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46 Cards in this Set
- Front
- Back
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Horner Syndrom |
miosis (small pupil), ptosis (lid droop), and anhidrosis (lack of sweat) Indicates preganglionic, central, or postganglionic lesion |
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Adie Pupil |
Both the pupillary response and accomodation are sluggish or impaired in one eye Indicates denervation of the nerve supply resulting from diabetic neuropathy or alcoholism |
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Argyll Robertson Pupil |
Virtually no response to light but brisk response to accomodation bilaterally; pupils are s,a;; and frequently irregular in shape. Indicates neurosyphalis and meningitis |
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Third Nerve Palsy |
Sudden ptosis, diplopia, and pain are some of the symptoms; pupil is fixed and dilated, extraocular motility is restricted. Indicates third nerve palsy. |
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Abnormal Extension |
Very stiff spastic movements may persist after noxious stimulations. Upper extremities are: extended, internally rotated, adducted, palms pronated. Lower extremities are: extended, back is hyperextended, and plantar flexion is present. Indicates damage to the mid-brain or upper pons. |
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Tic |
Brief, repetitive, similar but irregular movements, such as blinking or shrugging shoulders. Commonly associated with: Tourette syndrome, use of psychiatric medications, and use of amphetamines |
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Clonus/Myoclonus |
Rapid, sudden, clonic spasm of a muscle that may occur regularly or intermittently. Commonly associated with: seizures, hiccups, or just prior to falling asleep. |
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Abnormal Flexion |
Stiff spastic movements may persist after noxious stimulation. Upper extremities are: flexed and arms adducted. Lower extremities are: extended, internally rotated with plantar flexion Indicates damage to the cerebral cortex |
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Hemiplegia |
Sensation and motor strength are lost unilaterally. Indicates stroke |
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Flexion Withdrawal |
Gross movements of all body parts are away from the noxious stimulus. Rather then localizing pain to one side the patient may withdraw both arms when nail bed pressure is applied. Indicates CNS depression or injury |
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Flaccid Quadriplegia |
Sensation and muscle tones are completely lost. Indicates nonfunctional brainstem |
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Paralysis |
Loss of motor function resulting in flaccidity over the area of damage; may be one sided (hemiplegia), in all 4 extremities (quadriplegia) or only the legs (paraplegia) Commonly associated with stroke, spinal cord injury, chronic neuromuscular disease, bell palsy |
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Resting Tremor |
Prominent at rest, may decrease or disappear with voluntary movement. Commonly associated with parkinson disease |
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Intention Tremor |
Absent at rest, increase with movement, may worsen as movement progresses. Commonly associated with multiple sclerosis w/ damage to the cerebellar pathways, or essential tremor |
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Fasiculation |
Fine, flickering, irregular movements in small muscle groups seen under the skin, may not cause movement at the joint; can be difficult to see clearly because of facilitations Commonly associated with deterioration of the anterior horn cells |
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Dystonia |
Slow, involuntary, twisting movements that often involve the trunk and larger muscles; can be accompanied by twisted postures. Commonly associated with use of psychiatric medications |
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Choreiform Movements |
Brief, rapid, jerky movements that are irregular and unpredictable, commonly affects the face, head, lower arms, and hands. Commonly associated with huntington disease |
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Athetoid Movements |
Slow, involuntary, wormlike twisting movements that involve the extremities, neck, facial muscles, and tongue; can be associated with drooling and dysarthria Commonly associated with cerebral palsy |
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Differential Diagnosis: Strength |
Upper: spastic paresis or paralyis (may be flaccid in acute phase) Lower: flaccid paresis or paralysis |
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Differential Diagnosis: Muscle tone |
Upper: increased spasticity Lower: decreased/absent flaccidity |
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Differential Diagnosis: Muscle Stretch Reflexes |
Upper: increased prescence of Babinski sign Lower: decreased or absent |
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Differential Diagnosis: Muscle Atrophy |
Upper: Absent Lower: Present |
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Differential Diagnosis: Muscle Fasciculation |
Upper: Absent Lower: Present |
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Spastic Hemiparesis |
