Upgrade to remove ads
Principles in Neuro localization
Terms in this set (66)
-Neurological deficits that localize to a single point
-may be motor, sensory or both
Symptoms and signs that present all over the body are referred to as...
Basilar Skull fracture
- Sparing of the tarsal plate areas (Raccoon Eyes)
-often missed on CTs and x- rays because it may take several hour of signs to develop
Head or cord injuries, stroke, demyelinating disease, motor neuron disease, and spasticity may not develop until LATER
Motor neuron, plexus, peripheral nerves, neuromuscular junction, muscle ( w/ LMN signs)
spinal cord lesion
nerve root lesion
The somatosensory homunculus is located in the...
The motor homunculus is located in the...
Area of skin innervated by a particular nerve root's sensory fibers
Muscle groups innervated by a particular nerve root's motor fibers
Anterior and lateral region of the spinal cord, where motor nerve fibers gather together to leave the spinal cord
Posterior and medial region of the spinal cord, where vibratory and proprioception signals are primarily located
Dysfunction of language
Slurred speech (note the difference between dysarthria and aphasia)
Headache, fever, photophobia, and nuchal rigidity are strongly suggestive of...
CT and lumbar puncture. Start ABs STAT
What special test should be performed on a patient with suspected acute infectious meningitis?
A lesion in either the cortex or internal capsule both may result in motor or sensory deficits...
Look for higher cortical function deficits to differentiate. Examine speech, naming objects, naming colors, math or serial counting, neglect or bilateral simultaneous touch recognition, check visual fields.
What would you do to differentiate between cortical and subcortical hemispheric lesions in your neuro exam?
Upper motor neuron
- CNS: brain and spinal cord
-Increased tone, spasticity
-Arms: flexors stronger than extensors; legs: extensors stronger than flexors
Lower motor neuron
-PNS: peripheral nerves
-Muscle fasciculations (small twitches in the muscles)
Both UMNL and LMNL present as...
Links stimulus to response
Corticospinal (motor) tract crosses in the pyramidal decussation, in the...
Lesions below the medulla will cause ___________ motor weakness
Lesions above the medulla will cause ____________ motor weakness
2-3 spinal segments above the entry point into the spine
Spinothalamic (pain and temperature) tract crosses...
Lesions at a given spinal level will cause _______________ pain and temperature sensation loss starting 2-3 dermatomal segments below the level of the lesion
Face and limb symptoms, alteration in consciousness, seizures, trouble creating or understanding language would indicate a lesion in the _____.
1. Contralateral face, arm and leg weakness.
2. Numbness, language deficits and visual field cut
Cortical lesions present with...
Middle Cerebral Artery distribution (anterior division)
A cortical lesion that presents with:
1. contralateral face, arm and arm>>leg weakness and numbness.
2. Language disturbances
3. Visual field cut may be present
4. Gaze preference (looking toward lesion- cannot move eyes away form lesion)
Posterior Cerebral artery division
Visual fiel cut contralateral to the lesion; macular visual area often spared
receptive (cannot understand) or expressive (cannot generate speech)
Aphasia can be
MOTIVATION to speak.
Aphasia is usually associated with the left hemispher but the right hemisphere can affect the....
Difficult or unclear articulation of speech that is otherwise linguistically normal.
A language disorder that affects a person's ability to communicate.
Difficulty in speaking due to a physical disorder of the mouth, tongue, throat, or vocal cords.
A subcortical lesion that presents with:
1. Pure motor hemiplegia contralateral to the lesion
2. Pure hemisensory deficit contralateral to the lesion
A subcortical lesion that presents with:
1. Pure hemisensory deficit contralateral to the lesion
2. May have language disturbance, gaze preference, and other cortical signs very similar to a cortical lesion
Look for cranial nerve deficits and/or face deficits ipsilateral to the lesion and limb deficits contralateral to the lesion; this difference between facial and limb findings is called "crossed" neurological deficits.
A spinal cord injury that results from a lesion to half of the spinal cord causing ipsilateral weakness and increased reflexes with contralateral pain and temp disfunction
"spinal sensory level"
The loss of sensation from one point downward is known as a _______________ and is highly suggestive of a spinal cord injury.
Usually in the cervical or upper thoracic cord. Causes a "cape-like" pattern of weakness and numbness across the upper extremities (because spinothalamic tracts cross near the _________ and are compressed at the affected levels) with increased reflexes, weakness, and spasticity in the lower extremities
Ascending pain, numbness, and weakness found in the PNS
Neuromuscular junction disease that produces worsening double vision, ptosis and weakness with exercise
Neuromuscular junction disease that produces improving weakness with exercise.
Look for weakness without sensory change
Think: bicerebral hemispheres
Presents with lethargy/delirium.
Think: cerebral cortex
Presents with seizures
Think: Thalamus or meidal temporal lobes
Presents with memory problems
Think: contralateral hemisphere
Presents with hemibody sensory/motor issues
Think: Contralateral, posterior to optic chiasm
Presents with visual field problem
Think: LEFT cerebral cortex
Presents with language deficit
Think: RIGHT cerebral cortex
Presents with neglect
Vision, proprioception and vestibular inputs
Posture and gait sensory information includes:
Central gait: corticospinal lesions
Central gait: Inaccurate, variable stepping and irregular timing, cadence and forces----widened base, lurching, halting gait, irregular steps, all accentuated upon initiation, turning or speed changes
Central gait: rigid trunk, less/no armswing, slow, short steps, flexed knees, may be festinant
THIS SET IS OFTEN IN FOLDERS WITH...
Neuro Exam Highlights
Neuro Exam 1 Case Studies
Neuro Exam 4- Sleep
YOU MIGHT ALSO LIKE...
OTA 124 : Neuro Disorders
exam 3 chapter 23
OTHER SETS BY THIS CREATOR