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NMS IV test 1 Flashcards

1
Q

What are the functions of the posterior column

A

vibration, conscious proprioception, 2 point and light touch

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2
Q

What are the functions of the lateral spinothalamic tract

A

pain and temp (crosses at level)

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3
Q

What are the functions of the vestibular system

A

balance and spatial orientation

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4
Q

What are the functions of the cerebellar system

A

motor control coordinating voluntary movements

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5
Q

What are the functions of the Motor system - corticospinal tract

A

Carries motor and crosses in the brain stem

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6
Q

What are some characteristics of confusional states

A

Decreased level of consciousness, often reversible example head injury

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7
Q

What are some characteristics of dementias

A

Cognitive function and intellectual decline often irreversible example hemmorage or stroke

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8
Q

What would the patient complain of with a brain lesion

A

Mental status changes, HA, seizures, ICP visual compalaints

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9
Q

What would the patient complain of with a brainstem lesion

A

Crainial nerve deficitis

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10
Q

What would the patient complain of with a Pyramidal system lesion

A

uncoordinated voluntary actions

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11
Q

What would the patient complain of with an extrapyramidal system lesion

A

alterations in involuntary movements (athetosis, resting tumor, tics, dystonia)

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12
Q

What would the patient complain of with a cerebelllar lesion

A

uncoordinated motor movements; gait stance

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13
Q

What would the patient complain of with a spinal cord lesion

A

dissocation of sensory loss there may be LMN deficits if anterior horn or nerve root is also involved

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14
Q

What would the pt complain of with a peripheral NS lesion

A

dermatomal distrubution complaints, NTW

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15
Q

What neuro exam findind would be present with a brain lesion

A

mental status changes, motor/sensory deficits CONTRALATERAL to side of lesion (neuro signs/sx are dependent on where the lesion is located)

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16
Q

What neuro exam finding would be present with a brainstem lesion

A

CN deficits are usually IPSILATERAL, and motor/sensory deficits are CONTRALATERAL to the lesion (classical cross pattern)

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17
Q

What neuro exam finding would be present with an extrapyramidal lesion

A

resting tremors, chorea, athetosis, tics

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18
Q

What neuro exam finding would be present with a cerebellar lesion

A

ataxia and intention tremor Deficits are IPSILATERAL to the lesion past pointing, dysmentria

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19
Q

What neuro exam finding would be present with a spinal cord lesion

A

UMN signs, motor/sensory deficits IPSILATERAL to the lesion, pain/temp CONTRALATERAL to the lesion

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20
Q

What neuro exam finding would be present with a peripheral NS lesion

A

LMN signs flacid weakness, atrophy, fasculations hyporeflexia in dermatomal or plexus pattern

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21
Q

What are the 4 types of Aphasia

A

Brocca’s (poor speaking/caveman speech); Wernicke’s (poor comprehension), Conductive (pt has intact comprehension but can’t explain what they understood), Global (poor speaking and comprehension)

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22
Q

Anomia

A

inability to use or recognize names

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23
Q

Confabulations

A

the attempt to fill in memory gaps with false recollections

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24
Q

Dysarthria

A

disturbance of articulation

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25
Q

Dysphonia

A

inability/dysfunction of phonation; hoarseness

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26
Q

Dysmetria

A

disturbance of movement towards a target

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27
Q

Dysesthesia

A

disturbance of sensation

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28
Q

Paresthesia

A

sensation of tingling, pricking of numbmess

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29
Q

Ataxia (cerebella)

A

staggering, clumsy, drunken; seen in cerebellar disease, alcohol intoxication, and MS

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30
Q

Ataxia (Sensory)

A

Slappin foot gait, tabetic; commonly seen in posterior column diseases, tabes dorsalis, polyneuropathy

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31
Q

Ataxia (vestibular dysfunction)

A

broad based, festinating gait (parkinsons) Swining gait (hemiplegic/stroke)

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32
Q

Apraxia

A

inability to perform previously learned task

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33
Q

Agnosia

A

inability to recognize common stimuli (objects, colors, sound, etc.)

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34
Q

Astereognosis

A

inability to identify an object by touch

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35
Q

Agraphesthesia

A

inability to identify a number written on the hand

36
Q

Agraphia

A

inability to write

37
Q

Alexia

A

inability to read

38
Q

Dystonia

A

abnormal movements resulting in sustained abnormal postures

39
Q

Athetosis

A

slow, writhing movements

40
Q

Chorea

A

involuntary and unpredictable rapid irrregular muscle jerks

41
Q

What are the different types of tremors

A

Resting (basal ganglia) Intention (cerebellar), chorea, athetosis, distonia

42
Q

Myoclonus

A

sudden rapid twitchlike muscle contractions

43
Q

Characteristics of UMN lesion

A

Mild/late atrophy, clonus, hyperreflexial, absent abdominal reflex, spastic muscle tone, EMG/NCV normal

44
Q

Characteristics of LMN lesion

A

Atrophy, fasiculations, hyporeflexia, abdomainal reflex is normal, flaccid muscle tone, EMG/NCV positive for fibrillations

45
Q

Dominant cerebral hemisphere vs. non-dominant

A

Language center is usually in dominate hemisphere

46
Q

Papilledema

A

swelling of optic nerve

47
Q

Optic atrophy

A

atrophy to optic nerve

48
Q

Paralysis vs. paresis

A

paralysis = total loss of voluntarty motor control; Paresis = a partial loss of voluntary motor control

