Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NCS Exam > Random Mix > Flashcards

Random Mix Flashcards

1
Q

Parkinson’s tremor dominant vs Postural instability and gait disturbances

A
  • Tremor dominant = earlier onset, better prognosis, and cognition intact
  • Postural instability and gait = quicker progression, worse prognosis, and cognition IS affected.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Progressive supranuclear palsy characteristics PSP

A
  • ocular motor disturbances, unable to move eyes up or down (vertical palsy) c/o blurred vision
  • rapid progression
  • retropulsion/startle reflex
  • Early postural instability / falls
  • rigid trunk
  • WBOS
  • dysarthria/dysphasia
  • Levodopa has little to no effect
  • caused by damage to the brainstem
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Differences between parkinson plus syndromes vs idiopathic PD

A

Parkinson’s Plus:

  • lack/decreased response to levodopa
  • early onset of dementia
  • early onset of postural instability
  • marked symmetry of signs early on vs PD starts unilaterally
  • trunk involved more than limbs
  • ocular signs (vertical gaze and nystagmus)
  • early autonomic signs (IE hypotension and incontinence)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Multiple Systems Atrophy MSA

A
  • autonomic failure
  • severe orthostatic hypotension
  • urinary dysfunction
  • erectile dysfunction
  • sustained gazed evoked nystagmus
  • changes in cognition is LESS common
  • WBOS ataxic gait
  • caused by damage to the basal ganglia, cerebellum, and brainstem
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

cortical basal degeneration CBD

A
  • caused by damage to the frontal lobe, parietal lob, and dopamine in substantia nigra.
  • Progressive dementia
  • limb apraxia, usually unilateral
  • apraxic speech (non-fluent)
  • prominent sensory symptoms (alien hand, spatial neglect)
  • impaired upward and horizontal gaze
  • parkinsonism (rigid trunk, bradykinesia, NO resting tremor, marked dystonia, myoclonus)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Lesion to substantia Nigra

A

Narrow and shuffling gait, decrease arm swing, freezing of gait, falls in late stage of the disease (PD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

striatum vs lentiform nucleus

A

Striatum = caudate and putamen

Lentiform nucleus = putamen and globus pallidus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Damage to the globus pallidus

A

Causes Huntington’s disease (B athetoid and chorea movements)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

PD is caused by damage to what structure? How many neurons have to be loss before physical signs?

A
  • damage to basal ganglia, (SNpc) substantia nigra pars compacta (nigra because dopamaine is black on imaging) located in the midbrain
  • 60-80% are loss before physical signs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Sporadic vs genetic presentation of PD

A

Genetic PD (10%) = Atypical presentation: younger onset, dystonia, early dementia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

H&Y scale

A

0-5: higher is worse (+1.5 and +2.5)
0 = no signs or sx
1 = unilateral sx
1.5 = unilateral plus axial
2 = Bilateral but NO balance sx
2.5 = Bilateral and MILD balance (negative pull test)
3 = mild to moderate progression with Balance deficits
4 = severe disability but still able to stand and walk independently
5 = bedridden or w/c bound if not assisted.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

non- motor signs/symptoms of PD

A
  • sleep disturbances
  • dysautonomia (especially orthostatic hypotension)
  • constipation
  • cognitive: executive function, memory, motivation, memory, attention, in later stages dementia
  • affects the limbic system, depressed dopamine causes: depression, apathy, anxiety, anhedonia (inability to feel pleasure)
  • increased dopamine causes (later stages with shrinking therapeutic levels): euphoria, mania, impulsivity, pleasure seeking/risky behavior
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Evidence based treatment for PD:

A 
Evidence supports: 
- Pace controlled treadmill training
- forced cycling 
- LSVT Loud and Big
- Dance 
- boxing some research 
Mixed evidence: Tai Chi
No evidence yet: yoga, PWR!
Other: include cardiorespiratory training. Dual task helps with single and dual tasks but not balance. Exercise is disease modifying
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Where do cervical, thoracic, lumbar, and sacral spinal nerves exit

