Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Acute Care and Rehab > neuro assessments > Flashcards

neuro assessments Flashcards

1
Q

What basic observations should be done at the start of a neuro assessment?

A

Scars
Wasting of muscles
Involuntary movements
Fasciculations
Tremor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What aspects of involuntary movement may be observed?

A

Tremor
Clonus
Chorea
Associated reactions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What aspects of posture and balance should be observed?

A

Alignment and attitude of limbs
Neglect
Sitting balance
Standing balance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are aspects of sensory examination?

A

Superficial and deep

Superficial:
Pain
Temperature
Touch
Pressure

Deep:
Movement sense
position
vibration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How should a neuro assessment be started?

A

By confirming patient name, introducing self and checking if in any pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How is upper limb tone assessed for?

A

Elbow should be supported
With hand hold passively with different speeds move hand through range, then elbow then shoulder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What does hypertonia mean?

A

Excess resistance when moving through passive range
Can be sign of upper motor neuron lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is rigidity and what can it mean?

A

Rigidity is independent of velocity
Also known as “lead pipe” + tremor -> cog wheel
Can be seen in Parkinsons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is spasticity and what is it a sign off?

A

Velocity dependent resistance
Pyramidial causes such as stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is hypotonia associated with?

A

Lower motor neuron lesions
Lack of tone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is cog-wheeling and rigidity a sign of?

A

Can be a sign of Parkinson’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What might increased tone be a sign of?

A

Can be a sign of stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which regions should be tested for strength and what are their corresponding nerve roots in the upper limbs?

A

Shoulder abduction - C5
Shoulder adduction - C6/C7
Elbow flexion - C5/C6
Elbow extension - C7/C8
Wrist extension - C7
Wrist flex - C6/7
Finger ext - C7
Finger flex - C8
FInger abd - T1 (ulnar nerve)
Thumb abduction - T1 median nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What would upper limb extensor weakness be a sign of?

A

Extensor weakness with less affect on flexors suggests upper motor neuron lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How do lower motor neuron lesions present?

A

Present with focal patterns of weakness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What other muscle test can be done in the upper limb?

A

Pronator drift
With pt both arms straight, eyes closed and palms facing ceiling
Observe for pronation and lowering
- lesion contralateral corticospinal tract causing weak supinator than pronators

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How should reflex tests be performed and which areas should be tested in the upper limb?

A

Supinator / brachioradialis
Biceps
Triceps
For supinator and biceps a finger should be placed over the area and then hammer applied

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How should sensation be assessed?

A

Light touch with cotton wool over dermatome areas
Same areas should then be assessed using a neurotip
If disturbance occurs continue to see if normal after as may show disturbance in that spinal level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Why are deep tendon reflexes assessed?

A

To differentiate between upper and lower motor neuron lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is hoffman’s sign?

A

When flicking 3rd finger distal phalanx
Flexion of other digits is produced
Suggests upper motor neuron lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What does hyperreflexia suggest

A

Suggests upper motor neuron lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What does hyporeflexia suggest?

A

Suggests lower motor neuron disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What should be assessed prior to co-ordination?

A

Muscle power as reduced muscle power can appear as poor coordination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How can proprioception be assessed?

A

Move specific joints up and down and assess if patient can feel this occurring?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How can coordination be assessed in the upper limb?

A

Via having the patient touch their finger to their nose and then back to your finger, examiner should move finger

Can also put one hand over the other and supinate and pronate as fast as possible over and over

26
Q

What may be observed during a coordination test?

A

Dysmetria and tremors

27
Q

What is dysmetria?

A

When patient misses finger in finger to nose test
Indicates ipsilateral cerebellar lesions

28
Q

What is dysdiadochokinesia?

A

inability to perform fast alternating movement
Indicates ipsilateral cerebellar lesion

29
Q

What do the different modalities of sensory assessments test for?

A

Light touch is for spinothalamic and dorsal column
Pin prick assesses pain through spinothalamic
Vibration tests the dorsal column - column in tact if can feel stop of vibration

30
Q

In general what indicates a upper motor neuron lesion in an upper limb assessment?

A

Increased tone
Increased reflexes
Hoffman’s sign
Decreased power in a pyramidal pattern (extensors)

31
Q

In general what is are signs of lower motor neuron lesion in the upper limbs?

A

Reduced tone
Reduced reflexes
No hoffmans
Reduced power

32
Q

What is normal scapulohumeral rhythm?

A

Coordinated movement of humerus scapula and clavicle to achieve abduction and elevation

33
Q

What does a disturbed scapulohumeral rhythm indicate?

