NMS Words Flashcards
Agnosia
inability to recognize familiar objects with one form of sensation (i.e. visual agnosia)
Agraphesthesia
inability to recognize symbols, letters or numbers drawn or traced on the skin
Agraphia
inability to write due to a lesion within the brain and is typically found in combination with aphasia
akinesia
inability to initiate movement
Anosognosia
denial or unawareness of one’s illness; often associated with unilateral neglect
Fluent Aphasia
- temporal lobe, wernicke’s area, or regions of the parietal lobe
- word output and speech production are functional
- empty speech/jargon
- use of paraphrasias and neoglisms
- Types include
- _Wernicke’s _
- Conduction Aphasia
Non Fluent Aphasia
- frontal lobe (anterior speech center) of the DOMINANT hemisphere is affected
- poor word output and dysprosodic speech
- poor articulation and increased effort for speech
- content present, impaired syntactical words
- Types:
- Broca’s aphasia
- Global Aphasia
Receptive of Wernicke’s Aphasia
- lesion: posterior region, superior temporal gyrus
- Severe disturbance in auditory comprehension.
- Reading, writing and word recognition impaired.
- good articulation, use of paraphasias
- poor naming ability
- motor impairment not typical 2ndary to distance from motor cortex
Conduction Aphasia
(fluent type of aphasia)
- Lesion: supramarginal gyrus, arcuate fasciculus
- severe impairment w/ repetition
- intact fluency, good comprehension
- speech interupted by word-finding difficulty
- reading intact, writing impaired.
Expressive or Broca’s Aphasia
- Lesion: 3rd convolution of frontal lobe
- Most common form of aphasia
- Intact auditory and reading comprehension
- paraphasias are common
- motor impairment typical due to proximity to motor cortex
- Severe difficulty in verbal expression with impairment in object naming and writing abilities. (mostly w/ R hemiplegia)
Global Aphasia
- Lesion: frontal, temporal, parietal lobes
- Comprehension (reading/auditory) severely impaired
- _Impaired naming, writing, repetition skills _
- May involuntarily verbalize; usually without correct context
- may use nonverbal skills for communication
- Most common and severe form of aphasia
Apraxia
inability to perform movements previously learned even though there is no loss of strength, coordination, sensation or comprehension
Ideational apraxia:
person no longer understands the “idea” of how to do routine task
Ideomotor apraxia:
person cannot do a task on command but can do it spontaneously
Astereognosis
inability to recognize objects by touch alone
asynergia
inability to move muscles together in a coordinated manner
ataxia
uncoordinated movement, especially gait.
athetosis
slow, involuntary, wormlike, twisting motions (usually w/ CP)
causalgia
burning sensations which are painful. often associated with CRPS type I
Cheyne-Stokes respiration
a common and bizarre breathing pattern characterized by a period of apnea lasting 10-60 seconds followed by gradually increasing, then decreasing depth and frequency of respirations __accompanies depression of frontal lobe and diencephalic dysfunction. postulated to be a result of an abnormality in the neurological respiration center. can occur with severe cases of TBI or CHF
Dysprosody
impairment in the rhythm and inflection of speech
Decerebrate Rigidity
A characteristic of a corticospinal lesion at the level of the brainstem:
- results in extension contraction of the trunk and all extremities
Decorticate Rigidity
A characteristic of a corticospinal lesion at the level of the diencephalon where the trunk and lower extremities are positioned in EXT while the UE are flexed
Dysmetria
inability to judge distances (see cerebellar dysfunction)
dysphagia
inability to properly swallow
Dysarthria
slurred or impaired speech due to a motor defecit of the tongue or other muscles essential for speech
Lesion CN X or XII
Electromyography
study of the graphic record of contraction of a ms as a result of electrical stimulation. used to evaluate the voluntary electrical activity of the muscle.
