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CS! Neuro
Question | Answer |
---|---|
Cerebral lesions produce what type of effects? | Contralateral defects |
Frontal lobe | Primary motor cortex. Main controls: 1.personality. 2.intellect. 3.executive fnc. 4.impulse control. **Broca's Aphasia: Good comprehension but difficulty speaking. |
Parietal lobe | Sensory data. Lesion: Skin sensation impairment of contralateral side of body. |
Occipital lobe | Primary vision cortex |
Temporal Lobe | Primary auditory cortex. Functions: 1.hearing. 2.language. 3.taste. 4.smell. 5.balance. 6.emotions. **Wernicke's Aphasia: Poor comprehension, no difficulty speaking |
Limbic system | 1.hypothalamus. 2.Thalamus. **5 F's** 1.feeding. 2.fighting. 3.feeling. 4.fleeing. 5.fucking. |
Control of Cerebellum | 1.muscle tone. 2.Equilibrium. 3.posture. 4.fine movements. **lesions:ataxia, imbalance, abnormal rapid-alternating-movements |
Lateral spinothalmic tract | 1.Pain. 2.Temperature. |
Anterior spinothalmic tract | 1.superficial touch. 2.deep pressure. |
Signs and Symptoms of Neurologic Disease | 1.headache. 2.syncope. 3.dizziness. 4.ataxia. 5.dysphagia. 6.gait disturbance. 7.pain. 8.seizures. 9.weakness. 10.numbness |
5 levels of conciousness | 1.confusion. 2.lethargy. 3.delirium (confusion w/ disordered perceptions & anxiety). 4.Stupor (arousable for short periods). 5.Coma (glasgow scale out of 15. lower = more severe the impairment in conciousness). |
What two CN are involved in the Corneal Reflex? | Sensory Limb: CN V1. Motor Limb: CNVII |
Upper and Lower motor Neuron lesions on CNVII | Upper: STROKE (Normal function to upper face, contralateral weakness to lower face). Lower: Bell's Palsy (Total ipsilateral side of face paralyzed). |
Weber-Rinne Test | tests CNVIII. Weber: Pt should hear both sides equally. Rinne: AC>BC (2:1) ratio is normal |
Lesion on CN X | Uvula deviates away from the side of the lesion. **Tested when pt says "AAHHH" |
CN XI muscle strength grading | Trapezius and sternocleidomastoid. 0:Absent. 2:Weak (movement with gravity eliminated). 3.Fair (movement against gravity). 5.Normal (movement against gravity w/ full resistance). |
Lesion on CN XII | The tongue will deviate towards the ipsilateral side when protruded. |
Cerebellar motor coordination test | Romberg: Pt's eyes first open then closed (be ready to catch patient. ...Hell Romberg ****ed her |
Carpel tunnel testing | Median nerve entrapment/palsy. 1.Tinnel's test. 2.Phalen's test. |
Peripheral Neuropathy | PNS disorder resulting in motor and sensory loss of one or more nerves (hands and feet). |
Stereognosis | the ability to recognize familiar objects in your hand with your eyes closed. |
Areas of decreasing sensitivity in a Two-point discrimination test | 1.Tongue. 2.Fingertips. 3.Toes. 4.Palms. 5.Chest/forearms. 6.Back. 7.Upper arms/ thighs |
Graphesthesia | Drawing a letter or number on the palm of the pt's hand and they should be able identify what it is. |
Grading reflexes | 0:No response. 1+ Sluggish/ Diminished (lower motor disorder). 2+ Active. 3+ Slightly hyper. 4+ Hyperactive/transient clonus (upper motor neuron defect) |
Conditions causing lower motor neuron defects | 1.Anterior horn cell pathology. 2.Myopathies. 3.Hypothyroidism. |
Conditions causing upper motor neuron defects | 1.Pyramidal tract disease. 2.Hyperthyroidism. 3.Pre-Eclampsia. 4.Metabolic disorders. |
Signs of Lower motor neuron defects | 1.Diminished reflexes. 2.Muscle atrophy. 3.decreased muscle tone. 4.sensation may follow dermatome. 5.Fasciculation present. 6.Damage only affects IPSILATERAL side. |
Signs of Upper motor neuron defects | 1.hyperreflexia. 2.Increased muscle tone. 3.no muscle atrophy. 4.sensation affects entire limb. 5.no fasciculation. **Damage above brainstem:contralateral side. Below: ipsilateral side. |
Superficial reflexes | 1.Corneal. 2.Upper abdomen. 3.lower abdomen. 4.Cremasteric. 5.Plantar/toe signs |
Toe signs | 1.Babinski (J on lateral foot). 2.Chaddock (lateral foot). 3.Schaeffer (squeeze achilles). 4.Oppenheim (Knuckles on shin, move down). 5.Gordon (squeeze calf). 6.Bing (pin pricks on dorsilateral foot). 7.Gonda/stransky (pull 4th toe out/down and rele |
Ankle Clonus | Can be seen with toe sign tests. rhythmic oscillating movements with rapid dorsiflexion of the foot. Associated with an upper motor neuron lesion |
Gait problems: Stroke | Lower Limb: 1. stiff/extended. 2.Plantar flexed, foot drag. Upper limb: 1.Flexed/Adducted. 2.Doesn't swing. |
Gait problems: Parkinson's | Posture is stooped and body is rigid. Hesitation on starting and stoping short steps. |
Gait problems: Cerebellar ataxia | 1.Wide stance. 2.Lurching from side to side. 3.swaying of the trunk. |
Gait problems: Tabes | Foot slapping |
Gait problems: Sensory ataxia | 1.wide stance. 2.foot brought down heel then toe. 3. + Romberg. |
Meningeal Irritation: Brudzinski sign | 1.Flex neck forward. + sign if involuntary felxion of hips/kness with neck felxion. |
Meningeal Irritation: Kernig's Sign | 1.Flex legs at knee and hip. 2.straighten the legs. + sign if pain and resistance to straightening. |
Meningeal Irritation: Nuchal rigidity | 1.Pt supine and flex neck. + sign if pain/resistance to neck motion. **Indicates meningitis and intracranial hemorrhage. |