function of the traps muscle fiber function?
Serratus anterior (scapular abduction & upward rotation)
If there is a medial winging of scapula, which muscle would compensate for the horizontal forward reach?
Pectoralis major
If there is winging of the Serratus anterior, the ___ would then compensate.
Trapezius mm
What is the synergistic action of the upper fibers of the traps and levator scapulae?
Scapular elevation
What is the antagonistic action of the upper fibers and lower fibers of the traps?
Upper fibers: Elevation
Lower fibers: Depression
What is the antagonistic action of the upper fibers of the traps and levator scapulae?
Upper fibers: Upwardly rotate
Levator scapulae: Downwardly rotate
What is the innervation of the Rhomboids and the levator scapulae?
Dorsal scapular nerve
What are the muscles innervated by the CN XII?
Intrinsic mm of the tongue (Vertical, transverse, longitudinal fibers) and extrinsic mm of the tongue (Genioglossus, hyoglossus, styloglossus)
Case: If the pt. has R CVA, what tongue side will be paralyzed?
L side of the tongue would be paralyzed
In a pt c R CVA and L side of tongue is paralyzed where will the tongue deviate towards?
Tongue would deviate towards the L (towards the affected hemiplegic side; since it’s converging)
What is the most dangerous layer of the scalp?
Loose areolar connective tissue layer
What causes the risk of infection of the emissary veins in the loose areolar connective tissue layer?
Centripetal flow (emissary veins to SSS, IJV to SVC)
Which mater/ membrane of brain nutrition and blood supply (good perfusion)?
Pia mater
What is the Cushing’s triad of increased ICP
Hypertension, bradycardia, irregular respiration
What is the normal CSF volume in an adult?
90-150 mL
What is the normal CSF pressure in an adult?
90-180 mmH20
What is the normal CSF volume in a child?
60-100 mL
What is the normal CSF pressure in a child?
10-100 mmH20
What is the triad of hydrocephalus?
Dementia, ataxia, incontinence
What type of shunt will a pt receive of a pt c hydrocephalus who has no heart problems?
Ventriculoatrial VA shunt
Where will the CSF of a VP shunt be directed?
GI (Peritoneum)
What do you call the signs associated with basal skull fracture?
Racoon eyes sign and Battle sign
What is another term for the primitive hind brain?
Rhombencephalon
Where will you find the regulation of Hering-Breuer reflex?
Pneumotaxic respiratory center in the Upper Pons
Which is more severe and has a poorer prognosis (Decerebrate posturing/ Decorticate posturing)?
Decerebrate posturing
True or False. The fibers in the cerebellum do not decussate.
True
What lobe of the cerebellum is responsible for muscle tone?
Anterior lobe of the cerebellum/ Paleocerebellum
What lobe of the cerebellum is responsible for equilibrium?
Flocculonodular lobe/ Archicerebellum
In a pt c decorticate posturing where is the lesion located?
Corticospinal tract and thalamus
What is the Charcot’s triad of Multiple Sclerosis?
SIN
Scanning speech, Intentional tremor (movement tremor), Nystagmus (vertical and pendular)
What do you call the difficulty in performing rapidly alternating movements?
Dysdiachokinesia
What do you call the inability to maintain limb pos. after resistance have been removed?
Rebound phenomenon
What type of posturing can be seen in a pt. c TBI (Decerebrate posturing/ Decorticate posturing)?
Decerebrate posturing
What do you call the syndrome which refers to the Paralysis of the upwards gaze (Vertical gaze center affectation)?
Parinaud’s syndrome
What hormone is responsible for the production of milk?
Prolactin
What hormone is associated with the release of progesterone for ovulation?
Luteinizing hormone LH
What are the roles of the limbic lobe?
Emotional behavior, memory and sexual drive
Which hemisphere is generally the dominant hemisphere?
Left hemisphere
If a pt has Broca’s aphasia what type of questions should you ask the pt?
Close-ended questions answered by yes or no
What is the BA 39 (Angular gyrus) responsible for?
Reading and writing
What BA functions as a sensory motor collaborator/ sensory motor integrated area?
BA 40 (Supramarginal gyrus)
What BA is known as the sensory association area?
BA 5 and 7
Is dopamine an inhibitory neurotransmitter or excitatory neurotransmitter?
Both inhibitory and excitatory neurotransmitter
Case: A lesion in the optic chiasm will lead to what vision problem?
Bitemporal heteronomous hemianopsia (lesion at the decussation)
