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(9th) > Neuro Dx > Flashcards

Neuro Dx Flashcards

1
Q

L5 NR Evaluation

A

Disc Level (L4)

MM:

  • foot dorsiflexion: tibialis anterior and extensor hallicus longus
  • big toe dorsiflexion: extensor hallicus longus (deep fibular/peroneal nn)
  • toes 2,3,4 dorsiflexion: extensor digitorum longus&brevis (deep f/p)
  • hip and pelvis abduction: gluteus medius & minimus (superior gluteal)

Reflex: none

Sensation: lateral leg, dorsum of foot and middle three toes

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2
Q

L4-L5-S1 Dermatome Evaluation

A

L4 right: L4 left
L5 right: L5 left
S1 right: S1 left

L4 right: L5 right
L5 right: S1 right

L4 left: L5 left
L5 left: S1 left

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3
Q

Jendrassik Maneuver

AKA Reinforcement Test

A

pt hooks hands/feet together and pulls on clenched hands or feet at the moment the reflex is performed

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4
Q

Uvular/Palateal Reflex

A

Raising of the uvula upon phonation or touching with a tongue depressor

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5
Q

Interscapular Reflex

A

Drawing inward of scapula when skin or interscapular space is irritated

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6
Q

Abdominal Reflex

A

Umbilicus deviation to stroked side.

Absence is only normal if bilateral (Beevor Sign)

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7
Q

Plantar Reflex

A

Plantarflexion (curling) of toes upon stroking sole of foot

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8
Q

Fakuda Step Test

A

pt marches in place, eyes closed, for 50 steps
( + ) a turning to one side
( i ) vestibular lesion on the side of rotation

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9
Q

Barognosis

A

Ask pt to identify difference between two same sized objects of different weight

Evaluating integrity of somatosensory cortex

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10
Q

Schaefer Sign

A

Squeezing of achilles tendon to elicit Babinski’s (alternative)

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11
Q

Ankle Clonus

A

Continued involuntary contraction (sustained plantar flexion) of foot upon quick
forcible dorsiflexion of the foot

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12
Q

Pallesthesia of foot

A

Place handle of vibrating 128Hz fork on joint line of lower extremity

Utilize 3 distal interphalangeal joints, if abnormal, continue to evaulate proximally until normal finding is achieved at base of 5th metatarsal, or medial and lateral malleoli.

Ask pt to identify when he or she feels vibration and when dr has stopped the vibration

( + ) inability to identify
( i ) dorsal column involvment

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13
Q

C4-C5-C6 Dermatome Eval

A

C4 right: C4 left
C5 right: C5 left
C6 right: C6 left

C4 right: C5 right
C5 right: C6 right

C4 left: C5 left
C5 left: C6 left

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14
Q

Fajersztajn Test
AKA Well-Leg-Raising Test of Fajersztajn
AKA Cross-over Sign

A

pt supine, dr performs SLR on UNAFFECTED leg to 75* or until produces pain down affected leg

if NO PAIN, examiner dorsiflexes foot

( + ) pain down affected leg (cross-over sign)
( i ) medial disc protrusion

( + ) decrease in pain down affected leg
( i ) lateral disc protrusion

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15
Q

Extraocular Movements
(Cardinal fields)

Evaluating CN III, IV, VI
(oculomotor, trochlear, abducens)

A

observe pts eyes for normal conjugate/parallel movements of eyes and nystagmus as you have them follow finger or pencil while making wide “H” in the air

(CN4/IV) Trochlear = down and in
(CN6/VI) Abducens = lateral
(CN3/III) Oculomotor = all others

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16
Q

Apraxia

A

Following complex motor commands,

“pretend to comb your hair”, “pretend to brush your teeth”

17
Q

Diadochokinesia:

Patting Test/Supination-Pronation Test

A

Coordination - testing cerebellum

18
Q

Dysmetria:

Heel-shin/Index Finger Test

A

coordination - testing cerbellum

19
Q

Direct Light Reflex

A

Ipsilateral pupillary constriction when light is shined in the eye
A: Optic
IC: Midbrain
E: Oculomotor (ipsilateral)

20
Q

Indirect Light Reflex

A

Contralateral pupillary constriction when light is shined in the eye

A: Optic
IC: Midbrain
E: Oculomotor (contralateral)

21
Q

Glabella AKA McCarthy

A

Contraction of orbicularis occuli muscle upon percussion of supraorbital ridge (glabella)

22
Q

Test Visual Acuity

A

screen by reading print
screen with shapes and/or colors

Evaluate optic nerve CN II

23
Q

Evaluate Facial Nerve ( CN VII)

A

Ask pt about change sin taste sensations sweet, salty andsour in anterior two thirds of tongue

Inspect face:

  • raise eyebrows
  • close eyes tightly
  • show teeth
  • puff out cheeks
  • smile
  • frown
24
Q

Evaluate Vestibulo-Cochlear Nerve

A

Finger Rub/Whisper test - sensory cochlear portion

assess hearing by rubbing fingers together near the EAM , find maximal distance sound can be heard

25
Q

Rinne Test

A

tuning fork to mastoid bone for bone conduction, begin counting.
pt tells you when sound isno longer heard, then move to EAM without touching pt

Normal: air conduction 2x as long as bone

Conduction Deafness/Sensorineural deafness

26
Q

Evaluate Hypoglossal Nerve

A

Inspect tongue for:
atrophy, fasciculations, deviation

Have pt stick out tongue and test bilateral with tongue depressor, or use tongue in cheek method

unilateral paralysis = protruded tongue deviates to involved side

27
Q

Fromet Paper Sign

A

( + ) The patient is seen to flex the thumb thereby recruiting the median nerve to compensate for apparent weakness
( i ) Ulnar nerve paralysis (weakness or palsy of the adductor pollicus muscle)

28
Q

L’Hermitte Sign

A

pt sitting or supine, examiner passively flexes patient’s head to the chest

( + ) Electric shock-like sensations down the spine and/or through extremities.
( i ) Dural irritation, severe spinal cord injury or degeneration.

29
Q

Turyn

A

( + ) Pain in the gluteal region or radiating sciatic pain.

( i ) Sciatic radiculopathy

30
Q

LIndner Sign

A

pt supine, examiner flexes patient’s head toward the chest.
( + ) Pain along sciatic distribution or sharp, diffuse pain (leg)
( i ) Sciatic radiculopathy

31
Q

Roo’s/EAST

A

( + ) ischemic pain, heaviness of the arms, or numbness and tingling of the hand.
( i ) Thoracic outlet syndrome on side involved
(Evan’s considers this test to be most
accurate for TOS evaluation)

32
Q

Adson’s

A

( + ) Pain and/or paresthesia, decreased or absent pulse amplitude, pallor.
( i ) Compression of the neurovascular bundle by scalenus anticus or cervical rib.

33
Q

Halstead

A

( + ) Pain and/or paresthesia, decreased or absent pulse amplitude, pallor.
( i) Compression of the neurovascular bundle by scalenus anticus or cervical rib.

34
Q

Costoclavicular/Eden’s

A

( + ) pain and/or paresthesia, decreased or absent pulse amplitude, pallor.

( i ) compression of the neurovascular bundle between the clavicle and 1st rib.

35
Q

Hyperabduction/Wright’s

A

( + ) pain and/or paresthesia, decreased or absent pulse amplitude, pallor.
( i ) compression of the axillary artery by pectoralis minor or coracoid process, Thoracic outlet syndrome.

(9th) (10 decks)

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