Term
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Definition
| inability to think with usual speed and clarity - attention span & trouble remembering(memory), decreased speed of thought and thoughts less clear |
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Term
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Definition
| Drowsy, falls asleep – but rouses & responds – it’s confusion plus sluggishness, don’t say if someone is just tired, someone reading the chart will think very sick, pt may fall asleep when talking to you |
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Term
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Definition
| Disordered perception, attention , anxiety, inappropriate reaction-temporary state, goes away, temporary, altered perceptions, hallucinations, confused, lethartgic and may have hallucinations |
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Term
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Definition
| Aroused by rigorous repeated painful stimuli, only simple motor activity, moaning, pt will only rouse in response to pain |
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Term
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Definition
| unresponsive even with painful stimuli-state of unconsciousnes |
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Term
| Decorticate means there is abnormal ___ and the lesion is above the ____. |
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Definition
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Term
| Decerebrate is abnormal ___ meaning the lesion is in the ____, this is worse than decorticate, it is a deeper coma, brain just trying to keep most basic function alive. |
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Definition
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Term
| The Glasgow Coma scale is a ___ test of consciousness. It looks at ___, ___, and ___ responses. There are versions for adults, children, and infants. |
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Definition
- quantitative
- eye, verbal, and motor responses |
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Term
| what are the max and min scores on the glasgow coma scale? |
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Definition
- max 15, each category gets a max of 5
- min 3, each category gets a min of 1 |
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Term
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Definition
(corticospinal tract above brainstem)
Unilateral brain damage
Paralysis with flaccidity early on, then spasticity= tightness
No spontaneous movement |
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Term
| decorticate is damage to the ___ tract. Explain. |
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Definition
- corticospinal tract
Abnormal flexor response- arms curled up
Arms tight to sides, with flexion of elbows, wrist, fingers
Extended legs |
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Term
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Definition
(damage to brainstem)-worst, may need respirator
Abnormal extensor response
Arms and legs extended
Jaws clenched
May have back rigidly arched |
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Term
| With decorticate the corticospinal tract is damaged. The ___ spinal tract gets disinhibited, so motor neurons in the cervical cord supplying the flexor muscles of upper extremities are overly active. The __ ___ tract gets disrupted so the flexors of lower extremity are not supplied so the legs are extended. |
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Definition
- rubrospinal
- lateral corticospinal |
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Term
| The corticospinal tract is concerned specifically with discrete voluntary skilled movements, especially of the distal parts of the limbs. As a lesion that results in hemiplegia occurs in the brain or spinal cord, hemiplegic muscles display features of the Upper Motor Neuron Syndrome. Features other than weakness include decreased movement control, clonus (a series of involuntary rapid muscle contractions), spasticity, exaggerated deep tendon reflexes and decreased endurance. |
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Definition
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Term
| If corticospinal tract is damaged above the brainstem, then the ___ side will be damaged. If the corticospinal tract is damaged below the brainsttem then the damage will be on the ___ side. |
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Definition
- contralateral
- ipsilateral |
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Term
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Definition
Sudden onset of acute confusional state with disordered perceptions
Sundowning |
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Term
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Definition
Clinical syndrome of failing memory,
intelligence, behavioral abnormalities
- also can exhibit sundowning |
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Term
| delirium is acute onset. dementia happens over a period of time |
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Definition
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Term
| for remote memory what should you ask patient? |
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Definition
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Term
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Definition
| difficulty speaking, lack of facial sensation, trouble moving tongue |
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Term
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Definition
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Term
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Definition
| - describe something simple with lots of words |
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Term
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Definition
- can understand written and spoken language
- cannot physically speak
- motor problem |
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Term
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Definition
- aka receptive aphasia
- can't understand and can't make sense of written or oral language
- can physically speak but it won't make sense |
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Term
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Definition
| broca's + wernicke's aphasia |
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Term
| Folstein's mini mental status exam: |
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Definition
Orientation (10 points)
What is the; year, season, date, day, month?
Where are we; state, county, town, clinic, floor?
