Clin Med-Cox. Ch 8

Front 1

__ is the inability to perform previously learned activities despite haveing intact motor fcn (or mildly impaired)
-agnosia
-apraxia
-stroke
-tia

Back 1

apraxia

Front 2

apraxia is a feature of damage to the non-dominant __.

-temporal cortex
-parietal cortex
-occipital cortex
-frontal cortex

Back 2

parietal cortex

Front 3

what must you prove your pt has before testing apraxia?

Back 3

appropriate strength (4/5 at least)

Front 4

what are symptoms of apraxia?

Back 4

pt is unable to do normal task like dressing or reading a book, like trying to put pants over their head

Front 5

__ is defined as a sudden onset of focal neurological deficit due to a vascular event.

-mi
-stroke
-tia

Back 5

stroke

Front 6

what are some risk factors for stroke?

Back 6

htn
hypercholestolemia
dm
smoking
positive family history

Front 7

what are 2 types of hemorrhagic stroke?

Back 7

subarachnoid
intercranial hemorrhagic

Front 8

what are the primary risk factors for hemorrhagic stroke?

Back 8

htn
antiplatelet and anti-coagulant drugs
bleeding disorders

Front 9

what are the greatest risk factors for thromboembolic stroke?

Back 9

a fib and recent MI

Front 10

the anterior circulation of the brain is derived from what?

Back 10

carotid arteries

Front 11

the carotid arteries divide into what branches that make up the circle of willis?

Back 11

anterior and middle cerebral arteries

Front 12

the posterior circulation of the circle of willis arises from?

Back 12

the two vertebral arteries that ascend in the neck and join to form the basilar artery

Front 13

a lacunar stroke is cuaswed by disease of a __ vessel within the substance of the brain.

Back 13

small vessel

Front 14

a lacunar infarct of the internal capsule may cause a dense hemiparesis, via involvement of the __ __.

Back 14

pyramidal tracts

Front 15

__ is caused by degeneration of the dopamine-containing cells in the substantia nigra of the basal ganglia.

Back 15

parkinson's disease

Front 16

what are some physical findings of the arms in PD?

Back 16

resting tremors that improve with movement
tone will identify rigidity
bradykinesia (ask pt. to tap hands to thighs quickly)

Front 17

what are some facial features you might see in the face of a PD pt?

Back 17

mask-like (expressionless)
drooling
monotone voice

Front 18

What are other common findings of PD pt's?

Back 18

shuffling gait
stooped posture
lack of arm swing
micrographia (small, spidery handwriting)

Front 19

what is seborrhoea?

Back 19

greasy skin often found in PD pt's

Front 20

what is needed in the tx of PD?

Back 20

L-dopa

Front 21

what does L-dopa do?

Back 21

it restores the dopamine within the brain and they are particularly useful in the tx of bradykinesia and rigidity

Front 22

what is the tx if a pt's predominant sx is tremor?

Back 22

anti-cholinergic drugs

Front 23

what is Parkinsonism?

Back 23

idiopathic form of the disease that may result from other conditions that effect the basal ganglia

Front 24

what are other conditions that may cause parkonsonism?

Back 24

AD
wilson's disease
heavy metal poisoning

Front 25

what are 3 other syndromes that are known as parkonson plus syndromes?

Back 25

steele richardson olsewski syndrome
shy-drager syndrome
olivo-ponto-cerebellar syndrome

Front 26

__ __ is a range of diseases that can affect the cerebellum?

Back 26

cerebellar syndromes

Front 27

cerebellar syndromes can be acute or chronic and may lead to incoordination and loss of balance, what are some causes?

Back 27

MS
ETOH
CVA
tumors
Friedreich's ataxia and other inherited neurodegenerative syndromes.

Front 28

__ is a dx of unknown etiology characterized by 2 or more episodes of neurological dysfcn.

Back 28

MS

Front 29

what is the cause of MS?

Back 29

attributable to multiple plaques scattered thru out the CNS.

Front 30

what are you looking for to dx MS?

Back 30

two neurological dysfunctions which are separated both in time and site.

Front 31

why would MS have 2 different neurological dysfunctions in different areas at different times?

Back 31

examples of diffusely scattered multiple plaquest scattered thruout the CNS.

Front 32

T/F

cerebellar signs may be present, with or without UMN or LMN signs.

Back 32

true

Front 33

what other features may you find elsewhere indicating MS?

Back 33

nystagmus-due to cerebellar involovement
ataxic nystagmus-due to involvement of of the median longitudinal fasciculus
optic atrophy
spastic paraparesis

Front 34

what is the tx of an acute episode MS?

Back 34

tx a short high dose IV methyl-prednisone

interferon has more recently been shown to have modest beneficial effect, but universally acceptable

baclofen is useful for treating spasicity

Front 35

__ is a disease characterized by progressive degeneration of motor fibers.

-MS
-motor neuron disease
-proximal myopathy

Back 35

motor neuron disease

Front 36

what are the 3 types of motor neuron disease?

Back 36

-progressive muscular atrophy
-amyotrophic lateral sclerosis
-progressive bulbar palsy

Front 37

which type of motor neuron disease is r/t anterior horn cell degeneration leading to LMN signs?

-progressive muscular atrophy
-amyotrophic lateral sclerosis
-progressive bulbar palsy

Back 37

progressive muscular atrophy

Front 38

which motor neuron disease is related to lateral corticospinal tract involvement.

-progressive muscular atrophy
-amyotrophic lateral sclerosis
-progressive bulbar palsy

Back 38

amyotrophic lateral sclerosis

Front 39

which motor neuron disease affects the motor cranial nerves IX-XII.

-progressive muscular atrophy
-amyotrophic lateral sclerosis
-progressive bulbar palsy

Back 39

progressive bulbar palsy

Front 40

what type of features could you see in a pt with motor neuron disease?

Back 40

dysarthia
dysphagia
wasted fasciculating tongue (bulbar palsy)
spastic paraparesis