Neuro Exam Flashcards
Intro - what’s the acronym and what does it stand for?
WIIPPPE Wash hands Introduce yourself Identity Permission Pain Position Expose
General inspection - what are you looking for?
SWIFT on patient:
Scars Wasting of muscles Involuntary movements Fasciculations Tremor
Specific signs e.g. Neurofibromas
Face - hypomima, ptosis, ophthalmoplegia
What do you look for after general inspection?
Pronator drift - contralateral UMN
Tone (ask patient to be floppy)
Increased tone
Spasticity
Rigidity - independent of how quickly you try to do the movement - cog wheel rigidity - parkinsons
Hypotonia
LMN lesion
Power
MRC power scale?
Hyperreflexia
UMN lesion
Hyporeflexia
LMN lesion
Light touch
Dorsal columns
Vibration sensation
Interphalangeal joint
Move more proximally along the inter boney joints until they can feel the vibration
Proprioception of thumb
Ask patient to move thumb up or down
DO NOT put hand on nail
Proprioception of thumb - how do you do this and what are some dos and don’ts?
Move patient’s thumb up or down SLIGHTLY
DO NOT put hand on nail
What would dysdiadokinesia suggest?
Cerebellar pathology
What else do you do for the coordination test?
Clapping alterative movement
Finger nose test
Make sure the arm has to stretch fully
What other signs might someone with past pointing and intentin tremor
Dysdiodiokinease Ataxia Nystagmus Intenion tremor S?
Dysarthria
