Neuro Flashcards
Knee flexion is assessing which nerve root(s) and peripheral nerve?
L5/S1 - sciatic
Finger abduction is assessing which nerve root(s) and peripheral nerve?
T1 - ulnar
What is/are the role(s) of CN V?
Sensory - facial sensation Motor (V3 only) - muscles involved in mouth opening/mastication/swallowing
Where do you test sensation for the L4 nerve root?
Medial malleolus
Knee extension is assessing which nerve root(s) and peripheral nerve?
L3/4 - femoral
What cranial nerve is responsible for the afferent limb of the gag reflex?
CNIX
Using a normal Snellen chart on the wall, how far away should the patient be standing?
6m
What is/are the role(s) of CN III?
Motor - movement of eye muscles (SR, IR, MR, IO, LPS) Parasympathetic - pupillary constriction (via sphincter pupillae)
What cranial nerve is responsible for the efferent limb of the corneal reflex?
CNVII
Muscle wasting and fasciculations on examination is suggestive of what type of lesion?
LMN
If assessing a patient with potential Parkinson’s, what are the most important areas to examine?
Gait, tone, tremor, bradykinesia
If Weber’s test lateralises to the non-affected side, what type of hearing loss does this suggest?
Sensorineural
A resting tremor associated with Parkinson’s should resolve upon what movement?
Holding hands out in front of them and spreading fingers apart
What type of hearing loss is suggested by bone conduction being louder than air conduction in Rinne’s test?
Conductive
Big toe extension is assessing which nerve root(s) and peripheral nerve?
L5 - common fibular
Where do you test sensation for the C6 nerve root?
Tip of thumb
What type of lesion will cause a non-forehead sparing facial nerve palsy?
LMN lesion e.g. Bell’s palsy, Ramsay-Hunt, MS
What further examinations would you want to do to rule out a Parkinson’s plus syndrome?
Eye movements, full neurological exams and lying/standing BP
What cranial nerve is responsible for the efferent limb of the gag reflex?
CNX
What cranial nerve is responsible for the afferent limb of the corneal reflex?
CNV1
What happens to reflexes in an UMN lesion?
Brisk
If using a hand held Snellen chart to assess visual acuity, how far away from the patient should it be held?
30cm
Ankle dorsiflexion is assessing which nerve root(s) and peripheral nerve?
L4 - common fibular
Hip flexion is assessing which nerve root(s) and peripheral nerve?
L1/2 - femoral
Wrist extension is assessing which nerve root(s) and peripheral nerve?
C6 - radial
Elbow extension is assessing which nerve root(s) and peripheral nerve?
C7 - radial
Thumb abduction is assessing which nerve root(s) and peripheral nerve?
T1 - median
Which nerve roots are you testing with the supinator jerk?
C5/6
Where do you test sensation for the C8 nerve root?
Tip of little finger
Where do you test sensation for the T1 nerve root?
Medial mid forearm
If there is unilateral hypoglossal nerve pathology, in what direction will the tongue be deviated?
Towards the affected side
What is/are the role(s) of CN VI?
Motor - movement of eye muscle (LR)
Where do you test sensation for the C5 nerve root?
Regimental badge patch area
Hip extension is assessing which nerve root(s) and peripheral nerve?
L5/S1 - gluteal
If Weber’s test lateralises to the affected side, what type of hearing loss does this suggest?
Conductive
Where do you test sensation for the C4 nerve root?
Shoulder tip
Where do you test sensation for the L5 nerve root?
Dorsal 1st web space
Where do you test sensation for the L3 nerve root?
Medial thigh just above knee
Shoulder abduction is assessing which nerve root(s) and peripheral nerve?
C5 - axillary
What is/are the role(s) of CN X?
Special sensory - taste to epiglottis and pharynx Sensation - lots of areas of the head/neck/viscera Motor - muscles of the pharynx and larynx Parasympathetics - heart, lungs and upper 2/3rds of gastric system Visceral afferents - aortic arch chemoreceptors and baroreceptors
What is/are the role(s) of CN I?
Special sensory - olfaction
What type of lesion will cause a forehead sparing facial nerve palsy?
UMN lesion e.g. stroke
Elbow flexion is assessing which nerve root(s) and peripheral nerve?
C5/6 - musculocutaneous
Finger flexion is assessing which nerve root(s) and peripheral nerve?
C8 - median and ulnar
What is pronator drift assessing for?
Subtle upper motor neurone lesion
What is/are the role(s) of CN II?
Special sensory - vision
What is/are the role(s) of CN VII?
Sensory - external auditory meatus and anterior 2/3rds of tongue Motor - muscles of facial expression and stapedius Parasympathetic - lacrimal and submandibular/submental glands
Finger extension is assessing which nerve root(s) and peripheral nerve?
C7 - radial
What is/are the role(s) of CN VIII?
Special sensory - audition and proprioception
What happens to tone in an extrapyramidal lesion?
Increased (rigid)
What is/are the role(s) of CN XII?
Motor - tongue muscles
What happens to tone in a LMN lesion?
Normal or reduced
What happens to reflexes in a LMN lesion?
Reduced
What is/are the role(s) of CN IX?
Sensory - external auditory meatus and middle ear, pharynx and posterior 1/3rd of the tongue Special sensory - taste to the posterior 1/3rd of the tongue Motor - stylopharyngeus Parasympathetics - parotid gland Visceral afferents - to carotid sinus/body baroreceptors and chemoreceptors
What is/are the role(s) of CN IV?
Motor - movement of eye muscle (SO)
Which nerve roots are you testing with the knee jerk?
L3/4
What is/are the role(s) of CN XI?
Motor - trapezius and sternocleidomastoid
What are some specific symptoms you should ask about when taking a headache history?
Nausea/vomiting, photo/phonophobia, neck stiffness, rashes, neurological deficits
What happens to tone in an UMN lesion?
Increased (spastic)
Which nerve roots are you testing with the biceps jerk?
C5/6
Ankle plantarflexion is assessing which nerve root(s) and peripheral nerve?
S1 - tibial
Getting a patient to open their jaw against resistance tests the strength of which muscles?
Pterygoid
Where do you test sensation for the S1 nerve root?
Lateral heel
What are some red flag symptoms you should ask about in a neuro history?
Headaches, fits/faints, changes in vision, motor/sensory deficits, memory changes
Where do you test sensation for the L2 nerve root?
Antero-medial mid-thigh
What additional special tests would likely be useful as part of a lower limb neurological exam?
Straight leg raise and femoral stretch test
How should visual acuity be recorded?
6 over the number of the smallest line they can read
What happens to tone in a cerebellar lesion?
Reduced
If there is unilateral vagus nerve pathology, in what direction will the uvula be deviated?
Away from the affected side
What are the 5 ways of testing CN II?
Visual acuity, visual fields, colour vision, reflexes, fundoscopy
Which nerve roots are you testing with the triceps jerk?
C7
Where do you test sensation for the C7 nerve root?
Tip of middle finger
Which nerve roots are you testing with the ankle jerk?
S1