neuro exam Flashcards
no menace, intact PLR
contralateral brain disease
menace intact but no PLR
visual cortex disease
no menace, no PLR
CN II disease
what does the palpebral reflex test
CN II, CN VII. not the brain
asymmetrical abscent palpebral, eyelid droop, normal chewing
facial n paralysis
CN nerves to swallow
9, 10, 11
what is the difference between G2 and G3 neuro scale
G2- consistently abnormal in a unique circumsance i.e in a circle
G3- abnormal all the time
UMN to both limbs
C1-C6
UMN to pelvic limbs only
T3-L2
LMN to hind limbs, urine dribbling
L3-S3
no urine output, big bladder
T2-L2
all limbs normal, fecal incont
S3-caudal
mentation changes, head pressing circling – locate lesion
brain
hypermetria, intention tremors– locate lesion
cerebellum
multiple CN deficits, dull, obtundation– locate lesion
brainstem
focal seizure, central blindness – locate lesion
brain
how to differentiate peripheral vestibular disease from central peripheral disease
peripheral- usually only one CN affected. base wide stance, staggering
central- multiple CN, mild prop deficits
both fast phases are away from the lesion while they tilt toward the lesion
what is the clinical signs of paradoxical vestibular
opposite head tilt and nystagmus than central. nystagmus toward the lesion . hypermetria gait
what does UMN signs to the limbs look like
hypometria, flexor paresis, spastic prop deficits
LMN signs to the limbs
weakness, extensor paresis- more flexion, short striding,
what are UMN signs to the hind limbs
flexor paresis, toe dragging
urine dribbling localization
L3-S3
valuable first step post lesion localization
radiographs
if we are suspicious of cervical compression what can we do
contrast cervical myelopathy
best modality for assessing spinal cord
CT
normal TNCC, Protein and RBC numbers from a CSF tap
TNCC <6
Protein <100
RBC <1
mononuclear cells in CSF suggest
viral meningitis or neoplasia
where is the safest location to get CSF fluid
lumbosacral
what size needle for CSF tap
18g 1.5in needle
