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OMM II > Neuro Exam > Flashcards

Neuro Exam Flashcards

1
Q

What is the main question asked when doing a neurological exam?

A

Where is the lesion? (CNS, PNS)

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2
Q

What is the first sign of cauda equina?

A

Bladder retention

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3
Q

When should you consider a neurologic exam prior to performing OMM? (2)

A
  • Pain in the axial skeleton

- Evaluating a joint problem that has neurologic symptoms associated with it

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4
Q

Is smooth or jagged (“give way”) weakness more concerning?

A

Smooth

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5
Q

If a pt comes in with bilateral LE weakness, what should you ask?

A

Numbness/weakness in other parts of the body

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6
Q

LMN lesions have what type of paralysis?

A

Flaccid

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7
Q

UMN lesions have what type of paralysis?

A

Spastic

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8
Q

True or false: it is okay to skip sections of the neuro exam if there are no symptoms in that area

A

False

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9
Q

Fasciculations are indicative of UMN or LMN lesions? What are these?

A

UMN

Stimulation of motor units (LMN units)

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10
Q

What are parkinsonian symptoms?

A

Resting tremors

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11
Q

What are the characteristics of cerebellar walking?

A

Wide based gait

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12
Q

Heel walking is checking for what spinal level?

A

L5

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13
Q

Toe walking is checking which spinal level?

A

S1

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14
Q

Romberg test is checking for what function?

A

Proprioception

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15
Q

Sway and falling with closing eyes in Romberg is positive for what type problem?

A

Proprioception

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16
Q

Sway and falling withOUT closing eyes in Romberg is positive for what type problem?

A

Cerebellar

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17
Q

How do you test for Hoffman’s reflex?

A

Flipping the dorsal surface of the middle finger, and observing for contraction of the thumb and second digit

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18
Q

What does Hoffman’s reflex check for?

A

UMN lesions

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19
Q

What is clonus?

A

To and fro rhythmic oscillation of a body part. Hyperreflexia

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20
Q

True or false: any clonus in mature individuals is abnormal

A

False- only sustained clonus

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21
Q

What is abortive clonus?

A

Few oscillations when eliciting clonus

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22
Q

What is the grade for hyperactive or hyperreflexia?

A

3/4

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23
Q

What is the grade for hyperreflexia with sustained clonus?

A

4/4

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24
Q

What is the root level for the biceps reflex? What is the peripheral nerve?

A

C5

Musculocutaneous n

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25
Q

What is the root level for the brachioradialis reflex?

A

C6

Radial n

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26
Q

What is the root level for the triceps?

A

C7

Radial n

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27
Q

What is the root level for the quadriceps?

A

L4

Femoral n

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28
Q

What is the root level for the achilles tendon reflex?

A

S1

Tibial n

29
Q

True or false: to test reflexes, you should flex or extend the joint to alter the tension

A

true

30
Q

What is a Jendrassik maneuver?

A

Distracting the individual while assessing reflexes

31
Q

What is a positive Babinski sign?

A

Extension of the great toe, and flaring of the remaining digits (“up going”)

32
Q

What is the appropriate way to document a babinski sign?

A

Flexor or extensor response

33
Q

Which side of the foot should the babinski sign be started from? Why?

A

Lateral side of the plantar foot, otherwise may elicit the plantar grasp reflex, which may show as a down going Babinski

34
Q

Grade this muscle strength: FROM against gravity only

A

3

35
Q

Grade this muscle strength: FROM with gravity eliminated

A

2

36
Q

Grade this muscle strength: no joint motion, but a slight muscle contraction can be palpated or observed

A

1

37
Q

What causes the “give-way” weakness? (2)

A
  • pain

- Not understanding physician

38
Q

What are the four muscles that you should not be able to overcome?

A
  • Trapezius
  • Triceps
  • Quad extension
  • Gastrocnemius
39
Q

What are the ASIA sensory points?

A

A series of points to test, to check for spinal cord injury

40
Q

What are the common pitfalls of the neuro exam?

A
  • Relying too much on the history

- Not having a reproducible way to elicit reflexes

41
Q

What does Tandem walking test for?

A

Cerebellum

42
Q

How do you ensure reproducibility with strength testing?

A

Overcome them for a few degrees

43
Q

If a patient has full strength, but only to a certain degree of flexion/extension, how should this be documented?

A

5/5 strength at (__) degrees of whatever

44
Q

Where is C3 sensation tested?

A

Supraclavicular fossa

45
Q

Where is C4 sensation tested?

A

Top of AC joint

46
Q

Where is C5 sensation tested?

A

Lateral antecubital fossa

47
Q

Where is C6 sensation tested?

A

Dorsal, proximal thumb

48
Q

Where is C7 sensation tested?

A

Dorsal, proximal middle finger

49
Q

Where is C8 sensation tested?

A

Dorsal, proximal 5th finger

50
Q

Where is T1 sensation tested?

A

Medial antecubital fossa

51
Q

Where is L2 sensation tested?

A

Medial anterior thigh

52
Q

Where is L3 sensation tested?

A

Medial, anterior knee

53
Q

Where is L4 sensation tested?

A

Medial malleolus

54
Q

Where is L5 sensation tested?

A

Medial dorsal foot

55
Q

Where is S1 sensation tested?

A

Inferior lateral malleolus

56
Q

Where is S3 sensation tested?

A

ITs

57
Q

What spinal level: shoulder abduction/elbow flexion

A

C5

58
Q

What spinal level: wrist extension

A

C6

59
Q

What spinal level: elbow extension

A

C7

60
Q

What spinal level: Long (3rd) finger flexion at the DIP

A

C8

61
Q

What spinal level: Finger abduction

A

T1

62
Q

What spinal level: hip flexion

A

L2

63
Q

What spinal level: Knee extension

A

L3

64
Q

What spinal level: ankle dorsiflexion

A

L4

65
Q

What spinal level: big toe extension

A

L5

66
Q

What spinal level: Ankle plantarflexion

A

S1

67
Q

Which has more prominent atrophy: UMN lesion, or a LMN lesion?

A

LMN

68
Q

Which has fasciculations: UMN or LMN lesions?

A

LMNs

OMM II (43 decks)

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