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63 Cards in this Set
- Front
- Back
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Nervous System Functions
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Rapid Communication
sensory input; motor output reflexes Higher brain functions |
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Central Nervous System
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Brain + Spinal Cord
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Nervous System
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CNS + Peripheral Nervous System
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Afferent =
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sensory neurons
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Efferent =
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Motor Neurons
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important for emotional response and memory
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temporal lobes
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frontal lobes
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Attention, motivation, behavior, working memory, judgment, fund of knowledge, task organization
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Attention, motivation, behavior, working memory, judgment, fund of knowledge, task organization
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frontal lobes
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Temporal lobes
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important for emotional response and memory
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constructional apraxia
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inability to draw or construct two-three dimensional forms or figures and impairment in the ability to integrate perception into kinesthetic images.
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Asking questions about month, date, day of week and place tests orientation, which involves not only memory but also attention and language. Three-word recall tests recent memory for which the temporal lobe is important. Remote memory tasks such as naming Presidents, tests not only the temporal lobes but also heteromodal association cortices.
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orientation memory
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Digit span, spelling backwards and naming months of the year backward test attention and working memory which are frontal lobe functions.
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attention working memory
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These frontal lobe functions can be tested by using problem solving, verbal similarities and proverbs
What would you do if you saw a house on fire? How are an apple and orange similar? What is the meaning of “a bird in hand is worth two in the bush”? |
Judgement-abstract reasoning
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This is a test of verbal fluency and the ability to generate a set of items which are frontal lobe functions. Most individuals can give 10 or more words in a minute.
Give me as many words (not Proper or capital) that start with the letter “M” |
set generation
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Asking the patient to follow commands demonstrates that they understand the meaning of what they have heard or read. It is important to test reception of both spoken and written language.
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receptive language
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In assessing _____________ language it is important to note fluency and correctness of content and grammar. This can be accomplished by tasks that require spontaneous speech and writing, naming objects, repetition of sentences, and reading comprehension.
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expressive language
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The patient is asked to perform skilled motor tasks without any nonverbal prompting. Skills tested for should involve the face then the limbs. In order to test for ___________ the patient must have normal comprehension and intact voluntary movement. ________ is typically seen in lesions of the dominant inferior parietal lobe.
Wink Pretend to suck on a straw Pretend to drink from a cup |
praxis
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Gnosis is the ability to recognize objects perceived by the senses especially somatosensory sensation. Having the patient (with their eyes closed) identify objects placed in their hand (stereognosis) and numbers written on their hand (graphesthesia) tests parietal lobe sensory perception.
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gnosis
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The _____________ is important for visual spatial sensory tasks such as attending to the contralateral side of the body and space as well as constructional tasks such as drawing a face, clock or geometric figures.
Draw a face, clock Copy a geometric design |
non-dominant parietal lobe
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Tests for _______________ function includes right-left orientation, naming fingers, and calculations.
Touch left little finger to right elbow Identify the right index finger Serial sevens |
Dominant parietal Lobe
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Recognition of colors and faces tests
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Visual recognition - visual association cortex
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brainstem =
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midbrain
pons medulla oblongata |
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-information relay from vision and auditory pathways and involved in visual and auditory reflexes (loud noises cause you to blink, and turn your head)
functions: 1. Contains ascending (Sensory)and descending (motor) tracts 2. eye reflexes (for visual tracking of objects/horizon) 3. Contains the nuclei for cranial nerves III and IV |
midbrain
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1. Contains ascending and descending tracts
2. contains nuclei for cranial nerves V, VI, VII, and VIII 3. visceral reflex centers, including nuclei related to: sleep, hearing, equilibrium, taste, eye movements, facial expression, facial sensation, respiration, swallowing, bladder control, and posture |
pons
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1. Contains ascending and descending tracts
2. decussating(crossing sides of body) of motor tracts at pyramids 3. Contains the nuclei for cranial nerves IX, X, XI, XII 4. Centers for vasomotor (blood pressure), heart rate and contractility, and respiration are located here |
medulla oblongata
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Clinically, there are 2 major somatosensory pathways that are examined.
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The first is the spinothalamic (ST) and the second is the dorsal column-medial lemniscus (DCML) system.
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The principle sensory modalities for the ST system are _____ and ____________
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pain and temperature
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The principle sensory modalities for DCML system are (3) ?
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vibratory
position sense discriminatory or integrative sensation. |
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common psychiatric disease
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Mood disorders
Speech Disorders Anxiety Disorders Psychotic Disorders Organic Brain Disorders (Stroke, infarct, etc.) |
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____________ is a common mental disorder that presents with depressed mood, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy, and poor concentration. These problems can become chronic or recurrent and lead to substantial impairments in an individual's ability to take care of his or her everyday responsibilities. At its worst, __________ can lead to suicide, a tragic fatality associated with the loss of about 850 000 thousand lives every year
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depression
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is defined as the intentional taking of one's own life. Prior to the late nineteenth century, suicide was legally defined as a criminal act in most Western countries. In the social climate of the early 2000s, however, suicidal behavior is most commonly regarded and responded to as a psychiatric emergency.
