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74 Cards in this Set
- Front
- Back
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What symptoms are associated with UMN damage?
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Weakness, Atrophy, Hyperreflexia, Hypertonicity
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Symptoms of LMN damage?
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Weakness, Severe atrophy, Hypo/areflexia, Flaccidity
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When getting a neurological history, you should assess _ and _ immediately at the start of the interview
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Appearance and Demeanor
look for emotions, posture, non verbal communication, personal hygiene, and gait disturbances |
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Regarding the level of consciousness...
_ is when the pt awakens to voice commands answers appropriately and could wake up |
Somnolence
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Regarding the level of consciousness...
_ is when the pt awakens to verbal and tactile cues, answers appropriately but cannot maintain alertness |
Lethargy
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Regarding the level of consciousness...
_ is when the pt Responds to noxious stimuli only, somewhat appropriately, but cannot verbalize or initiate cognition |
Stupor
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Regarding the level of consciousness...
_ is when the pt has an inappropriate response to noxious stimuli |
Obtunded
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Affect vs mood?
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Observable outward tone or demeanor (affect) - Climate
Patient’s description of emotion (mood) - Weather |
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_ is a deficit in the muscles of speech in the mouth, not due to a problem in the brain
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Dysarthria
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_ is the inability to make a sound. Example: Laryngitis, paralyzed vocal cords
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Dysphonia
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_ is when the pt repeats everything you say
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echolalia
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_ is when someone takes way too long to get to the point, or maybe never gets to the point
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circumlocutions
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By asking the pt about current events, you _
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confirm their orientation, and test recent memory
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_ is ability to recognize objects
_ is failure to recognize common everyday items, this occurs with lesions in the _ |
Gnosis
Agnosia, nondominant parietal lobe |
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_ is the inability to recognize or correctly orient the parts of one's own body.
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Autotopagnosia
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_: the ability to perform a motor function
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Praxis:
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Regarding the glasgow coma scale ... A score of less than _associated with > 80% morbidity.
A score of less than _ is associated with > 80% mortality. |
8
4 |
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What are the three major categories that are looked at in the glasgow coma scale?
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verbal response, eye opening, and motor
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What is the purpose of doing a psych evaluation?
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PACE
Psychiatric Management Establish and Maintain Therapeutic Alliance Complete Psychiatric Assessment Evaluate the Safety of the Patient |
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When performing a psych eval, whenever possible, you should _. This will make patients feel more important as well as gives you the opportunity to observe the pts behavior.
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schedule the interview
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(T/F) You should always shake hands before conducting a psych interview in order to be polite and make the pt more comfortable
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False. Shake hands when culturally appropriate
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You should always address the patient by _
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their last name
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When evaluating someone's speech what are the three parameters you are looking at?
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rate, volume, inflection (monotone or animated)
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When evaluating someone's affect, you are evaluating it's:
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range (degree of reactivity - flat, blunted)
stability (stable or labile?) appropriateness (to the situation) |
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What is the medical terminology for a neutral mood?
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euthymic
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A corticospinal tract damaged above the medulla produces motor impairment on the _ side with _ DTR’s and muscle tone.
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contralateral
increased |
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Below the medulla lesion of the corticospinal tract produces impairment on the _side with _ DTR’s and muscle tone.
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ipsilateral
decreased |
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(T/F) You get paralysis with damage to the basal ganglia
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false.
you get bradykinesia and involuntary movements but no paralysis |
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Equilibrium, gait, and posture is coordinated by _
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the cerebellar system
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Biceps flexion tests nerves _
Extension of triceps tests _ |
C5-6
C6,7,8 |
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Wrist extension tests _
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C6,7,8 (Radial nerve)
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Thumb opposition tests _
Grip tests _ |
C8, T1 (median nerve)
C7,8,T1 |
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Weak abduction of the thumb results from _
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C8 and T1 fibers of the Ulnar Nerve
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Quad extension tests _
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L2, L3, L4, quadriceps mm
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Hip flexion tests _
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L2, L3, L4, iliopsoas mm
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Knee flexion tests _
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L4, L5, S1 hamstrings
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Plantar flexion tests _, dorsiflexion tests _
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S1,
L4,L5 |
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To test the spinothalamic tract, use a _
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paper clip for sharp sensation. This tract is responsible for pain and temperature
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To test the posterior columns, use a _
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tuning fork on bone for vibration or position sense on fingers and toes.
