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General Neuro
Neuro
| Question | Answer |
|---|---|
| UE flexion synergy pattern | scap elevation ad retraction shoulder abd and ER elbow flexion forearm supination wris/finger flexion |
| LE flexion synergy | hip flexion, abd, ER Knee flexion ankle DF/IV toe DF |
| Number of spinal nerves (how are they divided) | 8 cervical 12 thoraicic 5 lumbar 5 sacral 1 coccygeal |
| Sympathetic and Parasympathetic Neurotransmitters | S: Norepinepherine P: Acetylcholine |
| Admoninal Reflex Level? Normal | T8-L1 abs contract deviate belly button in direction of stimulus |
| Corneal Blink reflex Normal nerves | Both eyes blink with stimulus of one Trigeminal facial |
| Cremasteric reflex normal nerve level | brisk and brief elevation of testical ipsi to stroke L1-2 |
| Gag reflex nerves | glossopharangeal and vagus |
| Plantar reflex nerves & + normal | L5-S1 Babinski (toes flare) toes flex |
| REFLEX GRADING | 0 no 1+ depressed 2+ normal 3+ exaggerated 4+ hyperactive |
| how to test superficial sensation | temperature light touch pain |
| how to test deep sensaiton | proprioception kinesthesia vibration |
| How to test corticcal sensation | B simultaneous stimulation stereognosis 2 pt discrimiantion barognosis localization of touch |
| what tuning fork Hz should be used | 128Hz |
| Monofilament protective sensation | |
| Barognosis | wt of differnet objects in hand |
| Graphesthesia | identify number of letter drawn on skin |
| Kinesthesia | identify direction and extent of movement of a joint or body part |
| Localization | identify exact spot being touched |
| proprioception | identify statically ehre limb is positoined |
| Stereognosis | identify object witout sight in hand |
| Superficial Pain | Perceive noxious stimulus using pen cap, paper clip end or pin |
| Two point discrimination | identify one or 2 points |
| Mono filament loss of protective sensation | 5.07 (10 g) |
| Allodynia | sense pain in response to stimulus that would not normally produce pain |
| Analgesia | absent of pain while remaining consious |
| Anesthesia | absent of touch sensation |
| Causalgia | constant reelentless, burning hyperesthesia & hyperalgesia after peripheral nerve injury |
| Dysesthesia | disortion of any of senses (especially touch) |
| Hyperesthesia | heightened sensation |
| Hyperpathia | extreme exaggerated response to pain |
| Hypesthesia | diminished sesnation to touch |
| Neuralgia | sever and multiple shock like pains that radiate from a specific nerve distribution |
| pallanesthesia | loss of vibration sensation |
| paresthesia | abdnormal sensation (tingling, pins and needles burning) |
| Wallerian Degeneration | degeneration that occurs distally specifically to myelin sheath and axon |
| common cause of axillary nerve injury | fx of humerus ant dislocation of shoulder |
| common cuase of musculocutaneous injury | fx of clavicle |
| common cause of radial nerve injury | radial tunnel compression fx of humerus |
| common cause of median nerve injury | carpal tunnel protator teres entrapment |
| common cause of ulnar nerve injury | cubital tunnel entrapment of guyons canal |
| common cause of femorla nerve injury | arhtoplasty displaced acentabular fx ant dislocation of femure hysterectomy appendectomy |
| common cause of sciatic N injury | blunt force trauma to buttocks THA accidental injection to nerve |
| common cause of obturator N injury | fixation of femure fx THA |
| common cause of peroneal N inury | femur, tib, fib Fx positioning during surgical procedures |
| common cause of Tibial N injury | tarsal tunnel entrapment popliteal fossa compression |
| common cause of Sural N injury | calcaneous fx Laterall malleolus Fx |
| Agnosia | inability to recognize familiar objects w one form of sensation |
| Akinesia | inability to initiate movement |
| Aphasia | disturbance to language that results in errors in word choice, comprehension or syntax |
| Expressive or brocas aphasia | sever difficulty in verbal expression impairment in object naming and writing abilities (R hemi) |