A

Dynamic functioning of stabilisers and humerus are disturbed if dysfunction

34
Q

What are the phases of scapulo thoracic rhythm

A

1st stage 30* elevation
- scapula stays same
- humerus 30*
- clavicle 0-5
2nd stage
- humerus 40* abduction (up to 90)
- Scapula 20* lateral rotation
- Clavicle 15* elevation
3rd stage
- humerus 60* abduction , 90 lat rotation to avoid impingement
- scapula 30-40* lateral rotation
- Clavicle 30-50* rotation posteriorly, 15* elevation

35
Q

How should scapulohumeral rhythm be observed?

A

Both ascending and descending
Important to observe both as weakness of muscles that control scapula more obvious in descending phase or scapula jumping
If scapula moves more than humerus may be reverse scapulohumeral rhythm

36
Q

What position should most neurological examinations be conducted in?

A

Supine with upper body at 45 degrees

37
Q

How should gait be assessed?

A

Check can walk without help
Stand without arms
Walking normal in line
Tandem walking
Toe walking
Heel walking

38
Q

What does standing without arms assess?

A

Proximal arm weakness

39
Q

What should be assessed in normal gait?

A

Speed
Symmetry
Balance
Arm swing

or

Posture
Arm swing
Stability, stride length and height
Turning

40
Q

What does toe walking test?

A

Plantarflexion strength

41
Q

What does heel walking assess?

A

Dorsiflexion strength

42
Q

What is romberg’s test?

A

Feet together
Hands by side
Eyes closed
Positive if lose balance and suggests if pt has ataxia is sensory in nature

43
Q

What is romburg’s test a sign of?

A

Proprioception

44
Q

How is tone assessed in the lower limb?

A

Leg roll
Knee lift
Ankle clonus - more than 5 contractions in a row show clonus
Passive movements

45
Q

How will knee lift vary with tone?

A

Excess tone heel will raise with knee

46
Q

What lower limb muscle groups are assessed for strength and what are their corresponding nerve roots?

A

Hip flexors: L1/L2
Hip extensors: L5/S1/S2
(Adductors: L2/L3
Abductors: L4/L5)
Knee extension: L3/L4
Knee flexion: L5/S1
Dorsiflexion: L4/L5
Plantarflexion: S1/S2
Great toe extension: L5
(Ankle inversion: L4
Ankle eversion: L5/ S1)

47
Q

What do changes in strength in the lower limbs indicate?

A

Lower limb flexion affected greater than extensors shows upper motor neuron lesion
Focal pattern of weakness suggests lower motor neuron lesion

48
Q

What reflexes should be tested in the lower limbs

A

Knee jerk: L3/L4
Achilles: L5/ S1
Externally rotate leg and dorsiflex foot
Plantar reflex (babinski): S1

49
Q

What is indicated if babisnki is positive?

A

Upper motor neuron lesion

50
Q

How is proprioception assessed in the lower limb?

A

Moving toes
Moving leg

51
Q

How is coordination assessed in lower limb?

A

Heel to shin, fast as possible
Fast feet tapping against hands

52
Q

What does an abnormal heel-shin indicated?

A

Lower limb weakness
Impaired joint proprioception
Cerebellar disorder

53
Q

What movements can be done if absent?

A

Jaw clench
Jendrassic’s manouevre

54
Q

What are common co-ordination abnormalities?

A

Shuffling gait
Ataxic gait
Waddling gait
High stepping gait

55
Q

What is the trunk control test?

A

4 item test battery
- Each item scored 0, 12 or 25 points
- 0 if can’t without assistance
- 12 if can do with non muscular assistance, abnormal well or arms to stabilise in sitting
- 25 if patient is able to complete task normal

56
Q

What is the trunk control test for?

A

Impairments in muscle function in those that have suffered a stroke or similar disorders

57
Q

What are the 4 items of the trunk control test

A
  1. Lie in supine and roll to weak side
  2. Roll to strong side
  3. Sit on side of bench for 30 s without arms to support self
  4. Sit up from supine lying position

Can assist patient with tasks and ensure safety by staying close to patient and ensure safe

58
Q

How is the trunk control test evaluated?

A

50 or less 6 weeks post-stroke indicates poor recovery

59
Q

What scale can be used to assess spasticity?

A

Modified ashworth scale
0- no increase in tone
1- slight increase in tone with a catch and release or minimal resistance at end of range
2 = as before but with minimal resistance through range following catch
3 = more marked increase tone through ROM
4 = considerable increase in tone, passive movement difficult
5 = affected part rigid

60
Q

How can reach be assessed?

A

Functional reach test
Cone reaching task

61
Q

How can balance be assessed?

A

4 square step test
Single leg stand
Functional reach test
4 stage balance test

Acute Care and Rehab (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions