Clincal Exam - Neurologic

Front 1

Brodman area 17

Back 1

primary visual

Front 2

houses higher mental functions; general movement, visceral, perception, behavior

Back 2

cerebral cortex

Front 3

lobe location of motor cortex

Back 3

frontal lobe

Front 4

lobe responsible for processing sensory data

Back 4

parietal lobe

Front 5

recognition of body parts and awareness of body position (proprioception)

Back 5

parietal lobe

Front 6

location of primary vision center

Back 6

occipital lobe

Front 7

location of perception and interpretation of sounds and determination of their source

Back 7

temporal lobe

Front 8

lobe involved in integration of taste, smell, balance

Back 8

temporal lobe

Front 9

responsible for interpretation of speech

Back 9

Wernike's area

Front 10

mediates the sense of smell and certain patterns of behavior, visceral response that determine survival

Back 10

limbic system

Front 11

dysfunction of ___ causes distorted perception and inappropriate behavior

Back 11

limbic system

Front 12

integrates voluntary movements with sensory info

Back 12

cerebellum

Front 13

responsible for producing precise and steady movement

Back 13

cerebellum

Front 14

controls involuntary movements

Back 14

brainstem

Front 15

4 components of brainstem

Back 15

medulla, pons, diencephalon (thalami, 3rd ventricle), midbrain

Front 16

provides constant muscle stimulation to counteract gravity; also regulates CV function/respiration

Back 16

reticular formation

Front 17

fibers that conduct impulses from below the brainstem and up into cerebral cortex

Back 17

reticular activating system

Front 18

major integrating center for perception of various sensations (pain/temp)

Back 18

thalamus

Front 19

relays impulses between cerebrum, cerebellum, pons and medulla

Back 19

thalamus

Front 20

transmits info between brainstem and cerebellum

Back 20

pons

Front 21

relays motor info from cortex to contralateral cortex

Back 21

pons

Front 22

site of decussation of descending cortiospinal tract

Back 22

medulla

Front 23

4 CNs with PNS function

Back 23

3, 7, 9, 10

Front 24

processing station between motor cortex and upper brainstem

Back 24

basal ganglia

Front 25

allows gross intentional movement without conscious thought by exerting a fine tuning effect on motor movements

Back 25

basal ganglia

Front 26

reflex center for eye and head movement

Back 26

midbrain

Front 27

houses pineal body, sexual development and behavior

Back 27

epithalamus

Front 28

processing center of internal stimuli for ANS

Back 28

hypothalamus

Front 29

taste, anterior 2/3rds

Back 29

CN 7 - facial

Front 30

taste, posterior 1/3rd

Back 30

CN 9 - glossopharyngeal

Front 31

termination of spinal cord in adult

Back 31

L1/2

Front 32

part of spinal cord with nerve cell bodies

Back 32

gray matter (butterfly portion)

Front 33

3 descending spinal tracts

Back 33

corticospinal, reticulospinal, vestibulospinal

Front 34

2 ascending spinal tracts

Back 34

spinothalamic, spinocerebellar

Front 35

desc tract that permits skilled, delicate and purposeful movements

Back 35

corticospinal (pyramidal) tract

Front 36

desc tract that causes extensor muscles to suddenly contract upon a fall

Back 36

vestibulospinal tract

Front 37

desc tract that IV the CNs

Back 37

reticulospinal

Front 38

asc tracts for proprioception (2)

Back 38

anterior and dorsal spinocerebellar

Front 39

asc tract that carries fibers for touch, deep pressure, vibration, position sense, stereognosis and 2 point discrimation

Back 39

dorsal (posterior) column of spinocerebellum tract

Front 40

2 components of dorsal column

Back 40

fasciculus gracilis and cuneatus

Front 41

asc tract that carries fibers for superficial touch and deep pressure

Back 41

anterior spinothalmic

Front 42

asc tract that carries the fibers for superficial pain and temperature

Back 42

lateral spinothalamic

Front 43

desc tract for rapid rhythmic alternating movements

Back 43

lateral and anterior corticospinal

Front 44

desc tract for voluntary movement

Back 44

lateral and anterior corticospinal

Front 45

desc tract for deep tendon reflexes

Back 45

lateral and anterior corticospinal

Front 46

desc tract for plantar reflex

Back 46

lateral and anterior corticospinal

Front 47

desc tract for posture, Romberg

Back 47

medial and lateral reticulospinal

Front 48

desc tract for gait

Back 48

medial and lateral reticulospinal

Front 49

desc tract for instinctual motor reactions

Back 49

medial and lateral reticulospinal

Front 50

lower motor neurons originate in which part of spinal cord?

Back 50

anterior (ventral) horn

Front 51

black children are more advanced developmentally than white children until at least ___ yo?

Back 51

3 yo

Front 52

primitive reflexes in newborn (6)

Back 52

yawn, sneeze, hiccup, blink at light/sound, pupillary contraction, withdrawal from painful stimulus

Front 53

brain growth continues until what age?

