+ Findings Flashcards
Rhomberg Test:
Pt falls with eyes open and with eyes closed to the right
Cerebellar Deficit
and/or
Vestibular Mechanism Deficit
(to the right)
Vibration: Pt does not feel vibration in ankle
Palanesthesia
Rhomberg Test:
Pt falls with eyes closed only to the right
Dorsal Column Pathology (to the right)
Hopping on one foot:
Pt falls with eyes open and closed to the left
Cerebellar Deficit
and/or
Vestibular Mechanism Deficit (to the left)
Hopping on one foot:
Pt falls with eyes closed only to the left
Dorsal Column Pathology (to the left)
Squatting on one foot:
Pt falls with eyes open and closed
Cerebellar Deficit
and/or
Vestibular Mechanism Deficit
Squatting on one foot:
Pt falls with eyes closed only
Dorsal Column Pathology
Finger-to-Nose test:
Pt has uncoordinated movement when attempting to touch the tip of his/her nose with the tip of finger with eyes open and closed
Dyssynergia
Finger-to-Nose Test:
Pt is inaccurate at measuring the distance when attempting to touch the tip of his/her nose to the tip of their finger with eyes open and closed
Dysmetria
Finger-to Finger:
Pt is uncoordinated when attempting to touch the tips of their index fingers together, straight out in front of them. Eyes open and eyes closed
Dyssynergia
Finger to finger:
Pt is inaccurate at measuring the distance between the tips of their index fingers when trying to touch them together. Eyes both open and closed
Dysmetria
Finger-to-Nose-to-Finger:
Pt is uncoordinated when trying to touch their nose followed by touching the doctors finger as it moves throughout space in front of them.
Dyssynergia
Heel to Shin:
Pt is uncoordinated when attempting to run their heel down their opposite shin from knee to ankle. Done bilaterally with eyes open and closed.
Dyssynergia
Heel to shin:
Pt is inaccurate in measuring the distance between their heel and the shin of their opposite leg.
Dysmetria
Testing for the ability to perform rapid alternating movements: Pt is unable to pat knees rapidly, and pronate/supinate the hands with eyes open and closed.
Dysdiadochokinesia
Holmes Rebound Phenomenon:
Pt is uncoordinated when contracting flexors in forearm against resistance by the doctor when eyes are both open and closed.
Dyssynergia
Holmes Rebound Phenomenon:
Pt is inaccurate at measuring the distance when resisting force from doctor against flexed forearm, and likely hits him/herself in the face when eyes are both open/closed
Dysmetria
Tandem Gait:
Pt uncoordinatedly walks in a line, heel to toe, while looking directly in front of them when eyes are open, and also when eyes are closed
Dyssynergia
Tandem Gait:
Pt is inaccurate at measuring the distance between their heel to toe when walking in a straight line with eyes both open and closed
Dysmetria
Joint Position Test:
Doctor holds pt finger from the sides and points the tip either up or down. Pt is unable to determine which direction the finger is pointing
unable to distinguish whether finger is pointing up or down:
possible posterior column disease (proprioception)
Abadie’s Sign:
Pt feels no discomfort when pinching the achilles tendon
dorsal column disease
ie: tabesdorsalis
Pitre’s Sign:
Pt feels no discomfort when doctor pinches pt testicles
Dorsal column disease
ie: tabesdorsalis
Biernacki Sign:
Pt feels no discomfort when pinching or striking the ulnar nerve
Dorsal column disease
ie: tabesdorsalis
Stereognosis:
With eyes closed, pt is unable to identify the object in their hand within a few seconds without switching hands. Both hands are checked
loss of higher cortical functions and memory
Barognosis: Pt is unable to assess the relative weight of similarly sized and shaped objects that have different weight.
