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30 Cards in this Set

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CNS - What are the parts of the CNS?
Motor and sensory
Cortical, subcortical, brainstem, cord
CNS Motor are located in the
Descending
Precentral gyrus, internal capsule, circuite with basal ganglia, thalamus, cerebellum, brainstem, decussate at medulla, anterior horn
CNS Sensory are located in
Ascending
Spinothalmic and dorsal column, medial lemniscal, thalamus, postcentral gyrus and cerebellum
PNS - What are the parts fo the PNS?
Motor and sensory
Ventral and dorsal roots
Peripheral nerves
Peripheral Nerves carry impulses to
Carry impulses to and from the spinal cord
Upper Motor Neuron
Descending pathways from cortex to brainstem (corticobulbular tract, cortex to spinal cord (coticospinal tract)
Corticobulbular tract are located in the
Cortex to brainstem
Corticospinal tract are located in the
Brainstem to spinal cord
Upper motor neurons orginate and terminate where?
Originate and teminate within the central nervous system
Upper motor neurons located
The descending pathway from the brain to the spinal cord
Upper motor neurons influence
Influence and modify spinal reflex arc
Lower motor neuron originate and terminate where?
Originate in anterior horn of spinal cord and terminate in muscle fibers
What are cranial nerves?
Lower motor neurons
What are the parts of basic comprehensive exam?
Mental status
Cranial status
Motor nerves
Sensory system
Reflexes
Cerebellum (hemisphere versus vermis)
Gait
Mental state relates to what of a patient?
Mood and thought of a patient
What does the mental status exam attempt to distinguish?
Focal neurological deficits
Diffuse neurological deficits
Primary psychiatric illness (depression, anxiety, etc.)
Psychiatric illness secondary to or associated with the neurological disease
The extent of the mental state testing will depend on what?
Depend on patient problem.
Some patients will require simple assessment
What are some mental status exam basics?
Appearance and behavior
Speech and language
Affect
Mood (SIGECAPS)
Thought content
Thought processes
Perceptual disturbances
Insight and judgement
Congnitive function (at least MMSE)
Appearance and behavior?
Watch patient while you take history.
Appearance and behavior -What do signs of self neglect imply?
depression, dementia, alcoholism, drug abuse
Does the patient appear depressed?
Furrowed brow, immobile, downcast facies, slow monotonous speech
Does patient behave appropriately?
Over familiar and disinhibited or aggressive
Unresposinve, with emotional response
Unresponsive with emotional response
flat affect
Over familiar, disinhibited, and aggressive
Frontalism
Does the patient's mood change rapidly?
Crying and laughing easily
Crying and laughing easily
emotional lability
Does patient show appropriate concern about his symptoms and disability?
Lack of concern in face for significant disability
Lack of concern in face for signficant disability
Bell indifference - consider hysterical disease (conversion disorder)
Level of consciousness
Alert, confused,lethargy
Alert
speak in normal tone of voice to patient, patient opens eyes, looks at you, responds appropriately