49
Q

clonus

A

series of reflex contractions of a muscle which has been suddenly stretched

50
Q

Hypotonia vs. hypertonia

A

Hypo = reduced resistance to PROM, flaccidity Hyper=ridiged usually d/t extrapryamidal lesion

51
Q

Scotoma

A

Irregular visual field deficit

52
Q

Know the visal field defects based on the location of the lesion

A

See diagram in notes

53
Q

Signs of meningeal irritation

A

kernigs/brudzinski signs, nuchal ridigity, spinal ridigity

54
Q

Hemiplegic gait

A

Swinging gait; commonly seen in strokes

55
Q

Scissor gate

A

Spastic (sue to spasticity of adductor mm) seen in cerebal palsy and myelopathy

56
Q

steppage gait

A

equine or foot drop gait; seen in L5 radiculopathy or peroneal nerve disease or weakness of tibialis anterior

57
Q

Apraxic gaint

A

Magnet gait due to diffuse cerebral damage seen in alzheimers, huntingtons, and hydrocephalus

58
Q

Waddling gait

A

seen in weak gluteus muscles and muscular distrophy; trendelenburg may be +

59
Q

festinating gain

A

shuffling gait short steps hard to start and stop seen in parkinsons

60
Q

Know and understand all aspects of the neuro exam discussed in class

A

Interview, mental status exam, posture/gait/station, coordination, cranial nerve exam, motor sensory and reflexes provocative test, ancillary studies

61
Q

Know your DDX’s

A

Where is the lesion, What type of lesion (destruction, compression, circulatory) What is the pt age?..

62
Q

Bells palsy

A

Dysfunction of cranial nerve VII

63
Q

Trigeminal neuralgia

A

disorder of CN V and causes stabbing or electric shock like pain in the face

64
Q

Ocular palsys

A

CN VI causes double vision

65
Q

Know the crainal nerve patterns

A

review on own

66
Q

Accustic Neuroma (cerebellopontine angle tumor)

A

Slow growing tumor on CN VII causes problems with balance and hearing

67
Q

Chronic alcoholic encephalopathy

A

Wernickes encephalopathy and Korsadoffs dementia

68
Q

Wernickes encephalopathy

A

B1/thiamine deficiency seen in chronic alcoholics and severe malnutrition;usually reversible;sx = confusional states, opthalmoplegia, ataxia; tx= abstinence, IV injections of B1, detox

69
Q

Korsakoffs dementia

A

A contuination of wernickes encephalopathy, seen in chroninc alcoholics;IRREVERSIBLE; affects the temporal lobe; causes amnestic dementia (can’t form new memories)

70
Q

Acute confusional states caused by alcohol withdrawl

A

hallucinations begin ~ 48 hours after stoping; may get seizures (poor prognosis); Delirum Tremens begin 3-5 days post and last up to 72 hours (15% risk of mortality)

71
Q

Meningitis

A

Viral or Bacterial causes flu-like sx stiggneck petechia body rash seizures and confusional states LOC possible Assume bacterial until proven otherwise

72
Q

1st degree concussion

A

mild nol LOC (dazed or stunned) PTA< 30 min

73
Q

2nd degree concussion

A

LOC < 5 min; PTA 30 min to 24 hours

74
Q

3rd degree concussion

A

LOC > 5 min; PTA > 24 hours

75
Q

second impact syndrome

A

A person who has sustained 1 minor head injury has a 4 fold increase in risk of having second concussive injury ; second impact triggers a rapidly declining sequella w/I seconds to min

76
Q

Boxers dementia (pugliestica dementia)

A

dementia caused by multiple concusions

77
Q

Epidural hematoma/hemorrhages

A

MC results from a lateral skull fx; lacerates middle meningeal A; Most rapid bleed (minutes to hours); medical emergancy

78
Q

Subdural hematoma

A

Following trauma can be acute (min to hours) subacute(days-wks) or chronic (wks to mos); most commonly presents as a slower bleed venous bleeding; usually not associated with skull fractures; elderyl are more susceptible

79
Q

intercerebral hemorrhages

A

coup/cotntracoup injuries; typically located at the frontal/occipital lobes; SX= altered LOC, HA, signs of meningeal irritation, may have focal brain signs

80
Q

Subarachnoid hemorrhages

A

Most occur spontaneously and are d/t congenitally abnormal blood vessels in circle of willis resultin in a rupture into the subarachnoid space; SX= severe rapid HA, altered LOC, meningeal irriatation and nausea and vomiting

81
Q

What are some red flags for serious and immediate emergency referral

A

“I need my very special head protection” signs of open head injury/skull fx, glasgow coma scale

82
Q

What is the glasgow coma scale

A

scores level of consciousness on a 3 to 15 point scale can be used as an outcome marker

83
Q

What are some signs of dementioa

A

loss of memory, disorientation, loss of judgement, loss of abstrect thinking, loss of ability to calculate

84
Q

What are some causes of dementia

A

Alzheimer’s, multi-infarct dementia, trauma, hydrocephalus, metabolic (B123 deficiency), infections, drugs/toxins, brain tumors, parkinsons, herediarty

85
Q

Multi-infarct dementia

A

vascula dementia from multiple tiny strokes over time; associated with hypertension and diabetes

NMS 4 (3 decks)

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