Neyrological System Flashcards
Dysarthria
Impaired speech due to weakness of the muscles that control speech
Dysphasia or aphasia
Impaired or absence of the ability to speak due to neurological abnormalities
Dysgraphia or agraphia
Impaired or absence of the ability to write
Dyspraxia or apraxia
impaired or absent ability
to perform purposeful movements in the
absence of paralysis.
Glasgow coma scale
Eyes
Open spontaneously 4
Open to command 3
Open to pain 2
Do not open 1
Speech
Sensible/orientated 5– what’s your name, where are you, what month is it?
Confused 4– speaking in phases or relatively complete sentences
Inappropriate words 3–
Incomprehensible sounds 2
None 1
Motor
Obeys commands 6
responses Localizes stimuli 5
Withdraws from stimuli 4
Flexion responses or deCORticate 3
Extension responses or dEcErEbratE meaning the brain stem is affected 2
None 1
EVM-456
Things that can affect GCS
- paralyzed patient can’t check for motor
- intubation : verbal affected
- injuries to the bone
- swelling
- sedation
- hearing problems
- mental deficits
Deep vein thrombosis
Risk factor for DVT:
- recent surgery
- immobility
- long travel
- pregnancy
- hormone therapy with estrogen eg COC
- cancer
- thrombophilia
- systemic lupus eeytgematous
- polycythemia
Causes : numerous but remember antiphospholipid syndrome
Presentation: calf or leg swelling, dilated superficial veins, tenderness, colour change to the leg, oedema
Hx: risk factors + risk of PE (shortness of breath, palpitations, pleuritic chest pain)
Diagnosis: D-diner (but it’s not specific)
Ataxic gait Ddx
Cerebellar disease
Acute alcohol intoxication
Migraine
Post traumatic/post concussive
Multiple sclerosis
Hemiplegic gait Ddx
Vascular diseases: stroke, diabetic neuropathy
Infective: encephalitis, meningitis, brain abscess
Traumatic brain jnjury
Congenital: cerebral palsy
Multiple sclerosis
Disease process affecting both the myelin and neurons (neurodegenration)
- stroke
Disease process affecting only the myelin sheath
- multiple sclerosis
- Guillean Barre syndrome
Lower motor neuron lesion presentation
- lower motor neuron lesion (i.e., injury of anterior
horn cells and/or the peripheral nerve(s) in which
their axons travel) - The muscle(s) would be paralyzed and would be floppy (flaccid).
- Reflexes would be diminished or lost.
- The muscle would no longer be under any control, and left
to its own devices it would twitch (fasciculate).
-The classic symptoms of a lower motor neuron lesion are flaccid paralysis, diminished or absent reflexes, fasciculations, and, over time, muscle atrophy.
Upper motor neuron lesion presentation
- The affected muscles become paralyzed.
- In addition, because of the
loss of higher control, the lower motor neuron fires spontaneously, causing spasm in the affected muscles,
a state of tonic contraction. - With this loss of inhibition
from above, reflexes eventually become exaggerated or
hyperactive. - Also, primitive reflexes can resurface because of the loss of upper motor neuron inhibition.
- One example is Babinski’s sign. If you stroke the bottom of the foot, the toes should normally curl down. If the big
toe goes up, this is Babinski’s sign, and is abnormal in
adults.
NB: Babinski’s sign indicates an upper motor neuron lesion anywhere from the motor cortex through the corticospinal tract’s path in the brainstem and spinal cord.
Lower motor neuron lesion presentation summary
- weakness or paralysis
- Flaccidity and decreased reflexes
- fasciculations
- muscle atrophy (severe)
- decreased tone
- distribution of weakness distal or segmental
- Babinski sign absent
Corticobulbar tract supplies
The brain stem
Synapses at the upper part of the medulla
