27: Approach To Neuro Exam Flashcards
Dysarthria
Defective articulation, usually due to defect in motor control
Aphasia
Disorder in producing or understanding language, usually due to lesion in the dominant hemisphere (usually left)
Esotropia
Eye position drifting
Vertical diplopia
Double vision that increases when looking down
What is the most common isolated CN palsy?
CN 6
Three conditions that can cause CN 6 palsy?
SAH, late syphilis, trauma
Convergent strabismus
Inability to abduct the eye
Horizontal diplopia
Max separation of images when looking towards the paretic LR muscle
Why does jaw deviate towards the weak side in a CN 5 lesion?
Unopposed action of opposite lateral pterygoid muscle
90% of trigeminal neuralgia is caused by?
Aberrant vein or artery compressing the nerve
Hyperacusis
Increased sensitivity to sound due to stapedius not working
What can cause bilateral facial palsy?
Guillain-Barré syndrome
Supranuclear facial palsy
Spares upper face, usually associated with hemiplegia
Three ways to test CN 8
- Whisper test
- Finger rub test
- Weber-Rinne test
Two phases of nystagmus
- Slow drift away from object of focus
2. Saccade: quick reaction back
Three types of nystagmus
Horizontal, vertical, rotator
Potential causes of nystagmus
Vision impairment at early age, disorder of labyrinth, drug toxicity
What does it mean if you document “CNs are grossly intact”
You have spent time talking to the pt and dont see anything that warrants a CN exam, but havent actually tested for anything
What is the appropriate way to document CN testing
CNs II-XII are intact to testing
Stereognosis
Ability to ID shapes of objects, recognizing objects placed in the hand
Graphesthesia
IDing numbers written on the palm
Double simultaneous stimulation
Ability to feel two locations being touched simultaneously
Thalamic sensory loss
Hemisensory loss of all modalities
Cortical loss of sensory
Intact primary sensations but loss of cortical sensations
Cerebellar ataxia presentation
Staggering, unsteady, feet wide apart, other cerebellar signs present
Sensory ataxia presentation
Unsteady, feet wide apart, feet thrown forward and slapped down heel-to-forefoot, pts watch ground while walking
Parkinsonian gait
Stooped forward, shuffling gate with fenstrations, decreased arm swing
How many pts with acute bacterial meningitis will have nuchal rigidity
84%
What other condition besides meningitis can cause nuchal rigidity
SAH
