Neuro Flashcards
how should you summarise
general observations -muscle wasting and fasciculations tone power reflexes co-ordination sensation summary differential
what should you do before testing vibration sense
test on sternum
how should you complete the exam
neck stiffness and kernigs sign
how do you assess temperature sensation
use freeze spray on sternum and then arms and legs
what should you do before testing sensation
ask the patient if they have noticed any altered sensation or numbness
what are the important sensory modalities
light touch
pinprick
vibration
proprioception
how do you assess cerebellar drift
ask patient to hold out arms with palms facing up
look for upward drift
push down one hand and then the other
how do you perform a heel shin test
first do with eyes open and then eyes closed, this differentiates between a cerebellar and sensory cause
what causes sensory ataxia
sensory peripheral neuropathies
conditions causing dysfunction of the dorsal columns
how should you elicit foot clonus
foot in same position as ankle jerk
brachioradialis reflex
C6
triceps reflex
C7
biceps reflex
C5
what should you remember when eliciting reflexes
ensure the muscle is exposed and watch the muscle rather than the joint movement
compare side to side, reflexes should be symmetrical
what is a normal reflex
++
screening for LL power
lift your leg up, don’t let me push it down
squeeze your knees together, don’t let me push them apart
kick your leg out
curl your ankle towards you
curl your big toe up
point your foot down
Screening for UL power
make wings with your arms pull me towards you push me away make a fist, push up and then down squeeze my fingers spread your fingers apart put your thumb up
how do you grade muscle power
0-5
5 = normal power
what does clonus suggest
UMN lesion
how do you test for knee clonus
knee extended
grip lateral borders of the patella
pull down sharply and hold
how do you assess lower limb tone
roll right leg side to side
place hand under knee and pull upwards and drop back on to bed
which muscles should you palpate
quadriceps and calves
how should you look for fasciculations
rest hands on your lap and look for fasciculations in large muscle groups
general inspection
around the bed
posture, symmetry, muscle wasting, movements
skin
inspection and palpation of upper and lower limb
inspection of fasciculations shake hands ask if right or left handed palpate muscle bulk pronator drift and cerebellar
tone
upper limb
lower limb
clonus x2
reflexes
UL
LL
clonus
babinski
what are the steps
general inspection inspection and palpation UL and LL tone power reflexes coordination gait sensation
