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WVSOM -- Tips for Success Neurology

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What is function of frontal lobe?   Primary motor cortex. Personality, intellect, executive function and impulse control.  
What will a lesion in the frontal lobe result in?   seizures, change in consciousness, paresis and paralysis  
What is the function of the parietal lobe?   sensory data  
What will a lesion of the parietal lobe result in?   impairment in skin sensation on contralateral side of the body  
What is the function of the occipital lobe?   primary visual cortex  
What is the function of teh temporal lobe?   primary auditory cortex. Hearing, language, taste, smell, balance, behavior and emotions  
What is the primary function of the limbic system?   Feeding fighting, feeling, fleeing and fucking.. (5Fs)  
What is the function of the cerebellum?   controls muscle tone, equilibrium and posture  
What will a lesion in teh cerebellum result in?   ataxia, postural abnormality, wide stance gait, imbalance, intention tremor, abnormal rapid alternating-movements, impaired muscle tone and speech  
What is the function of the lateral spinothalamic tract?   pain and temperature  
What is teh functino of teh Anterior spinothalamic tract?   superficial touch and deep pressure  
What is the function of the posterior columns?   conscious proprioception, vibration and light touch  
What is the function of the spinocerebellar tracts?   unconscious proprioception  
What are the 5 key areas to the neurologic exam?   mental status cranial nerves Motor-coordination -- cerebellar sensory reflexes  
What is assessed with mental status?   oriented x 3 Mini mental status exam geriatric depression scale consciousness  
What is the mini mental status exam?   MMSE is normally a standardized 30 question form filled out with the patient  
What is a bad score in the geriatric depression scale   Greater than 5  
What is assessed with conscousness?   if tehre is: confusion lethargy delirium stupor coma  
what is confusion?   inappropriate response to questions, decreased attention span  
What is lethargy   drowsy when awakened -- responds appropriately  
What is delirium   Confusion with disordered perceptions or anxiety with inappropriate reason or stimuli  
What is stupor?   arousable for short poeriods after visual, verbal or painful stimuli  
Waht is coma   not awake and not aware  
What is glasgow coma scale   used in cases of head trauma or hypoxia. Lower the score more severe teh impairment in consciousness. Less than 8, INTUBATE  
What is apraxia   patient has no motor deficits but is unable to perform an activity  
What is construct apraxia?   unable to construct or draw simple designs (clock face). Lesion of the parietal lobe  
What is dyspraxia   incompletely performs the activity. Leasion in the deep frontal lobe  
Pneumonic for function of cranial nerves   Some Say marry Money But My Browther Says Big Brains  
How do you test oflaction?   test using a strong odor  
How do test the optic nerve   visual acuity using charts. Ophthalmoscopic exam  
How do you test occulomotor/trochlear adn abducens?   assess size, shape, and symmetry 6 cardinal fields of gaze confrontation or peripheral vision test Accomodation direct and consensual reflex  
How do you test trigeminal motor function?   Observe and say "I am looking for any muscle atrophy, deviation of the jaw, or fascicualtions"  
How do you test trigeminal sensory function?   Ask patient to close eyes. assess patient's ability to feel light touch on forehead, cheeks, and jaw bilaterally.  
What does the corneal reflex test?   Sensory limb of CN V Motor Limb of CN VII  
What happens with an upper motor neuron lesion to CN VII   stroke normal function to upper face contralateral weakness of lower face  
What happens with lower motor neuron lesion to CN VII?   Bell's Palsy Total involement of ipsilateral face paralized  
What is muscle tone with upper motor neuron leason?   increased  
What is muscle atrophy with upper motor neuron?   little to none  
What is sensation to upper motor neuron?   may affect entire limb  
What are reflexes with an upper motor neuron?   hyperactive POSTIVE babinski  
Is there faasciculation with upper motor neuron lesions?   no  
What is motor effect with upper motor neuron lesion?   paralysis of voluntary movements  
Where is location of insult with upper motor neuron lesion?   damage above level of brainstem affects CONTRALTERAL side Damage below level of brainstem affects the IPSILATERAL side  
What is muscle tone with lwer motor neuron lesion?   decreased  
Waht is muscle atrophy with lower motor neuron leasion?   may follow dermatones or peripheral nerves  
What are reflexes like with lower motor neuron lesion?   weak to absent absent babinski  
Is there fasciculation with lower motor neuron loss?   yes  
where is location of insult in a lower motor neuron lesion?   damage affects muscle on the ipsilateral side of the body  
How do you test CN VIII?   assess hearing using fingertips moving Weber-Rinne Test  
How do you test the sensory function of the glossopharyngeal nerve?   taste to posterior 1/3 of tongue Sensory portion of the gag reflex  
How do you test the motor function of the glossophryngeal nerve?   swallowing  
How do you test the vagus nerve?   ability to swallow quality of speech inspect the palate and uvula lesion = uvula deviating away from side of lesion  
How do you test spinal accessory nerve?   shoulder shrug and head turn  
How do you test the hypoglossal nerve   tongue movement and proturusion lesion = tongue devation toward the side of lesion  
How do you test cerebellar function?   finger-nose-finger finger-finger heel-shin  
What does finger-nose-finger test for?   tandem gait  
What does finger-finger test for?   rapid alternating movements  
What does heel-shin test for?   Romberg Test evaluates mainly balance  
What is a dermatone?   band of skin innervated by the sensory nerve root of a single spinal segment  
What is carpel tunnel?   median nerve palsy use tinnel's and phalen's tests  
How do you test sensory loss?   perform with touch, pain, deep ressure adn vibration.  
What is peripheral neuropathology?   disorder of the PNS that results in motor and sensory loss in the distribution of 1 or more nerves, most commonly the hands and feet. Sensation of numbness, tingling, burning and cramping. Associated with diabetes  
How do you rate reflexes?   0-4  
What is normal reflex?   2+  
What do deep tendon reflexes that are hyperactive mean?   Upper motor neuron disorder  
What if deep tendon reflexes are absent?   neuropathy or LOWER motor neuron disorder  
Where do you check deep tendon reflexes?   Bicepts and brachioradial triceps patellar achilles  
What are you tsting with biceps and brachioradial reflexes?   c5-c6  
What are you testing with tricep reflexes?   c6-c8  
What are you testing with patellar reflexes?   L2-L4  
What are you testing with achilles reflex?   S1-S2  
What is babinski?   stroke lateral sole of the foot and move in and upside down J fasion to sole of forefoot  
What is Chaddock sign?   stroke teh lateral foot  
What is schaeffer sign?   squeeze the achilles tendon  
What is oppenheim sign?   press knuckles on skin and move distal  
What is gordon sign?   squeeze calf briefly  
Waht is bing sign?   multiple light pinpricks on the dorslolateral foot surface  
What is gonda/stransky sign?   pull the 4th toe outward and downward briefly and quickly release  
What is a bad toe sign?   up going toes or sustained ankle clonus  
What is gait like in a stroke?   spastic hemiparesis affected leg is stiff and extended with plantar flexion of foot. foot is dragged with scraping of the toe. affected arm is flexed adn adducted and does not swing  
What is gait like with Parkinsons?   shuffling posture is stopped and body is rigid. Steps are short with heistaion on starting and stopping  
What is gait like with cerebellar infarct?   WIDE STANCED, STAGGER ADN LURCHING FROM SIDE TO SIDE. ACCOMPANIED BY SWAYING OF TEH TRUNK  
What is gait like with tabes?   foot slapping  
What is gate like with sensory deficit   wide stance, with foot being brought down on heal then toe. Postitive romberg  
What is romberg test?   stand with feet together and eyes closed.  
What is brudzinski sign?   flex teh neck forward Positive sign -- involuntary flexion of hips and knees when flexing the neck INDICATES MENINGEAL IRRITATION  
What is Kernig's sign?   flex the leg at the knee and hip when the patient is supine and then attempt to straighten the legs. Positive sign -- pain in the lower back adn resistance to straightening the leg at the knee. Indicates -- Meningeal Irritation  


   


 

 

 

 

 

 
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