Neurological Flashcards
Cerebral cortex lobes (4)
Frontal, parietal, occipital, temporal
Personality, behavior, emotions, intellectual functions
Frontal lobe
Mediates motor speech
Broca’s aphasia
What happens when the Broca’s aphasia is damaged?
Expressive aphasia results; person cannot talk
When a person understands language and knows what they want to say, but can only produce a garbled sound
Expressive aphasia
Center for sensation
Parietal lobe
Visual reception
Occipital lobe
Hearing, taste, smell, Wernicke’s aphasia
Temporal lobe
Associated with language comprehension
Wernicke’s aphasia
Person hears sound but it has no meaning, like hearing a foreign language
Receptive aphasia
When Wernicke‘s aphasia is damaged ___ results
Receptive aphasia
A coiled structure located under the occipital lobe
Cerebellum
Function of cerebellum (3)
Motor coordination, equilibrium, balance
T or F: the cerebellum does not initiate movement
True
Inspect muscles for ? (4)
Size, symmetry, strength, tone
Moving extremities through passive range of motion, supporting the joint tests muscles for __ 
Tone
Expected finding for muscle tone
Mild, even resistance to movement
Abnormally small muscle, occurs with disuse or injury
Atrophy
Increase size and strength
Hypertrophy
Weakness of the muscle
Paresis
Absence of strength
Paralysis or plegia
How to assess hand grasp test
Cross fingers and wrists, allow patient to squeeze with their hands 
How to assess pedal push
Put palm of hand underneath bottom of patient’s foot, allow them to “step on the gas“
Expected finding for hand grasp and pedal push tests?
Strength is equal bilaterally
RAM
Rapid alternating movement. Ask patient to pat their knees simultaneously at an increasing speed
Any imbalance in the cerebellar coordination tests may indicate
Cerebellar disease
Name 4 tests that assess cerebellar’s function in coordination
RAM, finger-to-finger test, finger-nose-finger, heel-to-shin
Touching the thumb to each finger on the same hand, starting with the index finger; then reverse direction
Finger-to-finger test
With open eyes, pt must touch nurse’s moving finger, their nose, then nurse’s finger again
Finger-nose-finger test
Patient must take their heel to their knee and run it down their shin without taking their foot off
Heel-to-shin test
Name three tests that assess cerebellar function in balance
Romberg, tandem walking, shallow knee bend
When patient stands up with feet together and arms at side for 20 seconds
Romberg test
Expected finding for Romberg test
Balance and posture maintained with possible slight sway
If patient loses balance during a Romberg test, that is a positive or negative test?
Positive
For a positive Romburg test, patient may have ___ or ___
Cerebellar disease; loss of vestibular function
Walking heel-to-toe in a straight line
Tandem walking
Having patient go down and come back up on one leg, using their hand on table for balance
Shallow knee bend test
Pain test and light touch test are ___ sensory pathways
Anterolateral (spinothalamic)
Lightly applying a sharp or dull paper clip to a random part of the patient’s body. Two seconds between each stimulus
Expected finding?
Pain test
Patient should be able to identify between dull and sharp on both sides of their body
Decreased pain sensation
Hypoalgesia 
Increased pain sensation
Hyperalgesia
Absent pain sensation
Analgesia
Lightly touching cotton ball to patient and having them say “now” when they feel it
Expected finding?
Light touch test
Patient is able to identify the light touch and its location
Decreased touch sensation
Hypothesia
Increased touch sensation
Hyperesthesia
Absent touch sensation
Anesthesia
Three tests that assess posterior dorsal sensory pathways
Vibration, kinesthesia, fine touch
Four types of fine touch tests
Stereognosis, graphesthesia, extinction, point location
Holding the base of a vibrating tuning fork on a bony surface of patient’s hand or foot
Vibration test
Expected finding of a vibration test
Patient can identify when vibration starts and stops
If unable to feel vibrations, patient may have
Neuropathy; diabetes or alcoholism
Peripheral neuropathy is worse at the ___, but improves when ?
Feet; move up the leg
With patient’s eyes closed, move their toe/finger up or down. Hold the digit by the sides
Kinesthesia test
Expected finding of kinesthesia test
Patient should be able to detect the movement of direction
With patient’s eyes closed, give them a familiar object to hold in one hand
Expected finding?
Stereognosis test
Patient identifies object
If patient fails any fine touch tests, this may indicate lesions of the
Sensory cortex
Tracing a number or letter in palm of patients hand
Expected finding?
Graphesthesia test
Patient identifies what you drew
Simultaneously touch both sides of body and same position
Expected finding?
Extinction test
Patient identifies how many sensations were felt and where
Touching patient’s skin and withdrawing the stimulus promptly
Expected finding?
Point location test
Patient identifies where you touched them
Grading scale for reflexes
0-4
Very brisk, large movement
4+ reflex scale
3+ reflex grade
Brisker than average
2+ reflex scale
Small movement, average, expected
1+ reflex scale
Diminished, smallest movement
0 reflex scale
No response
Support patient’s forearm on yours, placed them on patient’s bicep tendon and strike a blow on your thumb
Expected finding?
Biceps tendon
Contraction of bicep muscle and flexion of forearm
Hold patient’s upper arm, strike tendon just above elbow
Expected finding?
Tricep reflex
Extension of forearm
Hold patient’s thumbs to suspend forearms, strike forearm 2 - 3cm above radial process
Expected finding?
Brachioradialis reflex
Flexion and supination of forearm
Legs dangling freely and knees flexed, strike tendon
Expected finding?
Quadriceps reflex
Extension of lower leg
Hold patient’s foot in dorsiflexion, strike Achilles tendon
Expected finding?
Achilles reflex
Foot plantar should flex against my hand
Glasgow coma scale tells us if our patient is ___
Expected finding for total?
Oriented x3
15 points
Glasgow coma scale eye-opening grades
4: spontaneous eye-opening
3: Eye-opening to speech
2: Eyes opening in response to pain
1: no response
Glasgow coma scale motor response grades
Unexpected grades?
6: obeys verbal commands
5: patient points to pain
4: patient withdraws from pain
3: patients hands flexed to chest
2: patients hands extended outwards
1: no response
3-1
Glasgow coma scale verbal response grades
5: patient answers question correctly
4: Patient answers incorrectly
3: Patient answer is inappropriate or off-topic
2: patient answer is incomprehensible
1: no response
Brush infants check in your mouth, infant turns head in the same direction an open mouth
Rooting
When lips are touched, infant has __ reflex
Sucking
