Cerebellar and Proprioceptive Tests

Question 1

Romberg’s Test

Answer 1

pt. looking straight ahead, feet shoulder width, Dr. near pt., pt. closes eyes. Pos: pt takes a step or falls. Eyes open and closed Cerebellar or vestibular deficit. Eyes closed Dorsal column pathology

Question 2

Hopping on one foot

Answer 2

pt. hops on each foot with eyes open and closed. Pos: pt takes a step or falls. Eyes open and closed Cerebellar or vestibular deficit. Eyes closed Dorsal column pathology

Question 3

Squatting on one foot

Answer 3

Pt. squats on each leg with eyes open and closed. Pos: pt takes a step or falls. Eyes open and closed Cerebellar or vestibular deficit. Eyes closed Dorsal column pathology

Question 4

Finger to nose

Answer 4

Pt. arms out to sides, touches fingers to nose with eyes open and closed. Pos: Dyssynergia = uncoordinated movement or Dysmetria = inaccuracy in measuring distance

Question 5

Finger to finger

Answer 5

Pt. arms out to sides, touches fingers in front of them with eyes open and closed. Pos: Dyssynergia = uncoordinated movement or Dysmetria = inaccuracy in measuring distance

Question 6

Finger to nose to finger

Answer 6

Dr. finger about 2 ft. in front of pt., pt. goes to Dr.’s finger to their nose. (Dr. moves finger). Pos: Dyssynergia = uncoordinated movement

Question 7

Heel to shin

Answer 7

Pt. heel goes knee to ankle, performed bilaterally with eyes opened and closed. Pos: Dyssynergia = uncoordinated movement or Dysmetria = inaccuracy in measuring distance

Question 8

Testing Diadochokinesia

Answer 8

Ability to perform rapid alternation movements (patting knees, forefinger to thumb, sup. hands) eyes open and closed. Pos: Dysdiadochokinesia - inability to perform, possible cerebellar dysfunction

Question 9

Holmes Rebound Phenomenon

Answer 9

Pt. contracts flexors of forearm against Dr. resistance, random release. eyes open and closed. should see check reflex. Pos: Dyssynergia = uncoordinated movement or Dysmetria = inaccuracy in measuring distance

Question 10

Tandem Gait

Answer 10

Pt. heel toe walks eyes open and closed. Pos: Dyssynergia = uncoordinated movement or Dysmetria = inaccuracy in measuring distance

Question 11

Joint Position Test

Answer 11

Dr. stabilizes hand or foot and grabs digit from sides and flexes or extends it. Ask pt. if it is pointing up or down, their eyes will be closed. Pos: if pt. cannot tell posterior column disease (proprioception)

Question 12

Abadie’s Sign (Deep pain)

Answer 12

Pinching the Achilles

Question 13

Pitres’ Sign (Deep pain)

Answer 13

Pinching the testicles

Question 14

Biernacki Sign (Deep pain)

Answer 14

Pinching or striking ulnar n.

Question 15

Stereognosis

Answer 15

Pt. attempts to ID common object in hand with eyes closed. check both hands. Multimodal

Question 16

Barognosis

Answer 16

Pt assesses relative weight of similarly sized objects of different weights. check both hands. Multimodal

Question 17

Topognosis

Answer 17

Pt. touches the same spot the Dr. just touched. Multimodal

Question 18

Graphognosis

Answer 18

Pt. tries to ID number or letter drawn on chest back or palm. Multimodal

Question 19

2 pt. discrimination

Answer 19

finger tips 2-4mm, dorsum of fingers 4-6mm, palm 8-12mm, dorsum of hand 20-30mm. check both hands. Multimodal

Question 20

Somatognosis

Answer 20

Dr. puts arm next to pt. and with eyes closed, pt. attempts to touch their own arm. Multimodal

Question 21

What structure does testing light touch evaluate

Answer 21

anterior spinothalamic tract

Question 22

What structure does testing pain and temperature evaluate

Answer 22

lateral spinothalamic tract

Question 23

What strucutre does testing vibration evaluate

Answer 23

Posterior column