Full Exam Review Flashcards
Number of spinal nerves
31
Spinal nerve injury
Level of nerve and below will no longer work
SCAT
Sport Concussion Assessment Tool used as baseline prior to competitive sport
FAST
Face drooping, arm weakness, speech problems, time to call 911 for stroke (especially ischemic)
Requirements for neurological exam
Penlight, tongue blade, cotton swab, tuning fork, percussion hammer
Indicators for increased ICP
Falling pulse, rising BP, falling respirations, widening pulse pressure, and decreased O2 saturation
Coma according to GCS
Score of 8 or below
Receptive aphasia
- Language comprehension
- Wernicke’s area (temporal)
- Produced speech makes no sense/cannot write
- Patient is unaware of problem
Expressive aphasia
- Speech productive
- Broca’s area (frontal)
- Can understand but cannot produce
- Frustrating for patients
CN II lesion
Loss of direct light reflex
CN III lesion
Loss of consensual light reflex
Light reflex in blind patients
No constriction as without sensory input, there will be no motor response
Light reflex in unconscious
Should still be a response
Oculomotor/abducens/trochlear nerve tests
Hold up finger and have patient follow finger with eyes
Facial nerve motor function test
Raise eyebrows, frown, clench eyes, bare teeth, smile, puff out cheeks
Facial nerve sensory function test
Anterior 2/3 of tongue; lost with loss of motor function
Glossopharyngeal/vagus nerve motor function test
Aah uvula, palate rise, gag reflex
Glossopharyngeal/vagus nerve sensory function test
Posterior 1/3 of tongue
Spinal testing
Movement/power of arms/legs and for sensation (sharp/dull/vibration sensations) on skin of arms/legs
Tandem walking
Toe-to-heel; no need to look at feet or wobble
Romberg’s test
Close eyes and stand with feet together; will wobble with cerebellar injury
Pronator drift
Test for upper motor neurons
Tests for coordination/skilled movement
Rapid alternating movements, finger-to-finger, finger-to-nose, heel-to-shin
Reduced reflexes
Peripheral problem
Exaggerated reflexes
Central problem
Biceps reflex
C5/C6; depress biceps tendon
Brachioradialis reflex
C5/C6/C7; strike relaxed brachioradialis tendon
Triceps reflex
C6/C7/C8; strike triceps tendon with sharp end while forearm is hanging loose at right angle
Patellar reflex
L2/L3/L4; strike patellar tendon
Ankle jerk reflex
S1/S2; strike Achilles’ tendon of dorsiflexed foot
Abdominal reflex
Blunt object stroke from lateral to medial of all quadrants; supine and relaxed
Cremasteric reflex
Lightly stroke superior and medial part of thigh (male only)
Babinski reflex
L4 to S2; sole of foot stimulated with blunt instrument; CNS issues will fan toes if over 2 years of age; response is normal until age of 2