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74 Cards in this Set

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What symptoms are associated with UMN damage?
Weakness, Atrophy, Hyperreflexia, Hypertonicity
Symptoms of LMN damage?
Weakness, Severe atrophy, Hypo/areflexia, Flaccidity
When getting a neurological history, you should assess _ and _ immediately at the start of the interview
Appearance and Demeanor

look for emotions, posture, non verbal communication, personal hygiene, and gait disturbances
Regarding the level of consciousness...
_ is when the pt awakens to voice commands answers appropriately and could wake up
Somnolence
Regarding the level of consciousness...
_ is when the pt awakens to verbal and tactile cues, answers appropriately but cannot maintain alertness
Lethargy
Regarding the level of consciousness...
_ is when the pt Responds to noxious stimuli only, somewhat appropriately, but cannot verbalize or initiate cognition
Stupor
Regarding the level of consciousness...
_ is when the pt has an inappropriate response to noxious stimuli
Obtunded
Affect vs mood?
Observable outward tone or demeanor (affect) - Climate

Patient’s description of emotion (mood) - Weather
_ is a deficit in the muscles of speech in the mouth, not due to a problem in the brain
Dysarthria
_ is the inability to make a sound. Example: Laryngitis, paralyzed vocal cords
Dysphonia
_ is when the pt repeats everything you say
echolalia
_ is when someone takes way too long to get to the point, or maybe never gets to the point
circumlocutions
By asking the pt about current events, you _
confirm their orientation, and test recent memory
_ is ability to recognize objects
_ is failure to recognize common everyday items, this occurs with lesions in the _
Gnosis

Agnosia, nondominant parietal lobe
_ is the inability to recognize or correctly orient the parts of one's own body.
Autotopagnosia
_: the ability to perform a motor function
Praxis:
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
What are the three major categories that are looked at in the glasgow coma scale?
verbal response, eye opening, and motor
What is the purpose of doing a psych evaluation?
PACE
Psychiatric Management
Establish and Maintain Therapeutic Alliance
Complete Psychiatric Assessment
Evaluate the Safety of the Patient
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.
schedule the interview
(T/F) You should always shake hands before conducting a psych interview in order to be polite and make the pt more comfortable
False. Shake hands when culturally appropriate
You should always address the patient by _
their last name
When evaluating someone's speech what are the three parameters you are looking at?
rate, volume, inflection (monotone or animated)
When evaluating someone's affect, you are evaluating it's:
range (degree of reactivity - flat, blunted)

stability (stable or labile?)

appropriateness (to the situation)
What is the medical terminology for a neutral mood?
euthymic
A corticospinal tract damaged above the medulla produces motor impairment on the _ side with _ DTR’s and muscle tone.
contralateral
increased
Below the medulla lesion of the corticospinal tract produces impairment on the _side with _ DTR’s and muscle tone.
ipsilateral

decreased
(T/F) You get paralysis with damage to the basal ganglia
false.

you get bradykinesia and involuntary movements but no paralysis
Equilibrium, gait, and posture is coordinated by _
the cerebellar system
Biceps flexion tests nerves _

Extension of triceps tests _
C5-6

C6,7,8
Wrist extension tests _
C6,7,8 (Radial nerve)
Thumb opposition tests _

Grip tests _
C8, T1 (median nerve)

C7,8,T1
Weak abduction of the thumb results from _
C8 and T1 fibers of the Ulnar Nerve
Quad extension tests _
L2, L3, L4, quadriceps mm
Hip flexion tests _
L2, L3, L4, iliopsoas mm
Knee flexion tests _
L4, L5, S1 hamstrings
Plantar flexion tests _, dorsiflexion tests _
S1,

L4,L5
To test the spinothalamic tract, use a _
paper clip for sharp sensation. This tract is responsible for pain and temperature
To test the posterior columns, use a _
tuning fork on bone for vibration or position sense on fingers and toes.
Light touch, as in use of a cotton ball, tests _
both spinothalamic and dorsal columns
DTR are mediated through _ cell, and are recorded as _
the anterior horn cell

0(absent) to 4+ (hyperactive). 2+ is Normal
Biceps reflex tests _

Triceps reflex tests _
C5,6

C6,C7
Brachioradialis reflex tests _
C5,6
Patellar reflexes tests _

Achilles reflex tests _
L2,3,4

S1
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
spastic paralysis is indicative of a _ lesion
UMN
Corneal reflex tests CN _ and _
V and VII
To test for CN _, you check sensation on the face and motor eval of temporal and masseter muscles
CN V
To test for the CN _, have the pt raise their eyebrows, close eyes tight, smile, and puff cheeks
CN VII
To test for CN VIII, you ...
test hearing, rub your fingers together by both ears
You test CN _ simultaneously with CN _ by testing the gag reflex
CN IX and X
_ flapping of extended arms and wrists frequently seen in alcoholics indicative of metabolic encephalopathy
Asterixis:
_ sign: Flexion of the neck induces flexion of the hips and knees indicative of meningeal irritation
Brudzinski’s (meningeal)
_sign: Flex hip and knee, then extend the knee. Inability to extend the knee is a positive sign
Kernig’s
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
spastic paralysis is indicative of a _ lesion
UMN
You test CN XI by having the pt _
shrug their shoulders
You test CN XII by having the pt _
protrude their tongue
_ maneuver tests proprioception via posterior columns and vestibular fxn. The pt stands with their feet together, arms outstretched, and closes eyes
Romberg
When the pt is alternatly touching their nose to your finger, you are testing _
cerebellar function....unconscious proprioception via spinocerebellar tract
_ is when the pt has Supinated extended arms for 20-30 seconds with eyes closed
pronator drift


pronation of one arm suggests a contralateral corticospinal lesion
Ankle clonus with hyperactive reflexes is indicative of _
encephalopathy
What are the 5 things you MUST know how to do when performing an eye examination?
Measure and record visual acuity
Assess pupillary reflexes
Evaluate ocular motility
Evaluate visual fields by confrontation
Use the direct ophthalmoscope for fundus evaluation
A pt is legally blind if they have a vision of _
20/200
What are the 6 cardinal fields of gaze?
L, R, Up and L, Up and R, Down and L, Down and R
When you are looking up and right, what EOM are you using?
R superior rectus
L inferior oblique
When you look down and right, what EOM are you using?
Right Inferior rectus
Left Superior Obliqe
When you are looking down and left, what EOM are you using?
Left Inferior rectus
Right Superior Oblique
Cotton Wool spots, AV nicking and ateriolarsclerosis are associated with what disorder?
hypertensive retinopathy
_ 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.
Pheochromocytoma
(T/F) Papilledema is the swelling of the optic disc and results in an increased blind spot but relatively little visual loss
true
In a central retinal artery occulsion,there is (minimal/total) vision loss. The off white surrounding the cherry red spot is the _
total


infarcted retina
_ is Optic disc edema with visual loss, and can be associated with pain
optic neuritis
Dry macular degeneration results in _ visual loss, while wet results in _ visual loss
gradual

rapid