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NPTE study neuro
| Question? | Answer |
|---|---|
| efferent fibers | spinal nerves with anterior roots carrying motor information away from the CNS |
| afferent fibers | spinal nerves with posterior roots carrying sensory information toward the CNS |
| Autonomic Nervous System (ANS) | -emphasis on homeostasis and a person's response to stress -impulses often do not reach our consciousness -impulses produce largely autonomic responses |
| Somatic Nervous System (SNS) | -peripheral nerve fibers send sensory info to CNS -motor nerve fibers send info to skeletal muscle -controls voluntary movement and provides ability to sense all 5 senses |
| Limbic system | -involved in control and expression of mood and emotion, processing and storage of recent memory, olfaction, control of appetite, emotional response to food -lesions: behavior changes, extreme fearfulness, altered sexual behavior, changes in motivation |
| Left hemisphere | -language -sequence/perform movements -understand language -produce written/spoken language -analytical -controlled -logical -rational -express positive emotions -process verbally coded info in organized/logical/sequential manner |
| Right hemisphere | -nonverbal processing -artistic abilities -general concept comprehension -hand-eye coordination -spatial relationships -kinesthetic awareness -understand music -understand nonverbal communication -express negative emotions -body image awareness |
| Frontal lobe function | -voluntary movement -broca's area: speech, concentration -personality -temper -judgement -reasoning -behavior -self-awareness -executive functions |
| Parietal lobe function | -sensation of touch, kinesthesia, perception of vibration, temperature -receives info from other areas of brain (hearing, vision, motor, sensory, memory) -meaning for objects -interprets language and words -spatial and visual perception |
| Temporal lobe function | -primary auditory processing and olfaction -Wernicke's area: ability to understand/produce meaningful speech, verbal/ general memory, assist with understanding language -rear of lobe: interpret other people's emotion/reactions |
| occipital lobe function | -main processing center for visual info -process visual info (color, light, shapes) -judgement of distance (seeing in 3 dimensions) |
| frontal lobe impairments | -contralateral weakness -perseveration, inattention -personality changes, antisocial behavior -impaired concentration, apathy -Broca's aphasia -delayed/poor initiation -emotional lability |
| parietal lobe impairments | -dominant hemisphere: agraphia, alexia, agnosia -nondominant hemisphere: dressing apraxia, constructional apraxia, anosognosia -contralateral sensory deficits -impaired language comprehension -impaired taste |
| temporal lobe impairments | -learning deficits -Wernicke's aphasia (receptive deficits) -antisocial, aggressive behaviors -difficulty with facial recognition -difficulty with memory/ memory loss -inability to categorize objects |
| occipital lobe impairments | -homonymous hemianopsia -impaired extraocular muscle movement/ visual deficits -impaired color recognition -reading/writing impairment -cortical blindness w/ bilateral lobe involvement |
| hippocampus | -process of forming and storing new memories |
| basal ganglia | -responsible for voluntary movement -regulation of autonomic movement, posture, muscle tone, control of motor responses |
| amygdala | -emotional and social processing -involved in fear and pleasure responses/ arousal/ processing of memory/ formation of emotional memories |
| Anterior Cerebral Artery (ACA) impairments | -contralateral lower extremity motor/ sensory involvement -loss of bowel/ bladder control -loss of behavioral inhibition -significant mental changes -neglect -aphasia -apraxia -agraphia -perseveration -akinetic mutism w/ bil. involvement |
| MCA impairments | -most common sign of CVA -Wernicke's aphasia -homonymous hemianopsia -apraxia -flat affect (R hemisphere) -contralateral weakness/face sensory loss/ UE>LE -impaired spatial relations -anosognosia in non dominant hemisphere -impaired body schema |
| PCA impairments | -con. pain/temp. sensory loss/hemiplegia -mild hemiparesis -ataxia/ athetosis/choreiform mov. -thalamic pain syndrome -anomia -hemiballismus -visual agnosia -memory impairment -alexia/ dyslexia -cortical blindness from bil mov. |
