neurological exam 2 Flashcards
What type of aphasia would someone with CVA (stroke) most likely have?
expressive aphasia
If the results to a brain injury are expressive aphasia, which part of the brain was likely injured?
(rhymes with stroke or strokas lol)
Broca’s Area (motor speech area)
Which lobe associates with receptive aphasia?
Temporal
Which part of the brain associates with Proprioception?
Parietal
What does the Cerebellum deal with?
coordinates movement, maintains equilibrium, muscle tone, balance, and posture
What kind of data does the Parietal lobe process?
(remember what proprioception is, sensing what’s around you in relation to where you are)
data from senses (touch, sight, smell, hearing, taste)
What is ataxia and which part of the brain associates with it?
inability to control muscle movement
Cerebellum
Give the sequence of neurologic examination
- Mental status
- Cranial nerves
- Proprioception/Cerebellar function
- Sensory
- Reflex
Where is broca’s area located?
(lyrics from Train “soul sister)
frontal lobe left side
(your lipstick stains on the front lobe of my left-side brain)
Where would you find the motor cortex (initiates voluntary movement) and the Broca’s area (motor speech area) (if injured expressive aphasia)?
Frontal lobe
Which type of aphasia is when you can talk but cannot understand what others are saying? (can’t receive)
Which type of aphasia makes it so your workds don’t come out right? (can’t express yourself)
receptive aphasia (injury to wernickes area, temporal lobe)
expressive aphasia (injury to Broca’s area, frontal lobe)
Which Lobe of the brain is the primary auditory reception area?
(hint: the place where wernicke’s area is found)
Temporal Lobe
Which lobe is the primary vision center?
Occipital Lobe
What word describes the ability to know where you are in relation to everything else?
Proprioception
If you have ataxia, what part of the brain isn’t functioning correctly?
Cerebellum
What part of the body mediates reflexes?
Spinal Cord
Which part of the spinal cord is arranged in a butterfly shape with anterior and posterior horns?
nerve cell bodies
Name the two pathways of the CNS
Left Cerebral Cortex
Right Cerebral Cortex
Which one of the 2 CNS pathways, receives sensory info from and sends motor function to the right side of the body?
Left Cerebral Cortex
Which one of the 2 CNS pathways receives sensory info from and sends motor function to the left side of the body?
Right Cerebral Cortex
What is stereognosis?
(hint:what’s in the bottom of my purse?)
fine localized touch, without looking you can ID familiar objects by touch
Sensation travels via which type of fibers?
afferent
(sensory in)
List in order the places sensation travels to via afferent fibers
(Sensory Pathways)
from peripheral nerve
to
posterior dorsal root
to
spinal cord
then to
Spinothalamic tract or Posterior dorsal columns
Posterior Dorsal Columns have fibers that conduct sensations of what?
(3 things)
fine localized touch (stereognosis)
vibration
proprioception (position)
Which “Tract” deals with pain, temperature, and crude touch?
Spinothalamic Tract
Pain and temperature sensations travel via which type of fibers?
afferent
Give the order of how Pain and temperature sensations travel on the Spinothalamic tract.
(Where do thcome from and where all do they go?)
Peripheral nerve
to
posterior dorsal root
to
spinal cord
then synapse with a 2nd sensory neuron
then ascends up lateral spinothalamic tract
How does Crude touch travel?
up the Anterior Spinothalamic Tract
Which pathway mediates very skilled purposeful movement like writing?
(Motor Pathways)
Corticospinal or Pyramidal Tract
Which “Tracts” control Lower Body movement, maintain muscle tone, controls gross automatic movements such as walking?
Extrapyramidal Tracts
Does the Cerebellar System operate on a conscious or subconscious level?
subconscious
(coordination, equilibrium, posture)
Which Nervous System are the Upper Motor Neurons located in?
CNS
(entirely in the CNS)
CVA, Cerebral Palsy, & MS effect which Motor Neurons, Upper or Lower?
Upper
(descending motor fibers)
Which Nervous System are the Lower Motor Neurons mostly located in?
PNS
(Peripheral Nervous System)
Spinal Cord Lesions
Poliomyelitis
& ALS
all effect which Motor Neurons, Upper or Lower?
(hint: PNS)
Lower Motor Neurons
What happens with ALS?
(Lou Gehrigs disease)
deterioration of nerve fibers towards muscles, myelin sheath deteriorates
characterized by stiff muscle, muscles twitching, muscles decrease in size.
difficulty speaking, swallowing, and eventually breathing
(No cure)
What system of the body is responsible for carrying input to the CNS via afferent fibers and delivering output from the CNS via efferent fibers?
Peripheral Nervous System
(PNS)
(a bundle of never fibers outside of the CNS)
If an adults toes flare out during a Babinski reflex test, is that the correct reaction or is something wrong?
not correct reaction.
they most likely have a head injury
(only babies should react with a toe flare, adults toes should curl in)
What do Migraines and Seizures have in common?
Aura
(this is something they see or hear prior to having oone of these occur, a warning sign)
Which disease has a sign of tremors?
Parkinsons
difficulty swallowing is _________
difficulty speaking is _________
dysphagia
dysphasia
What can cause a headache
(what is a headache)
constriction of vessels
dehydration
stress
high BP
hypertension
anxiety
What is the highest score on a Glasgow Coma Scale?
What is the lowest score possible on a Glasgow Coma Scale?
15
3 (you’re basically dead)
What do you use to check when a patient is comatose?
Glasgow Coma Scale
What is the name of the balance test where you have a person stand with feet together and arms at the side, with their eyes closed and see if they sway
(church sway)
Romberg Test
3 ways to check coordination and skilled movement?
finger-to-finger test
finger-to-nose test
heel-to-shin test
If you were assessing for the Spinothalamic Tract, what would you use?
sharp/dull
light touch
cold/hot
List all of the areas you would test for stretch or deep tendon reflexes
(6 places)
- Biceps reflex
- Triceps reflex
- Brachioradialis reflex
- patellar reflex
- plantar reflex
- achilles reflex
When you are grading reflex, what do the numbers of the grading scale represent?
4+
3+
2+
1+
0
4+ = very brisk
3+ = Brisk
2+ = Average, normal
1+ = Diminished, low normal
0 = No response
another name for the Babinski reflex?
Plantar reflex
(up the lateral side of sole of foot)
How to perform a Bicep reflex assessment?
place thumb on bicep tendon
strike a blow on your thumb
how to assess for tricep reflex?
have patient let their arm go limp as you suspend it by upper arm
strike the triceps tendon directly just above the elbow
how do you perform the reflex test on the brachioradialis?
hold patients thumb to suspend forearm in relaxation
strike the forearm directly, about 2-3 cm above the radial styloid process
how do you perform the achilles reflex test?
position the patient with knee flexed and the hip externally rotated
hold the foot in dorsiflexion, and strike the achilles tendon
Seizures and Strokes are disorders of which nervous system?
CNS
Name the two types of abnormal positionings that are associated with disorders in the CNS
Decorticate
Decerebrate
Which abnormal positioning (decorticate, or decerebrate) is the worst, where the person is no longer having the defense mechanism response of trying to protect their core (internal organs)?
Decerebrate
Name 3 disorders of the PNS (Peripheral Nervous System)
(hint: jeff wescott had one of them)
Trigeminal Neuroglia (inflamed trigeminal nerve, facial pain)
Bell’s Palsy (face droops on one side)
Peripheral Neuropathy (diabetics)
