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Neurology


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In order to test sensitivity of these divisions, you can use your finger, or an orange pin (medical clinic supply type). Name these areas (image).
In order to test sensitivity of these divisions, you can use your finger, or an orange pin (medical clinic supply type). Name these areas (image).
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Opthalmic, Maxillary, Mandible

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True or false: Fifth-nerve palsies are very common in isolation.
False. They are typically rare in isolation.
Describe the "Jaw jerk" test
Put your forefinger gently on the patient’s loosely opened jaw. Tap your finger gently with a tendon hammer. Explain the test to the patient or relaxation of his jaw will be impossible. Normally, the jaw will not jerk much, unless there is a lesion.
What is this image showing a weakness in (what muscle)?
Weak right pterygoid. Deviates towards the weak side.
What would someone's face look like if they had a Lower motor neuron lesion?
One half or one quadrant of their face would droop, due to muscle palsy.
What would someone's face look like if they had an Upper motor neuron lesion?
This would cause one lower quadrant (on the effected side) to droop. It's important to note that UPPER motor neuron lesions affect ONLY the LOWER face. This is because the part of the facial nucleus controlling the upper half of the face is bilaterally innervated.
The Rinne Test is a test that uses bone conduction to test your hearing. What hearing apparatus is this mainly checking?
This test is checking the quality of hearing via the tiny hair follicles in our cochlea, that are part of our hearing apparatus. By comparing the two placements of the tuning fork, the practitioner can tell where the problem lies (drum or hairs).
This test asks you to look for nystagmus. What is the meaning of "nystagmus"?
Nystagmus is a vision condition in which the eyes make repetitive, uncontrolled movements.
Patients with IX Glossopharyngeal and X Vagus issues might have trouble with nerves relating to their mouths and many areas in the neck. You might get positive test results for dysarthria and dysphonia. What are dysarthria and dysphonia?
Dysarthria is a motor speech disorder in which the muscles that are used to produce speech are damaged, paralyzed, or weakened. Dysphonia refers to having an abnormal voice. It is also known as hoarseness. The voice can be described as hoarse, rough, raspy, strained, weak, breathy, or gravely (damage from cigarettes can cause this sound as well).
What are the 5 parts of a muscle examination
Tone Reflexes Power (Strength) Coordination Palpation/Inspection
When we palpate a muscle in an examination, what's something SPECIFIC we're looking for?
Examine specifically for wasting or hypertrophy (thickening of muscle fibers from use; exercise.), fasciculation (twitch)/involuntary movements (like protective spasm).
Name a cause for muscle wasting.
Lower motor neurone lesions (between spine and muscle), longstanding or developmental upper motor neuron damage (between brain and spine). Muscle disorders; rheumatoid arthritis, cachexia (wasting due to chronic illness).
What causes hypertrophy, and is it always bad?
Hypertrophy is not usually a bad thing. Causes: certain occupations (such as those requiring frequent use of muscles; farming, construction), and sports. This causes the thickening of muscle fibers, thus creating larger (but not necessarily stronger) muscles.
What is Fasciculation, and is it always a bad thing?
Fasciculation is not usually the sign of a medical issue... but it can be the sign of a severe disorder or injury. Usually, fasciculation is caused by stress, trauma, injury, or fatigue (in healthy people). A fasciculation, or muscle twitch, is a spontaneous, involuntary muscle contraction and relaxation, involving fine muscle fibers.
What is a general reason for a, atypical muscle spasm (not related to stress, trauma, injury, or fatigue)?
Lower motor neuron diseases/lesions, non-pathological fasciculation (after vigorous exercise in healthy people).
What's a "Myoclonic Jerk," and what might cause someone to have one?
Myoclonic jerks - sudden shock-like contractions of one or more muscles which may be focal or diffuse. They may occur singly or repetitively. Causes - Healthy individuals: when falling asleep or surprised by a sudden noise or stimulus. Epilepsy, diffuse brain damage and dementias.