| vertebral-basilar artery impairments | -loss of consciousness -hemiplegia/tetraplegia -comatose/vegetative state -inability to speak -locked in syndrome -vertigo -nystagmus -dysphagia -dysarthria -syncope -ataxia -Wallenberg syndrome |
| cuneocerebellar tract (Ascending tract) | -sensory tract to cerebellum -ipsilateral subconscious proprioception of neck/ UE |
| Fasciculus cuneatus (posterior/dorsal column) (Ascending tract) | -sensory tract -trunk, neck, UE proprioception/ vibration/ two-point discrimination/ graphesthesia |
| fasciculus gracilis (posterior/dorsal column) (Ascending tract) | -sensory tract -trunk and LE proprioception/ vibration/ two-point discrimination/ graphesthesia |
| spinocerebellar tract (dorsal/ventral) (Ascending tract) | -sensory tract -ipsilateral subconscious proprioception -tension in muscles -joint sense -posture of trunk and LE |
| spino-olivary tract (Ascending tract) | -sensory tract -relays info from cutaneous and proprioceptive organs |
| spinoreticular tract (Ascending tract) | -sensory tract -reticular formation that influences levels of consciousness |
| spinotectal tract (Ascending tract) | -sensory tract -info for spinovisual reflexes -assist w/ movement of eyes and head toward a stimulus |
| spinothalamic tract (anterior) (Ascending tract) | -crude touch/ pressure |
| spinothalamic tract (lateral) (Ascending tract) | -temperature/pain sensation |
| corticospinal tract (anterior) (descending tract) | -pyramidal motor tract -ipsilateral voluntary, discrete, skilled movements |
| corticospinal tract (lateral) (descending tract) | -pyramidal motor tract -contralateral voluntary fine movement -damage: + Babinski sign; absent abdominal reflexes; loss of fine motor or skilled voluntary movement |
| reticulospinal tract (descending tract) | -extrapyramidal motor tract -facilitation/ inhibition of voluntary and reflex activity through influence on alpha and gamma motor neurons |
| rubrospinal tract (descending tract) | -extrapyramidal motor tract -motor input of gross postural tone -facilitating activity of flexor muscles -inhibiting activity of extensor muscles |
| tectospinal tract (descending tract) | -extrapyramidal motor tract -contralateral postural muscles tone associated w/ auditory/visual stimuli |
| vestibulospinal tract (descending tract) | -extrapyramidal motor tract -ipsilateral gross postural adjustments to head movements -facilitating extensor muscles -inhibiting flexor muscles -damage: significant paralysis, hypertonicity, exaggerated deep tendon reflexes, clasp-knife reaction |
| Alpha A fibers | -alpha motor neurons, muscle spindle primary endings, golgi tendon organs, touch |
| Beta A fibers | -touch, kinesthesia, muscle spindle secondary endings |
| Gamma A fibers | -touch, pressure, gamma motor neurons |
| delta A fibers | -pain, touch, pressure, temperature |
| CN I | -olfactory -afferent (sensory) -smell -test: identify familiar odors |
| CN II | -optic -afferent (sensory) -sight -test: visual fields/ visual acuity |
| CN III | -oculomotor -efferent (motor) -voluntary motor: levator of eyelid, superior/medial/ inferior recti, inferior oblique muscle of eyeball -smooth muscle of eyeball -test: upward, downward, medial gaze / reaction to light |
| CN IIII | -trochlear -efferent (motor) -voluntary motor: superior oblique muscle of eyeball -test: downward and inward gaze |
| CN V | -trigeminal -afferent(sensory): touch/pain of face skin, mucous membranes of nose, sinuses, mouth, anterior tongue -efferent(motor): voluntary motor: muscle of mastication -Test: corneal reflex / face sensation/ clench teeth(push down on chin ) |
| CN VI | -abducens -efferent (motor) -voluntary motor: lateral rectus muscle of eyeball -test: lateral gaze |
| CN VII | -Facial -afferent(sensory): anterior tongue taste -efferent(motor): voluntary motor: facial muscles/ autonomic: lacrimal, submandibular, sublingual glands -test: close eyes tight/ smile and show teeth/ whistle and puff cheeks/ identify familiar taste |
| CN VIII | -vestibulocochlear -afferent (sensory) -hearing/ balance -test: hearing test, balance and coordination tests |
