Medical 9-Handouts-Neuro
Terms
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Which lobe contains the motor cortex associated with:
judgement
reasoning
voluntary eye movement
voluntary skeletal movements
fine repetitive motor move-
ments - frontal lobe
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Which lobe is responsible for
processing sensory data as it is received. Assists in the interpretations of tactile sensations (temp.pressure, pain, two point discrimination) as well as visual, taste, olfactory, auditory...recognition of body parts a - parietal lobe
- Which lobe is the primary vision center and provides interpretation of visual data?
- occipital lobe
- Which lobe is responsible for the perception and interpretation of sounds and determination of their source. Also involved with taste, smell, and balance.
- temporal lobe
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Cervical spinal nerves
C1 to C8 - these nerves (eight pairs) supply the back of the head, the neck and shoulders, the arms and hands, and the diaphragm
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Thoracic spinal nerves
T1 to T12 - these nerves (12 pairs) supply the chest, some muscles of the back, and parts of the abdomen
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Lumbar spinal nerves
L1 to L5 - these nerves (five pairs) supply the lower parts of the abdomen and the back, the buttocks, some parts of the external genital organs, and parts of the legs
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Sacral spinal nerves
S1 to S5 - these nerves (five pairs) supply the thighs and lower parts of the legs, the feet, most of the external organs, and the area around the anus
- What are IMMEDIATE symptoms of concussion?
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amnesia
memory loss
difficulty concentrating
headache
sensitivity to light and
dizziness - What are DELAYED symptoms of concussion?
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sleep disturbance
fatigue
depression
fogginess - More than ____ of concussions occur outside of organized sports and many individuals even return to high-risk activities before the it has healed.
- 80%
- The _____ component of treatment of a concussion is to be examination by your physician.
- first
- The _____ component is to avoid activities that could produce a _____ concussion.
-
second
second - _____ is really the only thing a patient can do who's undergone a concussion.
- Rest...nothing can speed recovery up
- A major symptom that may accompany a concussion is?
- hemorrhage...due to severed blood vessels in the brain...look for deterioration of function
- What are 2 types of concussions?
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simple
complex - What is a simple concussion?
- initial symptoms don't last more than a few minutes and will clear in about 24 hours...any physical activity might cause headache, dizziness, foggy thinking
- What is a complex concussion?
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If simple concussion symptoms return, then it's a complex concussion...
extends beyond 15 minutes or where individual experiences a loss of consciousness (however brief)...
takes a minimum of 7 days to clear - Following concussion, the individual should not return to high-risk activity until he or she has been _____ ____
- symptom free for at least one week
- If symptoms of the concussion persist beyond a _____ ____, it means that the brain has not healed itself
- 2 weeks
- Persistent symptoms of concussion are referred to as___ ____ _____...no treatment available
- post concussion syndrome
- What is Bell's Palsy?
- a LMN lesion of CN VII which occurs at or beyond the stylomastoid foramen
- Characteristic indications of a LMN lesion or Bell's Palsy includes the following, on the affected side?
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marked facial asymmetry
atrophy of facial muscles
eyebrow droop
smoothing out of forehead
and nasolabial folds
drooping of the mouth corner
uncontrolled tearing
loss of efferent limb of
conjunctival reflex
(cannot close eye)
lips cannot be held tightly
together or pursed
difficulty keeping food in
mouth while chewing on
the affected side - What causes Bell's palsy?
- not been pinpointed...may be herpes simplex 1 virus
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With Bell's palsy, most doctors assume that some process causes swelling of the 1_____ ____.
Because the facial nerve passes through a narrow, bony area within the _____, any swelling of the nerve causes it to be 3_______ against the skull's hard, -
1 facial nerve
2 skull
3 compressed
4 nerve's - Known causes of facial palsy are?
-
viral infections
shingles
Lyme disease
ear infections
compression of the facial
nerve by a benign tumor
called an acoustic neuroma
multiple sclerosis - Signals for voluntary movement of the facial muscles originate in the 1____ _____ (in association with other coritical areas) and pass via the 2______ in the posterior limb of the internal capsule to the 3____ ____ of CN VII. Fibers pass to both the 4___
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1 motor cortex
2 corticobulbar tract
3 motor nuclei
4 ipsilateral - Define spastic hemiparesis?
- the affected leg is stiff and extended with plantar flexion of the foot; movement of the foot results from pelvic tilting upward on the involved side...the foot is dragged, often scraping the toe, or it is circled stiffly outward and forward (circumduction); the affected arm remains flexed and adducted and does not swing
- Define spastic diplegia (scissoring)?
- the patient uses short steps, dragging the ball of the foot across the floor; the legs are extended, and the thighs tend to cross forward on each other at each step, due to injury to the pyramidal system
- Define steppage?
- the hip and knee are elevated excessively high to left the plantar flexed foot off the ground; the foot is brought down to the floor with a slap; the patient is uanble to walk on the heels
- Define dystrophic (waddling)?
- the legs are kept apart, and weight is shifted from side to side in a waddling motion due to weak hip abductor muscles; the abdomen often protrudes, and lordosis is common
- Define tabetic?
- the legs are positioned far appart, lifted high and forcibly brought down with each step the heel stamps on the ground
- Define cerebellar gait (cerebellar ataxia)?
- the patient's feet are wide-based; staggering and lurching from side to side are often accompanied by swaying of the trunk
- Define sensory ataxia?
- the patient's gait is wide-based; the feet are thrown forward and outward, bringing them down first on heels, then on toes; the patient watches the ground to guide or her steps; a positive Romberg sign is present
- Define Parkinsonian gait?
- the patient's posture is stooped and the body is held rigid; steps are short and shuffling, with hesitation on starting and difficulty stopping
- Define dystonia?
- jerky dancing movements appear nondirectional
- Define ataxia?
- uncontrolled falling occurs
- Define antalgic limp?
- the patient limits the time of weight bearing on the affected leg to limit pain
- Upper abdominal superficial reflex
- T7, T8, and T9
- Lower abdominal superficial reflex
- T10 and T11
- Cremasteric superficial reflex
- T12, L1, and L2
- Plantar superficial reflex
- L4, L5, S1, and S2
- Biceps deep tendon reflex
- C5 and C6
- Brachioradial deep tendon reflex
- C5 and C6
- Triceps deep tendon reflex
- C6, C7, and C8
- Patellar deep tendon reflex
- L2, L3, and L4
- Achilles deep tendon reflex
- S1 and S2
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Scoring Deep Tendon Reflexes
0
1
1+
2+
3+
4+ -
0 no response
1+ sluggish or diminished
2+ active or expected respons
3+ more brisk than expected,
slightly hyperactive
4+ brisk, hyperactive, with
intermittent or
transient clonus -
Characteristics of upper
motor neuron? -
muscle spasticity, possible
contractures
little or no muscle atrophy,
but decreased strength
hyperactive deep tendon and
abdominal reflexes;
absent plantar reflex
no fasiculations
damage above level of brain-
stem will affect opposite
side of body
paralysis of lower part of
face, if involved - Characteristics of lower motor neuron?
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muscle flaccidity
loss of muscle tone and
strength; muscle atrophy
weak or absent deep tendon,
plantar, and abdominal
reflexes
fasciculations
changes in muscles supplied
by that nerve, usually a
muscle on the same side as
the lesion
Bell palsy, if face involved;
coordination unimpaired