One side of body is normal, the other side is flexed from spasticity. The elbow, wrist, and fingers are flexed; the arm is close to the side. The affected leg is extended with plantar flexion of the foot. When ambulating, the foot is dragged, scraping the toe, or it is circled stiffly outward and forward. Indicates stroke |
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Scissors |
Moves the trunk to accomodate for the leg movements; legs are extended and knees are flexed. Leg cross over each other at each step similar to walking in water. Indicates spastic diplegia associated with bilateral spasticity of the legs |
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Parkinsonian |
Stooped posture, head and neck forward and hips and knees flexed; arms are also flexed and held at waist; there is difficulty in initiating gait , often rocking to start. Once in motion steps are quick, and shuffled, hard to stop once started. Indicates Parkinsons disease |
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Cerebellar Ataxia |
Wide based gait; staggers and lurches from side to side. Can't perform Romberg because of swaying of the trunk. Indicates cerebral palsy and alcohol intake |
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Sensory Ataxia |
Wide based gait; feet are loosely thrown forward, landing first on the heels and then on the toes. Patient watches the ground to help guide the feet. Positive Romberg sign from loss of position sense. Indicates Cerebral palsy |
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Dystrophic |
Wide gait; weight is shifted from side to side, with stiff trunk movement; abdomen protrudes and lordosis is common. Indicates weak hip abductors |
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Peripheral Neuropathy |
Sensory loss is distributed peripherally in a characteristic "glove" or "stocking" pattern. More diffuse and less specific than injury associated with an individual nerve Indicates diabetes mellitus or peripheral vascular disease |
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Individual Nerves |
Follows the pattern expected in the nerve with cutaneous distribution that follows the dermatome. Indicates trauma or injury |
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Spinal Cord Hemisection |
Nerves cross the spinal cord, pain and temp are lost below the level of the lesion on the opposite side. Position sense, vibration, and motor function are affected on the same side of the body. Indicates Brown-Sequard syndrome from spinal cord injury, tumor, mass |
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Complete Transection of the Spinal Cord |
All sensation and motor function is lost below the level of the lesion Indicates spinal cord injury, tumor, or mass |
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Grasp Reflex |
Test: apply palmar stimulation Abnormal findings: a grasping response is associated with dementia and diffuse brain impairment |
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Snout Reflex |
Test: elicit by tapping a tongue blade across the lips Abnormal Findings: present if tapping causes the lips to purse |
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Sucking Reflex |
Test: touch or stroke the lips, tongue, or palate Abnormal Findings: observe sucking movement of the lips this reflex may be noted furing oral care or oral suctioning |
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Rooting reflex |
Test: stroke the lateral upper lip Abnormal Findings: present if the patient moves the mouth toward the stimulus |
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Palmomental reflex |
Test: stroke the palm of the hand Abnormal Findings: present if stroking of the palm causes contracction of the same-sided muscle of the lower lip |
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Hoffman Sign |
Test: tap the nail on the third or fourth finger Abnormal Findings: positive if tapping elicits involuntary flexion of the distal joint of the thumb and index finger |
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Glabellar Reflex |
Test: tap the forehead to cause the patient to blink Abnormal findings: typically the reflex diminishes after 5 taps, abnormal if blinking continues. |
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Cheyne-Strokes Respiration |
Breathing pattern with period of apnea (10-60 seconds) followed by gradually increasing depth and frequency of respiration Effect: poor brainstem perfusion |
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Central Neurogenic Hyperventilation |
Rapid and deep respirations, sometimes greater than 40 breaths/min Effect: medulla or pons malfunction |
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Apneustic Breathing |
Sustained inspiratory effort, usually less than 12 breaths/min Effect: medulla or pons damage |
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Gasping |
Rapid, quick, difficult breaths; irregular respirations with varying rate and tidal volume Effect: Extensive pons damage, severe hypoxia |
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Biot Breathing (Cluster Pattern) |
Several short breaths followed by long irregular periods of apnea Effect: pons malfunction, increased ICP |
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Apnea |
Absence of breathing Effect: high cervical cord or extensive medulla damage, brain death |