How did "Choreatic" (Chorea) movements earn their name? (Knowing this will help you understand more about the condition)
Choreatic movements, which are all involuntary, tend to almost seem "choreographed," in that the movements are rhythmic, and "DANCELIKE". See video in "alternative answers"
Athetosis is similar to Chorea, however, it is a little different. Describe the movements a person with Athetosis might have. If you can only "act out" the movements in your head, that is also fine. I understand many students are ESL.
Athetosis is a movement dysfunction. It's characterized by involuntary WRITHING (often called "snake like") movements. With athetosis, the same regions of the body are repeatedly affected. These typically include the hands, arms, and feet. See video for "snakelike" movements in Athetosis.
What is muscle spasticity? Is it associated with upper or lower motor neuron lesions?
Spasticity is a velocity-dependent resistance to passive movement (i.e. muscle resists being stretched). Most often associated with upper motor neuron lesions/issues.
When stretching a muscle that is RESSISTANT to stretching, and then *suddenly* relaxes and stops resisting... do they have rigidity or spasticity?
Spasticity is muscle stiffness, but nearing the END of the ROM, it will RELEASE (stop resisting). See video in alternative answers to easily understand the different between the two! You'll never forget!
To reinforce UPPER limb reflex response (if reflex appears absent), what do you ask the patient to do?
To reinforce the upper limb reflexes ask the patient to clench their teeth.
To reinforce LOWER limb reflex response (if reflex appears absent), what do you ask the patient to do?
Ask the patient to interlock the fingers and pull one hand against the other.
True or False: Checking finger reflexes checks 3 cervical nerves.
FALSE. It checks 2 cervical nerves (C7 and C8) AND 1 thoracic (T1)
What is isometric testing?
Isometric tests are via contractions of a particular muscle or group of muscles via resistance (maintenance of position, while increasing muscle's workload).
What is isotonic testing?
Isotonic testing is tests done on a joint where resistance is used to "prevent" a direct motion, such as flexing the leg (preventing a kinetic chain from moving; preventing flexion or retraction of a limb).
What is the MRC Scale, and what does MRC stand for?
The Medical Research Council (MRC) Scale is for grading muscle power ("strength").
What is paresis?
Partial paralysis.
What is plegia?
Complete Paralysis
What is monoplegia paralysis??
Complete Paralysis involving a single limb
What is hemiplegia paralysis?
Complete Paralysis of one half of the body?
What is paraplegia paralysis?
Complete Paralysis of both legs.
What is tetraplegia paralysis?
Complete Paralysis of all 4 limbs.
What is Paraparesis?
PARTIAL paralysis of both legs.
What is Monoparesis?
PARTIAL paralysis of one limb... like what you might see in a stroke survivor.
Describe the Finger-Nose coordination test. What is this test checking for? (2 things)
Have the patient put their finger on their nose, then touch your outstretched finger, then to their nose again. It checks for dyssynergia and dysmetria
What is dyssynergia?
Dyssynergia is any disturbance of muscular coordination, resulting in uncoordinated and abrupt movements.
What is dysmetria?
Dysmetria is caused when the cerebellum isn't functioning correctly, causing uncoordinated movements.
What is Dyspraxia?
Is a neurological disorder that impacts an individual's ability to plan and process motor tasks. Also known as "developmental coordination disorder" (DCD).
What is Apraxia?
Apraxia is a neurological disorder characterized by the inability to perform learned (familiar) movements on command, (even though the command is understood and there is a willingness to perform the movement). (They would make poor mimes, because miming requires the ability to perform learned, common actions, without use of a prop.)
What ability does checking for stereognosis test?
The ability to perceive the form of solid objects by touch.
What ability does checking for graphaesthesia test?
Is the ability to recognize writing on the skin purely by the sensation of touch
What is hyperaesthesia?
Excessive physical sensitivity, especially of the skin
What is Brown-Séquard syndrome?
Ipsilateral to injury: motor weakness and loss of vibration and joint position sense Contralateral to injury: loss of pain sense and temperature
Define "proprioception".
Proprioception refers to the body's ability to perceive its own position in a space.