| Global aphasia | most sever reduced speech and comprehension reading and writting impaired |
| Receptive or Wernickes aphasia | sever disturbance in auditory comprehension impaired reading, writing, word recognition |
| Apraxia | inability to perform movements previously learned even though no loss in strength, coordination, sensation or comprehension |
| ideational apraxia | doesn't get how to do task |
| ideomotor apraxia | can not do task on command but cna do it spontaneously |
| Astereogenosis | inability to recognize object by touch |
| asynergia | inability to move muscles together in a coordianted manner |
| Ataxia | uncoordianted movement (especially gait) |
| Athetosis | slow, involuntary, worm like twisting mtions (CP) |
| What is reflex sympathetic dustrophy now called? | Causalgia |
| Cheyne Stokes Respiration | bizaree breathing pattern periods of apnea 10-60 sec followed by gradually increasing then decreasing depth and frequency of respiration |
| Chorea | Rapid involuntary movements |
| Clonus | rhythmic oscillations of muscle n response to sustaind stretch in pt w UMN |
| Contraction of extensor muscles of UE and LE bc of injury at brain stem | decerebrate rigidity |
| Contraction of flexor muscles of UE and contraction of extnesor muscles of LE | Decorticate Rigidity |
| Delirium | temporary confusion and loss of mental function |
| Dementia | loss of memory or intellectual function |
| Dysmetria | inability to judge distance |
| virus of shingles | herpes Zoster |
| Horners syndrome S&S | P: ptosis (eye lid) A: agnosia (lack of sweating) ipsi face M: Myosis (pupil restriction) |
| If nerve is damaged how is velocity and latency affected | Velocity slowed latency increased |
| Nystagmus | rapid back and forth movement of eye balls |
| Somatagnosia | lack of awareness of relationship of ones own body parts or the body parts of others |
| vision alterantion from damage to optic tract | Homonymous Hemianopsia |
| Vision alteration from damage to optic chiasma | temporal or peripheral vision fields B |
| Vision alteration from ptic nerve damage | monocular blindness |
| Tunning for level to test vibration sense? | 128 Hz |
| Number determines loss of protective sensation? | 5.07 monofilament |
| All of these conditions are stemming from an issue with___? akinesia bradykinesia athetosis chorea hemiballismus rigidity Dystonia Tremor | basal ganglai |
| Gait speed < 0.4 is for | house |
| gait speed 0.4-0.8 is for | limited community ambulatory |
| gait speed >0.8 | community ambulatory |
| NLI level | most caudal level w motor and sensory |
| Zone of partial preservation is only in what types | complete |
| Grief stages | Denial agression bargin Depression acceptance |
| neuropraxia def | myelin dysfunction reversible |
| axonotmesis | axon damage regeneration can occur |
| neurotmesis | axon, myelin, connective tissue component |
| anterior horn conditions | ALS Poliomyelitis |
| Neuromuscular junction conditions | myasthenia gravis |
| UMND characteristics and tests | Hyperactive atrophy no fascinations hypertonis ankle clonus babinski |
| LMND characteristics and tests? | decreased reflexes atrophy fasiculations hypotonic --> flaccid |
| parasympathetic roots are from? | cervical and lumbar |
| Sympathetic roots are from | thoracic |
| where is brocas area | frontal lobe |
| what does the frontal lobe do? | executive function voluntary movement personality emotions judgement |
| What does the parietal lobe do? | touch/sense proprioception pain sensaion temp |
| temporal lobe does? | auditory interpret emotions and actions |
| occipital lob controls | vision distance/demensions |
| white matter characteristics | in brain connects parts myelinated no dendrites projection and association fibers |
| Graymatter characteristics | unmyelinated neurons |
| Basal ganglia neuro diseases? | PD huntingtons touretts syndrome ADD obsesive compulsie |
| limbic system controls | mood emotion processing and store memory olfaction appetite emotional response to food |
