Neuro Complaint Flashcards
What do you start a neuro exam with?
Alert and orientation questions! (A&OX4)
A reversible condition that is common in older adults during hospitalization
Delirium
A non-reversible condition with memory loss
Dementia
What must you rule out before diagnosing dementia?
Depression and Delirium
What can be seen with a CN3 lesion?
ptosis, pupil asymmetry, opthalmoplegia = down and out
What can be seen with a CN4 palsy?
Eye drifts upwards, vertical diplopia (double vision when looking down like to walk down stairs), head tilting away from lesion side
What can be seen with CN6 palsy?
Inability to ABduct eye
What can be seen with a CN5 palsy?
Decreased sensation from face, loss of corneal reflex and jaw deviation towards weak side
Trigeminal neuralgia
Recurrent brief episodes of shock like pain that follow a CNV distribution on the face
- Caused from compression via vein or artery
- Can be elicited by touching face
What can be seen with CN7 palsy?
Paralysis of facial expression muscles, loss of corneal reflex, increased sensitivity to sound
Bell’s palsy?
Loss of muscle control on one side of the face
Crocodile tears syndrome
Crying while chewing
Vestibular division CN8 lesion?
Imbalance and nystagmus
Cochlear division CN8 lesion?
Hearing loss and ringing in ears
What is nystagmus?
Rhythmic oscillations of the eyes
What are a few tests to look for meningitis?
Nuchal rigidity, Brudzinski sign, Kernig sign
Describe the Brudzinski sign
pt supine, physician slowly flexes their neck
(+) = patient flexes hips and knees involuntarily
Describe the Kernig sign
pt supine, physician flexes at hip and knee
- Physician then extends knee but keeps hip flexed
(+) = pain/resistance to knee extension or passive flexion of neck
Lhermitte’s Phenomenon
Transient shock like symptoms that occur down spine and into limbs with flexion of the neck
What is Lhermitte’s Phenomenon associated with?
Multiple sclerosis
Hyperactive DTR?
CNS lesion
Hypoactive DTR?
PNS lesion
Babinski reflex?
Stroke plantar surface of lateral foot from heal to ball of big toe
(+) = dorsiflexion of toes and fanning
Could indicate CNS lesion
Types of headaches?
Tension, migraine, cluster
Qualities of a tension headache
Minutes to days
Starts posteriorly and radiates forward
Non-constant pressure
Qualities of a migraine headache
4-72 hours
Unilateral but can be bilateral in children
Severe, needs room with no stimulus (light)
Qualities of a cluster headache
15 mins-3 hours
Always unilateral near eye/temple
Sharp stabbing pain
What symptoms are red flags for a possible dangerous mass?
SNOOP
Systemic, neuro symptoms, old age, onset sudden, papilledema
What to check for with dizziness?
TiTrATE
Timing
Triggers
A and a Target Examination
Hallpike maneuver
Head rotated 45 degrees and then pt laid down supine
What is syncope?
Fainting
Possible causes of syncope?
Vasovagal
Carotid sinus syndrome
Vasovagal
Over correction to a stimulus of SNS (pain, sight of blood, etc.)