loss of higher cortical functions and memory
Topognosis: When touching the pt somewhere on the skin, they are unable to point to the area that had been touched when eyes are closed
loss of higher cortical functions and memory
Graphognosis:
Pt is unable to identify a letter or number written on their palm when their eyes are closed
loss of higher cortical functions and memory
2 point discrimination:
Pt is unable to determine the distance between two separate points
loss of higher cortical functions and memory
May be the greatest cause of headaches. Account for cervical pain influence on head pain
cervicogenic pain
Cervicogenic Pain is associated with which CN
CN V3
Greatest cause of dizziness
cervicogenic vertigo
Cerebellopontine angle lesion is a lesion in which CN’s
Unilateral CN V, VII, VIII
5, 7, 8
Cavernous sinus lesion deals with lesion in which CN’s
CN III, IV, V, VI
3, 4, 5, 6
Jugular Foramen Syndrome deals with lesion in which CN
Combined unilateral CN IX, X, XI
9, 10, 11
Bulbar Palsy deals with lesion in which CN’s
LMN combined bilateral CN X, XI, XII
10, 11, 12
Pseudobulbar Palsy deals with lesion of which CN’s
Combined bilateral UMN of CN X, XI, XII
10, 11, 12
MC cause of intrinsic brainstem lesion of younger pt
MS
MC cause of intrinsic brain stem lesion in older pt
Vascular disease
Complete loss of smell
Anosmia (CN I)
Decreased sense of smell
Hyposmia
Increased sense of smell
Hyperosmia
Pervision of smell
Parosmia
Abnormally disagreeable smell
Cacosmia
Meningiomas and Frontal Lobe Tumors may suppress a tract that results in issues with which cranial nerve
CN I
compresses olfactory tract
Causes of anosmia (4)
blocked nasal passage
common cold
trauma
age
Involves the optic nerve or tract, and the MC cause is multiple sclerosis
Retrobulbar Neuritis
Includes various forms of retinitis
Optic or Bulbar neuritis
commonly seen symptom of increased intracranial pressure due to brain tumors, abscesses, hemorrhage, hypertension, and other causes.
Papilledema (aka Choked disc)
Associated with decreased visual acuity and a change in the color of the optic disc to light pink, white, or gray
Optic atrophy
caused by processes that involve the optic nerve and do not produce papilledema
primary optic atrophy
A sequel of papilledema
secondary optic atrophy
characterized by ipsilateral blindness, anosmia and contralateral papilledema
Foster Kennedy Syndrome
Cerebromacular degeneration with severe mental deficiency occurring in jewish families and is associated with blindness, optic atrophy, and a dark cherry red spot in place of the macula
Tay-Sachs disease
Pupil reacts only to accommodation. it has neither a direct or indirect reaction to light. May be because of a diabetic complication
Argyll Robertson Pupil
Eyelid Ptosis deals with primarily which CN
Disease of CN III
The pupil reacts to light very slowly, remains constricted longer, then dilates slowly. Most often in young women and considered benign
Holmes- Adie Syndrome
Ptosis, pupilloconstriction, lack of sweating, red or flushed look and palpable increase in skin temp
Horner’s syndrome
blurred nerve fibers and cup, engorged veins, obliteration of physiological cup, and disc elevation and edema
papilledema
Inflammation behind the portion of the optic disc that can be visualized during fundiscopic exam
acute retrobulbar neuritis
in this case, fundus looks normal but pt has vision loss
central causes of facial paralysis should always be considered what
Trigeminal neuralgia
idiopathic syndrome or recurrent, usually sharp, painful facial sensation in the clear distribution of the opthalamic, maxillary, or mandibular divisions of CN V
Trigeminal neuralgia
Peripheral facial paralysis
Prosopoplegia
CN VII disorder
flaccid paralysis involving all ipsilateral facial muscles distal to lesion site
Bells Palsy (CN VII)
The forehead is spared, the eyes are only partially involved, and the mouth and neck are fully involved in facial paralysis
Stroke (CN VII)
Common etiologies for conductive hearing loss (4)
Auditory canal obstruction
direct/indirect trauma to tympanic membrane
trauma to ossicles
accumulation of fluid in the middle ear
Difficulty in act of swallowing would be associated with which CN
IX, X
Loss of vibratory sensation
Pallanesthesia