| hippocampus is the? | memory indexer long temr memory |
| what does the amygdala do? | emotional processing fear pleasure arousal procesing of memory formation of emotional memory |
| Components of diencephalon? | thalmus hypothalmus epithalmus |
| What does the thalmus integrate sensory wise? | everything except smell to the cerebra cortex |
| What does the thalmus relay for the motor systme? | from cerebellum to precentral motor cortex |
| What does the hypothalmus integrate? | regulate hormones and maintain body homeostatis |
| What does the Epithalmus integrate? | olfactory (smell) pineal gland |
| What is thalmic pain? | spontaneous pain on contra side of body to leasion |
| Hypothalmus is off what issues can arrise? | obesity sexual disintrest poor temp control diabetes insipidus |
| What is the midbrain the relay station for. | cerebrum, cerebellum, SC |
| What makes up the brain stem? | midbrain pons medulla oblongota |
| Cerebellum damage creates symptoms on what side? | ipsilateral |
| what CN come off of the Pons? | middle 4 |
| Pons regulates what? | Respiratrory rate orient head to vision and auditory |
| Medulla ablongotta Cn come off of it? | Last 4 |
| medulla oblongotta regualtes? | RR HO somatosensation info for organs arousal and sleep |
| What reflexes are regulates by the medulla oblongotta? | Vomit cough sneeze |
| damage to the medulla oblongotta creates what side impairments? | contralateral |
| What part of the SC is gray matter? | Center anterior, lateral, posterio horns |
| What is controlled through the anterior horn? | efferent motor |
| What is controlled through the lateral horn? | motor thoracic and upper lubar ANS Preganglion |
| What is regulated through the posterior horn? | afferent sensory |
| where are the cell bodies and ganglions in the gray matter of the SC? | posterior horn |
| what makes up the ascending white matter tracts of the spinal cord? | Spinothalamic Spinocerebrall Dorsal column medial lemniscus |
| what is sent through the spinothalamic pathway? | pain temp pressure |
| lateral spinothalamic orientation of head to toe on SC? | cervical medial sacral outer/lateral |
| ipsilateral sense of proprioception tension n muscles joint sense posture | |
| What is sent in the dorsal column medial leminscus? | all the the other sense besides temp, pain, touch/pressure |
| Orientation of head to toe with dorsal column medial leminscus? | sacral medial cervical lateral |
| where are the axons in the SC? | white matter |
| Where does the spinothalamic pathway cross at? | SC |
| Where does the dorsal column medial lemniscal pathway cross at? | meduall oblongata |
| The lateral corticospinal ltract pyramid orintation from head to toe? | medial is cervical latera/outer sacral |
| Anterior cortical spinal tract of Pyramidal tracts that are descending control? | ipsilateral voluntary discrete & skilled movement |
| lateral cortical spinal tract of Pyramidal tracts that are descending control? | contralateral voluntary fine movements |
| Damage to lateral corticospinal tract shows? | + babinski absent superfical abdominal reflex + cremastic reflex loss of fine motor and skilled voluntayr movement |
| Descending extra pyramidal tracts control? | grading of movements flexor withdrawl rflex |
| Damage to extra pyramidal descending tracts casues/ | paralysis hypertonicity exaggerated DTR clasp knife reaction |
| Wish stroke recovery are synergies or spasticity seen at the beginning of recovery? | synergy |
| Right CVA characteristics | L sided impairments poor attention impaired awarenss and judgement spatial deficits memory deficits emotional lability impulsive |
| Left CVA characteristics | Right sided impairments increased frustration aphasia dysphagia motor apraxia language impairments |
| what aphasia should be treated w simple yes and not pharases? | non fluent brocas |
| what aphasia should eb treated w words and gestures and manual cues? | fluent aphasia |
| ACA CVA symptoms? | LE>UE incontinent apraxia bradykinesia motor inaction |
