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Bates CH 17 Neuro
Bates CH 17 Neuro
31 pairs
8 cervical
12 thoracic
5 lumbar
5 sacral
Base of brain; coordinates all movement, 1 coccygeal
helps maintain
18. Peripheral CNS & peripheral nerves. project to heart,
body upright in space
nervous visceral organs, skin, & limbs
14. Lumbar L3-L4 or L4-L5 vertebral interspaces to system
puncture avoid spinal cord injuries (PNS)
15. Cauda equina. 19. Pheripheral
nerves
includes
37. Damage lower ipsilateral weakness & paralysis BUT 52. Triceps reflex Cervical 6,7
motor neuron muscle tone and reflexes decreased or 53. Abdominal lower Thoracic 8,9,10
absent reflex
38. Sensory pathways reflex activity, conscious sensation, 54. Abdominal upper Thoacic 10,11,12
locate body position in space, help reflex
regulate autonomic functions (ie: BP, HR,
55. Plantar response Lumbar 5, Sacral 1
respirations)
56. Anal reflex Sacral 2,3,4
39. Sensory relay impulses from skin, mucous
receptors membranes, muscle, tendons, viscera, 57. Common/concerning HA
through pheripheral projections to symptoms Dizziness/vertigo
posterior root ganglion where 2nd Weakness (generalize, proximal,
ganglia directs impulses to into spinal distal)
cord ->brain Numbness, abnormal or absent
sensation
40. Sensory impulses Travel to sensory cortex via 2 pathways:
Fainting or blacking out (near
1. spinothalamic tract: smaller sensory
syncope & syncope)
neurons w/ unmyelinated or thinly
Seizures
myelinated axons
Tremors or involuntary movements
2. posterior columns: larger neurons w/ 58. Primary HA migrane, cluster, and trigeminal,
heavily myelinated axons autonomic cephalagias
41. Spinothalamic arises in free endings in skin: pain, 59. Secondary HA structural, systemic or infectious (life
tract temperature, crude touch threatening)
42. Posterior column per 60. HA warning signs -sudden onset like "thunderclap" or
tract "worst HA of my life"
-new onset after 50 y/o
43. Small fiber DM patients
-associated papilledema, neck
neuropathy
stiffness, or focal neurologic deficits
reports sharp, burning, or shooting foot
-Precipitated by valsalva maneuver
pain.
or exertion
44. Large-fiber DM patients numbness and tingling or -recent head trauma
neuropathy no sensation at all. -change in patter from past HA
45. Lesions in sensory impairs finer discrimination -Lack of a similar HA in the past
cortex -Lack of similar HA in the past
ie: cannot appreciate size shape, texture. 61. episodic and tend to Migrane and tension
46. Disease posterior Position & Vibratory sense loss w/ peak over several
column preservation of other sensation. hours.
143. Loss of smell CNI (Sensory); Sinus conditions, head 162. Bilateral weakness in CN V Bilateral hemispheric disease
occurs in? CN? trauma, smoking, aging, use of cocaine, 163. CNS stroke patterns Ipsilateral facial & body
Parkinson's disease sensory loss d/t contralateral
144. Visual Acuity & CN II; (sensory) cortical or thalamic lesions
optic fundi checks 164. Brainstem lesions Ipsilateral face but
which CN? contralateral body sensory
145. Blurred margins in Papilledema loss
vision check 165. Isolated sensory loss pheripheral nerve disorders,
means lesion in trigeminal nerve (V)
146. Pallor during optic atrophy 166. acoustic neuroma Blinking absent &
vision check sensorineural hearing loss
147. cup enlargement Glaucoma 167. flattening of nasolabial fold facial weakness, CNVII
