Term
| What are the cerebral lobes? |
|
Definition
-frontal
-parietal
-temporal
-occipital |
|
|
Term
| What do the frontal lobes control? |
|
Definition
-personality
-IQ
-drive
-judgment
-attention span
-moral, ethical behaviors
-long term memory
-LOC
-voluntary movement
-motor speech |
|
|
Term
| What do the parietal lobes control? |
|
Definition
-sensory interpretation
---size
---shape
---feel
---calculation
---R/L discrimination
---proprioception
-sensory speech |
|
|
Term
| What do the temporal lobes control? |
|
Definition
-interpretation of sounds
-integration of taste and smell
-short term memory
-seizure focus |
|
|
Term
| What do the occipital lobes control? |
|
Definition
-primary visual cortex
-visual interpretation |
|
|
Term
| What does the cerebellum control? |
|
Definition
-reflexive control of muscle tone
-coordination
-equilibrium |
|
|
Term
| The ___?___ lobe controls behavior, ethics, and morals. |
|
Definition
|
|
Term
| The ___?___ lobe controls visual interpretation. |
|
Definition
|
|
Term
| The ___?___ lobe controls personality. |
|
Definition
|
|
Term
| The ___?___ lobe controls emotions. |
|
Definition
|
|
Term
| The ___?___ lobe controls receptive speech. |
|
Definition
|
|
Term
| The ___?___ lobe controls motor speech. |
|
Definition
|
|
Term
| The ___?___ controls coordination, posture, and balance. |
|
Definition
|
|
Term
| The ___?___ lobe controls voluntary motor. |
|
Definition
|
|
Term
| The ___?___ lobe controls hearing. |
|
Definition
|
|
Term
| The ___?___ lobe controls sensation. |
|
Definition
|
|
Term
| The ___?___ lobe controls memory. |
|
Definition
|
|
Term
| The ___?___ lobe controls thoughts. |
|
Definition
|
|
Term
| What does "acting frontal" mean? |
|
Definition
| acting disinhibited e.g. following a frontal lobe injury |
|
|
Term
| The occipital lobe is assessed through CN ___?___. |
|
Definition
|
|
Term
| The temporal lobe is assessed through CN ___?___. |
|
Definition
|
|
Term
| What are the basal ganglia responsible for? |
|
Definition
|
|
Term
| Movement disorders, such as Parkinson's, are related to which brain structure? |
|
Definition
|
|
Term
| The ___?___ controls arousability and wakefulness. |
|
Definition
| reticular activation system |
|
|
Term
| A persistent vegetative state (PVS) can occur when the ___?___ is still intact. |
|
Definition
| reticular activation system |
|
|
Term
| Where are the substantia nigra located? |
|
Definition
|
|
Term
| Where is the reticular activating system (RAS) located? |
|
Definition
| between midbrain and medulla |
|
|
Term
| The nuclei of CNs ___?___ are in the midbrain. |
|
Definition
|
|
Term
| The nuclei of CNs ___?___ are in the pons. |
|
Definition
|
|
Term
| The nuclei of CNs ___?___ are in the medulla. |
|
Definition
|
|
Term
| Where is the respiratory center located? |
|
Definition
|
|
Term
| What controls circulatory and vasomotor activity? |
|
Definition
|
|
Term
| The nuclei of CNs ___?___ are in the cerebral hemisphere. |
|
Definition
|
|
Term
| The spinal cord begins at ___?___ and ends at ___?___. |
|
Definition
|
|
Term
| The spinal cord is comprised of ___?___ and ___?___. |
|
Definition
-tracts
