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108 Cards in this Set
- Front
- Back
Inspiratory reserve volume
|
Men: 3.3 L
Women: 1.9 L |
|
Tidal volume
|
0.5 L
|
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Expiratory reserve volume
|
Men: 1.0 L
Women: 0.7 L |
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Residual volume
|
Men: 1.2 L
Women: 1.1 L |
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Vital capacity
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Men: 4.8 L
Women: 3.1 L IRV plus TV plus ERV |
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Inspiratory capacity
|
Men: 3.8 L
Women: 2.4 L IRV plus TV |
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Functional residual capacity
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Men: 2.2 L
Women: 1.8 L ERV plus RV |
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Total lung capacity
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Men: 6.0 L
Women: 4.2 L IRV plus TV plus ERV plus RV |
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RBC
|
4 - 5.5 M/µL
RBC (Child) 3.5 - 5.0 M/µL |
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WBC
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3.8 - 11.0 K / mm cubed
WBC (Child) 5.0 - 10.0 K / mm cubed |
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Hgb
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11 - 18 g/dL
Hgb (child) 10 - 14 g/dL |
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Hct
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35 - 50%
Hct (Child) 30 - 42% |
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Erythrocyte Sedimentation Rate (ESR)
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15 – 20 mm/hr
|
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Creatinine Kinase Index (CK-Index)
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0 - 3
|
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Creatinine Kinase-MB (CK-MB)
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0 - 3 ng/ml
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Total Creatinine Kinase
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38 - 120 ng/ml
|
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Albumin
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3.5 - 5.0 gm/dL
Albumin (newborn) 2.9 - 5.5 gm/dL Albumin (child) 3.8 - 5.4 gm/dL |
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BUN
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6 - 23 mg/dL
|
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Calcium (total)
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8 - 11 mg/dL
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Cortisol
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Cortisol (8 AM)
5 - 25 gm/dL Cortisol (8 PM) 2 - 9 gm/dL |
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Glucose
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Glucose (fasting)
72 – 110 mg/dL OR 4 – 5.9 mmol/L Glucose (2hr post) Under 140 mg/dL OR 7.8 mmol/L |
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Insulin
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0 - 180 pmol/L
|
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Rheumatoid Factor (RF)
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<80 IU/ml
|
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Cholesterol
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Cholesterol (total)
Less than 200 mg/dL desirable Cholesterol (HDL) 30 - 75 mg/dL Cholesterol (LDL) Less than 130 mg/dL desirable |
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Triglycerides
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Triglycerides (Male)
Greater than 40 - 170 mg/dL Triglycerides (Female) Greater than 35 - 135 mg/dL |
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Platelets
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140,000 - 450,000 / ml
|
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PT Lab values
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10 - 14 seconds
|
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PTT
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32 - 45 seconds
|
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Thrombin time
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11 - 15 seconds
|
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Osmolality of CSF
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290 - 298 mOsm/L
|
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Pressure of CSF
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70 - 180 mm/H2O
|
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Cardiac Output
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4 - 8 LPM
|
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Ejection Fraction
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60 - 75%
|
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Cerebral Perfusion Pressure
|
70 - 90 mm Hg
|
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Intracranial Pressure
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5 - 15 mm Hg or 5 - 10 cm H2O
|
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pH
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7.35 - 7.45
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PaCO2
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35 - 45 mm Hg
|
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O2 sat
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96 - 100%
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PaO2
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85 - 100 mm Hg
|