| CN IX | -glossopharyngeal -afferent(sensory): posterior tongue/ pharynx pain and touch; posterior tongue taste -efferent(motor): voluntary motor: select muscle of pharynx/ autonomic; parotid gland test: gag reflex/ ability to swallow |
| CN X | -vagus -afferent: pharynx/ larynx/ bronchi touch and pain; tongue and epiglottis taste -efferent(motor): voluntary motor: muscles of palate, pharynx, larynx; autonomic: thoracic and abdominal viscera test: gag reflex, ability to swallow, say "Ahhh" |
| CN XI | -accessory -efferent (motor) -voluntary motor: SCM and trapezius muscles -test: resisted shldr shrug |
| CN XII | -hypoglossal -efferent(motor) -voluntary motor: muscles of tongue Test: tongue protrusion (injured tongue deviates toward affected side) |
| superficial reflexes | -graded absent or present -abdominal reflex (T8-L1) -corneal "blink" reflex (trigeminal/facial nerves) -cremasteric reflex (L1-L2) -gag reflex (glossopharyngeal/ vagus nerves) -plantar reflex (L5-S1) |
| DTR reflex grading scale (0,+1,+2,+3,+4) | 0:no response (always abnormal) +1: diminished/ depressed response (may or may not be normal) +2:active normal response (NORMAL) +3:brisk/ exaggerated response (may or may not be normal) +4: very brisk/ hyperactive (always abnormal) |
| DTR reflex testing sites | -biceps tendon (C5-C6) -brachioradialis tendon(C5-C6) -triceps tendon (C6-C7) -Patellar tendon (L3-L4) -Achilles tendon (S1-S2) |
| barognosis | perceive the weight of different objects in hand |
| graphesthesia | identify # or letter drawn on skin w/out visual input |
| kinesthesia | identify direction and extent of movement of joint or body part |
| light touch | perceive touch through light pressure or use of cotton ball |
| localization | ability to identify the exact location of light touch on body using verbal response or gesturing |
| proprioception | identify static position of extremity or body part |
| stereognosis | identify object w/out sight |
| superficial pain | perceive noxious stimulus using pen cap/ paper clip/ pin |
| temperature | perceive warm/ cold test tubes |
| two-point discrimination | using 2 point caliper on the skin, identify one or 2 points without visual input |
| vibration | perceive vibration or pain through a tuning fork |
| allodynia | sensation of pain in response to a stimulus that would not typically produce pain |
| analgesia | absence of pain while remaining conscious |
| anesthesia | absence of touch sensation |
| causalgia | constant, relentless, burning hyperesthesia/ hyperalgesia that develops after peripheral nerve injury |
| dysesthesia | distortion of any senses, especially sense of touch |
| hyperesthesia | heightened sensation |
| hyperpathia | extreme exaggerated response to pain |
| hypesthesia | diminished sensation of touch |
| neuralgia | severe and multiple shock-like pains that radiate from a specific nerve distribution |
| pallanesthesia | loss of vibration sensation |
| paresthesia | abnormal sensations (tingling, pins, needles, burning sensations) |
| double crush syndrome | 2 separate lesions along same nerve create more severe symptoms |
| neuroma | abnormal growth of nerve cells |
| polyneuropathy | diffuse nerve dysfunction that is symmetrical and typically secondary to pathology not trauma |
| Wallerian degeneration | occurs distally, specifically to myelin sheath and axon |
| neurapraxia | -mildest form of acute care injury -myelin dysfunction -nerve conduction is preserved -symptoms: pain, minimal muscle atrophy, numbness or greater loss of motor and sensory function, diminished proprioception -common from pressure injuries |
| axonotmesis | -severe grade of injury to peripheral nerve -reversible damage (maintain anatomical relationship) -can regenerate distally to site of lesion (1 millimeter per day) -spontaneous and spotty recovery -traction, compression, crush injuries |
| Neurotmesis | -most severe grade of injury to peripheral nerve -irreversible injury -flaccid paralysis/ wasting of muscles, total loss of sensation -all motor/ sensory loss distal to lesion permanent -complete transection of nerve trunk |
| Upper motor neuron characteristics | -hyperactive reflexes -mild atrophy -absent fasciculations (involuntary muscle movement) -hypertonic |
| Lower motor neuron characteristics | -hypoactive/ absent reflexes -present atrophy -present fasciculations -hypotonic/ flaccid |