-nerve cell bodies |
|
|
Term
| Descending pathways control ___?___ while ascending control ___?___. |
|
Definition
-descending: motor
-ascending: sensory |
|
|
Term
| The anterior/ventral horn of the nerve cell bodies controls ___?___ while posterior/dorsal controls ___?___. |
|
Definition
|
|
Term
| How many pairs of spinal nerves are there? |
|
Definition
|
|
Term
| Where do spinal nerves end? |
|
Definition
|
|
Term
|
Definition
| a body region that is supplied by a spinal nerve |
|
|
Term
| What are important components of the neuro HPI? |
|
Definition
-sz
-pain
-gait
-weakness
-paresthesia: prickling, tingling, numbness |
|
|
Term
| What are important components of the neuro PMH? |
|
Definition
-trauma
-meningitis
-encephalitis
-deformities
-CV
---HTN
---aneurysms
---stroke
-brain surgery |
|
|
Term
| What are important components of the neuro FH? |
|
Definition
-hereditary
---Huntington's chorea
---neurofibromatosis
---muscular dystrophy
---Tay-Sach's
-alcoholism
-MR
-epilepsy
-HA
-Alzheimer's
-learning d/o
-weakness
-gait d/o
-thyroid
-DM |
|
|
Term
| What are important components of the neuro PSH? |
|
Definition
-environmental
---lead
---arsenic
---insecticides
-occupational
---equipment
---heights
---water
-dominance: hand, eye, foot
-ability to care for self
-ETOH, drugs |
|
|
Term
| What are important components of the neuro ROS-brain? |
|
Definition
-HA
-dizziness
-syncope
-sz
-LOC
-weakness
-paralysis
-sensory changes
-coordination problems
-tremors
-memory loss
-behavior change |
|
|
Term
| What are important components of the neuro ROS-eye? |
|
Definition
-visual acuity
-diplopia
-photophobia |
|
|
Term
| What are important components of the neuro ROS-ear? |
|
Definition
-tinnitus
-hearing loss
-vertigo |
|
|
Term
| What are important components of the neuro ROS-nose? |
|
Definition
|
|
Term
| What are important components of the neuro ROS-endocrine? |
|
Definition
-thyroid
-heat/cold intolerance
-wt changes
-lethargy
-nervousness
-polydipsia
-polyuria
-facial hair
-glove/hat size |
|
|
Term
| What is included in the "Walk around the Brain"? |
|
Definition
-LOC (F)
-speech/language (F, P, CNs)
-motor (F)
-sensory (P)
-coordination (C)
-cranial nerves (BS) |
|
|
Term
| What is the most sensitive indicator of neuro change? |
|
Definition
|
|
Term
| What are the components of LOC? |
|
Definition
-arousal/awakefulness
-awareness |
|
|
Term
| How is orientation (F) assessed? |
|
Definition
-name: first, last
-place: city, state, building, floor, room
-date: year, month, day of week, date, recent holidays |
|
|
Term
| How is long-term memory (F) assessed? |
|
Definition
| -repeat "x" in 3-5 min after saying words immediately after |
|
|
Term
| How is short-term memory (T) assessed? |
|
Definition
-DOB
-place of birth
-parents' names |
|
|
Term
| How is judgment (F) assessed? |
|
Definition
| -What would you do if you were in a crowded theater and saw a fire? |
|
|
Term
| How is attention span and concentration (F) assessed? |
|
Definition
| -note if I must frequently regain their attention |
|
|
Term
| How is fund of knowledge and current events (F) assessed? |
|
Definition
-"Who is the current president? Last three?"