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Light touch, as in use of a cotton ball, tests _
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both spinothalamic and dorsal columns
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DTR are mediated through _ cell, and are recorded as _
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the anterior horn cell
0(absent) to 4+ (hyperactive). 2+ is Normal |
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Biceps reflex tests _
Triceps reflex tests _ |
C5,6
C6,C7 |
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Brachioradialis reflex tests _
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C5,6
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Patellar reflexes tests _
Achilles reflex tests _ |
L2,3,4
S1 |
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What respiratory patterns would a comatose pt have if they had a lesion in ..
Cerebrum Midbrain Pons Medulla |
Rapid respirations with increasing and decreasing depth
rapid respirations slow, gasping irregular rate and depth |
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spastic paralysis is indicative of a _ lesion
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UMN
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Corneal reflex tests CN _ and _
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V and VII
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To test for CN _, you check sensation on the face and motor eval of temporal and masseter muscles
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CN V
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To test for the CN _, have the pt raise their eyebrows, close eyes tight, smile, and puff cheeks
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CN VII
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To test for CN VIII, you ...
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test hearing, rub your fingers together by both ears
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You test CN _ simultaneously with CN _ by testing the gag reflex
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CN IX and X
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_ flapping of extended arms and wrists frequently seen in alcoholics indicative of metabolic encephalopathy
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Asterixis:
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_ sign: Flexion of the neck induces flexion of the hips and knees indicative of meningeal irritation
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Brudzinski’s (meningeal)
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_sign: Flex hip and knee, then extend the knee. Inability to extend the knee is a positive sign
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Kernig’s
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What respiratory patterns would a comatose pt have if they had a lesion in ..
Cerebrum Midbrain Pons Medulla |
Rapid respirations with increasing and decreasing depth
rapid respirations slow, gasping irregular rate and depth |
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spastic paralysis is indicative of a _ lesion
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UMN
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You test CN XI by having the pt _
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shrug their shoulders
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You test CN XII by having the pt _
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protrude their tongue
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_ maneuver tests proprioception via posterior columns and vestibular fxn. The pt stands with their feet together, arms outstretched, and closes eyes
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Romberg
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When the pt is alternatly touching their nose to your finger, you are testing _
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cerebellar function....unconscious proprioception via spinocerebellar tract
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_ is when the pt has Supinated extended arms for 20-30 seconds with eyes closed
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pronator drift
pronation of one arm suggests a contralateral corticospinal lesion |
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Ankle clonus with hyperactive reflexes is indicative of _
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encephalopathy
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What are the 5 things you MUST know how to do when performing an eye examination?
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Measure and record visual acuity
Assess pupillary reflexes Evaluate ocular motility Evaluate visual fields by confrontation Use the direct ophthalmoscope for fundus evaluation |
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A pt is legally blind if they have a vision of _
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20/200
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What are the 6 cardinal fields of gaze?
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L, R, Up and L, Up and R, Down and L, Down and R
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When you are looking up and right, what EOM are you using?
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R superior rectus
L inferior oblique |
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When you look down and right, what EOM are you using?
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Right Inferior rectus
Left Superior Obliqe |
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When you are looking down and left, what EOM are you using?
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Left Inferior rectus
Right Superior Oblique |
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Cotton Wool spots, AV nicking and ateriolarsclerosis are associated with what disorder?
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hypertensive retinopathy
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_ is rare and occurs most often in young adults. It causes attacks of high blood pressure, headaches, excessive sweating, nausea and vomiting, anxiety, and loss of consciousness.
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Pheochromocytoma
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(T/F) Papilledema is the swelling of the optic disc and results in an increased blind spot but relatively little visual loss
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true
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In a central retinal artery occulsion,there is (minimal/total) vision loss. The off white surrounding the cherry red spot is the _
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total
infarcted retina |
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_ is Optic disc edema with visual loss, and can be associated with pain
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optic neuritis
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Dry macular degeneration results in _ visual loss, while wet results in _ visual loss
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gradual
rapid |
