Neurological clinical Assessment Flashcards
what is the munro-kelly doctrine?
cerebral partial pressure= mean arterial pressure - intracranial pressure
why would there be a fixed dilated pupil in herniation?
there is brain herniation under the falx cerebrum and over the tentorium
what would you observe in a non-communicative patient?
> posturing
focal lack of movement
eye movement
speech
what are the functions of the frontal lobe?
> voluntary control of movement > speech > saccadic eye movements > bladder control > gait > higher order
what is the function of the precentral gyrus?
voluntary control of movement
what is the function of the pars opercularis and pars triangularis?
speech
what is responsible for bladder control in the frontal lobe?
paracentral lobule
what part of the frontal lobe controls the gait?
the periventricular bit
what signs could you see in pyramidal weakness?
> UMN signs: weakness, increased tone, brisk reflexes, up going plantar
pronator drift
what part of the frontal lobe is involved in restraint and how would you examine this?
orbitofrontal cortex:
> is speech socially appropriate
> stroop test
> go-no go test
if the supplementary motor cortex (anterior cingulate) is affected what might be observed?
> lack of motivation
apathy
abulia
depression
what might happen if the dorsolateral prefrontal cortex is affected?
> loose ability to make and keep appointments
loose ability to give coherent account of history
struggle to spell WORLD backwards
(> ask them to same as many words as possible with a particular letter)
which is more anterior broccas or wernicks area?
broccas
when examining language what would you check?
> fluency > nominal aphasia > repetition > 3 step command > baby hippopotamus > orofacial movement > reading > writing
what is nominal aphasia?
where there is retrieval problems with words and they cannot express the words they wish
what area is responsible for fluency of speech?
brocas area
what area would be affected if there is poor speech repetition?
arcuate fasciculus
what are the functions of the parietal lobe?
> body image representation > multimodality assimilation > visuospatial coordination > language > numeracy
name some cortical sensory syndromes
> sensory inattention
asteroagnosia
dysgraphasthesia
two point discrimination
describe gerstmans syndrome (dominant)
> dyscalculia
finger ammonia
left/right disorientation
agraphia
What signs point to the non-dominant side of the parietal lobe?
> ideomotor apraxia (copy physical movements)
ideational apraxia (cannot create and carry out a plan)
constructional apraxia (copying drawing)
dressing apraxia
hemineglect
loss of spatial awareness
what are the functions of the temporal lobe?
> processes auditory input > language > encoding declarative long term memory > emotion (amygdala) > visual fields
what is the function of the heschl gyrus in the temporal lobe?
processes auditory input
what are cerebellum problems?
DANISHP > dysdiadochokinesla > ataxia > nystagmus > intention tremor > slurred speech > hypotonia > past pointing (> hydrocephalus)
describe (briefly) radiculopathy (nerve root)?
> unilateral
single myotome
single dermatome
lower motor neuron
Describe long tract signs in myelopathy
> clonus > upgoing plantars > increased tone > brisk reflexes > Hoffman sign > proprioception impairment (rombergs test, tandem walking)
describe the signs and symptoms in radiculopathy
> pain in single dermatome
dermatomal sensory disturbance
weakness in myotome
loss of reflex
is the exiting or the transversing nerve root affected by a spinal lesion?
the transversing root