Back 53

12-15 yo

Front 54

neuro changes in preg (3)

Back 54

tension HA, acroparesthesia, sleep disturbances

Front 55

# of neurons decreases by __% beginning at ___ yo

Back 55

1% beginning at 50 yo

Front 56

sensory perception of what 2 sensations is decreased in elderly?

Back 56

touch and pain

Front 57

mneumonic for CN by function

Back 57

Some Say Marry Money But My Brother Says Bad Business Marry Money

Front 58

DDx: inability to distinguish odors (3)

Back 58

inflam of mucous membranes, allergic rhinitis and smoking

Front 59

DDx: anosmia (2)

Back 59

trauma to cribiform plate or olfactory tract lesion

Front 60

Which CN is commonly the 1st to lose function with increased ICP?

Back 60

CN 6

Front 61

pts who wear contact lenses may have what diminished or absent reflex?

Back 61

blink reflex to corneal stimulation

Front 62

CN responsible for labial sounds (b,m,p)

Back 62

CN 7 - facial

Front 63

CN responsible for sweet taste

Back 63

CN 7 - facial

Front 64

CN responsible for salty taste

Back 64

CN 7 - facial

Front 65

CN responsible for sour taste

Back 65

CN 9 - glossopharyngeal

Front 66

CN responsible for bitter taste

Back 66

CN 9 - glossopharyngeal

Front 67

test used to evaluate vestibular function

Back 67

Romberg

Front 68

CN responsible for guttural sounds

Back 68

CN 10

Front 69

CN responsible for lingual sounds (l,t,d,n)

Back 69

CN 12

Front 70

how far from pt is your finger for the finger-finger test?

Back 70

18 inches

Front 71

DDx: consistent past-pointing (1)

Back 71

cerebellar disease

Front 72

DDx: + Romberg (loss of balance) (3)

Back 72

cerebellar ataxia, vestibular dysfunction or sensory loss

Front 73

balance or hopping on 1 foot should be maintained for how long?

Back 73

>= 5 sec

Front 74

affected leg is stiff/extended, foot plantar flexed and dragged, circumduction, arm flexed and adducted with no swing

Back 74

spastic hemiparesis

Front 75

short steps, dragging ball of foot, extended legs, scissoring

Back 75

spastic diplegia

Front 76

hip/knee elevated high, foot plantar flexed and slapped on ground, can't walk on heels

Back 76

steppage

Front 77

legs apart with weight shifted from side to side due to weak hip abductors

Back 77

dystrophic (waddling)

Front 78

legs apart and lifted high off ground, heel stamps on ground

Back 78

tabetic

Front 79

wide based stance, swaying trunk

Back 79

cerebellar ataxia

Front 80

wide based stance, heel to toe step, + Romberg

Back 80

sensory ataxia

Front 81

stooped posture, rigid body, short/shuffling steps with hesitation on start and diff stopping

Back 81

Parkinsonian

Front 82

jerky, dancing movement that appears nondirectional

Back 82

dystonia

Front 83

uncontrolled falling

Back 83

ataxia

Front 84

pt limits time of weight bearing on affected limb to limit pain

Back 84

antalgic limp

Front 85

primary sensory functions (6)

Back 85

superficial touch and pain, temp, deep pressure, vibration, joint position

Front 86

cortical sensory functions (5)

Back 86

stereognosis, 2 point discrimination, extinction, graphesthesia, point location

Front 87

inability to recognize objects by touch is called ___ and caused by ___

Back 87

tactile agnosia; parietal lobe lesion

Front 88

discrimination distance: tongue

Back 88

1 mm

Front 89

discrimination distance: fingertips

Back 89

2-8 mm

Front 90

discrimination distance: toes

Back 90

3-8 mm

Front 91

discrimination distance: palms

Back 91

8-12 mm

Front 92

discrimination distance: chest/forearm

Back 92

40 mm

Front 93

discrimination distance: back

Back 93

40-70 mm

Front 94

discrimination distance: upper arm/thigh

Back 94

75 mm

Front 95

pain and temp sensation occur 1-2 dermatomes below lesion on opposite side; proprioceptive loss and motor paralysis on same side

Back 95

Brown-Sequad Syndrome

Front 96

all sensations lost below lesion; pain, temp and touch lost 1-2 dermatomes below lesion

Back 96

complete transverse lesion of cord

Front 97

DDx: absent superficial reflexes (2)

Back 97

UMN or LMN lesions

Front 98

DDx: + Babinski, older than 2 yo

Back 98

pyramidal (corticospinal) tract disease

Front 99

DDx: absent reflexes (2)

Back 99

neuropathy, LMN lesion

Front 100

DDx: hyperactive reflexes (1)