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suicide
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a loss or impairment of voice from disease of larynx or its nerve supply
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aphonia/dysphonia
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defective muscular control of the lips, tongue, palate, or pharynx causing altered speech. Caused by motor lesion in CNS or PNS, parkinsonism, or cerebellar disease
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Dysarthria
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dominant cerebral hemishere problems related to understanding or producing language
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aphasia
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a loss of mental ability severe enough to interfere with normal activities of daily living, lasting more than six months, not present since birth, and not associated with a loss or alteration of consciousness.
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dementia
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To have a diagnosis of panic disorder, you must also have experienced recurrent unexpected panic attacks. These are panic attacks that occur "out of the blue," not triggered by anything in your environment.
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true
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pounding heart or increased heart rate
sweating trembling or shaking feeling as though you are being smothered or having trouble breathing choking chest pain/discomfort nausea or abdominal pains and/or discomfort feeling dizzy, lightheaded, or faint feeling as though things around you are unreal or feeling detached from yourself feeling like you are going to lose control or go crazy fear of dying numbness or tingling in extremities chills or hot flashes |
panic attack symptoms
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Psychotic Disorders
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Schizophrenia
Delusional Disorder Psychotic disorders |
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Mood disorders
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Depression
Manic episodes/ Manic Depression |
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Anxiety Disorders
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Obsessive-Compulsive: obsessions or compulsions that cause anxiety or distress, often time consuming
Acute Stress: often following a traumatic event a person may develop Posttraumatic Stress Disorder Generalized Anxiety: restlessness, easily fatigued, difficulty concentrating, irritability, muscle tension, poor sleep quality or ability |
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Sudden numbness or weakness of the face, arm, or leg (especially on one side of the body)
Sudden confusion, trouble speaking or understanding speech Sudden trouble seeing in one or both eyes Sudden trouble walking, dizziness, loss of balance or coordination Sudden severe headache with no known cause |
Cerebrovascular Accident (Stroke):
The symptoms of stroke are distinct because they happen quickly: |
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Cerebrovascular Accident (Stroke): risk factors
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High blood pressure
Heart disease Smoking Diabetes High cholesterol |
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Headaches: In your history or work up consider the following causes:
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1. Trauma (soft tissue swelling, fracture,etc.)
2. Tumor or space occupying lesion (blood) 3. Infection (virus, bacterial, mold/yeast) 4. Metabolic (diabetes, miasthenia gravis) 5. Inflammation (sinustis, soft tissue swelling) |
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• Location: varied
• Quality: Pressing/tightening pain, mild to moderate intensity • Onset: gradual • Duration: Minutes to days • Exacerbated with prolonged muscle tension, such as driving or typing • Alleviated with massage/manual therapies, relaxation • Sometimes photophobia or phonophobia, no nausea |
Tension Headache
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tension headache
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• Location: varied
• Quality: Pressing/tightening pain, mild to moderate intensity • Onset: gradual • Duration: Minutes to days • Exacerbated with prolonged muscle tension, such as driving or typing • Alleviated with massage/manual therapies, relaxation • Sometimes photophobia or phonophobia, no nausea |
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• Location:Unilateral in about 70%, bifrontal or global in
about 30% • Quality: Throbbing/aching, varied severity • Onset: Often rapid, 1-2 hours • Duration: 4-72 hours • Associated with nausea, vomiting, photophobia, phonophobia, visual auras (flickering zigzagging lines), motor auras affecting hands or arms , sensory auras (numbness or tingling preceeding headache) • Exacerbated by possibly allergic foods, caffeine, ETOH, tension, yeasts, premenstrual timing, bright lights and noise aggravate • Alleviated by quiet, dark room, sleep, pressure on involved artery |
Migraine
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migrain
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• Location:Unilateral in about 70%, bifrontal or global in
about 30% • Quality: Throbbing/aching, varied severity • Onset: Often rapid, 1-2 hours • Duration: 4-72 hours • Associated with nausea, vomiting, photophobia, phonophobia, visual auras (flickering zigzagging lines), motor auras affecting hands or arms , sensory auras (numbness or tingling preceeding headache) • Exacerbated by possibly allergic foods, caffeine, ETOH, tension, yeasts, premenstrual timing, bright lights and noise aggravate • Alleviated by quiet, dark room, sleep, pressure on involved artery |