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Gracile fascicle:
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Ascending
· Part of Dorsal Column-Medial Lemniscal (DCML) system · Discriminative (fine) touch, vibratory sense, position sense to lower extremities |
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Cuneate Fascicle:
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Ascending
· Part of Dorsal Column-Medial Lemniscal (DCML) system · Discriminative (fine) touch, vibratory sense, position sense to upper extremities |
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Spinocerebellar tract:
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Ascending
Dorsal & Ventral: · Proprioception from ipsilateral trunk and lower limb · Coordination of movements of the lower limb muscles · Posture maintenance *Dorsal=info from muscle spindles Ventral= info from golgi |
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Spinothalamic:
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Ascending
· Crude touch, pain, and temperature |
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Medial Longitudinal:
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Ascending/ Descending
· Info about direction eyes should move |
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Lateral Corticospinal/ Pyramidal:
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Descending
· Sensory modulation · Fine motor control of limbs and digits |
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Rubrospinal:
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Descending
· Voluntary movement of upper limb muscles · Large muscle movement of the arms and the legs · Fine motor control · Facilitates flexion and inhibits extension in UEs |
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Lateral reticulospinal:
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Descending
· Inhibits excitatory axial extensor muscles of movement |
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Medial reticulospinal:
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Descending
· Responsible for anti-gravity, extensor muscles |
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Vestibulospinal:
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Descending
· Facilitates extensor (antigravity) muscle tone and equilibrium · Medial: Controls correct position of the head and neck · Lateral: Maintains upright and balanced posture by stimulating extensors in the legs |
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Anterior corticospinal:
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Descending
· Voluntary movement of axial and upper limb muscles |
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Tectospinal:
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Descending
· Coordinates head and eye movements · Mediates reflex postural movements of the head in response to visual and auditory stimuli |
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COX-2 inhibitors
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Osteoarthritis
more selective, inhibit sysnthesis of PGs for pain and inflammation and spare beneficial PGs · Celebrex (celecoxib) - less gastritis - CV - possible MI, stroke |
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Glucosamine/Chondroitin
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Osteoarthritis
may provide substrates to help regenerate cartilage, synovial fluid - upset stomach - HA - Drowsiness - skin reactions - generally well-tolerated - may derive from shellfish |
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Viscosupplementation
|
helps restore viscosity of synovial fluid
· Hyaluronan (Orthovisc) · Synvisc - warmth, pain, stiffness, swelling, or puffiness where medicine’s injected |
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DMARDs
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Rheumatoid arthritis
- inhibit production of cytokines - inhibit cellular activation (monocytes, T and B lymphocytes) · Methotrexate (Rheumatrex) · Auranofin · Hydroxychloroquine · Cyclosporin · Penicillamine · Sulfasalazine · Azathioprine · Leflunomide - Inhibit many aspects of immune function - Attempt to delay or reverse progression - If tolerated, use before excessive joint destruction |
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opioids
|
acute pain
chronic pain - act on spinal cord dorsal gray matter and brain (thalamus, hypothalamus) - bind to specific receptors on pre-synaptic neuron to inhibit release of neurotransmitter and to receptors on post-synaptic neurons to make them less excitable · Codeine · Fentanyl · Hydrocodone (vicodin) · Meperidine (Demerol) · Oxycodone - Sedation - mood changes, confusion - respiratory depression - orthostatic hypotension - constipation - tolerance and dependence - consider timing of treatment with respect to timing of medication - PCA may help prevent overdose |
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NSAIDs
|
analgesic
anti-inflammatory antipyretic anitcoagulant anticancer? - inhibit synthesis of prostaglandins by inhibiting cyclooxygenase (key enzyme) - non-selective - COX-2 inhibitors - more selective, inhibit sysnthesis of PGs for pain and inflammation and spare beneficial PGs OTC: · Aspirin · Ibuprofen · Naproxen |
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Diuretics
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HTN
CHF act on kidneys to decrease total fluid volume in vascular system · Thiazides · Loop diuretics (Lasix) · Potassium sparing agents - electrolyte imbalance - orthostatic hypotension - weakness/fatigue - confusion, mood changes |