-sports
-wars
-catastrophic events |
|
|
Term
| The Mini Mental Status Exam (MMSE) assesses ___?___ function. |
|
Definition
| frontal and parietal lobe |
|
|
Term
| What is the total possible score on the MMSE? the score suggestive of dementia or delirium? |
|
Definition
|
|
Term
| What are the components of the MMSE? |
|
Definition
-orientation
-registration
-attention & calculation
-recall
-language |
|
|
Term
| How is language assessed? |
|
Definition
-speech
---fluency
---initiation
---articulation
---pronunciation
---rhythm
---inflection
---word substitutions
---confabulation
---perseveration
-repeat phrases ("no ifs, ands, or buts")
-name objects, their parts, their functions
-failure to use words, describing instead
-comprehension, following verbal cues ("put one finger on your right ear") |
|
|
Term
| What is the anatomy of the neuro motor system? |
|
Definition
-cortex: frontal lobes
-spinal cord: corticospinal tract, anterior/ventral horns of gray matter
-spinal nerves: ventral roots |
|
|
Term
|
Definition
| muscle regions supplied by motor fibers of specific nerves |
|
|
Term
| What is the muscle strength scale? |
|
Definition
-0: no movement
-1: flicker of muscle
-2: joint movement, not against gravity
-3: moves against gravity, not against resistance
-4: moves against resistance, but weak
-5: strong against resistance |
|
|
Term
| What is a principle of testing extremities' muscle strenght? |
|
Definition
|
|
Term
| Which spinal nerve(s) innvervate the deltoids? |
|
Definition
|
|
Term
| Which spinal nerve(s) innervate biceps/elbow flexion? |
|
Definition
|
|
Term
| Which spinal nerve(s) innervate triceps/elbow extension? |
|
Definition
|
|
Term
| Which spinal nerve(s) innervate wrist extension? |
|
Definition
|
|
Term
| Which spinal nerve(s) innervate finger flexion? |
|
Definition
|
|
Term
| Which spinal nerve(s) innervate finger extension and abduction? |
|
Definition
|
|
Term
| Which spinal nerve(s) innervate hip flexion (iliopsoas)? |
|
Definition
|
|
Term
| Which spinal nerve(s) innervate hip adduction? |
|
Definition
|
|
Term
| Which spinal nerve(s) innervate hip abduction? |
|
Definition
|
|
Term
| Which spinal nerve(s) innervate knee extension (quads)? |
|
Definition
|
|
Term
| Which spinal nerve(s) innervate knee flexion (hamstrings)? |
|
Definition
|
|
Term
| Which spinal nerve(s) innervate dorsiflexion? |
|
Definition
|
|
Term
| Which spinal nerve(s) innervate plantar flexion? |
|
Definition
|
|
Term
| Which spinal nerve(s) innervate big toe (extensor halucis longus- EHL)? |
|
Definition
|
|
Term
| Which spinal nerve(s) innervate biceps relex? |
|
Definition
|
|
Term
| Which spinal nerve(s) innervate brachioradialis reflex? |
|
Definition
|
|
Term
| Which spinal nerve(s) innervate triceps reflex? |
|
Definition
|
|
Term
| Which spinal nerve(s) innervate patellar reflex? |
|
Definition
|
|
Term
| Which spinal nerve(s) innervate achilles reflex? |
|
Definition
|
|
Term
| What are types of central pain for stimulus? |
|
Definition
-sternal rub
-trapezius squeeze
-supraorbital pressure
-submandibular pressure |
|
|
Term
| What is the anatomy of the neuro sensory system? |
|
Definition
-cortex: parietal lobes
-spinal cord: spinothalamic posterior columns, posterior/dorsal horns or grey matter
-spinal nerves: dorsal roots |
|
|
Term
| What sensory information is transmitted by the spinothalamic tract? |
|
Definition
-superficial pain: pinprick
-temperature: alcohol pad |
|
|
Term
| What sensory information is transmitted by the posterior column? |
|
Definition
-proprioception
-vibration |
|
|
Term
| The ADA recommends neurological screening for all diabetics ___?___ and high risk diabetics ___?___. |
|
Definition
|
|
Term
| What is the accepted as the medical standard for screening of the minimum level of protective sensation in the foot? |
|
Definition
|
|
Term
| What are risks if foot sensation is lost? |
|
Definition
|
|
Term
| What is the treatment for diabetic feet? |
|
Definition
-regular podiatric visits
-intensive foot education
-visual inspection of feet at every office visit
-therapeutic footwear |
|
|
Term
| What questions are used to assess calculation? |
|
Definition
-serial 7s: subtract 7 from 100 in a serial order
-6x7?
