Approach to Neuro Exam Basic Flashcards
A&O x1 vs x2 vs x3 vs x4
x1: person
x2: person and place
x3: person, place and time
x4 person, place, time, event
Delirium vs Dementia
Delirium: reversible
-screen usng CAM
Demential: nonreversible
-nee to eliminate depression and dementia before diagnosis
CN III lesions
- ptosis
- pupillary dilation
- external strabismus (down and out eye)
CN IV lesions
- exotropia
- weakness of downward gaze
- double vision looking down (diplopia)
- head tilt to opposite side of lesion
CN VI lesions
- inability to ABduct eye, medial strabismus
- horizontal diplopia
Nystagmus
-horizontal, vertical, rotatory
Causes: vision impairment, drug toxicity, disorder of cerebellar systems
CN V lesions
- decreased sensation to face
- loss of corneal reflex
- weakness of masticators
- jaw deviates toward weak side
- can see trigeminal neuralgia
CN VII lesions
- bells palsy: whole face
- Central 7: spares forehead, can wrinkle, associate with hemiplegia
- loss of corneal reflex
- croc tears: regen of nerve after trauma
CN VIII lesions
- dysequilibrium
- nystagmus
- sensineural hearing loss
- tinnitus in irritative lesions
Test for CN IX and X
- listen for hoarseness
- check gag reflex (rare)
- swallowing
- say AHHH
CN IX lesions
- loss of gag
- loss of sensation in post 1/3 tongue and pharynx
- slight dysphagia
CN X lesions
- Dysphonia
- Dysphagia
- Dyspnea
- Loss of gag or cough reflex
CN XI lesion
SCM paralysis turn head to opposite side
cant shrug shoulder
CN Documentation
CN II-XII intact to testing
Cortical Sensations
- Sterognosis
- Graphesthesia
- Two pt discrim
- extinction
- Sterognosis: id shapes, objects
- Graphesthesia: id numbers written in palm
- Two pt discrim: distinguish being touched by one or two points
- extinction: feel two locations simultaneously
Pattern of Sensory Loss
- thalamic
- cortical
- functional
- thalamic: hemisensory loss of all modalities
- cortical: intact primary but loss of cortical
- functional: non anatomical distribution
Muscle tone
-what muscle has @ rest
Cerebellar Ataxia
-staggering, unsteady, feet wide apart
Sensory Ataxia
-unsteady, feet wide apart, feet thrown forward and slapped down, pt watches ground
Parkinsonian
-stooped forward, shuffling gait, decreased arm swing
Brudzinski versus Kernig
Brudzinski: stretches FEMORAL N
Kernig: stretches SCIATIC N
