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Nurp 500: Health Assessment > Week 11- Neuro > Flashcards

Week 11- Neuro Flashcards

1
Q

4 regions of brain:

A

Cerebrum, diencephalon, brainstem, cerebellum

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2
Q

Aggregation of neuronal cell bodies:

A

Gray matter

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3
Q

Neuronal axons that are coated with myelin:

A

White matter

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4
Q

These allow nerve impulses to travel more quickly:

A

Myelin sheaths

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5
Q

Sections of spine:

A

Cervical c1-c8
Thoracic t1-t12
Sacral s1-s5
Coccygeal

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6
Q

The brain and the spinal cord:

A

CNS

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7
Q

Cranial nerves and the peripheral nerves:

A

PNS

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8
Q

The corticospinal tract, the basal ganglia system, the cerebellar system:

A

Motor pathways

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9
Q

Reflexes, conscious sensation, body position, regulate autonomic functions:

A

Sensory pathways

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10
Q

Muscle stretch reflexes (deep tendon reflexes):

A

Reflexes

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11
Q

Common or concerning neuro symptoms:

A

HA, dizziness

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12
Q

Primary HA:

A

Migraine, cluster, and trigemjnal autonomic cpehalgias

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13
Q

Red flags for HAs:

A

Sudden/thunderclap
New onset after 50
Fever/stiff neck
Worst HA of my life- subarachnoid hemorrhage
Dull HA increased by coughing
Recurring in the same position- Tumor/abscess
Migraine (pound)

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14
Q

Pins and needles:

A

Paresthesias

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15
Q

Distorted sensations:

A

Dysesthesias

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16
Q

A rhythmic oscillatory movement of a body part resulting from contraction of opposing muscle groups:

A

Tremors

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17
Q

An infarction of CNS tissue

A

Cerebrovascular ischemia

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18
Q

Transient episode of neuro dysfunction caused by focal brain, spinal cord, or retinal ischemia without infarction:

A

TIA

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19
Q

ABDC2 for stroke:

A

Age greater/equal to 60
BP greater than/equal to 140/90
Clinical features of focal weakness, impaired speech without focal weakness
Duration 10-59 minutes of greater/equal to 60 minutes
Diabetes

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20
Q

This causes visual field cuts and contra lateral hemiparesis and sensory deficits:

A

Occlusion of the middle cerebral artery

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21
Q

This causes aphasia:

A

Occlusion of the left middle cerebral artery

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22
Q

This cause neglect or inattention to the opposite side of the body:

A

Occlusion of the right middle cerebral artery

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23
Q

Warning signs of stroke:

A

Face drooping
Arm weakness
Speech difficulty
Time to call

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24
Q

Modifiable risk factors for stroke:

A 
HTN 
Smoking 
Dyslipidemia
Diabetes 
Weight, diet, nutrition 
Physical activity
Alcohol use
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25
Q

Disease specific risk factors for stroke:

A

Afib
CAD
OSA

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26
Q

Most common, slowly progressive, often asymptomatic, risk factor for ulcerations, arthropathy, and amputation:

A

Distal symmetric polyneuropathy

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27
Q

Unilateral thigh pain and proximal lower extremity weakness:

A

Autonomic dysfunction, mononeuropathies, and polyradiculopathies

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28
Q

Diabetic foot exam should include:

A

Pin prick sensation
Ankle reflexes
Vibration perception
Plantar light touch sensation (semmes-weinstein monofilament)

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29
Q

This often causes burning electrical pain in the lower extremities, often at night:

A

Distal symmetric polyneuropathy

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30
Q

Reactivation of latent varicella within the sensory ganglia that causes painful, unilateral vesicular rashes in dermatomal distribution:

A

Herpes zoster

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31
Q

Multifactoral syndrome, acute confusional state marked by sudden onset, fluctuating course, inattention and at time, changing level of consciousness:

A

Delirium

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32
Q

Declines in memory and cognitive ability that interfere with ADLs

A

Dementia

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33
Q

This is more common in individuals with medical conditions:

A

Depression

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34
Q

Components of a neuro exam:

A 
Mental status
Cranial nerves
Motor system 
Sensory system 
Deep tendon, abdominal and plantar reflexes
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35
Q

CN1 (olfactory) function is ___ and to test ___.

A

Sense of smell

Present with a non-irritating odor

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36
Q

Loss of smell may come with:

A

Head trauma, smoking, aging, cocaine use, Parkinson’s

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37
Q

CN II is the:

A

Optic nerve

38
Q

CN II (optic) function is ___ and is tested by ____.

A

Vision

Visual acuity, visual fields by confrontation, pupillary light reaction, near response

39
Q

CN III is the :

A

Oculomotor nerve

40
Q

CN III (oculomotor) function is___ and is tested by ____.

