Neurological Exam/Overview Flashcards
Central Nervous System Disorders
-upper motor neurons
-stoke
-MS
-Dementia
-Epilepsy
-Headaches
-MMT disorders
-CP
-SCI
-Brain tumors
Peripheral Nervous System Disorders
-lower motor neurons
Motor Neuron
-polio
-ALS
Peripheral Nerve
-neuropathies
Neuromuscular Junction
-myasthenia gravis
-lambert eateons
Myopathy
-muscular dystrophies
-congenital myopathies
Autonomic
Fascinomas
Capras Delusion
-belief that youve been replaced by imposter
-r hemiphere
Stiffperson Syndrom
-stiffness without weakness
-autoimmune
Prosopagnosia
-unable to recognize faces
-r hemiphere
Steps In Diagnosis
Clinical facts > signs and symptoms > localize lesion > diagnosis
c/o Weakness
-can mean a multitude of things
-fatigue, weakness, apathy, pain, decreased sensation, imbalance, drowsiness
Neurological Exam
- Mental Status/Language
- CNs
- Motor
- Sensattion
- Reflexes
- Coordination
- Gait
Mental Status
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
Speech and Language Disorders
-dysarthria: motor issue in speaking, slurred words
-Aphasia: language production (brocas and wernicke’s), affects dominant side (if r handed)
CN 1
-olfactory
-alzheimer’s and parkinsons loses it faster (asymptomatic)
-trauma causes symptoms
CN VII
-facial
Central: lower side, Peripheral (bells palsy) : both sides)
Motor Exam
Bulk: atrophy, pseudohypertrophy
Tone:
-Flaccidity: little resitance tto passive mmt
-Rigidity: steady muscular tension that is equal
-Spasticity: velocity depended tension in muscles
Upper Motor Neuron Signs
-stiffness, spasticity
-weakness in pyramidal pattern (flexors stronger in UE, extensors strogner in LE)
-hyperreflexia
-pathological reflexes
Lower Motor Neuron Signs
-weakness, muscle atrophy, fasciculations, cramps
-no sensory involvement
-no pain
-hypoactive reflexive
Romberg Sign
-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
Diagnostic Tests for Neuro Deficits
Lumbar Puncture
Neuroimaging
Neurophysiology
Lumbar Puncture
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
Computed Tomography
-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
Magnetic Resonance Imaging
-MRI (most preffered)
-no radiation, higher resolution, unmarred by bony (hemorrhages, vascular malformation, aneurysms, tumors, MS)
-some contraindications, no bone, long time
Magnetic Resonance Angiography
-MRA
-see blood flow/supply of brain
Myelography
-inject contrast into subarachnoid space using CT
-in lui of MRI
Conventional Angiography
-injetion of dye into cranial arteries from femoral
-see occlusions, aneurysm, malformations
PET
-brain injected with glucose to view metabolism
Distal Tractography
-follow tracts of brain and SC
DAT Scan
-dopaine intake
EEG
-brain electrical activity through scalp
-evaluate seizures, brain death, coma, dementia
-alertness
EMG
-insertion of needle into muscles and recording motor unit potentials
Nerve Conduction Velocities
-electrical stimulate over nerve with recording sensory and motor nerves
Localization: Brain
-hemibody
-contra
-aphasia
-visual issues
-UMNL
Localization: Spinal Cord
-bilateral
-up to a certain level
-weakness and sensation
-quick progression
-UMNL
Localization: Nerve/Root
-unilateral or bilateral
-dermatome/peripheral nerve
-LMNL
Diabetic Neuropathy doesnt cause weakness
Localization: Muscle
-more proximal muscles
-weakness