Nerve Conduction Velocity Test
determines the speed of propagation of an action potential along a nerve or muscle fiber, usually to assess the severity of nerve compression
Neoglism
substitution within a word that is so severe that it makes the word unrecognizable
somatagnosia
lack of awareness of the relationship of one’s own body parts or the body parts of others
homonymous hemianopsia
loss of half the visual field in each eye
Contralateral to the side of the cerebral hemisphere lesion (or optic tract)
bitemporal hemianopsia
a deficit of the temporal or peripheral visual fields, caused by injury to the optic chasm aka - tunnel vision
blindess
in one eye, results from damage to the optic nerve (monocular blindness)
Brain Anatomy: Frontal Lobe
Function:
- primary motor cortex
- voluntary movement, intellect, orientation
- Broca’s area (typically L hemi) controls motor aspect of speech, speech concentration
- Personality, temper, judgement, executive functions
Impairment:
- contralateral weakness
- perserveration, inattention
- personality changes, antisocial behavior
- Broca’s Aphasia (expressive deficits)
- delayed or poor initiation; emotional lability
Brain Anatomy: Parietal Lobe
Function:
- primary sensory cortex for integration of sensation
- associated w/ sensation of touch, kinesthesia, perception of vibration and temperature
- recieves info from other areas of brain regarding hearing, vision, motor, sensory and memory
- interprets language and words
- spatial and visual perception
Impairment:
- dominant hemi (typically L): agraphia, alexia, agnosia
- non dominant hemi (R): dressing apraxia, anosognosia
- contralateral sensory deficits
- impaired language comprehension
Brain Anatomy: Temporal Lobe
Function
- primary auditory cortex, processing and olfaction
- Wernicke’s area (typically L) - ability to understand produce meaningful speech, verbal and general memory assists with language
- rear of lobe enables humans to interprets other peoples emotions and reactions
Impairment:
- learning deficits
- wernkicke’s aphasia (receptive deficits)
- antisocial, agressive behaviors
- difficulty with facial recognition
- difficulty with memory/loss
- inability to categorize objects
Brain Anatomy: Occipital Lobe
Function:
- primary visual cortex
- main processing center for visual information
- processes visual information regarding colors, light, and shapes
- judgement of distance, seeing in 3D
Impairment:
- homonymous hemianopsia
- impaired extraocular muscle movement and visual deficits
- reading and writing impairment
- cortical blindness with bilateral lobe involvement
Limbic System
basic fucntions include feeding, aggression, emotions and endocrine aspects of sexual response
hypothalamus
bodily homeostasis: body temp, eating, water balance, anterior pituitary function/sexual behavior and emotion
Brain Anatomy: CNS
Telencephalon (Cebral hemispheres)
- frontal, parietal, temporal and occipital lobes
- insula
- limbic system
- basal ganglia
Diencephalon
- thalamus
- subthalamus
- hypothalamus
- epithalamus
Brainstem
- midbrain (mesencephalon)
- pons
- medulla oblongata
Cerebellum
Analgesia
–
Allodynia
Abarognosis
-
Herpes Zoster (shingles)
a painful inflammation of the posterior root ganglion, caused by a virus, resulting in the formation of vesicles along the course of the nerve
Horner’s syndrome
ptosis of the eyelid constriction of the pupil ipsilateral lack of face sweating *often accompanies stroke involving the Ant/Inferior or Post/Inferior Cerebellar arteries
Adaptive Equipment SCI - Head/Mouth Stick
wooden or metal rod, 12-18 in
Typically used by C3, C4, or C5s
used by quads to hold utensils or devices (pencils)
can be used to type, turn pages, dial phone
Adaptive Equipment SCI - Mobile Arm Support
attached to wheel chair
generally used to improve fxn w/ weak prox UE ms
Candidates: shoulder flexors, ER, elbow flex (1-3+/5)
helps w. self care, recreation, and use of hand control in power chair
Adaptive Equipment SCI - Static Wrist-Hand Orthosis
Candidates: C1-C5 that have no wrist ext
not a functional device