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Beta Blockers
|
-olol
HTN arrhythmias angina pectoris heart failure recovery from MI - block effects of epinephrine and norepinephrine to decrease HR and contraction - reduce sympathetic nervous system effect on cardiovascular system Cardioselective: · Atenolol · Metoprolol Nonselective · Pindolol · propanolol (Inderol) - bradycardia - bronchoconstriction - decreased maximal exercise capacity - orthostatic hypotension - depression, lethargy, dec libido - Cannot rely on vitals alone for exercise tolerance |
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K+ channel blockers
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arrhythmias
prolong cardiac repolarization · Amiodarone · Brentlium · Dofetilide · Ibutilide - initial increase in cardiac arrhythmias - potential pulmonary/liver damage with amiodarone |
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Vasodilators
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HTN
heart failure act directly on vascular smooth muscle to inhibit contraction · hydralazine · minoxidil - reflex tachycardia - orthostatic hypotension - dizziness. Headache - edema, fluid retention - avoid systemic heat |
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ACE inhibitors
|
-pril
HTN heart failure - Inhibits angiotensin converting enzyme to decrease formation of angiotensin II - prevent acute vasoconstriction - prevent vascular hypertrophy · captopril (Capoten) · enalapril (Vasotec) · lisinopril (Prinivil, Zestril) - allergic response/skin rash - dry cough, nausea, - dizziness |
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Organic Nitrates
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angina pectoris
Prinzmetal angina - venous dilation decreases cardiac preload (blood coming to heart) - arteral dilation decreases afterload (pressure heart pumps against) - decreased cardiac workload and O2 demand · Nitroglycerine - headache, dizziness - orthostatic hypotension - exaggerated response to systemic heat |
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Digitalis
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dig-
CHF arrhythmias - increases strength of cardiac contraction - stimulates vagus (to slow HR), inhibits sympathetic to heart (which normally inc HR) - digitalis toxicity (20-25%) - GI distress - Fatigue |
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Anticoagulants
|
venous thrombosis
increases effects of circulating protein antithrombin II to inactivate thrombin · Heparin - Heparin-induced thrombocytopenia (decreases platelets) |
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Oral Anticoagulants
|
inhibit Vitamin K function in liver to decrease synthesis of clotting factors
· Warfarin (Coumadin) - used in tandem with heparin - hemorrhage |
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Thrombolytics
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MI
ischemic stroke initiate clot breakdown to dissolve clots in coronary and carotid arteries · tPA · Eminase Retavase (bolus) - hemorrhage |
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Statins
|
-statin
hyperlipidemia inhibit HMG-CoA enzyme to decrease cholesterol biosynthesis and increase hepatic LDL breakdown Common names · Lipitor (atorvastatin) · Mevacor (lovastatin) · Pravachol (pravastatin) · Crestor |
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Antithrombotics
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MI
ischemic stroke - inhibit platelet activity to decrease platelet induced clots · Aspirin · Plavix - Hemorrhage |
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Rancho Levels
Level I |
- No Response
Patient does not respond to external stimuli and appears asleep |
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Rancho Levels
Level II |
- Generalized Response
Patient reacts to external stimuli in nonspecific, inconsistent, and non-purposeful manner with stereotypic and limited responses |
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Rancho Levels
Level III |
- Localized Response
Patient responds specifically and inconsistently with delays to stimuli, but may follow simple commands for motor action |
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Rancho Levels
Level IV |
- Confused, Agitated Response
Patient exhibits bizarre, non-purposeful, incoherent or inappropriate behaviors, has no short-term recall, attention is short and nonselective |
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Rancho Levels
Level V |
- Confused, Inappropriate, Non-agitated Response
Patient gives random, fragmented, and non-purposeful responses to complex or unstructured stimuli - Simple commands are followed consistently, memory and selective attention are impaired, and new information is not retained |
|
Rancho Levels
Level VI |
- Confused, Appropriate Response
Patient gives context appropriate, goal-directed responses, dependent upon external input for direction. There is carry-over for relearned, but not for new tasks, and recent memory problems persist |
|
Rancho Levels
Level VII |
- Automatic, Appropriate Response
Patient behaves appropriately in familiar settings, performs daily routines automatically, and shows carry-over for new learning at lower than normal rates. Patient initiates social interactions, but judgment remains impaired |
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Rancho Levels
Level VIII |
- Purposeful, Appropriate Response
Patient oriented and responds to the environment but abstract reasoning abilities are decreased relative to premorbid levels |