A

Cervical spinal nerves exit ABOVE the corresponding vertebral body
Thoracic and Lumbar spinal nerves exit BELOW
Sacral spinal nerves exit at the end of the spinal cord (L1-L2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Main nerve for Ankle DF

A

Anterior Tib innervated by the deep fibular nerve (L4 - S1) . Nerve wraps around fibular head.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Modified Rankin Score

A
  • recommended for acute care stroke and rehab stroke
  • score: 0- 5; higher = worse
  • 0: no symptoms at all
  • 1: no significant disability despite symptoms. Can carry out all usual activities
  • 2: slight disability; unable to carryout all previous activities but look after own affairs
  • 3: Moderate disability: requires some help but able to walk without assistance
  • 4: Moderate - severe disability: unable to walk without assistance and able to attend to own bodily needs without assistance
  • 5: severe disability: bedridden and requiring constant nursing care and attention
  • 6: Dead
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the highest level of complete SCI where it’s POSSIBLE to perform EVEN transfers Independently

A

possible at C6 (independent to some assistance)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the highest level of complete SCI where it’s POSSIBLE to perform UNEVEN transfers Independently

A

possible at C7 (independent to some assistance)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the highest level of complete SCI where it’s POSSIBLE to be independent with manual w/c indoors

A

C6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the highest level of complete SCI where it’s POSSIBLE to be independent with manual w/c outdoors

A

outdoors level ONLY = C7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What SCI level starts functional ambulation?

A

Functional ambulation starts at T10

22
Q

Highest SCI level someone could be independent with Ambulation?

A

T10 -L1 patient could be independent (or require some assistance) to amb with KAFO and AD short distances

23
Q

Highest SCI level for limited household ambulation

A

T11- T12

24
Q

Highest SCI level for independent house hold ambulation

A

L1

25
Q

Highest SCI level for limited community ambulation

A

L1

26
Q

Highest SCI level for full community ambulation

A

L3

27
Q

nominal vs ordinal vs interval vs ratio

A
  • nominal: yes/no; male/female
  • ordinal: ranking order with no set intervals IE first, second, third or good, fair, poor
  • intervals: has set intervals IE temperature, but NO true zero
  • Ratio: set intervals and true zero. IE ambulation distance and time.
28
Q

symptoms for AICA stroke

A
  • AKA lateral pontine stroke

- symptoms: same side ataxia, contrallateral weakness, contrallateral decreased pain and temperature, vertigo/nausea

29
Q

symptoms for PICA stroke

A
  • aka lateral medullar stroke or wallenberg syndrome
  • symptoms: same side ataxia, contralateral decreased pain and temperature of the body, same side for face, dysphagia/dysarthria, nausea/vertigo, horners syndrome (ptosis (eyelid droop), mtosis (pupil constriction), and decreased sweating on same side due to sympathetic trunk involvement)
30
Q

definition of therapeutic index

A

The RATIO between toxic dose in 50% of subjects to the effective dose in 50% of subjects

31
Q

watershed stroke

A
  • ischemia to distal branches of main cerebral arteries, caused by hypofusion
  • results in proximal weakness with distal strength ok
  • “barrel man”
32
Q

Lacunar stroke

A

stroke to distal branches of MCA which supply the basal ganglia and internal capsule
- high incident in elderly and with HTN

33
Q

what functions are spared in ALS?

A

sensory, bowel and bladder, cognition, and ocular motor

34
Q

Primary Lateral sclerosis (PLS)

A

UMN only; better prognosis then classic ALS but may progress to classic ALS

35
Q

Progressive Spinal Muscular atrophy (PMA)

A

LMN only

36
Q

typical ALS

A

UMN early on, followed by LMN signs

37
Q

Chronic inflammatory demyelinating polyneuropathy (CIDP) vs GBS

A

CIDP has chronic progressive course of 2 or more months or relapsing weakness vs BGS rapidly progresses 2-6 weeks. CIDP is more likely to have sensory signs (paresthesia, pain, loss of somatosensory feedback), CIDP is less likely to have preceding illness; independent amb is often maintained in CIDP, autonomic dysfunction and respiratory insufficiency is less common in CIDP.
- FOR BOTH: it’s important to monitor overwork weakness and DOMS 1-5 days post activity