| athetosis | slow twisting and writhing movements -large in amplitude -involuntary movements combined with instability of posture -primarily seen in face, tongue, trunk and extremities |
| chorea | brief irregular contractions that are rapid but not myoclonic jerks -"fidgeting" -ballism: choreic jerks of large amplitudes, flailing movements |
| dystonia | sustained muscle contractions causing twisting, abnormal postures, repetitive movements |
| tics | sudden brief repetitive coordinated movements at irregular intervals |
| tremors | involuntary, rhythmic oscillatory movements -resting: observed at rest, may disappear with movements -postural: observed with voluntary contraction to maintain posture -intention (kinetic): absent at rest, observed with activity |
| akinesia | inability to initiate movement |
| asthenia | generalized weakness |
| ataxia | inability to perform coordinated movements |
| bradykinesia | slow movement |
| clasp-knife response | resistance seen during ROM of hypertonic joint (greatest resistance at beginning of movement) |
| clonus | UMN lesion characteristic -involuntary alternating spasmodic contraction of muscle precipitated by quick stretch reflex |
| dysdiadochokinesia | inability to perform rapidly alternating movements |
| dysmetria | inability to control ROM and force of muscular activity |
| dystonia | large axial muscle involuntary movement |
| fasciculation | involuntary muscle twitch caused by random discharge of LMN and muscle fibers |
| hemiballism | involuntary and violent movement of large body part |
| lead pipe rigidity | uniform/ constant rigidity to resistance to ROM |
| cogwheel rigidity | inconsistent rigidity to resistance to ROM |
| automatic postural strategy: Ankle | first strategy -small range, slow velocity perturbation when feet are on the ground -muscles contract distal to proximal at ankle joint |
| automatic postural strategy: Hip | -greater force through pelvis and hips -hips move opposite direction from head -muscles contract proximal to distal |
| automatic postural strategy: Suspensory | -lower center of gravity during standing or ambulation -ex: crouch |
| automatic postural strategy: stepping | elicited through unexpected perturbations or when perturbation produces movement that COG is beyond BOS -LE and UE reach to regain new BOS |
| Berg balance scale | assess risk of falling -14 tasks -scored 0-4 -max score: 56 -less than 45: increased risk of falling |
| Fregly-Graybiel Ataxia Test battery | -assess and treat balance dysfunction -8 test condition measuring each leg, eyes open and closed -pass/ fail basis |
| Fugl-Meyer sensorimotor assessment of balance performance battery | assess balance specifically for pt's with hemiplegia -7 items, scored 0-2 -max score:14 |
| functional reach test | assess standing balance and risk of falling |
| romberg test | assess balance and ataxia |
| TUG test | assess person's level of mobility and balance |
| Tinetti | screen pts to identify if there increased risk of falling assessing sit to stand balance, gait (normal and fast), standing balance (eyes open/closed), slight perturbation, turning 360 |
| Fluent aphasia | word output and speech production are functional -speech lacks substance -substitutes inappropriate words -when someone is able to speak well and use long sentences, but what they say may not make sense |
| non-fluent aphasia | produce a failure in language expression, written or verbal, and are often associated with pathologies in Broca's brain area. -poor word output |
| wernicke's aphasia | -impaired comprehension -impaired writing -poor naming ability |
| conduction aphasia | severe impairment with repetition -intact fluency with good comprehension -speech interrupted by word finding difficulties -reading intact, writing impaired |
| broca's aphasia | -expressive aphasia -intact auditory and reading comprehension -impaired repetition and naming skills -paraphasia is common -motor impairment |
| global aphasia | -comprehension(reading/auditory) severely impaired -impaired naming, writing, repetition skills may involuntarily verbalize using incorrect context -may use nonverbal skills for communication |
| verbal apraxia | pt unable to articulate speech, but understand the task |
Created by:
ellypt