Neuro Exam Flashcards
Normal birthweight and head circumference
3 kilo
33 cm head circumference
What to check first in neuro exam in babies?
Sucking, rooting reflex, grasping reflex, and turn head to see extension of ipsilaferal arm (both sides). Also do the Babinski.
Gallant reflex
Check the curvature spine when you rub lower back
Holding reflex and placing reflex
Hold baby under arms and will extend legs to do an elementary walk. Bring him to edge of bed to see if they step if there is placing reflex
Put baby in prone position on belly
Check beller reflex to see if they push up and check the spine curvature. Also the climbing reflex to see if they moving if you slowly run them over a flat soft surface.
Sitting position in the air
See if baby straightens back and head
Morro reflex
Tonic, and extension phase in the arms due to dropping sensation. Followed by crying.
If neuro exam is normal what do you do next?
EEG and do an echo/ECG to check the heart for malformation
What if the neuro exam is abnormal
Follow patient for developmental changes
In older kids how do you start the neuro exam
Lay the patient down and check the meningeal sign and nuchal rigidity
How to look for peripheral neuro exam
Muscle tone (move joints passively), muscle mass, and muscle reflex
What is muscle tone for?
To maintain a posture during gravity
What happens to the Achilles’ tendon in hypotonia?
It is shortened
Have patient do pronator drift test and then
Have patient to sit up to see central muscles and do a coordination exam (closed eyes nose touch)
What comes after the coordinations exam
Then do reflex exam and tremmner finger exam
Have patient sit up and check
Shape of head, damage to head, épiçantes fold, low set ears, cleft palate
After head check
Any abnormalities of limbs
Check the cranial nerves
- olfactory
- optic nerve (eye field and and light and acuity)
- oculomotor, trochlear, and abducens (follow object and ask about double vision and check pupillary reflex)
- trigeminal (sensation of 3 areas of face and open jaw and move it symmetrically)
- facial (function of facial muscle, frown and smile)
- vestibulochoclear (whisper test and vestibular with nystagmus and balance exam)
- vagus (is swallowing test and uvula deviation)
- hypoglossal (tongue look for fasciculations and position)
- accessory (lift shoulder and try to push it down and see head turning during)
Standing body position check
Romberg and gait. Check squaring of patient. Have patient sit and try to stand