provides support and thung abduction
Adaptive Equipment SCI - Wrist Driven Orthosis
Tenodesis Splint
Candidates: C6 or C7 lesion
dynamic functional orthosis designed to assist grip
transfer muscle force produced by wrist extensors to create finger flexion
Mini-Mental State Examination (MMSE)
brief screening test for cognitive dysfunction
includes items for: orientation, registration, attention, calculation, recall and language
Score 1-30
21-24 = mild impairment
16-20 = moderate impairment
Anosmia
inability to detect smells, seen w/ frontal lobe lesions or CN I testing (-)
Myopia
impaired vision (near sighted)
Presbyopia
Imaired Near Vision (far sighted)
Pupillary Reaction
constriction by shining light in eye, Involves CN II and CN III
Strabismus
Eye deviates from normal conjugate position - impaired eye movements
Strabismus of CN III Testing
eye pulled outward by CN VI, eye cannot look upward, downward or inward
Esotropia
eye pulled inward (strabismus of CN VI)
Paralysis of Ipsilateral Facial Muscles
(With either Bells Palsy or Stroke V)
inability to close eye
droop in corner of mouth
Difficulty w/ speech articulation
Nystagmus
constant, involuntary cyclical movement of the eyeball
Rinne’s Test
- Bone/Air conduction
- holding a vibrating tuning fork on mastoid process and then **in front of the ear. **
- Conductive Loss: Sound heard through bone is equal to or longer than air
Webers Test
- vibrating tuning fork placed on top of head
- Unilateral Conductive Loss: sound lateralized to impaired ear
- Sensorineural Loss: sound heard in good ear
Dysphonia
Hoarseness vs. Nasal Quality indications
hoarseness: denotes vocal cord paralysis
nasal quality: denotes palatal weakness
Central Cord Syndrome
-
Bilateral
- motor function loss (UE>LE) corticospinal
- analgesia *spinothalamic *
Brown Sequard Syndrome
(Hemisection)
-
Ipsilateral
- motor paralysis (spastic) corticospinal
- loss of proprioception, vibration, 2 point discrimination dorsal columns
-
Contralateral
- analgesia spinothalamic
Anterior Cord Syndrome
-
Bilateral
- motor loss (spastic paralysis) corticospinal
- analgesia *spinothalamic *
Posterior Cord Syndrome
Bilateral loss of proprioception, deep pressure, vibration, tactile discrimination and epicritic sensations (stereognosis, etc) Dorsal columns
Cauda Equina Injury
- Flaccid paralysis of spinal reflexes, bowel and bladder
- Variable nerve root damage (motor and sensory)
- Incomplete lesions are common
- Potential for nerve regeneration - often incomplete, slows and stops after ~1 year
Kernig’s Sign
- Patient positioned in supine, flex hip and knee fully to chest and then extend knee
- (+) pain and increased resistance to extending the knee due to spasm of hamstrings
- _Bilateral (+) suggests meningeal irritation _
Brudzinki’s Sign
- Patient in supine, flex neck to chest
- (+) causes flexion hips and knees (drawing up)
- (+) suggests meningeal irritation
Signs of Increased ICP 2nd to Cerebral Edema or Brain Herniation
- level of consciousness
- restless confusion to unresponsive
- vital signs
- increased BP, slow pulse
- periods of apnea, Cheyne-Stokes Resp
- increased temp
- Headache
- Vommiting (CN X)
- Pupillary Changes (CN III)
- ipsilateral dilation, bilat
- Papilledema at entrance to eye
- progressive impaired motor function
- rigidity, weakness, hemiplegia, UMN
- Seizure activity
Myadrisis
Dilation of pupils
(sympathetic Response)
Sympathetic stimulation
- stressful situations - widespread activation
- inhibition salivation and tearing
- **pupil dilation **
- increased HR
- dilates blood flow in skeletal ms
- constricts blood to skin/viscera
- relaxes airways
- stimulates epinephrine/norepinephrine
- decreases peristalsis, motility, digestion
- increases sweating
- stimulates glucose product/release
- relaxes bladder
Parasympathetic Stimulation
- Conservation and homeostasis, local/short act
- stimulates salivation and tearing
- constricts pupils
- slows HR
- dilates blood vessels to gut
- constricts airways
- stimulates pancrease to release insulin and digestive enzymes
- stimulates urinary bladder to contract
