neurophysiology Flashcards
what investigations are involved in neurology?
PNS- nerve conduction study and EMG
CNS- EEG, MRI and NCCT
what do nerve conduction studies show?
SMALL- axon loss
SLOW- demyelination- MS, GB syndrome
what does an EMG show?
muscle problems
myopathy- lower motor unit with the same or normal NCS - motor neurone disease
myasthenia gravis- jitter
what does an EEG show?
it is seizure classifying
when is a NCCT used?
1st modality for stroke, ICH, increased inter cranial pressure
what are MRIs used for?
for MS, myelopathy and diagnosing brain infarction
takes longer but is the most specific for CNS pathology
how will a spine neurological problem present? where will it radiate?
back pain will radiate to both legs and will be bilateral
how will a brain neurological problem present? where will it radiate?
headache, vision loss/ changes but will usually cause unilateral symptoms
what are the steps to a mini neurological exam
- vitals- BP, HR, temp,RR, 02 sats
- GCS/ AVPU
- Lateralising signs
- Pupils
what is a lateralising sign?
where you have pathology that indicates one brain hemisphere rather than overall
e.g- pronator drift
homonymous hemianopsia on one side
unilateral weakness
what does AVPU stand for?
Alert
response to Voice
response to Pain
Unresponsive
neuro exam
Inspection
Tone
Power
Reflex
Sensation
Coordination
( In the pouring rain she came)
cognitive testing
cranial nerves
gait
mental status- confusion
what is GCS out of? what does it measure
15
how alert a patient is
the scores go from 1-6
how to remember steps for GCS and what is each section out of
MOVE 654
motor- /6
verbal-/5
Eye-/4
what are 1-6 of the motor section of GCS?
Motor
1-no movement -
2-abnormal extension
3-abnormal flexion
4-flexion to withdraw
5-localises
6-obey command
what do you do if someone is unresponsive for GCS?
squeeze two fingers between mandible and mastoid junction and should elicit a painful response
or rub fist on sternum
VERBAL GCS score rating
1- no response
2- incomprehensible - can’t understand
3- inappropriate- swearing , agitated, delirious
4- confused, content of words not normal
5- orientated for time place and person
eye response GCS score rating
1- none
2- pain
3- speech
4- spontaneous
at what GCS score do you intervene and what do you do?
less than 8
intubate!
what does it mean when the GCS is less than 3
patient is comatose
not responding to anything
in a vegetative stative
what is your main descending tract?
corticospinal
what are your two ascending tracts?
DCML
spinothalamic
what does DCML tract carry?
light touch, proprioception, proprioception, 2 point discrimination, vibration
what does spinothalamic tract carry?
pain, temperature