A

Pupillary constriction, opening the eye (lid elevation) and most EOMs

Pupillary light reaction, near response (constriction and accommodation), EOMs, convergence

41
Q

Abnormal pupillary constriction

A

Anisocoria- CN III palsy

42
Q

Ptosis plus opthomoplegia:

A 
Intracranial aneurysm (awake)
Transtentorial herniation (comatose)
43
Q

If anisocoria worsens in the darkness, the small pupil has abnormal dilation and can be related to:

A

Horner syndrome or simple anisocoria

44
Q

CN IV is called:

A

Trochlear

45
Q

CN IV (trochlear) function:

A

Downward, internal rotation of the eye

46
Q

CN IV (trochlear) test:

A

EOMs, convergence

47
Q

Binocular diplopia in CN IV neuropathy caused by:

A

MG, trauma, thyroid opthalmopathy

48
Q

CN V is called:

A

Trigeminal

49
Q

CN V ( trigeminal) function:

A

Motor-temporal and masseter muscles (jaw clenching, lateral pterygoids)

Sensory- facial (ophthalmic, maxillary, mandibular

50
Q

CN V (trigeminal) test:

A

Motor- clench teeth,open jaw, move side to side
Sensory- pain on forehead, cheeks, and chin
Corneal reflex- touch cornea with cotton

51
Q

Unilateral jaw weakness caused:

A

Pontine lesions

52
Q

Bilateral jaw weakness caused by:

A

Bilateral hermispheric diagnosis

53
Q

Ipsilateral facial and body sensory loss from contra lateral cortical or thatlmic lesions caused by:

A

Stroke

54
Q

Blinking absent on both sides with:

A

CN V lesions

55
Q

CN VI is called:

A

Abducens

56
Q

Abducens function:

A

Lateral deviation of the eye

57
Q

CN VI (abducens) test:

A

Six cardinal fields of gaze, convergence

58
Q

Nystagmus May be associated with:

A

Cerebellar diagnosis

59
Q

CN VII is called:

A

Facial

60
Q

CN VII (facial) function:

A

Motor- facial movements (expression, closing the eye, closing the mouth)
Sensory- taste for salty, sweet, sour, and bitter; sensation from the ear

61
Q

Blinking absent one the side of weakness in:

A

Lesions of CN VII

62
Q

CN VII (facial) test:

A

Raise eyebrows, frown, close both eyes tightly, try to open them, show both upper and lower teeth, smile, puff out both cheeks

63
Q

Flattening of the nasolabial fold and drooping of the lower eyelid suggest:

A

Facial weakness

64
Q

CN VIII is called:

A

Acoustic

65
Q

CN VIII (acoustic) function:

A

Hearing (cochlear division) and balance (vestibular division)

66
Q

CN VIII (acoustic) test:

A

Whispered voice test, Rinne, Weber

67
Q

Vertigo with hearing loss and nystagmus:

A

Meniere disease

68
Q

CN IX is called:

A

Glossopharyngeal

69
Q

CN IX (glossopharyngeal) function:

A

Motor- pharynx

Sensory- posterior portions of the eardrum, the pharynx, and the posterior tongue

70
Q

CN IX (glossopharyngeal) test:

A

Difficulty swallowing, movement of the soft palate and the pharynx (symmetric), uvula midline

71
Q

Hoarseness caused by:

A

Vocal cord paralysis

72
Q

Dysphagia caused by

A

pharyngeal or palatal weakness

73
Q

CN X is called:

A

Vague

74
Q

CN X (vagus) function:

A

Motor- palate, pharynx, and larynx

Sensory- pharynx and larynx

75
Q

CN X (vagus) test:

A

Difficulty swallowing, movement of the soft palate and the pharynx (symmetric), uvula midline

76
Q

CN XI is called:

A

Spinal accessory

77
Q

CN XI (spinal accessory) function:

A

Motor- SCM and upper portion of the trapezius

I’m

78
Q

CN XI (spinal accessory) test:

A

Look for atrophy or fasciculations, shrug against resistance, turn head to each side against hand, observe for contraction of the opposite SCM and note the force of the movement against your hand

79
Q

CN XII is called:

A

Hypoglossal

80
Q

CN XII (hypoglossal) function:

A

Motor- tongue

81
Q

CN XII (hypoglossal) test:

A

Tongue protrude midline, move tongue side to side and note symmetry

82
Q

Proprioception is:

A

Body position

83
Q

Ability to identify an object by feeling it:

A

Stereogenosis

84
Q

Number identification when a number is drawn on patients palm:

A

Graphesthesia

85
Q

Two-point discrimination is:

A

Two ends of opened paper clip, or two pins, touch a finger pad simultaneously; find the minimal distance at which a person can discriminate the two points: normal is <5mm on the finer pad

86
Q

+4 grade for reflexes is:

A

Very brisk, hyperactive with clonus

87
Q

If reflexes are hyperactive, follow up with:

A

Ankle clonus test

88
Q

Ankle clonus test:

A

Support the knee partially flexed
Dorsiflex and plantarflex the foot while encouraging patient to relax
Look for rhythmic oscillations-CNS disease

89
Q

Oculocephalic reflex is the:

A

Doll’s eye movements- hold eyes open, turn head quickly from side to side- eyes should move to opposite side that head is turned

90
Q

Ice water into the ear canal; intact brainstem, eyes will deviate toward ear being tested:

A

Oculovestibular relfex

Nurp 500: Health Assessment (11 decks)

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