38
Q

GBS test results

A
  • Nerve conduction velocities are abnormal/decreased.
  • distal compound motor action potential (CMAP) predicts prognosis. poor outcome is CMAP is < 20% of normal at 3-5 weeks
  • elevated CSF proteins
39
Q

CIDP test results

A
  • elevated CSF protein levels
  • slowed/decreased nerve conduction velocities
  • prolonged distal motor latency
  • partial motor conduction block
40
Q

better prognosis if diagnosis earlier

A

ALS and MS

also worse prognosis if male for MS

41
Q

ALS test results

A
  • nerve conduction velocity testing: usually normal BUT could be slightly slowed.
  • EMG: reduction in the number of motor units, fibrillations (small) and positive sharp waves, fasciculations (larger). Signs of reinnervation = long duration polyphasic units
42
Q

MS test results

A
  • MRI of brain and SC will see plaques and atrophy ( need 2 lesions and 2 attacks to dx unless > 1 yr then just 2 lesions)
  • evoked potentials (visual) - just tells you if optic tract is intact
  • CSF: oligoclonal bands (just tells you if there is inflammation)
43
Q

EDSS scoring

A

1 - 10 with .5 increments; Higher = worse

0 - 4.5 = Independent ambulation
5.0 - 7.5 = Impaired / limited ambulation
8.0 - 9.5 = restricted to w/c or bed
10 = dead

Ambulation:

  1. 0 = 200 meters
  2. 5 = 100 meter
  3. 0 = unilateral / intermittent assistance
  4. 5 = constant or bilateral assistance
  5. 0 = 5 meters
  6. 5 = steps

0 - 3.5 = normal to mild

  1. 0 -5.5 = mild to moderate
  2. 0 -7.5 = mod to serve
  3. 0 -9.5 = severe
44
Q

Error based learning vs reinforcement learning locations

A
  • Error based learning (error data and trial by error) = cerebellum
  • Reinforcement learning (No error data; binary outcome only; successful movements will be reinforced) = basal ganglia
45
Q

Feed forward vs feed back mechanism motor responses

A
  • Feed forward (anticipatory / know it’s coming) = cerebellar
  • Feed back (reactionary / don’t know it’s coming) = brain stem and SC
46
Q

Evidence Based Treatment: Cerebellar

A
  • external cueing (rhythmic auditory stimulation, EMG, and visual biofeedback
  • case studies for loading trunk (considered compensatory), no evidence for loading limbs
  • balance training to include static, dynamic, and optokinetic stimulation
  • dynamic balance and whole body movements over limb coordination
  • utilize reactive feed back reactions (Brain stem and SC) and reinforcement learning (BG) to compensate for damaged cerebellar
47
Q

Evidence Based Treatment: Cerebellar

A
  • adaptation exercises (VOR retraining): used mostly for unilateral hypofunction
  • substitution (dissociation of head and eye movement): used for CNS dysfunction and bilateral hypofunction, when there is no vestibular system.
  • Habituation (desensitization): unilateral hypofunction and central vestibular
48
Q

Evidence Based Treatment: TBI

A

• Address self efficacy
• Increase executive function
• Restrict activities/environment first then add distractions and environmental challenges / dual tasks as motor ability improves
• Encourage cardiorespiratory fitness program
• Address coordination and posture
.Address balance deficits because they are more related to h/o falls than attention/dual tasks

49
Q

CIMT protocol

A

need 10 degrees finger extension, 20 degrees wrist extension, no cog or sensory deficit. Training paretic UE for 6hrs a day x 2 weeks. Restraint of UE 90% of waking hours during this time

50
Q

how to prevent shoulder pain in manual w/c

A
  • Strengthening of posterior shoulder muscles for power and endurance
  • Strengthening of shoulder external rotators
  • Stretching anterior shoulder structures
  • Biofeedback training
  • Arm ergometry
  • move wheels forward
  • push with a semicircular pattern which has more time in push phase vs recovery phase and hands fall below the push rim during the recovery phase.
  • move the wheels forward, although this makes the w/c less stable.

NCS Exam (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions