Stack #65395
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| Slow degenerative disease or growing tumor | gradual uninterrupted development of symptoms
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| rapid and uninterupted development of symptoms | infection rapid growing tumor or rapidly progressive disease
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| rapid development of symptoms | occlusive vascular disease of large arteries
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| disease of small arteries or degenerative disease (ms) | gradual development of symptoms over months with remissions
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| neurologic exam | motor, sensory, equilibrium, consciousness, mentation
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| cn1 olfactory | loss of smell (anosmia)
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| cn2 optic | loss of visual acuity, blindness, color blindness
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| cn3, 4, 6 occulomotor, trochlear, abducens | weakness or paralysis of ocular muscles
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| cn7 facial | weak jaw muscles and deviation to one side on opening and closing
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| cn8 auditory/vestibular | loss of hearing
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| cn 9, 10 glossopharyngeal, vegas | diminished or absent sensation in the posterior pharyngeal wall and diminished or absent gag and swallowing reflexes
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| cn 11 spinal accessory | poor control of muscles of the neck and shoulder
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| ch12 hypoglossal | weak or paralized muscles of tongue prevents volitional movement
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| motor system | range of movement, reflexes, muscle tone and strength and gait
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| hypertonia | increased resistance to passive movement
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| hypotonia or flaccidity | decreased resistance to passive movement
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| spasticity | muscles of the limb are tense, hard, and resist stretching
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| rigidity | relaxed limb evenly resist movement in any direction
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| hemiplegia | paralysis of both limbs on the same side
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| hemiparesis | weakness of both limbs on the same side
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| tremor | pattern of small cyclic involuntary movements
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| chorea | quick forceful and abrupt involuntary movements
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| tics | stereotypic repetitive movements such as blinking, coughing, clearing the throat
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| circmducted gait | patients with hemiplegiea or severe hemiparesis throwing leg over something
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| evaluation somesthetic (bodily) sensation | pain, numbness or abnormal sensations
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| evaluating equilibrium | feeling dizzy or light headed, illusions
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| conciousness and mentation | patients with confusion, impaired in their orientation to the environment
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| evaluating mental status | consciousness, attention and concentration, orientation and memory, mood and behavior, thought content, language and speech
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| lower motor neuron | hypotonia
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| pyramidal | direct activation
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| upper motor neuron | spastic
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| extrapyramidal damage | produces involuntary movements (dyskinesia)
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| athetosis | slow writhing sinuous involuntary movements
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| dystonia | prolonged involuntary contractions of muscle groups
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| myoclonus | individual muscles contract in short, irregular bursts
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| cerebellar injury | causes disruptions in the force, velocity, and targeting of movements (ataxia)
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| dermatomes | distributions of sensory regions for cranial and spinal nerves
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| confusion | delirium, acute confusional state
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| lethargy | somnolence
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| cerebral angiograpyy (arteriography) | x-ray that provides visualization of cerebral veins and arteries
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| myelography | visualization of the spinal cord and surrounding space
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| computerized tomography (CT) | computer generated photograph-lie images of cross-sectional slices of internal structures
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| echo arteriography and doppler ultrasound | computer-generated images of cerebral blood vessels from high-frequency sound waves
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| Magnetic resonance imaging (MRI) | photograph-lie images of cross-sectional slices of internal structures with a strong magnetic field, reflects chemical composition of tissues (particulary water)
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| regional cerebral blood flow measurement (rCBF) | measures blood flow in various brain regions, brain metabolism
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| positron emission tomography (PET) | ingetion of mildly radioactive material , reflects metabolism
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| Electroencephalograpy (EEG) | electrical activity of cerebral cortex
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| lumbar puncture | spinal tap
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| left handers who become aphasic | have less severe aphasia, recover language better
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| phonemic paraphasias | the word
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| apraxia | condition of difficulty with morot plannin
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| cerebral plasticiy | brain's potential to reassign function, lessens with age
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| perisylvian reagion | broca's. wernicke's, supramarginal gyrus, angular gyrus, arcuate fasciculus
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| broc's | plans and organizes speech movements
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| motor strip | activation of muscles for articulation
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| arcuate fasiculus | primary route by which linguistic messages formulated in wernick's area reach broca's area
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| right side | interpretation....pitch, speed, stress, intontaion
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| literal/phonemic paraphasias | mispronounced parts of words
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| supramarginal gyrus | writing
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| heschels | whre sound lands, perception of stimulus and discrimination.
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| comprehention of speech | cochlea, cranial nerve, hesch;'s area, wernicke's area
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| semantic paraphasia | incategory substitution, right file folder, wron word (boy for girl)
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| unrelated paraphasia | not related at all
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| preservative paraphasia | previous word reused
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| connectionist model | all areas connected in someway
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| Wenicke's role in speech comprehension | 1. recognizes the message as speech 2. then finds semanitical meaning of word 3. consults its book of syntactic rules 4. interpreted literally or figuratively 5. sends instruction to other parts of the brain regarding how to respond
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| comprehension of printed materials | 1. lands on visual cortex 2. visual cortex encodes sends to ...3. wernicke's area via the posterior corpus callosum, then same as auditory process
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| how the brain performs spontaneous speech | 1. Wernicke's retrieves the words then sends coded sentence to broca's who tranlates and orders sounds, activates primary motor cortex, motor strip uses pyramidal system to put speech muscles in action, wernickes area monitors and repairs
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| repetition | tests entire language circuit
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| how the brain performs repitition | 1. auditory cortex 2. wernicke's area (mening extracted, coding the sentence) 3. arcuate fasciculus 4. broca's area recodes 5. primary motor cortex 3. pryyamidal fibers to the cortico bulbar tract 7. cranial nerves 8. wenicke's area monitors
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| how the brain performs oral reading | same as speech repetition but wernick's receives message from the visual cortex
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| how the brain performs writing | wernicke's formulates a message, gets the spelling right, sends it via the arcuate faciulus to premotor cortex, to the motor cortex, down the cortico spinal tract, to the persons hand and arm
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| wernicke's aphasia | receptive, fluent sensory
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| 4 classification of aphasia | cortical persylvian, transcortical border zone, subcortical aphasia, non-localized
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| broca's aphasia | motor aphasia, experssive aphasia, dysfluent, anterior
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| broca's aphasia symptoms | < 5 words per utterance, repetion abnormal, confrontation naming poor, reading comprehension fair to good, writing is poor, auditroy comprehsion good, oral reading poor, spasticity of right arm
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| conduction aphasia symptoms | camprehension and articulation are intact, spontaneous speech is better than repetition, conversational speech is fluent with literal paraphasias, pauses, hesitation and anomia, dysprosodic, looks like mild to moderate broca's
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| cortical aphasias | broca's, wernicke's, conduction, global
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| global aphasia | large lesion, severe impairment of both understanding and expresson, mute or repeptive, coprhension better than production, reading and writing are severly impaired
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| transcortical motor aphasia | nonfluent aphasia, dysfluent and effort in conversation, serial speech, repetition and coprehension appear adequate
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| transcortical sensory aphasia | fluent aphasia, marked by paraphasias, reading, comprehension, writing and naming are poor, repetition good
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| subcortical aphasia | lesion in the thalamus, marked by berbal paraphasia and neologisms, auditory and reading comprehension and repetion are intact, reduced vocal volume, word finding deficits with frequen perserveration (get stuck)
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| anomic aphasia | fluent but interrupted by word finding difficulties, occurs in most types of dementia, can be stressed induced
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| apraxia | difficulty carrying out volitioal movementsequences in the absence of weakness, paralysis, sensory loss or incoordination in the muscles used for the movements
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| ideational apraxia | doesn't have the idea underlying the movement. doesn't have the idea of the object, always affects both sides of the body.
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| ideomotor apraxia | can't perform movement when asked, but will do it spontaneously, comprehends but can't plan sequence of movements
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| buccofacial apraxia | oral movments, non-verbal apraxia
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| limb apraxia | unable to command volitionial movements with the arm, wrist and hand
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| apraxia of speech | can't sequence sounds to get the word out
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| isolation syndromes | motor and sensory transcortical aphasias
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