Neuro

Question 1

DTR scale

Answer 1

Scale 0-4+

• 0+ no response
• 1+ sluggish or diminished
• 2+ active or expected response
• 3+ brisk or more than expected
• 4+ hyperactive; may elicit clonus

Question 2

Oculocephalic reflex (Doll’s eyes)

Answer 2

used to assess the health of comatose/lethargic patients. Test by holding eyes open and rotating head from side to side, up and down.
Reflex is present if eyes move in the opposite direction of the head movements (i.e. doll’s eyes). This is NORMAL response.
Absence of doll’s eyes (i.e. eyes fixed upon movement of head) = brainstem dysfunction/trauma.

Question 3

Kerig sign

Answer 3

flex pt’s leg at the knee and hip when pt is supine, then attempt to straighten the leg. Positive Kerig = pt has pain in lower back and resistance to straightening leg at the knee. Suggests meningitis

Question 4

Brudzinski sign

Answer 4

may be present when assessing for neck stiffness. With patient supine, flex the neck and observe for involuntary flexion of hips/knees = positive Brudzinski sign. Suggests meningitis

Question 5

Gower sign

Answer 5

when child rises from seated position by maneuvering into a position supported by both arms and legs, pushing off the floor, then resting hands on the legs and pushing the trunk up.
Suggests proximal muscle weakness

Question 6

Clonus

Answer 6

To test for ankle clonus (esp if reflexes are hyperactive), support pt’s knee in partially flexed position and dorsiflex their food with your other hand. Maintain foot in dorsiflexed position. No rythmic oscillating movements should be palpated/seen.
Sustained clonus, meaning repeated rythmic muscle contractions, suggests UMN disease

Question 7

Romburg sign

Answer 7

Have pt stand with heels touching and eyes closed. Make sure to spot patient for safety.
Loss of balance = positive Romberg, indicates cerebellar ataxia, vestibular dysfunction, sensory loss

Question 8

Pronator drift

Answer 8

After completing Romberg, have pt continue standing, eyes closed, place both arms out with palms supine (i.e. “pizza box” pose). See if arms drift up or down. Then tap on one arm and then the other and watch if they drift or return easily to same position

Question 9

Decortiate posturing / flexor posture

Answer 9

abnormal posture with stiff with bent arms at the side, clenched fists, and legs out straight. The arms, wrists, and fingers are bent and flexed on the chest. Feet are dorsiflexed. Sign of severe brain damage

Question 10

Decerebrate posturing / extensor posture

Answer 10

arms and legs stiffly held straight out, toes pointed downward (plantar flexed), forearms pronated, clenched jaw, and head/neck being arched backwards

Question 11

Spasticity

Answer 11

Stiff and rigid muscles, unusual tightness. Associated with increased tendon reflex and hypertonia

Question 12

Flaccidity

Answer 12

Lacking firmness and strength. think opposite to spasticity

Question 13

Hemiplegia

Answer 13

total or partial paralysis of one side of the body that results from impairment to the motor centers of the brain

Question 14

Paraplegia

Answer 14

Complete paralysis of the lower half of the body including both legs, usually caused by damage to the spinal cord

Question 15

Delirium

Answer 15

Impaired cognition, consciousness, mood, and behavioral dysfunction of acute onset (Hours) May include hallucinations, incoherence, poor memory

Question 16

Dementia

Answer 16

A chronic, slowly progressive disorder of failing memory, cognitive impairment, behavioral problems, and personality changes that after begin after age 60 . Onset over months to years

Question 17

Depression

Answer 17

A mood disorder in which feelings of sadness, loss, anger, or frustration interfere with everyday life for an extended period. Onset over days- weeks

Question 18

Stupor

Answer 18

a state of near-unconsciousness or insensibility, commonly caused by drugs or alcohol

Question 19

Coma

Answer 19

A state of prolonged unconsciousness, including a lack of response to stimuli, from which it is impossible to rouse a person. Measured by the Glascow Coma Score, which includes eye opening, verbal & motor response

Question 20

Lethargy

Answer 20

A state of being drowsy, unenergetic, sluggish, and listless

Question 21

Parasthesia

Answer 21

an abnormal sensation, typically tingling or pricking (“pins and needles”)

Question 22

Receptive aphasia / Wernicke’s aphasia

Answer 22

Fluent, rapid speech with inflections and articulations like a sentence, but lack a meaning (paraphasias). Have malformed or invented words (Neologisms). (Seidel pg 71) Can get stuff out but it doesn’t make sense

Question 23

Expressive aphasia / Broca’s aphasia

Answer 23

Slow, laborious, nonfluent speech. Inflections and articulations are impaired, however words are meaningful. Have a trouble getting stuff out, but when they do it makes sense

Question 24

Vertigo

Answer 24

A feeling that you or your surroundings are moving when you are still, feel like you are spinning or falling. Associated with nausea/vomiting

Question 25

Areflexia

Answer 25

Absence of reflexes

Question 26

Hyperreflexia

Answer 26

Overactive or overresponsive reflexes. Twitching/Spastic movements. Associated with UPPER motor neuron issue

Question 27

Hyporeflexia

Answer 27

Under-active reflexes. Associated with LOWER motor neuron issue