-How many quarters in $1/75? |
|
|
Term
| What tests are used to assess coordination? |
|
Definition
-rapid alternating movements (RAM): flapjacks, fingers-thumb
-finger to nose (FTN)
-heel-shin
-balance: Romberg
-gait |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| How are CNs III, IV, VI assessed? |
|
Definition
|
|
Term
|
Definition
-facial sensation
-corneal
-masseter muscle: chewing |
|
|
Term
|
Definition
-facial symmetry
-close lid
-corneal |
|
|
Term
|
Definition
|
|
Term
| How is CN IX & X assessed? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| What are the EOMs (clockwise from top inner)? |
|
Definition
-inferior oblique (IO): CN III
-medial oblique (MO): CN III
-superior oblique (SO): CN IV
-inferior rectus (IR): CN III
-lateral rectus (LR): CN VI
-superior rectus (SR): CN III |
|
|
Term
| Gaze is made up of the integrated function of ___?___ and ___?___. |
|
Definition
|
|
Term
|
Definition
-0: absent
-1+: hypo
-2+: normal
-3+: hyper
-4+: hyper with clonus |
|
|
Term
| ___?___ paralysis occurs after poisoning. |
|
Definition
|
|
Term
| ___?___% of people have language and motor on the same side. |
|
Definition
|
|
Term
| How long is central pain applied? |
|
Definition
|
|
Term
| When there is palate asymmetry, the uvula deviates ___?___ the sag. |
|
Definition
|
|
Term
| When there is tongue asymmetry, it deviates ___?___ the weaker side. |
|
Definition
|
|
Term
| What are guidelines for testing CN I Olfactory? |
|
Definition
-check for obstruction, mucus, inflammation
-1 nostril at a time
-non-irritating stimulants that don't stimulate CN V |
|
|
Term
| What are guidelines for testing CN II Optic? |
|
Definition
-determine if pt wears glasses
-test each eye with examiner's eye covered |
|
|
Term
| What are guidelines for testing CN III Oculomotor? |
|
Definition
-test 1 eye at a time
-darken room only if pupils very small
-lids shouldn't dip below top of iris
-move eyes toward nose (adduct), up, down, out |
|
|
Term
| What are dysfunctions of CN I Olfactory? |
|
Definition
|
|
Term
| What are dysfunctions of CN II Optic? |
|
Definition
-blind eye
-bitemporal hemianospia, "tunnel vision"
-homonymous hemianopsia, "field cut"
-afferent pupillary defect (APD) |
|
|
Term
| What are dysfunctions of CN III Oculomotor? |
|
Definition
-non-reactive pupil
-ptosis
-EOMs |
|
|
Term
| What are guidelines for testing CN IV Trochlear? |
|
Definition
|
|
Term
| What are guidelines for testing CN VI Abducens? |
|
Definition
| -ability to look out (abduct) |
|
|
Term
| What are guidelines for testing CN V Trigeminal? |
|
Definition
-touch 3 zones of face
-gently stroke cornea with cotton
-clench teeth |
|
|
Term
| What are guidelines for testing CN VII Facial? |
|
Definition
|
|
Term
| What are guidelines for testing CN VIII Acoustic? |
|
Definition
-not routinely tested on a conscious pt
-high frequency sounds
-Weber
-Rinne |
|
|
Term
| What are guidelines for testing CN IX Glossopharyngeal, X Vagus? |
|
Definition
-touch each side of palate
-make palate generated sounds ("ka", "ga") |
|
|
Term
| What are dysfunctions of CN IX, X? |
|
Definition
-palate sags on weaker side
-uvula swings to strong side
-decreased cough
-dysarthria |
|
|
Term
| What are guidelines for testing CN XI Spinal Accessory? |
|
Definition
-turn chin against resistance
-raise shoulders against resistance |
|
|
Term
| What are guidelines for testing CN XII Hypoglosseal? |
|
Definition
-stick out tongue
-use tongue to push away examiner's hand on other side of the cheek
-make tongue generated sounds ("la") |
|
|
Term
| What are dysfunctions of CN VII? |
|
Definition
-tongue deviates to weak side
-dysarthria |
|
|
Term
| When a patient is confused, ___?___ is the 1st to go. |
|
Definition
|
|
Term
| What are characteristics of confusion? |
|
Definition
-disoriented