Back 100

UMN lesion

Front 101

reflex level: upper abdominal

Back 101

T7-9

Front 102

reflex level: lower abdominal

Back 102

T10-11

Front 103

reflex level: cremasteric

Back 103

T12-L2

Front 104

reflex level: plantar

Back 104

L4-S2

Front 105

reflex level: bicep

Back 105

C5-6

Front 106

reflex level: brachioradial

Back 106

C5-6

Front 107

reflex level: tricep

Back 107

C6-8

Front 108

reflex level: patellar

Back 108

L2-4

Front 109

reflex level: achilles

Back 109

S1-2

Front 110

what other than nuchal rigidity can cause pain in neck on flexion (2)

Back 110

swollen lymph nodes and superficial trauma

Front 111

involuntary flexion of hips/knees when flexing the neck

Back 111

Brudzinski sign

Front 112

pain in lower back and resistance to straightening when straightening leg from flexion

Back 112

Kernig sign

Front 113

do babies who sleep prone or on their backs roll over sooner?

Back 113

prone

Front 114

coordinated sucking and swallowing is function of what part of the brain?

Back 114

cerebellum

Front 115

which DTR is present at birth (1)?

Back 115

patellar

Front 116

is ankle clonus common/expected in an infant?

Back 116

yes, 1-2 beats

Front 117

Dx: in infant, rhythmic twitching of facial/extremity/trunkal muscles, asymmetric posturing, occuring in paroxysmal episodes

Back 117

seizures

Front 118

reflex: ability to lift head and extend spine when laid prone

Back 118

Landau

Front 119

reflex: curves trunk toward side stroked

Back 119

Galant/trunk curvature

Front 120

reflex: turns whole body in direction the head has been turned

Back 120

neck righting

Front 121

children with multiple soft signs are found to have ____

Back 121

learning problems

Front 122

which two taste sensations are first impaired in elderly?

Back 122

sweet and salty

Front 123

Dx: progressive dementia, HA, short term memory loss, behavioral changes, hyperreflexia, weakness in arms/legs, ataxia, incontinence

Back 123

HIV encephalopathy

Front 124

Dx: fatigue, incontinence, sexual dysfunction, muscle weakness, ataxia, blurred vision, hyperactive DTR, paresthesia, emotional changes

Back 124

MS

Front 125

cause of MS

Back 125

break down of blood-brain barrier allowing immune cells to cause demyelination of white matter

Front 126

Dx: excessive discharge of cerebral neurons, incontinence

Back 126

generalized seizure disorder

Front 127

most common cause of encephalitis

Back 127

virus

Front 128

Dx: fever, confusion, lethargy, coma, meningeal signs, paralysis

Back 128

encephalitis

Front 129

Dx: fever, chills, nuchal rigidity, HA, seizures, vomiting, change in consciousness

Back 129

meningitis

Front 130

do young infants exhibit nuchal rigidity with meningitis?

Back 130

no

Front 131

Dx: CSF that smells like alcohol

Back 131

cryptococcal meningitis

Front 132

Dx: circular rash

Back 132

Lyme disease, stage 1

Front 133

Dx: HA, meningitis, encephalitis, polyneuritis, facial paralysis, chorea, ataxia

Back 133

Lyme disease, stage 2

Front 134

Dx: arthritis, acrodermatitis

Back 134

Lyme disease, stage 3

Front 135

cause of Lyme disease

Back 135

Borrelia burgdorferi spirochete

Front 136

Dx: HA, papilledema, vomiting, motor dysfunction, unsteady gait, seizures, personality change

Back 136

space occupying lesion

Front 137

most common site of CVA

Back 137

distribution of anterior circulation of brain

Front 138

Dx: insidious muscle fatigue and progressive weakness of voluntary muscles with repetitive activity

Back 138

myasthenia gravis

Front 139

Dx: widespread inflam or demyelination of asc and desc peripheral nerves leading to impaired conduction of impulses

Back 139

Guillain-Barre

Front 140

mneumonic for peripheral neuropathy

Back 140

Idiopathic/Inherited, Metabolic/Mechanical, Drugs/DM, Infection, Sarcoidosis, Tumor, Autoimmune/Allergy, Lack of vitamins

Front 141

Dx: delayed gross motor devel, alteration in muscle tone, abnormal posture/motor/reflexes, mental retardation

Back 141

cerebral palsy

Front 142

cause of cerebral palsy

Back 142

static and nonprogressive cerebral lesions

Front 143

Dx: retinal hemorrhages, altered consciousness, subdural/subarachnoid hemorrhage

Back 143

shaken baby syndrome

Front 144

Dx: loss of voluntary hand movements, hand wringing movement, ataxia, rigidity in legs, growth retardation, seizures, loss of facial expression, autistic behavior

Back 144

Rett syndrome (only in girls)

Front 145

Dx: compression of lumbosacral plexus and peripheral nerves in pelvic wall causes femoral neuropathy and weakness in LE

Back 145

maternal obsteric palsy

Front 146

Dx: fatigues with minimal exertion, muscle/joint pain, dyspnea, dysphagia, cold intolerance

Back 146

postpolio syndrome