Registration (3 points)
Name 3 objects
Attention & Calculation (5 points)
Serial 7’s
OR
WORLD backwards
Recall (3 points)
Repeat 3 previously named objects after 10 minutes
Language (9 points)
Identify 2 objects
Repeat “no ifs, ands or buts”
Follow 3 stage command
Read and obey written command
Write a sentence
Copy intersecting pentagons |
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Term
| what is max score on Folstein's mini mental exam? |
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Definition
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Term
| cognitive impairment test may help detect ___ ___ earlier. The maximum score is a ___. Is a lower or higher score better? |
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Definition
- mild dementia
- 28
- lower score is better |
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Term
| what test may help diagnose early dementia? |
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Definition
| - cognitive impairement test |
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Term
| what test is least sensitive and specific to dementia? |
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Definition
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Term
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Definition
Easiest of the 3 to administer
Least sensitive & specific for dementia
“FACT”
Patient names 5 fruits, animals, colors, towns |
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Term
| confrontation tests what CN? |
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Definition
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Term
| lesion to CN III oculomotor? |
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Definition
- ptosis
- downward and lateral gaze
- mydriasis (pupil dilation)
- double vision
- accomodation diffiuclties due to ciliary paralysis |
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Term
| trochlear nerve innervates the ___ __ _muscle which moves the eye __ and ___. |
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Definition
- superior oblique
- down and out |
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Term
| what nerve innervates lateral rectus? |
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Definition
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Term
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Definition
if looking at something in distance, pupils will dilate
- then if look at something close up, the pupils will constrict and lens changes shape |
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Term
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Definition
| extracolar muscles in tact |
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Term
| Weber tests for conductive hearing loss. |
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Definition
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Term
| with Rinne's test a positive test is ___. |
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Definition
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Term
| If air conductance is not longer than bone conductance with Rinne's test then there is ____ hearing loss meaning there is ___ damage in the ___ ear. |
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Definition
- sensoryneural
- nerve
- ipsilateral |
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Term
| which cranial nerve is responsible for sour and bitter tastes? |
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Definition
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Term
| tests for glossopharyngeal nerve? |
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Definition
- gag
- swallow
- sour/bitter taste |
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Term
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Definition
- gag
- swallow
- uvula deviation to opposite side of lesion
- palate symmetry |
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Term
| past pointing is a symptom of ____ ___. |
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Definition
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Term
| Romberg, rapid alternating movements, and fine motor skills all test for ___ lesions. |
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Definition
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Term
| walking on tip toes tests? |
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Definition
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Term
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Definition
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Term
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Definition
| lack of coordinated muscle movements |
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Term
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Definition
- wide base
- staggering and lurching side to side with swaying of trunk |
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Term
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Definition
- wide base
- feet thrown foward and outward, high stepping gait, often slap foot down |
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Term
| If patient is ataxic, do Rhomberg test. If rhomberg is positive you have ____ ataxia. If Rhomberg is negative you have ___ ataxia. |
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Definition
- ataxic with positive rhomberg= sensory ataxia
- ataxic with negative rhomber= cerebellar ataxia |
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Term
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Definition
| Jerking, dancing movements that appear nondirectional |
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Term
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Definition
Affected leg stiff & difficult to move – extended w/ plantar flexion of foot
Foot moved by tilting pelvis & dragging/circling outward & forward |
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Term
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Definition
| Slapping gait of affected foot due to weakness of dorsiflexors of the foot |
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Term
| what tests for LMN lesion? |
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Definition
Superficial (light) touch
Superficial pain (sharp/dull)
Temperature and deep pressure
Vibratory
Position in space |
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Term
| dorsal column controls proprioception and 2 point discrimination |
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Definition
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Term
| spinothalamic tracts control light touch, pressure, pain, and temperature |
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Definition
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Term
| dorsolateral column comtrols vibratory sense |
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Definition
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Term
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Definition
Supraclavicular: cervical plexus (C4)
Axillary: posterior deltoid (C6)
Radial: back of 2/3 of arm, forearm, hand and of 1st-3rd fingers, proximal portion (C7)
Median: thenar eminence, tips of 1st thru 3 to 4th fingers (C6)
Ulnar: hypothenar eminence, 5th finger, ½ of 4th, back of 5th finger (C8)
Saphenous: medial thigh & lower leg to arch of foot (L2, 3)
Sural: gastrocnemius, posterolateral aspect of ankle and posterolateral foot (S1, S2)
Superficial peroneal: lateral leg (L5)
Deep Peroneal: anterior leg to top of foot (L4,5) |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
|
Definition
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Term
|
Definition
|
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Term
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Definition
|
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Term
| scoring of deep tendon reflexes: |
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Definition
0 : no response
1+ : sluggish or diminished
2+ : active or expected response
3+ : more brisk than expected, slightly hyperactive
4+ : brisk, hyperactive, with intermittent clonus |
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Term
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Definition
| - associated with meningitis or intracranial hemorrhage |
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Term
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Definition
| patient supine> flex neck> positive sign if patient flexes at hip or knee |
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Term
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Definition
| patient supine> flex leg at knee and hip> attempt to straightn LE> positive if resistance to straightening |
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Term
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Definition
Palmar
Sucking
Rooting
Plantar
Moro
Placing
Stepping
Fencing or asymmetric tonic neck |
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Term
| Palmar reflex and when it disappears? |
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Definition
- touch palm and baby's hand curls around object
- disappears around 6 months |
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Term
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Definition
touch lips and patient starts sucking
- disappears around 4 months |
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Term
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Definition
touch corner of mouth and baby will turn that way
- disappears around 4 months |
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Term
| Babinski sign, when does it disappear? |
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Definition
|
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Term
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Definition
- startle reflex
- drop head and upper body and arms reach out
- disappears at 3 months |
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Term
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Definition
place feet on hard surface and baby will move feet like walking
- disappears around 6 weeks |
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Term
| fencing aka asymmetric tonic neck reflex: |
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Definition
lay baby flat and turn head one way
- ipsilateral arm and leg will extend
- contralateral arm and leg will flex
- occurs from 2-6 months |
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