|
Glascow Coma Scale
3 Categories & Score Interpretation |
Eye Opening
Verbal Motor Best Possible = 15 Worst Possible = 3 If trached Best Possible = 10T Worst Possible = 2T |
|
Glascow Coma Scale
Eye Opening |
4 = Spontaneous
3 = To speech 2 = To pain 1 = None |
|
Glascow Coma Scale
Verbal |
5 = Oriented
4 = Confused 3 = Inappropriate words 2 = Moans 1 = None Modified for Infants 5 = Babbles 4 = Irritable 3 = Cries to pain 2 = Moans 1 = None |
|
Glascow Coma Scale
Motor |
6 = Follows commands
5 = Localizes to pain 4 = Withdraws to pain 3 = Abnormal flexion 2 = Abnormal extension 1 = None |
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CN I
|
Olfactory
Smell Sensory only |
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CN II
|
Optic
Vision Sensory only |
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CN III
|
Oculomotor
Muscles of the eye Motor and Sensory |
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CN IV
|
Trochlear
Serves the superior oblique eye muscle Motor and Sensory |
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CN V
|
Trigeminal
Sensory from face and mouth; Motor to muscles of mastication Motor and Sensory |
|
CN VI
|
Abducens
Serves the lateral rectus eye muscle Motor and Sensory |
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CN VII
|
Facial
Serves the muscels of facial expression, lacrimal glands, and salivary glands Motor and Sensory |
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CN VIII
|
Vestibulocochlear
Equilibrium and hearing Sensory only |
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CN IX
|
Glossopharyngeal
Serves the pharynx for swallowing, posterior third of tongue, parotid salivary gland Motor and Sensory |
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CN X
|
Vagus
Sensations from visceral organs, and parasympathetic motor regulation of visceral organs Motor and Sensory |
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CN XI
|
Accessory
Serves muscles that move head, neck and shoulders Motor and Sensory |
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CN XII
|
Hypoglossal
Serves muscles of the tongue Motor and Sensory |
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Stereognosis
|
- The ability to perceive and recognize the form of an object using cues from texture, size, spatial properties, and temperature
- Inability = Astereognosis - Mediated by the DCML pathway |
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Barognosis
|
- The ability of evaluating the weight of objects, or to differentiate objects of different weights by holding or lifting them
- Inability = Baragnosis - Mediated by the DCML pathway |
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Graphesthesia
|
- The ability to recognize writing on the skin purely by the sensation of touch
- Mediated by the Parietal lobe opposite to the side of the hand tested & the DCML pathway |
|
Apraxia
|
- The loss of the ability to execute or carry out learned purposeful movements, despite having the desire and the physical ability to perform the movements.
- Due to damage of typically frontal and parietal lobes |
|
Ideational Apraxia
|
- Loss of ability to conceptualize, plan, and execute the complex sequence of motor actions involving the use of tools or objects in everyday life.
- An individual is unable to plan movement related to an object because he has lost the perception of the object's purpose - Often due to lesions in areas of the frontal and temporal lobes |
|
Ideomotor Apraxia
|
- Inability to correctly imitate hand gestures and voluntarily pantomime tool use, e.g. pretend to brush one's hair.
- The ability to spontaneously use tools, such as brushing one's hair in the morning without being instructed to do so, may remain intact, but is often lost. - Due to a decrease in blood flow to the left hemisphere of the brain and particularly the parietal and premotor areas - It is frequently seen in patients with corticobasal degeneration |
|
Constructional Apraxia
|
- The inability or difficulty to build, assemble, or draw objects.
- Often caused by lesions of the inferior right parietal lobe |
|
Anosognosia
|
- Deficit of self-awareness, a condition in which a person who suffers certain disability seems unaware of the existence of his or her disability.
- Due typically to the parietal lobe damage or a diffuse lesion on the fronto-temporal-parietal area in the right hemisphere |
|
Somatognosia
|
- The awareness we have of the parts of our body
- Inability = Asomatognosia |
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Visual Agnosia
|
- Can see but cannot recognize or interpret visual information
- Due to a disorder in the parietal lobes. |
|
Dysarthria
|
Difficult or unclear articulation of speech that is otherwise linguistically normal
|
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Neuropraxia
|
- Disorder of the peripheral nervous system in which there is a temporary loss of motor and sensory function due to blockage of nerve conduction, usually lasting an average of six to eight weeks before full recovery
|
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Axonotmesis
|
- Disruption of nerve cell axon
- The rate of outgrowth of regenerating nerve fibers is about 1 mm to 2 mm per day - Nerve regeneration may take several months |
|
Neurotmesis
|
- The most serious nerve injury in the scheme
- Both the nerve and the nerve sheath are disrupted - While partial recovery may occur, complete recovery is impossible. |
|
Spinoreticular Tract
|
Ascending
· Deep and chronic pain |