Neurological Exam/Overview

Question 1

Central Nervous System Disorders

Answer 1

-upper motor neurons

-stoke
-MS
-Dementia
-Epilepsy
-Headaches
-MMT disorders
-CP
-SCI
-Brain tumors

Question 2

Peripheral Nervous System Disorders

Answer 2

-lower motor neurons

Motor Neuron
-polio
-ALS

Peripheral Nerve
-neuropathies

Neuromuscular Junction
-myasthenia gravis
-lambert eateons

Myopathy
-muscular dystrophies
-congenital myopathies

Autonomic

Question 3

Fascinomas

Answer 3

Capras Delusion
-belief that youve been replaced by imposter
-r hemiphere

Stiffperson Syndrom
-stiffness without weakness
-autoimmune

Prosopagnosia
-unable to recognize faces
-r hemiphere

Question 4

Steps In Diagnosis

Answer 4

Clinical facts > signs and symptoms > localize lesion > diagnosis

Question 5

c/o Weakness

Answer 5

-can mean a multitude of things

-fatigue, weakness, apathy, pain, decreased sensation, imbalance, drowsiness

Question 6

Neurological Exam

Answer 6

1. Mental Status/Language
2. CNs
3. Motor
4. Sensattion
5. Reflexes
6. Coordination
7. Gait

Question 7

Mental Status

Answer 7

Alert: awake and interactive

Lethargy: appears sleepy, aroused with stimulation

Stupor: arouses briefly to vigorous stimuli, but do not interact

Coma: unresponsive to external stimuli

-orientation, memory, concentration, judgement, praxis

Question 8

Speech and Language Disorders

Answer 8

-dysarthria: motor issue in speaking, slurred words

-Aphasia: language production (brocas and wernicke’s), affects dominant side (if r handed)

Question 9

CN 1

Answer 9

-olfactory
-alzheimer’s and parkinsons loses it faster (asymptomatic)
-trauma causes symptoms

Question 10

CN VII

Answer 10

-facial

Central: lower side, Peripheral (bells palsy) : both sides)

Question 11

Motor Exam

Answer 11

Bulk: atrophy, pseudohypertrophy

Tone:
-Flaccidity: little resitance tto passive mmt
-Rigidity: steady muscular tension that is equal
-Spasticity: velocity depended tension in muscles

Question 12

Upper Motor Neuron Signs

Answer 12

-stiffness, spasticity
-weakness in pyramidal pattern (flexors stronger in UE, extensors strogner in LE)
-hyperreflexia
-pathological reflexes

Question 13

Lower Motor Neuron Signs

Answer 13

-weakness, muscle atrophy, fasciculations, cramps
-no sensory involvement
-no pain
-hypoactive reflexive

Question 14

Romberg Sign

Answer 14

-standing with feet together while eyes are open but falls when closed
-earliest sign of DCML disease

-need 2/3 sensory systems to maintain balance

Question 15

Diagnostic Tests for Neuro Deficits

Answer 15

Lumbar Puncture
Neuroimaging
Neurophysiology

Question 16

Lumbar Puncture

Answer 16

Diagnosis:
-infectious conditions
-hemorrhage
-high pressure
-cancer

Inject meds: chemotherapy and anesthesia

Function:
-L4-L5
-Measure pressure: 80-200 mmH20, pressure, glucose, cells

Complications:
-headache, bleeding, infection, back pain

Question 17

Computed Tomography

Answer 17

-CT/CAT Scan
-quick, good view of bone and vascular structures
-radiation exposure and poor visualization of brain

Hyperdense: Bright, calcium, bone, blood
Hypodense: dark, csf ,fat, edema, stroke, fluid, air

Question 18

Magnetic Resonance Imaging

Answer 18

-MRI (most preffered)
-no radiation, higher resolution, unmarred by bony (hemorrhages, vascular malformation, aneurysms, tumors, MS)
-some contraindications, no bone, long time

Question 19

Magnetic Resonance Angiography

Answer 19

-MRA
-see blood flow/supply of brain

Question 20

Myelography

Answer 20

-inject contrast into subarachnoid space using CT
-in lui of MRI

Question 21

Conventional Angiography

Answer 21

-injetion of dye into cranial arteries from femoral
-see occlusions, aneurysm, malformations

Question 22

PET

Answer 22

-brain injected with glucose to view metabolism

Question 23

Distal Tractography

Answer 23

-follow tracts of brain and SC

Question 24

DAT Scan

Answer 24

-dopaine intake

Question 25

EEG

Answer 25

-brain electrical activity through scalp
-evaluate seizures, brain death, coma, dementia
-alertness

Question 26

EMG

Answer 26

-insertion of needle into muscles and recording motor unit potentials

Question 27

Nerve Conduction Velocities

Answer 27

-electrical stimulate over nerve with recording sensory and motor nerves

Question 28

Localization: Brain

Answer 28

-hemibody
-contra
-aphasia
-visual issues
-UMNL

Question 29

Localization: Spinal Cord

Answer 29

-bilateral
-up to a certain level
-weakness and sensation
-quick progression
-UMNL

Question 30

Localization: Nerve/Root

Answer 30

-unilateral or bilateral
-dermatome/peripheral nerve
-LMNL

Diabetic Neuropathy doesnt cause weakness

Question 31

Localization: Muscle

Answer 31

-more proximal muscles
-weakness