in vision check and drooping lower lid
148. Bitemporal defect in optic chiasm, pituitary tumor
hemianopsias
149. Poor visual acuity Optic neuritis
168. Bell's palsy affects both upper & lower face, taste 187. muscle hypotonia PNS dx
loss, hyeracusis (increased sensitivity or flaccidity
to certain frequency and volume
188. velocity Corticospinal tract dx
range of sound), increased/decreased
dependen
tearing
increased tone
169. Central lesion affects lower face only worsens @
extreme range
170. Whispered test CNIII,
which CN 189. Velocity Spasticity, seen in corticospinal tract
dependent diseases
171. Conductive hearing excess cerumen, otosclerosis, otitis
increased tone
loss media
worsens at the
172. Sensorineural aging extremes of
hearing loss range. Rate
173. Vertigo w/ hearing Meniere dx dependent,
loss & nystagmus increasing with
rapid movement
174. Uvula does not rise Lesion CN X.
when the patient 190. Increased with Rigidity
says "AH" resistance,
throughout ROM
175. Palate side fails to Unilateral paralysis
and in both
rise & is pulled
directions, it is
toward normal side
not rate-
176. difficulty Pharyngeal or palatal weakness. dependent
swallowing
191. Absent strength Paralysis or plegia
177. Unilateral absence Lesion CN IX and X
192. 1/2 of the body Hemiparesis
of gag reflex
paralysis
178. Trapezius weakness CN XI; Pheripheral nerve disorder
193. Impaired strength Paresis
with atrophy and
or weakness
fasciculations
194. legs paralysis Paraplegia
179. Shoulder droops, Trapezius paralysis
scapula displaced 195. Quadriplegia All 4 limb paralysis
down & laterally 196. Muscle strongest When shortest
180. Bilateral weakness CN XII; pt unable to raise head off 197. Muscle weakest when longest
SCM muscle pillow
198. grade muscular
181. Tongue atrophy ALS, past polio response
and fasciculation s
182. protruded tongue Unilateral cortical lesion
deviates away form
the side of the
cortical lesion
183. Tongue deviates to CN XII lesion
weak side
184. Pseudohypertrophy Increased bulk w/diminished strength.
ie: Duchenne form of muscular 199. peripheral radial Wrist extensor weakness
dystrophy nerve damage &
hemiplegia of
185. Mild atrophy d/t corticospinal tract injury stroke or MS
muscle disuse seen
in
186. Fasciculations with Peripheral motor neuron disease
atrophy and muscle
weakness
200. Cervical radiculopathy, de Quervain Weak hand grip 212. unable to stand Cerebellar ataxia
tenosynovitis, carpal tunnel with feet together
syndrome, arthritis, epicondylitis eyes open/closed
201. Weak finger abduction ulnar nerve 213. Pain and spinothalamic tractsp
disorders temperature
202. Hip symmetric weakness of myopathy. 214. position and posterior column
proximal muscles vibrations
203. Symmetric weakness distal polyneuropathy & 215. light touch both pathways
weakness PN disorders
216. Decerebrate Neck: extended
204. nystagmus, dysarthria, hypotonia, Cerebellar dx Arms: adducted
ataxia w muscle Forearms: pronated
coordination. wrist and fingers: flexed
205. Rapid alternating movements = dysdiadochokinensis
Lesions on diencephalon, midbrain or
movements slow, irregular, clumsy = cerebellar dx
pons. Hypoxia, hypoglycemia
Upper motor neuron 217. Decorticated: Upper arms: flexed tight to sides,
weakness & basal elbows, wrist, and fingers flexed
ganglia dx also
impair these destructive lesion of corticospinal
movements but not tracts within or near cerebral
same manner hemispheres.
206. Point-to-point movements: clumsy, cerebellar dx 218. small pinpoint 1-2.5cm damage to sympathetic
unsteady, inappropriately speed, pupils pathways in hypothalamus, metabolic
force, directions variable encephalopahty, including drugs
219. Midposition fixed 5-6cm: fixed to light: structural
Incoordination worsens moderately
pupils damage to midbrain
w eyes closed = loss of position
sense. Consistent deviation to 1 side 220. Large pupils severe anoxia, sympathomimetic
worsens w eyes closed = past effects (seen after cardiac arrest)
pointing = cerebellar or vestibular atropine like agent, phenothiazides,
dx tricyclic,