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65 Cards in this Set
- Front
- Back
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upper motor neurons refer to
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brain & spinal cord
ie: central nervous system |
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lower motor neurons refer to
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12 cranial nerves + 31 spinal + branches
peripheral nervous system |
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Brain consists of 4 parts
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Cerebral Cortex
Diencephalon Brainstem Cerebellum |
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Cerebral cortex is broken into lobes (4)
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Frontal lobe
Parietal lobe Occipital lobe Temporal lobe |
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Broca's area is found
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in the frontal lobe, and governs speech formation
ie, person who has this can understand speech, but not speak themselves |
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Wernicke's area is found
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in the temporal lobe. it governs speech comprehension.
ex: someone with this cannot comprehend other's speech |
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What does frontal lobe govern
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personality, behaviors, emotions, intellectual function
Primary motor area |
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What does parietal lobe govern
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primary sensory area
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What does occipital lobe govern
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visual perception CNII
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What does temporal lobe govern
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hearing, taste & smell
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what % of people are left hemisphere dominant?
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95%
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Parts of the Diencephalon (deep in brain)
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Basal ganglia
thalamus hypothalmus |
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basal ganglia govern
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auto arm swing, part effected by parkinsons
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thalamus governs
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main relay station, synapse formed
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hypothalamus governs
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temperature control
sleep pituitary gland regulation some emtion |
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parts of the brainstem (3)
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Midbrain
Pons Medulla |
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Midbrain
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anterior
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Pons
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ascending/descending
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Medulla
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motor sensory nerve tracks, vital autonomic center (breathing/heart etc) site of pyramidal decussation
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pyramidal decussation
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crossing of motor fibers
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major motor pathways (3)
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corticospinal or pyramidal tract
extra pyramidal tract cerebellar system |
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corticospinal or pyramidal
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voluntary movement, skilled and discrete
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extrapyramidal tract
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motor fibers
basal ganglia gross body movement |
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cerebellar system
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equilibrium
posture coordination |
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major sensory pathways (2)
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Spinothalamic tract
posterior column |
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spinothalamic tract
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spine->thalamus
temperature pain (sharp/dull) crude/light touch (cotton ball) fine discretion @ cortex |
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posterior column
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proprioception (position)
vibration fine localized touch (graphesthesia) |
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which portion of the spine is sensory? motor?
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posterior: sensory
anterior: motor |
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required for a reflex arc (5)
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intact sensory nerve
fxn'l synapse in cord intact motor neuron intact neuromuscular junction competent muscle |
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What reflexes test what?
ankle knee |
ankle: Sacral 1
knee: L2, L3, L4 |
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what reflexes test what?
brachial radialis bicep |
both test C5 & C6
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what reflexes test what?
tricep plantar |
tricep: C6 & C7
plantar: L5 & S1 |
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mental status: define
lethargic |
drowsy
ie: concussion |
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mental status: define
obtunded |
only seen in hospital
open eyes, responds slowly, no interest in environment |
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mental status: define
stuperous |
only seen in hospital
only awakened by painful stimuli, maybe verbally responsive |
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mental status: define
comatose |
only seen in hospital
always unarousable |
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what is the first thing to go with orientation? (ANOx3)
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Time.
then place then person |
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Language, and inability to follow directions to the end indicates what?
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dementia
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why don't use ammonia to test CN I?
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it messes up CN V
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Bells Palsy
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paralysis of half of face, including brow, due to cut in cranial nerve VII
can't close eye, can't raise brow, no nasal labial fold on one side |
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What is the sensory portion of CN VII test?
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taste
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How is stroke different than Bells Palsy?
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the pt. can still raise their eyebrows and close their eye. It is really only the lower portion of the face that is paralyzed.
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What is the vestibular portion of CNVIII?
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Romberg test: the feet together, hands at your side
abnormal to fall back |
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3 kinds of muscle tone?
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Flaccid
Spastic Rigid |
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Flaccid?
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decrease in muscle tone: early stroke, polio
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Spastic
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increase in muscle tone, increased resistance to extension, inuurty to corticomotor spinal tract
[later stroke victims, think curled bicep] |
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Rigid
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constant state of contraction
parkinsons, parkinsonism cog wheel rigidity damage of the extra pyramidal tract |
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hypotrophy of muscle can be due to
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muscle or lower motor neuron disease
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involuntary movements (3)
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fasiculation
tick tremor >tension tremor >pill rolling |
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fasiculation
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rapid twitching of resting muscle
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tick
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repetitive twitch at inappropriate time
neurological/psychological ex: shoulder shrug |
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Tremor
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Pill rolling = parkinsons
Tension tremor = extension, tremor when pouring water |
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spinothalamic tract:
if pt response to pain, you you don't have to test |
temperature
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Posterior column:
tactile discrimination tests? |
stereognosis (object)
graphesthesia (draw #) two point discrimination extinction (touch different hands) |
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tests of cerebellar function
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rapid alternating movements
point to point movements |
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coordination tests
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cerebellar function
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point to point movement tests
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finger to finger
finger to nose heel to shin |
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heel to shin test being bouncy can indicate
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MS
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pronator drift test weakness can indicate
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small stroke
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pronator drift test overshoot can indicate
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cerebellar problem
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cerebellar function test
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gait
tandem walking romberg test shallow knee bend |
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+ babinski can indicate
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upper motor neuron problem
spinal cord damage following a seizure losta drugs |
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how test for clonus (4+ reflex)
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support knee, dorso flex foot
cog wheel rigidity in motion |
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increase in muscle tone
increase in reflexes and up going toe indicate |
upper motor neuron problem
ie: damage to spinal cord or cerebral cortex |
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loss of muscle tone
less relexes indicate |
lower motor neuron problem
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