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Neuro - Neuro exam 1&2

Terms in this set (19)

Lesions of sudden onset
dz of cerebrovascl. ex. stroke
slowly progressive focal lesions
expanding mass lesions ex. tumore, abcess
lesions w/ exacerbating and remitting courses
demyelination ex. MS
Relentlessly progressive lesions involving all areas of nervous system
degenerative disorder of nervous system ex. Alzheimer's
Aspects of mental status assessed
1. orientation
2. memory
3. attention
4. math
5. construction
6. abstraction
7. information
Patients who perform badly on mental status exam fit into which 2 categories?
Dementia - slowly progressive intellectual decline
Encephalopathy - refers to an acute or subacute change in patient's mental state. i.e. delirium. patient usually gets better after a few hours. key word = metabolic disturbance, broca not hurt
What is significant in language and speech?
We need to always rule our dysarthria & aphasia.

Dyasarthria = speech disorder, slurred speech, which can be caused by a ton of neuro or non-neuro causes. ex. medications or intoxication

Aphasia = language abnormality
What are 2 types of aphasia?
Expressive aphasia/motor/Broca's - usually seen following a lesion involving percentral gyrus, inferior frontal lobe, mainly in left hemisphere for right handed and most lefty's. Patent has difficulty producing language, but can still understand.

Receptive aphasia/sensory/Wernicke's - involves lesion of supramarginal & angular gyri in parietal lobe as well as posterior superior temporal lobe, mainly in left hemisphere for right handed and most lefty's.
Lession in both WEnicke's and Broca's area results in:
global aphasia, pateint canot understand or speak, can be due to MCA stroke
What is conduction aphasia? Step
results in lesion in arcuate fasciulus which connects both areas. Patients can understand & speak. Key words = patient is having trouble repeating back a sentence
An ACA-MCA watershed infarct does what?
transcortical motor aphasia - destroys connections between Broca's area and the rest of the frontal lobe that is needed for Broca to fxn properly. key words = looks like Broca, but with preserved repetition.
What does an MCA-PCA watershed infarct look like?
transcoritcal sensory aphasia - this disconnects Wernicke's area from parietal and temporal areas. Looks like Wernicke's, but w/ preserved repetition. key word= patient becomes agitated...
When should smell be evaluated??
- after head trauma b/c olfactory nerve may have been sheared off as it penetrates cribriform plate
- meningiomas can cause loss of smell by invading cribirom plate

* most common cause for loss of smell = non-neurologic, due to inflammation of nasal mucosa during an upper resp. infection.
3 components of optic n. evaluated:
- visual acuity
- visual fields
- opthalmoscopic exam
The only lesion that affects visual acuity:
anything anterior to the optic chiasm
lesion in the temporal lobe that affects vision affects what?
Part of optic radiations called Meyer's loop, lesion results in contralateral superior homonymous hemianopsia key word = common visual field deficit
lesion in retina or optic n
ipsilateral visual loss w/ decreased visual acuity
lesion at optic chiasm
bitemperal hemianopsia
lesion posterior to optic chiasm
contralateral homonymous hemianopsia
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