neuro exam Flashcards
what are cafe au lait blotches a sign of
neurofibromatosis
why is it useful to shake hands with the patient
assess myotonia
which muscles should be palpated for muscle bulk
quadriceps and calves
what does a flexed upper limb and extended lower limb suggest
hemiplegia
what does a wrist drop suggest
radial nerve palsy
what is chorea
abrupt involuntary movements
what is a postural tremour
tremour when the limb is maintained in a position
what does a fasciculation with weakness suggest
LMN degeneration
what lesion does clonus suggest
UMN
how is power assesed
scale of 0-5
0- no muscle contraction 1-flicker of contraction 2- joint moves when gravity is eliminated 3- movement against gravity 4- movement against resistance but weak 5- normal power
what nerves are used in hip abduction
L4/5/S1
glut medius and minimus, sartorius, tensor fascia latae
what nerves does knee flexion use
L5/S1
shoulder abduction
C5
elbow flexion
musculocutaneous nerve
C5,6
elbow extension (triceps)
c6/7/8
wrist extension
c6,7,8
wrist flexion
c6,7,8
finger flexion
T1
how do you classify reflexes
0 absent \+ normal but reduced \++ normal \+++ increased, could be normal \++++ greatly increased
brachioradialis reflex
C6
triceps reflex
C7
biceps reflex
C5
knee jerk reflex
L3/4
ankle jerk reflex
S1
babinski reflex
L5, S1, S2
what is sensory ataxia
loss of coordination caused by loss of sensory input into the control of movement
(not cerebellar dysfunction)
how can you tell if an ataxia is sensory rather than cerebellar
movement is near normal when eyes are open but much worse when closed
what lesions could cause a sensory ataxia
sensory peripheral neuropathies
dorsal column dysfunction
what is a positive Romberg’s test
swaying with eyes closed indicates proprioceptive or sensory defect
what are the signs of cerebellar disease
nystagmus dysarthria dysdiadokinesia intention tremor past pointing cerebellar drift and rebound hypotonia
what does the acronym DANISH stand for
Dysdiadokinesia ataxia nystagmus intention tremor slurred speech hypotonia
light touch, vibration, proprioception
dorsal columns
pain and temp
spinothalamic
what is Kernig’s sign
hip flexion
further knee extension is painful
indicates meningeal irritation
how do you test for nerve root irritation
straight leg raising
a test done during the physical examination to determine whether a patient with low back pain has an underlying herniated disk,
patient lies down and legs are lifted in the air