-inattention
-memory problems
-agitation
-restlessness
-irritability |
|
|
Term
| What are characteristics of lethargy? |
|
Definition
-oriented x3
-slow, sluggish speech, mental processes, motor |
|
|
Term
| What are qualities of obtundation? |
|
Definition
-readily arousable to stimulation
-responds verbally with 1-2 words
-follows commands
-very drowsy |
|
|
Term
| What are qualities of stupor? |
|
Definition
-minimal spontaneous movement
-response to pain: motor-localize, vocal-incomprehensible sounds, eye-opening |
|
|
Term
| What are qualities of a light coma? |
|
Definition
-unarousable
-no spontaneous movement
-purposeful withdrawal to pain
-brainstem reflexes intact |
|
|
Term
| What are qualities of a coma? |
|
Definition
-unarousable
-no spontaneous movement
-abnormal response to pain (flexion, extension)
-brainstem responses may be intact |
|
|
Term
| What are qualities of a deep coma? |
|
Definition
-unarousable
-no response to pain
-spontaneous posturing (extension) |
|
|
Term
| What is the anatomy and defect of motor dysphasia? |
|
Definition
-frontal lobe
-use of spoken word |
|
|
Term
| What is the anatomy and defect of sensory dysphasia? |
|
Definition
-temporal and parietal lobe
-understanding written or spoken word |
|
|
Term
| What is the anatomy and defect of dysarthria? |
|
Definition
-pons (VII-me me), medulla (IX/X- ga ga, XII- la la)
-articulation |
|
|
Term
| When is lower extremity (LE) drift tested? |
|
Definition
| when feel difference in strength |
|
|
Term
| What are defects of upper motor neurons? |
|
Definition
-stroke
-spinal cord injury (spastic paralysis/weakness, hyperreflex) |
|
|
Term
| What are defects of the lower motor neurons? |
|
Definition
| -Guillain-Barre Syndrome (flaccid paralysis/weakness, hypo-/arreflex) |
|
|
Term
|
Definition
| inability to recognize common objects via senses |
|
|
Term
|
Definition
| inability to recognize common objects via touch |
|
|
Term
|
Definition
| inability to carry out a skill in the absence of paralysis |
|
|
Term
|
Definition
| inability to recognize a number or letter traced on palm of hand |
|
|
Term
|
Definition
| inability to recognize two simultaneous stimuli on opposite sides of the body, or proximally and distally, though either one can be sensed alone |
|
|
Term
|
Definition
| innate difficulty in learning or comprehending simple arithmetic |
|
|
Term
|
Definition
| deficit in attention to and awareness of one side of space; inability for a person to process and perceive stimuli on one side of the body or environment that is not due to a lack of sensation |
|
|
Term
| What is dysdiadokokinesia? |
|
Definition
| inability to perform rapid alternating movements (RAM) |
|
|
Term
|
Definition
| inability to perform finger to nose (FTN); inability to judge distance or scale |
|
|
Term
|
Definition
| unable to maintain balance |
|
|
Term
|
Definition
-fall to side of lesion
-cerebellar problem |
|
|
Term
| What condition is associated with scissor gait? |
|
Definition
|
|
Term
| What is Parkinsonian gait? |
|
Definition
-aka festinating
-shuffling, a- or hypokinetic |
|
|
Term
| What are causes of unrelenting, unrelieved, and worsening HA? |
|
Definition
-subarachnoid hemorrhage (SAH)
-subdural hematoma
-intracerebral hemorrage |
|
|
Term
| What is a cause of HA >50 yo, new onset, no history? |
|
Definition
|
|
Term
| What are causes of severe HA with stiff neck and fever? |
|
Definition
|
|
Term
| What are causes of worst HA of life (WHOL)? |
|
Definition
| subarachnoid hemorrhage (SAH) |
|
|
Term
| What is Chiari malformation? |
|
Definition
-displacement of cerebellar tonsils through foramen magnum (opening at base of skull)
-s/s: HA, fatigue, muscle weakness in head and face, dysphagia, dizziness, nausea, impaired coordination, paralysis |
|
|
Term
|
Definition