| MCA CVA symptoms? | UE>LE aphasia perceptual deficit HH sensory ataxia limb apraxia |
| Dominate side MCA CVA Symptoms? | aphasia brocas and wernickes |
| Non dominate side MCA CVA symptoms? | percetual: neglect, spadial disorganization |
| Major stroke invovles what artery and what symptoms? | internal corotid ACA and MCA but more MCA |
| PCA CVA symptoms of peripheral ? | occipital --> vision |
| PCA CVA symptoms of central? | Thalmus--> thaomus pain subthalmus --> involuntayr movement midbrain --> webers syndrome |
| What is webers syndrome? | ptosis (sagging eye lid) deviated eye |
| Vertebribasilar artery CVA types/locaitons? | superior cerebellar anterior inferior Posterior inferior cerebellar Artery (PICA) |
| Supeior cerebellar CVA symptoms? | movement coordination pain/tmep |
| Anterior inferior CVA symptoms? | Horners syndrome (pstosis, anhydrosis, myosis) PAM |
| PICA CVA Symptoms? | wallenberge syndrome -dysphagia ipsi face & contra body ptosis horseness pain |
| Webers syndrome cause? | Central PCA central PCA |
| Horners syndrome what? cause? | anterior inferior vertebropasialr artery CVA ptosis, anhydrois, myosis |
| Wallenberg syndrome what> cause? | PICA CVA ipsi face & contra body sensory ataxia dysarthria vomit nausea pain |
| levels of Rancho Los Amigos TBI scale | I --> X |
| what Racnho levles need total assist? | no response general response local respose I --> III |
| what Ranch TBI need max assist? | Confused aggitated confused inapproprite IV,V |
| what rancho level TBI need mod assist? | confused appopriate VI |
| what rancho level need min assist | automatic appropriate |
| What ranco level needs SBA? | purposeful approriate x2 |
| What Rancho level needs mod I? | last purposeful appropiate |
| List rancho levels? | no response general response local resonse confused aggitted confused innapriparite confused approrpiate autopatic approriate puposeful approprite x3 |
| What rancho level is it important to focus on structure? | confused inappropriate |
| when do past memories more than recent begin to show in rancho level for tbi? | confused approprite |
| What TBI rancho level is like a robot? | Automatic appropriate |
| what TBI level shows carryover fro new learning but intoleranct to stress? | first purposeful appropriate |
| what TBI level should you watch for depression and utilize to do lists? | 2nd purp app |
| when can periodic periods of depression be seen and can multi task w breaks w TBI level? | last purp app |
| what TB level shoulde you shift between differnet tasks every 2 hours? | 2nd purposeful appropiraite |
| list ASIA impairment scale names? | A complete B sensry incomplete C motor incomplete Dmotor incomplete E normal |
| What is the difference between ASIA C & D motor incomplete? | C MMT <3/5 D MMT > 3/5 |
| spinal shock resolves in? | 24 hours |
| Brown sequard MOI? S&S | stab/gun --> hemi section ipsi motor & contra pain & temp |
| Anterior cord syndroem MOI & SYS | hyperflexion motor corticospinal & spinothalamc Pain & tempt |
| Central cord Syndrome MOI & S&S/ | hypertextension (stenosis & DJD) UE Motor and sensory loss LE varies |
| Posterior cord Syndrome MOI? S&S? | compression, tumor, alcohol syndrome loss dorsal column senses |
| Cauda Equinus injury S&S and outcome? | bowel bladder sex regneration possible due to LMN periph nerve |
| intercostal nerve roots? | T1-12 |
| abdominal nerve roots? | T5-12 |
| Cough above what level will be impaired? | T10 |
| Vital capacity impaired at anythign above level of injury at? | T10 |
| injury of what level affect bowel and bladder? | S2-4 |
| bladder UMN impairment condition? | Reflexive empty when filled |
| Bladder LMN conditions and meaning? | Autonomous/nonreflexive flaccid bladder and need stimulous to empty |
| Autonomic dysreflexia occur aboe what levle? S&S? | T6 ^ BP, bradycaridia, pounding headache, flushing sweating, anxiety |
| what SCI level uses glossopharangyeal breathing to cough? what level uses manual assistance? | C4 C5 |
| Startingat what SCI level can they cough independnelty and use manual WC at home?? | C6 |
