Neuro
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| Frontal Lobe | Thinking/Personality Center (Personality change after trauma). Two cortexes - sensory & motor.
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| Sensory Cortex | Frontal Lobe - Post central gyrus
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| Motor Cortex | Frontal lobe - Precentral gyrus (thicker)
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| Parietal Lobe | Receptive speech (hearing)
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| Temporal Lobe | Expressive speech (talking) - contralateral to the dominante side
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| Occipital Lobe | Vision Center
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| Cerebellum | Execution of Smooth Movements. Supplied by superior, anterior inferior and posterior inferior cerebellar arteries.
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| Basal Ganglia | Controls nonpurposal (unintentional) movement (ex. Parkinson's - Pill rolling)
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| Brainstem | Mid brain, Pons & medulla (continuous with the spinal cord)
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| Meninges | Pia, Arachnoid & Dura
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| CSF | Made in the choroid plexus in the lateral ventricles (Subarachnoid Space) -> 3rd ventricle (anterior to brain stem) -> 4th ventricle -> medial foramina magendie & two lateral foramin luschka. Reabsorbed by the arachnoid granulations then to dural sinuses.
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| Hydrocephalizaion caused by | Damaged arachnoid granulations
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| Blood thinner herbs | Ginko, Garlic & ginsing. Together they are more potent than coumadin.
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| Licorice Root | Increase blood pressure
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| Recommended hours of sleep per night | 8-10
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| Gloscow Coma Scale | Motor Response: 1-6Eye Opening: 1-4Verbal: 1-5
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| Orientation questions - inorder | Time, Place, Person
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| Spelling questions - in order | World (5) - Hand (4) - Cat (3)
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| Papiledema (Opthamoscopic Exam) | Loss of venous pulsation
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| Hypoglossal lesion | Tongue deviates toward lesion
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| Strength Grade | 5 - Full force4 - Less force3 - Against gravity2 - Lateral Movement1 - No movement
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| Biceps reflex | C5** & C6
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| Brachioradialis reflex | C5 & C6**
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| Triceps Reflex | C7** & C8
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| Patellar Reflex | L3** & L4
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| Achilles Reflex | S1** & S2
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| Babinskis | S1 or above UMN lesion
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| Meningeal Irritation S&S | Posterior HA, Fever & altered mental status
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| Coordination Testing (Basal Ganglia & Cerebellum) | Finger-Nose, Heel-Shin, Rapid alternating movements & balance.
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| Basal Ganglia VS. Cerebellum | BG - Tremor @ rest that disappears with movement.
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| Peripheral Nerve Lesions | Dermatome or myotome distribution. Radicular Pain. LMN signs.
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| CNS Lesions | General deficits within an extremity. Loss of sensation. UMN signs.
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| Spinal Cord Lesions | UMN & Dermatome defect or Dissociation of sensation modalities
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| When to use lumbar punture for Dx. | Meningitis, encephalitis, meningeal cancer, GBS (Guillain-Barré Syndrome ), acute demyelinating disorders, bengin intracranial hypertension, seizure, storke, polyneuropathy, subarachnoid hemorrhage (must CT scan prior to r/o brain herniation)
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| Post Lumbar puncture | Patient lies supine for 6 hours to minimize HA & postential CSF leak
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| CT Pros & Cons | Pro - cheap, fast, good blood localization & decrease in claustrophobia.Cons- Poor visualization of posterior fossa, cervical structures, and acute changes
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| MRI Pros & Cons | Pros - Visualizes posterior fossa, cervical structures, soft tissues and acute changes well.Cons - Expensive, long, small area, patients cant be on ventilation or have metal implants.
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| CT myelogram | Dye w/in subarachnoid space. Visualization around spinal cord.
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| EMG (Evoked potential studies) | Localizes lesion. Elucidates etiology of nerve damage (metabolic, polyneuropathy, radiculopathy, myelopathy or compressive.
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| EEG | Localizes defect. Can be used to determine brain death or coma.
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| Tracts | 4 sensory & 1 motor
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| Sensory Tracts | Spinothalamic, Posterior Column, Spinal Cerebellar
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| Spinothalamic Tract | Pain, temperature & light touch. Enters spinal cord & decussates (crossover) 1 or 2 levels up from entry location. Terminates in sensory cortex.
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| Posterior Column | Conscious stereognosis (3-D object discrimination), proprioception & light touch.Enters spinal cord and travels to medulla. Decussates at medulla and follows medial limbicus to sensory cortex.
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| Spinal Cerebellar Tract | Unconscious proprioception. Always stays ipsilateral to the sensory cortex. Patient leans toward the side of the cerebellar lesion.
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| Motor Tract | UMN (everything before spinal junction)-> crosses medulla -> corticospinal tract -> alpha interneuron -> LMN
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| UMN Dz. S&S | Hyoerreflexic. Spastic (tough to move). No atrophy to muscles. No vesiculation (twitch). Positive babinskis sign.
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| Babinskis sign | Toes fan & ankle, knee, hip dorsiflex & patient withdraws.
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| LMN Dz. S&S | Hyporeflexic. Flaccid. Atrophy. Vesiculation (Twitches). Normal (negative) babinskis.
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