Neurology Flashcards
What is aphasia?
Central inability to either form or understand language
What is the broca aphasia?
Motor aphasia, nonfluent
Patient can not correctly speak or understand language
Patient is aware and frustated
Impaired repetition
What is the Wernicke aphasia?
Sensory aphasia, fluent
Patient can speak fluently but lacks sense
Cant comprehend
Usually unaware
Impaired repetition
What is global aphasia?
Broca + wernicke + arcuate fasciculous
Mute or babbling patient, cant comprehend speech, nonfluent
What is conduction aphasia?
Involves the arcuate fasciculus
Fluent
Comprehension and speech production
Impaired repetition with paraphasia (patient transpose sounds and try to correct their mistakes), aware
What is anomic aphasia?
Not on a specific brain location
Isolated difficulty on finding the right words
What is transcortical aphasia?
Brain damage results in separations between the language centers and areas involved in production or comprehension of speech
Can be motor, sensory or mixed
Examination of the I cranial nerve
OLFACTORY NERVE - ask the patient to smell something with eyes closed
Examination of the II cranial nerve
OPTIC NERVE
- Visual acuity (snellen chart)
- Color vision (ishihara plates)
- Visual field (confrontation)
- Papilla (fundoscopy)
Examination of the III, IV and VI cranial nerve
III = OCULOMOTOR
IV = TROCHLEAR
VI = ABDUCENS
- Eye movement (follow the finger)
- Visual acommodation (finger towards the patient should constrict the pupil)
- Eyelid ptosis (open and close eyes)
Examination of the V cranial nerve
V = TRIGEMINAL NERVE
- FACIAL SENSATION
- MUSCLE FUNCTION OF THE MASSETER
Examination of the VII cranial nerve
VII = FACIAL NERVE
- MOTOR FUNCTION OF MIMIC
- SENSE OF TASTE
Examination of the VIII cranial nerve
VIII = VESTIBULOCOCHLEAR
- HEARING
- VESTIBULOOCULAR REFLEX - Head impulse test / caloric test
- SENSE OF BALANCE - Romberg test, heel to toe walking
Examination of the IX and X cranial nerves
IX = GLOSOPHARYNGEAL
X = VAGUS NERVE
- Palatal movement
- Sense of taste (IX)
- Vocalization (X)
Examination of the XI cranial nerve
XI = ACESSORY
Motor funcion of trapezius and sternocleidomastoid
Examination of the XII cranial nerve
HYPOGLOSSAL NERVE
- Tongue muscules motor function
What nerves are evaluated in the pupillary reflex?
Optic nerve (afferent) and oculomotor (efferent)
What nerves are evaluated on the corneal, conjunctival and lacrimation reflexes?
V1 of trigeminal nerve
What nerves are evaluated on the jaw jerk reflex?
V3 of trigeminal (masseter muscle)
What nerves are evaluated on the gag reflex?
Glossopharyngeal nerve (elevation of the palate)
What nerves are evaluated on the cough reflex?
Vagus nerve (cough receptos in trachea and large bronchi)
What is the difference between upper motor neuron injury vs lower motor neuron injury?
In LOWer motor neuron lesions, muscle mass, tone, power, and reflexes are LOW.
In UPper motor neuron lesions, muscle tone, reflexes, and toes (Babinski sign) are UP
What is myoclonus?
Involuntaly twitch of muscles
What is asterixis?
Abrupt loss of muscle tone during sustained contration - FLAPPING
(hepatic encephalopathy)
What is akathisia?
Inability to stay still
How is muscle power graded?
From 0 (complete paralysis) to 5 (normal power)
What is the pronator drift test?
Downwards drift = upper motor lesion
Upwards drift = cerebellar lesion
What is the clasp-like response?
Initial resistance when attempting passive movement of the extremities, followed by a rapid decrease in resistance
Upper motor neuron damage
What is clonus?
Involuntary and rhythmic muscular contractions
Arises from a lack of inhibitory afferent stimuli of α-motor neurons
What is the difference between clonus and myoclonus?
Myoclonus = arrhytmical, sudden jerks of a muscle or group of muscles, associated with renal or liver failure
Clonus = rhythmic contractions and relaxations of a muscle group
What is meningism?
Nuchal rigidity + headache + photophobia
What is the kernig and brudzinski sign sign?
Kernig sign: In a supine patient, extension of the knee when the thigh is flexed at the hip causes pain (knee at a 90° angle).
Brudzinski sign: In a supine patient, passive flexion of the neck provokes involuntary lifting of both legs.
What is the lasegue test?
Test for nerve irritation
Lifting the leg > 45° induces pain of the lumbar roots
What is nystagmus?
Nystagmus is an involuntary, repetitive, and twitching movement of one or both eyes.