| Question |
Answer |
| Frontal Lobe |
Thinking/Personality Center (Personality change after trauma). Two cortexes - sensory & motor. |
| Sensory Cortex |
Frontal Lobe - Post central gyrus |
| Motor Cortex |
Frontal lobe - Precentral gyrus (thicker) |
| Parietal Lobe |
Receptive speech (hearing) |
| Temporal Lobe |
Expressive speech (talking) - contralateral to the dominante side |
| Occipital Lobe |
Vision Center |
| Cerebellum |
Execution of Smooth Movements. Supplied by superior, anterior inferior and posterior inferior cerebellar arteries. |
| Basal Ganglia |
Controls nonpurposal (unintentional) movement (ex. Parkinson's - Pill rolling) |
| Brainstem |
Mid brain, Pons & medulla (continuous with the spinal cord) |
| Meninges |
Pia, Arachnoid & Dura |
| CSF |
Made in the choroid plexus in the lateral ventricles (Subarachnoid Space) -> 3rd ventricle (anterior to brain stem) -> 4th ventricle -> medial foramina magendie & two lateral foramin luschka. Reabsorbed by the arachnoid granulations then to dural sinuses. |
| Hydrocephalizaion caused by |
Damaged arachnoid granulations |
| Blood thinner herbs |
Ginko, Garlic & ginsing. Together they are more potent than coumadin. |
| Licorice Root |
Increase blood pressure |
| Recommended hours of sleep per night |
8-10 |
| Gloscow Coma Scale |
Motor Response: 1-6Eye Opening: 1-4Verbal: 1-5 |
| Orientation questions - inorder |
Time, Place, Person |
| Spelling questions - in order |
World (5) - Hand (4) - Cat (3) |
| Papiledema (Opthamoscopic Exam) |
Loss of venous pulsation |
| Hypoglossal lesion |
Tongue deviates toward lesion |
| Strength Grade |
5 - Full force4 - Less force3 - Against gravity2 - Lateral Movement1 - No movement |
| Biceps reflex |
C5** & C6 |
| Brachioradialis reflex |
C5 & C6** |
| Triceps Reflex |
C7** & C8 |
| Patellar Reflex |
L3** & L4 |
| Achilles Reflex |
S1** & S2 |
| Babinskis |
S1 or above UMN lesion |
| Meningeal Irritation S&S |
Posterior HA, Fever & altered mental status |
| Coordination Testing (Basal Ganglia & Cerebellum) |
Finger-Nose, Heel-Shin, Rapid alternating movements & balance. |
| Basal Ganglia VS. Cerebellum |
BG - Tremor @ rest that disappears with movement. |
| Peripheral Nerve Lesions |
Dermatome or myotome distribution. Radicular Pain. LMN signs. |
| CNS Lesions |
General deficits within an extremity. Loss of sensation. UMN signs. |
| Spinal Cord Lesions |
UMN & Dermatome defect or Dissociation of sensation modalities |
| When to use lumbar punture for Dx. |
Meningitis, encephalitis, meningeal cancer, GBS (Guillain-Barré Syndrome ), acute demyelinating disorders, bengin intracranial hypertension, seizure, storke, polyneuropathy, subarachnoid hemorrhage (must CT scan prior to r/o brain herniation) |
| Post Lumbar puncture |
Patient lies supine for 6 hours to minimize HA & postential CSF leak |
| CT Pros & Cons |
Pro - cheap, fast, good blood localization & decrease in claustrophobia.Cons- Poor visualization of posterior fossa, cervical structures, and acute changes |
| MRI Pros & Cons |
Pros - Visualizes posterior fossa, cervical structures, soft tissues and acute changes well.Cons - Expensive, long, small area, patients cant be on ventilation or have metal implants. |
| CT myelogram |
Dye w/in subarachnoid space. Visualization around spinal cord. |
| EMG (Evoked potential studies) |
Localizes lesion. Elucidates etiology of nerve damage (metabolic, polyneuropathy, radiculopathy, myelopathy or compressive. |
| EEG |
Localizes defect. Can be used to determine brain death or coma. |
| Tracts |
4 sensory & 1 motor |
| Sensory Tracts |
Spinothalamic, Posterior Column, Spinal Cerebellar |
| Spinothalamic Tract |
Pain, temperature & light touch. Enters spinal cord & decussates (crossover) 1 or 2 levels up from entry location. Terminates in sensory cortex. |
| Posterior Column |
Conscious stereognosis (3-D object discrimination), proprioception & light touch.Enters spinal cord and travels to medulla. Decussates at medulla and follows medial limbicus to sensory cortex. |
| Spinal Cerebellar Tract |
Unconscious proprioception. Always stays ipsilateral to the sensory cortex. Patient leans toward the side of the cerebellar lesion. |
| Motor Tract |
UMN (everything before spinal junction)-> crosses medulla -> corticospinal tract -> alpha interneuron -> LMN |
| UMN Dz. S&S |
Hyoerreflexic. Spastic (tough to move). No atrophy to muscles. No vesiculation (twitch). Positive babinskis sign. |
| Babinskis sign |
Toes fan & ankle, knee, hip dorsiflex & patient withdraws. |
| LMN Dz. S&S |
Hyporeflexic. Flaccid. Atrophy. Vesiculation (Twitches). Normal (negative) babinskis. |
Amanda Leigh Brooks
on 2009-09-16
Spanish 3
