MASTER NEURO SECTION

pain and temperature sensation is carried by what

small unmyelinated fibers

vibration and proprioception is carried by

large myelinated fibers

What tract is responsible for pain and temperature sensation?

Lateral spinothalamic tract

what tract is responsible for vibration and proprioception?

DCML

what tract is responsible for crude touch

anterior spinothalamic tract

what is peripheral neuropathy

loss or altered sensation at the end of nerves and goes proximally

what does CN 3 responsible for?

eyes up

eyes down

eyes in

eyes up and in

what would happen if CN 3 is affected?

dilation of the pupils

cn 4 helps the eye move

down and in

what cn would be affected if a patient was experiencing hearing loss

cn 8

if bc is better than ac, it would be what type of hearing loss

conductive

if ac is better than bc, it would be what type of hearing loss

sensorineural

if conductive hearing loss, the weber test would be louder

on affected side

if sensorineural hearing loss, the weber test would be louder

on normal side

cn 5 provides

sensation to the face and anterior 2/3 of the tongue

cn 7 provides

taste to the anterior 2/3 tongue

what cn would be involved in the corneal reflex

cn 5 and 7

what provides sensory in corneal reflex

cn 5

what provides motor in the corneal reflex

cn 7

what provides sensation and taste to the posterior tongue

cn 9

The uvula will deviate to the

strong side

The tongue will deviate toward the

weak side

what cn supplies the tongue

cn 12

ankle strategy activates muscles in what direction

distal to proximal

hip strategy activates muscle in what direction

proximal to distal

if a patient is using ankle strategy with a forward sway, what muscles will activate

paraspinals, hamstrings, gastroc

if a patient is using ankle strategy with a backward sway, what muscles will activate

abdominals, quads, tib ant

if a patient is using hip strategy with a forward sway, what muscles will activate

abdominals, quadriceps

if a patient is using hip strategy with a backwards sway, what muscles will activate

paraspinals, hamstrings

in the CTSIB, what would be unstable with a somatosensory dependency

4,5,6

in the CTSIB, what would be unstable with a visial dependency

2,3,5,6

in the CTSIB, what would be unstable with a vestibular dependency

5,6

if the sensation is compromised/removed from the patient, what does it mean?

the patient is dependent on it

if the sensation has been given to the patient and the patient still sways with it, what does it mean?

the sensation is impaired

what hemisphere is called the dominant hemisphere?

left hemisphere

what is the acronym for hearing loss

CANS (conductive affected ear, sensorineural normal ear)

what is parkinson's disease

progressive neurodegenerative disorder due to loss of neurons in the substantia nigra

what are the cardinal signs of parkinson's?

resting tremor, rigidity, akinesia, postural instability

what is dyskinesia

involuntary, repetitive, smooth, muscle movements

what is dystonia

prolonged, involuntary muscle contractions

what is multiple sclerosis

an autoimmune disease that is a demyelinating disease of the CNS; it disrupts their ability to send signals to the rest of the body

what are some s/s of multiple sclerosis?

spasticity, numbness and paresthesia, extensor spasticity in LE, ataxia, scissoring, dysphagia, FATIGUE

what are unique s/s of MS?

Lhermitte's sign, uhthoff's phenomenon, charcot's triad

What is relapse-remitting MS?

short duration attacks with full or partial recovery

what is primary progressive MS?

steady increase in disability without attacks

what is secondary progressive MS?

initial relapsing-remitting MS that suddenly begins to have decline without periods of remission

What is clinically isolated syndrome MS?

1st episode of inflammatory demyelination in CNS --> can become MS is progressed

what are the interventions of MS?

don't overfatigue, manage overheating, exercise in the morning

what is amyotrophic lateral sclerosis?

Progressive, degenerative disease with loss of upper and lower motor neurons

what are s/s of ALS?

UMN + LMN presentation without sensory loss

• muscle atrophy, fasciculations, spasticity, hyperreflexia

Only motor neurons will be affected, and sensation is preserved

what leads to death with ALS

respiratory muscle weakness

what to add to a patient with festinating gait

add a toe wedge or declining heel to move COM posterior

what is guillain barre syndrome

An autoimmune disease in which the peripheral nerves become inflammed. Results in numbness and paralysis in the legs, upper body, and face. Level of independence depends on extent of paralysis.

what are s/s of GBS?

motor loss distal to proximal

glove and stocking sensory loss

decreased reflexes

fatigue

what is the key muscle group for segmental level C5?

elbow flexors

is conus medullaris bilareral or unilateral symptoms?

bilateral

is cauda equina bilareral or unilateral symptoms?

unilateral

what spinal cord level can use a standard wheelchair

C7

what spinal cord level can transfer independently

C7

what orthotic is needed at SC level L2

HKAFO

What orthotic is needed at SC level L3

KAFO

what is the rule for picking an orthotic

asia level D+ or higher can go down a level for orthotic

what level is appropriate for stand pivot

L2/3 and below

What SC level is appropriate for glossopharengeal breathing

C3/4

what levels are the abdominals originated

T7-T12

what direction do you facilitate an assisted cough

down and up to ascend up. hands on the epigastric area.

what are the key symptoms of autonomic dysreflexia

bradycardia + hypertension

what is the steps of action for a patient with autonomic dysreflexia

1- sit pt up and lower legs

2- remove painful stimuli

what is spinal shock

It is a common occurrence in spinal cord injury in which the spinal cord swells above and below the level in injury; symptoms all decrease and pt will recover slowly.

what is neurogenic shock

Caused by spinal cord injury, usually from absense of sympathetic nervous system; short lasting

what are key muscles needed for transfers

-lats

-pec major

-rotator cuff

-serratus anterior

-triceps

what levels would have a spastic bladder

seen in patients with injury above S2 sacral segments

what levels would have a flaccid bladder

seen in patients with injury below S2 sacral segments

which is lighter and easier to carry: a folding or rigid frame

rigid frame is generally lighter

what are common deficits in spina bifida

abnormal tone, hydrocephalus, meningitis, foot deformity, arnold chiari malformation

what is arnold chiari malformation

herniation of brain tissue into spinal canal

what is tethered spinal cord

spasticity in muscles with sacral nerve roots, increased tone in legs, increase in lumbar lordosis, back or butt pain, change in urologic function, change in gait pattern

what gait do patients experience with cerebral palsy?

scissor gait or spastic gait

what is athetoid/dyskinetic cerebral palsy

involves damage to the basal nuclei ganglion, continuous involuntary writhing movements, often associated with hyperbilirubinemia

anything SCI C5 or above will use what

a power wheelchair with a controller to steer

What symptoms does levadopa dramatically improve

bradykinesia and rigidity in patients with parkinson's

what is an effective strategy to improve kinesthetic awareness

ambulating in front of a mirror

a patient who experiences a stroke involving the left MCA would experience what signs and symptoms

apraxia, aphasia, right hemiparesis

what is the motor innervation at spinal cord level C6

wrist extensors

what is the most common signs and symptoms of a L sided MCA stroke

aphasia, homonymous hemianopsia, motor hemiphegia, neglect and/or apraxia

what are examples of inhibitory sensory stimulation techniques

prolonged stretch, deep pressure and warmth

what are examples of facilitatory techniques

quick stretch, tapping, and approximation