neuro exam III Flashcards
Are protopathic fibers myelinated or unmyelinated? Big or small? What sensations are tested?
small and unmyelinated
poorly localized touch, pain, temperature perception
Are epicritic fibers myelinated or unmyelinated? Big or small? What sensations are tested?
myelinated
big fibers.
fine, discriminative touch, vibration, and proprioception.
4 types of cortico-sensory modalities
stereognosis (ability to ID objects by touch alone)
graphesthesia (ability to recognizes numbers drawn on the hand)
2 pt discriminatio
double simultaneous stimulation. extinction indicates parietal lobe lesion.
I see truncal ataxia. Where is the lesion?
midline cerebellar vermis
Are cerebellar lesions contralateral or ipsilateral?
ipsilateral
What is past pointing?
pt elevates the arm vertically and then returns to the horizontal to touch dr’s hand. start with eyes open, then close them. a drift suggests ipsilateral vestibular apparatus lesion
What is compass turning test?
have pt march in place with eyes closed. rotation of the body suggests ipsilateral vestibular pathology.
What does the biceps reflex test?
C5-C6
What does the tricepts reflex test?
C7-C8
What does the brachioradialis test?
C5-C6
What does knee jerk test?
L3-L4
What does ankle jerk test?
S1-S2
What is a normal muscle stretch relfext?
2
What is the abdominal reflex?
stroke skin othe abdomin from the belly button toward any quadrant and look for deviation of the umbilicus towards the quadrant that was stroked. upper quedrants are T6-T9; lower qudrants T10-T12
What is the anal wink reflex?
stroke the perianal skin and look for contraction of the external anal sphincter on the stroked side. tests S3-S5
What is the cremasteric reflex?
stroke the skin on the inner thigh of the male; look for testicle elevation on that side. Tests L1-L2
What is the bulbo-cavernosus reflex?
sqeeze the glans penis and look for contraction of the external anal sphincter. Tests S3-S4
What is the normal Babinski? What is the significance of a positive Babinski?
flexion of the great toe Positive Babinski indicates UMN lesion.
What are the 4 frontal release signs?
snout reflex, palmomental reflex, grasp reflex, glabellar sign (tap the forehead and look for persistant blinking. normal people stop blinking)
Difference btw UMN and LMN lesions in terms of reflexes, spontaneous motion and muscle tone/bulk
UMN: in tact bulk, spastic tone, no spontaneous movements, incr. relfexes
LMN: atrophy in bulk, flaccid tone, fasiculations, decr. reflexes