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• Location: Unilateral, near eye
• Quality: Deep, continuous, severe • Onset: Abrupt, peaks within minutes • Duration: Up to3 Hours • Associated with lacrimation, rhinorrhea, miosis, ptosis, eyelid edema, conjunctival infection • Possibly related to ETOH sensitivity |
cluster headache
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cluster headache
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• Location: Unilateral, near eye
• Quality: Deep, continuous, severe • Onset: Abrupt, peaks within minutes • Duration: Up to3 Hours • Associated with lacrimation, rhinorrhea, miosis, ptosis, eyelid edema, conjunctival infection • Possibly related to ETOH sensitivity |
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• Location: Previous Headache pattern
• Quality, Onset, Duration: Variable and related to previous headache type • Fever, CO, hypoxia, & caffeine withdrawal can all exacerbate this headache type |
Secondary Headaches: Analgesic or withdrawal Rebound
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Secondary Headaches: Analgesic or withdrawal Rebound
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Location: Previous Headache pattern
• Quality, Onset, Duration: Variable and related to previous headache type • Fever, CO, hypoxia, & caffeine withdrawal can all exacerbate this headache type |
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• Pain along distribution of Occipital Nerve
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*Secondary Headaches: Occipital
Neuralgia |
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• Location: Around eye/orbit and possibly occiput
• Q: Steady, aching, dull • Onset: Gradual • Duration: Variable • Exacerbated by Prolonged eye use, esp. close reading • Alleviated by eye rest • Eye may feel sandy, “gritty”, and have redness of the conjunctiva |
*Secondary Headaches: Eye
Disorder Related |
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• Location: Around eye/orbit, unilateral
• Quality: Steady, aching, often severe • Onset: Often rapid • Duration: Variable • Exacerbated by eye dilation often • Associated with diminished vision, nausea, vomiting • Refer for opthalmic eval. |
*Secondary Headaches: Acute
glaucoma |
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• Location: near frontal or maxillary sinus
• Quality: ache or throbbing, variable severity, Rule out migraine • Onset: Variable • Duration: Often several hours, ove over several days or more prolonged • Exacerbated by coughing, sneezing, jarring head • Associated with local tenderness, nasal congestion and discharge, allergic symptoms, fever • Alleviated with analgesics, antibiotics, decongestants, nasal flush |
Secondary Headache: Sinusitis
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• Location: Generalized
• Quality: Steady or throbbing, very severe • Onset: Often rapid • Duration: Variable, often days • Associated with fever, neck stiffness • Refer for spinal tap/CBC |
*Secondary Headache:
Meningitis |
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• Location: Temporal or occipital artery, or other
involved artery, age-related (older) • Quality: Throbbing, generalized, persistent, often severe • Onset: Gradual or rapid • Duration: Variable • Associated with fever, weight loss, scapl tenderness, visual loss, polumyalgia rheumatica • Exacerbated by Mov’t of neck and shoulders |
*Secondary Headache: Giant Cell
(temporal) Arteritis |
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• Location: May be localized to injured area, but sometimes
referred • Quality: Generalized, dull, aching, constant • Onset: 1-2 days post injury • Duration: Weeks, months, even years • Associated with poor concentration, memory alterations, vertigo, irritability (often minor brain injury/concussion) • Exacerbated: with mental exertion, straiing, ETOH, emotional excitement • Alleviated with rest |
*Secondary Headache: Posttraumatic
Headache |
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• Location: Generalized
• Quality: Very severe, “worst of my life”, “like a baseball bat hit my head” • Onset: Often abrupt, severe • Duration: variable, sometimes days • Associated with nausea, vomiting, possible loss of consciousness, neck pain • Refer for immediate CT |
*Secondary Headache: Subdural
or subarachnoid hematoma |
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• Location: trigeminal distribution, most commonly
divisions 2 & 3> 1 • Quality: Shock-like, stabbing, burning, severe • Onset: Abrupt, paroxysmal • Duration: Months • Associated with exhaustion from recurrent pain • TX: Steroid injections, acupuncture, surgery, medication |
*Secondary Headache: trigeminal
Neuralgia |
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Common Causes of Cranial
Nerve Pathology |
• Metabolic: Diabetes, Guillan-Barre
• Trauma: tissue swelling on nerve/nuclei, boney damage to nerve, blood on nerve or nucei, scar • Infection: Viral infection possible in many nerves • Stroke/Infarct/anemia: Altered blood supply to nerve • Congenital damage/defect |
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Worry about an undiagnosed skull fracture
in a patient post skull trauma or skull (cranio-facial) surgery that notes chronic sinus drip. It may be CerebroSpinal Fluid! |
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Movement disorders in the eye can be
muscular or nerve related. Very commonly sudden onset disorders in CN III, IV, or VI may be related to metabolic nerve damage, such as seen in diabetes. They may also relate to stroke, TIA, etc. |
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