Cerebellar Flashcards
What are the steps to a cerebellar examination?
Introduction General inspection Face Focused Upper limb Focussed lower limb Complete
What needs to be done on general examination?
General appearance and accoutrements
Gait Ax
Postural Ax
What general signs of cerebellar disease might be observed on general inspection?
- Wheelchair
- Neurological signs
- Sigs of neglect
- Posture
How can gait assessment give us clues about cerebellar disease?
Walk with them.
Sit in chair to standing with arms folded.
Walk away then back, heel to toe if possible.
What does DANISH stand for?
Dysdiadochokinesia Ataxia Nystagmus Intention tremor Slurred/staccato speech Hypotonia
How should posture be assessed?
Romberg test - ask pt to close eyes and assess stability (offer your hands to steady them if they are nervous)
What are the types of ataxia?
How do we test them?
Sensory (Romberg’s test)
Truncal (sit to stand with arms crossed)
Ataxic gait (watch them walk)
What cerebellar signs are tested in the face?
- H test for nystagmus and saccades
- Look from one target to another (hypometric saccades)
- Speech
How does the H test look for nystagmus?
Pause at the lateral gaze and watch for eye beats indicating nystagmus
What are saccades?
A quick simultaneous movement of both eyes between 2 or more phases of fixation in the same direction.
What speech tests are done in a cerebellar examination?
- Ask pt to say “west register street” , “baby hippopotamus”, and “british constitution”
- Move tongue side to side
What are the focussed upper limb tests or cerebellar examination?
- Pronator drift with rebound test
- Test for tone (hypotonia)
- Co-ordintion
How is co-ordination tested in upper limb?
- Finger-nose test
- Hand slapping
What does finger-nose test examine for?
Intention tremor
Dysmetria (past pointing)
What does hand slapping test check for?
Dysdiodochokinesia