| -tumor that starts in brain or spine, arises from glial cells |
|
|
Term
|
Definition
| -tumor arising from meninges |
|
|
Term
|
Definition
-aka acoustic neuroma, neurinoma
-benign nerve sheath tumor composed of Schwann cells, which normally produce the insulating myelin sheath covering peripheral nerves |
|
|
Term
| What is the work-up for a HA? |
|
Definition
-head CT w/o contrast: blood
-head CT w/ contrast: tumor, abscess
-MRI: tumor, stroke
-LP: SAH, infectious
-blood work
---CBC: infection, anemia
---ESR: inflammation
---BMP: metabollic
---thyroid |
|
|
Term
| What is a cause of mental status change with fever and stiff neck? |
|
Definition
|
|
Term
| What is a cause of acute mental status change in the elderly? |
|
Definition
|
|
Term
| What are causes of mental status change associated with head trauma? |
|
Definition
-epidural hematoma (EDH)
-subdural hematoma (SDH)
-subarachnoid hemorrhage (SAH)
-contusions |
|
|
Term
| What is a cause of mental status change associated with paralysis of upward gaze? |
|
Definition
|
|
Term
| Vitamin ___?___ deficiency is associated with mental status change. |
|
Definition
|
|
Term
| What labs are part of the work up for mental status change? |
|
Definition
-BMP/CMP
-ABG
-U/A and culture
-ESR
-B12/folic acid
-thyroid
-HIV
-RPR: syphilis
-Lyme
-tox screen |
|
|
Term
| What studies are part of the work up for mental status change? |
|
Definition
-pulse ox
-CXR
-ECG
-EEG
-head CT
-LP |
|
|
Term
| What are position differences between vertigo and dizziness? |
|
Definition
-vertigo: when stationary
-dizziness:quick movement, bending over, lying to standing |
|
|
Term
| What is the difference in timing between vertigo and dizziness? |
|
Definition
-vertigo: day or night
-dizziness: worse in AM when first wake up |
|
|
Term
| Which has nystagmus: vertigo or dizziness? |
|
Definition
|
|
Term
| What are central causes of vertigo? |
|
Definition
-tumor
-stroke
-AVM
-MS
-vertebrobasilar migraine
-Meniere's Dz
-labrynthitis
-cholesteatoma
-perilymphatic fistula
-benign positional vertigo/cupulolithiasis |
|
|
Term
|
Definition
-arteriovenous malformation
-abnormal connection bw arteries and veins that is usually congenital and usually occurs in the CNS |
|
|
Term
|
Definition
| abnormality of fluids in inner ear |
|
|
Term
|
Definition
| inflammation of the vestibular labyrinth of the inner ear |
|
|
Term
|
Definition
| skin growth behind middle ear |
|
|
Term
| What is perilymphatic fistula? |
|
Definition
| abnormal communication between the inner ear fluids and the middle ear |
|
|
Term
| What is benign positional vertigo/cupulolithiasis? |
|
Definition
| debris in semicircular canal |
|
|
Term
| What are some cardiovascular causes of dizziness? |
|
Definition
-arrhythmia
-postural hypotension |
|
|
Term
| What are some causes of dizziness? |
|
Definition
-syncope
-sz
-cardiovascular
-cerebrovascular
-hypoglycemia
-medications
-migraines |
|
|
Term
| What are some causes of seizures? |
|
Definition
-tumor
-lesion
-hemorrhage
-encephalitis |
|
|
Term
| What are some causes of loss of consciousness? |
|
Definition
|
|
Term
| What are some causes of weakness and paralysis? |
|
Definition
-tumor
-lesion
-stroke
-sz
-spinal cord
-spinal nerves |
|
|
Term
| What are some causes of sensory changes? |
|
Definition
-tumor
-lesion
-stroke
-sz
-spinal cord
-spinal nerves |
|
|
Term
| What are some causes of coordination problems? |
|
Definition
|
|
Term
| What are some causes of tremors? |
|
Definition
|
|
Term
| What are some causes of memory loss? |
|
Definition
-tumor
-lesion
-dementia
-sz |
|
|
Term
| What are causes of behavior change? |
|
Definition
|
|
Term
| What are some causes of vision changes? |
|
Definition
-MS
-tumor
-lesion
-stroke
-sz |
|
|
Term
| What are some causes of smell changes? |
|
Definition
|
|
