neuro exam III

Question 1

Are protopathic fibers myelinated or unmyelinated? Big or small? What sensations are tested?

Answer 1

small and unmyelinated

poorly localized touch, pain, temperature perception

Question 2

Are epicritic fibers myelinated or unmyelinated? Big or small? What sensations are tested?

Answer 2

myelinated
big fibers.
fine, discriminative touch, vibration, and proprioception.

Question 3

4 types of cortico-sensory modalities

Answer 3

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.

Question 4

I see truncal ataxia. Where is the lesion?

Answer 4

midline cerebellar vermis

Question 5

Are cerebellar lesions contralateral or ipsilateral?

Answer 5

ipsilateral

Question 6

What is past pointing?

Answer 6

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

Question 7

What is compass turning test?

Answer 7

have pt march in place with eyes closed. rotation of the body suggests ipsilateral vestibular pathology.

Question 8

What does the biceps reflex test?

Answer 8

C5-C6

Question 9

What does the tricepts reflex test?

Answer 9

C7-C8

Question 10

What does the brachioradialis test?

Answer 10

C5-C6

Question 11

What does knee jerk test?

Answer 11

L3-L4

Question 12

What does ankle jerk test?

Answer 12

S1-S2

Question 13

What is a normal muscle stretch relfext?

Answer 13

2

Question 14

What is the abdominal reflex?

Answer 14

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

Question 15

What is the anal wink reflex?

Answer 15

stroke the perianal skin and look for contraction of the external anal sphincter on the stroked side. tests S3-S5

Question 16

What is the cremasteric reflex?

Answer 16

stroke the skin on the inner thigh of the male; look for testicle elevation on that side. Tests L1-L2

Question 17

What is the bulbo-cavernosus reflex?

Answer 17

sqeeze the glans penis and look for contraction of the external anal sphincter. Tests S3-S4

Question 18

What is the normal Babinski? What is the significance of a positive Babinski?

Answer 18

flexion of the great toe Positive Babinski indicates UMN lesion.

Question 19

What are the 4 frontal release signs?

Answer 19

snout reflex, palmomental reflex, grasp reflex, glabellar sign (tap the forehead and look for persistant blinking. normal people stop blinking)

Question 20

Difference btw UMN and LMN lesions in terms of reflexes, spontaneous motion and muscle tone/bulk

Answer 20

UMN: in tact bulk, spastic tone, no spontaneous movements, incr. relfexes
LMN: atrophy in bulk, flaccid tone, fasiculations, decr. reflexes