Neuro Lect 2

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  1. Red flag symptoms you absolutely can't miss!
    • "worst headache of my life" (thunderclap)
    • sudden blindness
    • back pain worse at night
    • bowel/bladder incontinence
    • suicidal ideation with plan
  2. What neurologic structure is affected with coma (decreased level of consciousness)?
  3. What neurologic structure is affected with disorientation (lack of orientation to time and place)?
    temporal lobe
  4. What neurologic structure is affected with amnesia (memory loss)?
    temporal lobe
  5. What neurologic structure is affected with aphasia (speech problems)?
    • frontal lobe
    • temporoparietal lobe
  6. What neurologic structure is affected with inappropriate affect (inappropriate emotional display)?
    bilateral cerebral damage
  7. What neurologic structure is affected with agnosia (inability to recognize objects)?
    nondominant parietal lobe
  8. What neurologic structure is affected with apraxia (inability to follow orders)?
    frontal lobe
  9. What are the different levels of consciousness and how are they described?
    • alert: awake and talking
    • lethargic: pts are drowsy but open eyes to look at you, respond to questions then fall asleep
    • obtunded: pts open eyes and look at you but respond slowly and are somewhat confused
    • stuporous: pts aroused with painful stimuli
    • coma: no response to painful stimuli (non localizing)
  10. Very important abnormal behavior pattern that often indicates an acute medical problem.
  11. What score on the Folstein mini mental status exam suggests a cognitive disorder?
  12. Patient can form words without difficulty but there are errors in content. Patient is unaware that responses are nonsense. Due to a lesion in the temporal/parietal lobe language area.
    Wernicke's aphasia (receptive aphasia)
  13. Patient is unable to form or find words (unable to produce words). Patient is aware of the deficit. Due to a lesion in the anterior speech area.
    Broca's aphasia (expressive aphasia)
  14. What is the possible pathologic cause of stock/glove sensory loss?
    peripheral neuropathy
  15. What is the possible pathology for sensory loss ascending from the feet to the trunk?
    spinal cord lesion
  16. What is the possible pathology for loss of pain and temperature sensation on one side and loss of joint position on the other side?
    hemi-cord syndrome
  17. What is the possible pathology for "cape" distribution of pain and temperature loss?
    central cord lesion (syringomyelia)
  18. What is the possible pathology for sensory loss on the right face and left side of the body?
    right lateral medullary syndrome
  19. What is the possible pathology for sensory loss along a strict horizontal level to pain both anteriorly and posteriorly?
    likely non-organic
  20. A tendency for one arm to pronate and drift downwards during the pronator drift test is suggestive of what?
    UMN lesion on that side
  21. Clinical term for inability to perform rapidly alternating movements that is usually caused by MS in adults and cerebellar tumors in children.
  22. What two findings on exam strongly point to a structural lesion in an unconscious patient?
    • consistent symmetry between right and left sided responses
    • abnormal reflexes that point to specific areas within the brainstem
  23. What are the two main maneuvers used to produce a noxious stimulus in a comatose patient?
    • press very hard with thumb under the bony superior roof of the orbital cavity
    • press pen hard on one of the pt's fingernails
  24. Changes int he texture of skin, edema, venous prominence, callus formation, loss of nails and sweating abnormalities of the feet are manifestations of what issue?
    peripheral autonomic nerve dysfunction
  25. What are the indications for performing a lumbar puncture?
    • infection (meningitis, encephalitis)
    • SAH
    • dementia
    • malignancy
    • MS
    • ICP
  26. What are the contraindications for a lumbar puncture?
    • suspected intracranial mass lesion/elevated ICP (risks herniate, examine for papilledema, get head CT before LP)
    • infection at site of puncture
    • coagulopathy
    • lack of pt cooperation
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Neuro Lect 2
neuro lect 2
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