3 Neurologic Exam

Question 1

Purpose of neuro exam?

Answer 1

Determine where is lesion?

- CNS vs PNS

Question 2

When to do neuro exam (yellow slide)

Answer 2

pain/problem in axial skeleton

neurologicl sx (radiating pain, burning pain)

Question 3

Pitfalls of the neuro-exam (4)

Answer 3

skip sections?

doing the screening like that’s all you need to do (abnormalities need further evaluation)

relying too much in history, versus screen

not having reproducible exam.

Question 4

Hoffman’s sign

Answer 4

UE similar to babinski

observe contraction of ipsilateral thumb with flicking middle finger

Question 5

What kind of clonus is bad clonus?

Answer 5

Sustained clonus

Question 6

Grading reflexes?

Answer 6

0/4 - absent reflex
1/4 - muscle twitch
2/4 - normal reflex
3/4 - hyperactive reflex
4/4 - hyperactive reflex with clonus

Question 7

Nerve root for biceps reflex?

Answer 7

C5

Question 8

Nerve root for brachioradialis reflex?

Answer 8

C6

Question 9

Nerve root for triceps reflex?

Answer 9

C7

Question 10

Nerve root for patellar reflex?

Answer 10

L4

Question 11

Nerve root for achilles reflex

Answer 11

S1

Question 12

Do you downgrade a reflex for distraction maneuvers?

Answer 12

Nope! But you do for augmentation

Question 13

Which side of foot to do Babinski?

Answer 13

lateral side; avoid medial plantar grasp reflex (false negative)

Question 14

Manual muscle testing scale?

Answer 14

5/5 Full ROM full strength
4/5 full ROM, less strength
3/5 full ROM against gravity (not opposition)
2/5 full ROM w/o gravity
1/5 muscle twitch
0/5 no joint motion or muscle contraction