S1_L1-2: Approach to Diagnosis & Neuro Exam Flashcards
Signs/Symptoms of increased intracranial pressure (IICP) in NON-INFANTS
Headache, vomiting, papilledema, lateral rectus palsy (diplopia with internal squint), altered sensorium (deterioration in the level of consciousness), and Cushings Triad (↑ BP, ↓ Pulse, ↓ Respirations)
Signs/Symptoms of meningeal irritation
Headache, nuchal (neck) rigidity, Brudzinski’s Sign, Kernig’s Sign
Signs/Symptoms of increased intracranial pressure (IICP) in INFANTS
Bulging fontanel, separation of sutures, and rapid enlarging head size (Hydrocephalus)
What is the Normal Respiratory Rate (Breaths per minute)?
12-20 breaths per minute
Explain how to perform the Brudzinski’s Sign.
Patient is in supine and the examiner flexes the patient’s neck.
What is the expected findings in a (+) Brudzinski’s Sign?
Patient will involuntarily flex hip and knee. (+) wincing pain
Explain how to perform the Kernig’s Sign.
Patient is supine and the examiner flexes the patient’s hip, then extends the knee.
What is the expected findings in (+) Kernig’s Sign?
Patient feels an excruciating pain.
What is a secondary tumor of the brain?
A tumor that grows outside the CNS
What is a primary tumor of the brain?
A tumor that grows within the CNS
Type/Distribution of MASS LESION
Focal
Type/Distribution of PERIPHERAL NEUROPATHY
Diffuse
Type/Distribution of MULTIPLE SCLEROSIS
Multi-focal
Type/Distribution of NUTRITIONAL ENCEPHALOPATHY
Diffuse
A neurologic illness with a bulbar onset manifests with?
Swallowing and speech problems
Diagnostic test that is MORE SENSITIVE to mass lesions, strokes, brain abscess, and demyelinating disease COMPARED TO A CT SCAN?
Magnetic Resonance Imaging (MRI)
It is a cortical electrodiagnostic study
Electroencephalogram (EEG)
It is used to detect myopathies
Muscle Biopsy
Ancillary procedure for hypokalemic paralysis
Serum Potassium
The GOLD STANDARD of Angiograms
Digital Subtraction Angiogram / Catheter Angiogram
Angiogram that is NON-INVASIVE?
Magnetic Resonance Angiogram
Angiogram that is the MOST ACCURATE BUT INVASIVE?
Catheter Angiogram / Digital Subtraction Angiogram
Diagnostic test used to detect TB of the spine?
Spine X-ray
Medical term for TB of the spine?
Pott’s Disease
What is the Transcranial Doppler Ultrasound (Ultrasonography) used for?
Stroke, Hydrocephalus
What is the purpose of the ancillary procedure: Serologic Test
It is used to identify the different types of bacteria or virus causing the infection
Diagnostic test for Myoneural Junction (Neuromuscular Junction) Disorders?
Nerve Stimulation Studies (NSS)
Components of the Cushings Triad?
↑ BP, ↓ Pulse (Bradycardia), and ↓ Respirations
What are the prominent bladder signs?
Bowel or bladder incontinence, constipation, dysuria, and no bowel movement.
A lesion that is bilateral and often presents with a symmetrical deficit is in the level of the _____?
Spinal cord
TRUE OR FALSE: The cerebrum is responsible for fine movements.
False
TRUE OR FALSE: Cerebellar affectation presents with incoordinated movements. It does not present with weakness.
Both statements are true.
Cause of Amyotrophic Lateral Sclerosis (ALS)
Degenerative
Cause of Alzheimer’s Disease, Dementias
Degenerative
Cause of Myasthenia Gravis
Immunologic, autoimmune
Cause of Spina Bifida
Congenital / Developmental
Cause of subarachnoid hemorrhage
Trauma / neurotrauma
Cause of Hyponatremia
Toxic / metabolic
Cause of brain abscess
Infection
Cause of Stroke
Vascular / Circulatory problem
Source: Merritt’s Neurology, 14th ed.
Due to cerebral ischemia or hemorrhage. It strikes “out of the blue” and manifests as hemiparesis or other focal brain signs
Cause of Arteriovenous Malformation (AVM)
Congenital / Developmental
Cause of B1, B6, B12 Defiency
Nutritional
What is the most common vascular / circulatory problem?
Stroke
Cause of Parkinson’s Disease
Degenerative
Cause of Landry-Guillain-Barre Syndrome
Demyelinating and autoimmune
Cause of meningitis
Infection
Cause of intracerebral hemorrhage
Trauma / neurotrauma
Cause of aneurysm
Congenital / Developmental
TRUE OR FALSE: In a spinal cord lesion, there are normal findings above the level of the lesion.
True
TRUE OR FALSE: Atrophy occurs with time in a peripheral nerve lesion.
True
Other name for Bilateral Pyramidal Tract Signs
Pathologic Reflexes
Cause of Craniostenosis
Congenital / Developmental