Neuro Exam Flashcards
What needs to be observed with a neuro exam?
- Mentation
- Behaviour
- Posture
- Gait
What can be seen as wrong with mentation? Abnormalities
*Alert
*Disorientated / confused
*Depressed / obtunded
*Stuporous - unconscious but can be roused by painful stimuli
*Comatose - unconscious and unresponsive
What location of lesion is seen with stuporous / comatosed mentation?
Brainstem problem
usually more severe
no response
What is abnormal behaviour observed?
*Aggression
*Compulsive walking / circling
*Loss of learnt behaviour
*Vocalisation
*Hemineglect syndrome - ignore half of their environment - e.g only eat half of the food
What can be seen abnormal with posture? Where is the disease likely to be?
*Head tilt - vestibular disease
*Head +/or body turn - forebrain disease
What posture abnormalities are seen with advanced disease?
*Decerebrate rigidity - extension of all limbs - usually comatose / stuporous
*Decerebellate rigidity - hyperextension of Thoracic limbs
What is Schiff-sherington
- hyperextension of Thoracic Limbs (maintaining voluntary movement and normal CP) and paralysis of PLs
- interference with Border cells –inhibitory neurons in cranial lumbar spinal cord that inhibit the TL extensor muscles
- lesion in thoracic or cranial lumbar spine
What lesions can cause ataxia (uncoordinated gait)
- spinal or less commonly peripheral nerve disease
- vestibular disease (“off balance”)
- cerebellar lesions (“drunken gait”)
What does spinal ataxia cause?
*Decreased sensory information arriving from the limbs to CNS
-legs don’t know where they are
What is vestibular ataxia?
What does vestibular ataxia cause?
- loss of orientation of the head with the eyes, neck, trunk and limbs and results in loss of balance
-typically = falling, rolling towards side of lesion
What is cerebellar ataxia?
- typically with inability to regulate rate, range or force of movement –
dysmetria:
– hypometria (shorter protraction phase)
– hypermetria (longer protraction phase)
What is paresis?
-Usually from problem affecting spine
-weakness, reduced voluntary movement of limbs
What is paralysis?
Complete absence of voluntary movement
What are the 4 sections of the neuro exam?
- Postural reactions
- Spinal reflexes and muscle tone
- Spinal pain
- Cranial nerve examination
What is observed with postural reactions?
– paw position; hopping; hip sway; wheelbarrow; extensor
postural thrust; placing responses