| what level can do self LE ROM? | C7 |
| what level can live at home alone except for heavy work? | C8 |
| What SCI can walk w a walker? | T6-8 |
| When are PD pts best do do PT? | morning after meds |
| what are the hoehn and Yahr PD stages? | 1: uni involvmenet 2: B involvmeent no balnace issues 3: imapired righting reflex 4: severly disabling (walker) 5: confined to bed or WC |
| MS cause? | demyelination |
| when are MS pts best for PT | morning |
| Relapse remitting MS? | days to moths attac then full or partial recovery |
| Secondary progressive MS? life line? | relapse remitting but progressive 5-10 years |
| Primary Progressive MS? life span | Steady decline from onset not past 40 |
| Progressive relapsing MS? | progressive from onset but clear exacerbations |
| Most common MS type? | relapse remitting |
| ALS/Lou Gehrigs disease involves what part of NS? | UMN & LMN & CNs |
| what has muscel weakness first w ALS? | hands |
| What 2 CN are responsible for Pupilary reflex and how? | II: optic sensory brings info in III: oculomotor constricts pupil N |
| CN affected by ALS? | 5,7,9,10,12 |
| lie expectancy of ALS? | 2-5 years |
| Myesthenia Gravis disease type? | Autoimmune of motor end plates |
| What is the first S&S of MG? | eye lids |
| Muslce weakness moves in what direction and MG progresses/ | Proximal to distal |
| GB is typically caused from____origi to the immune sysem? | viral |
| S&S of BG? | symmetrical distalto proximal LMN & CNs stocking glove |
| Recoveyr from GB can take up to ____w some impairments still. | 1 year |
| Bells palsy affects what CN? | VII facial |
| what is post polio? | muscular dystrophy decades after initla polio |
| Post polio S&S? | Asymmetrical muscle weakness myalgia fatigeu decreased endurance |
| Tx of post polio? | orthotics low intensit endurane enercy concervaiton |
| Duchennes muscular Dustrophy cause? | genetic affecting males |
| Duchennes S&S | 3-7 yo gowers sign scoliosis progress afte 11 yo |
| Charcot marie tooth disease causes and what is affected? | hereditiaty peroneal and distal eg (foot drp & stork foot deformitu) |
| TX of Charcot marie tooth? | orthotic for equinovarus deformity |
| vertigo lastin seconds is normally? | BPPV or TIA |
| Vertigo lasting hours is normally? | Meniers or stroke |
| Vertigo lasting days is normally? | vestibular neuritis/labyrinthitis TBI |
| H tests what CN? | 3 oculomotor 4 trochlear 6 abducens |
| BPPV posterior canal test? Tx? | Dix hallpike EPly |
| BPPV horizontal canal test?TX? | roll test appiani |
| what outcoem measure is good to use w Vertigo? | DGI |
| EPly maneuver and lamperts/BBQ ROll which ear is being treated? | the one down or rotated towards |
| Dix hallpike test what eye are u testing and what direction will the eye beating go? | one that is down beats toward affected ear |
| Difficulty with smooth pursite and saccad are impairments with what? | CNS |
| dificulty w dynamit visual acuity means impairment with? | VOR vestib occular reflex |
| D2 motion? | Sward |
| D1 motion? | answering phone |
| What is Simian line (palmar crease) seen in? | downs syndrome |
| Erbs palsy affects what nerve roots? | C5-6 |
| huntingtons MOI? prognosis/ | degeneration and atrophy of basal ganglai death 15-20 years |
| S&S of huntingtons | mental deterioration speech disturbances ataxic gait |
| what type of rigidity is seen in parkinsons disease? | lead pipe or cog wheel cog wheel more common |
| Occulta myelomeningocele means? | incomplete fsion of vertebral arch no neurla tissue protuding |
| Meningocele myelomeningocele means? | incomplee fusion w neural tissue sticking out |
| Myelomeningocele myelomeningocele means? | incomplete fusion meninges sticking out spinal cord sticking out |
| when to contact a doctor when a seizure is happening? | time it and greater than 5 min |
| Types of seizures and symptoms? | Petite mal: "day dream" grnad mal: entire body |
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KelsM
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