Neuro exams

Question 1

what is the MRC muscle power scale?

Answer 1

5 - normal power
4 - active movement against gravity and resistance
3 - movement against gravity
2 - active movement with gravity eliminated
1 - flicker/trace of contraction
0 - no contraction

Question 2

what are the dermatomes of the face?

Answer 2

Trigeminal nerve branches

V1 - ophthalmic - forehead
V2 - maxillary - cheek
V3 - mandibular - jaw

Question 3

what are the 2 dermatomes of the head?

Answer 3

C2 - top of head
C3 - supraclavicular fossa

Question 4

what are the upper limb dermatomes?

Answer 4

C4 - acromioclavicular joint
C5 - regimental patch
C6 - palmar side of thumb
C7 - palmar side of middle finger
C8 - palmar side of little finger
T1 - medial aspect of antecubital fossa

Question 5

what are the dermatomes of the torso?

Answer 5

T2 - apex of axilla
T3 - 3rd intercostal space
T4 - 4th intercostal space/nipples
T5 - 5th intercostal
T6 - xiphisternum
T7 - 1/4 of way from xiphoid process and umbilicus
T8 - 1/2 way from xiphoid process to umbilicus
T9 - 3/4s of way from xiphoid process to umbilixus
T10 - bellybutton
T11 - midway from bellybutton to inguinal ligament
T12 - inguinal ligament

Question 6

what are the dermatomes of the lower limb?

Answer 6

L1 - inguinal region and top of thigh
L2 - Lateral thigh
L3 - medial epicondyle of femur
L4 - medial malleolus
L5 - dorsum of foot
S1 - lateral aspect of calcaneus
S2 - popliteal fossa
S3 - horizontal gluteal crease (bottom of butt)
S4 /5 - perineal area

Question 7

what myotome innervates shoulder shrugging?

Answer 7

C4

Question 8

what myotome innervates shoulder abduction, external rotation and elbow flexion?

Answer 8

C5

Question 9

what myotome innervates wrist flexion?

Answer 9

C6

Question 10

what myotome innervates elbow extension and wrist flexion?

Answer 10

C7

Question 11

what myotome innervates thumb extension and finger flexion?

Answer 11

C8

Question 12

what myotome innervates finger abduction?

Answer 12

T1

Question 13

what myotome innervates Hip flexion?

Answer 13

L2

Question 14

what myotome innervates knee extension?

Answer 14

L3

Question 15

what myotome innervates ankle dorsiflexion?

Answer 15

L4

Question 16

what myotome innervates big toe extension?

Answer 16

L5 - large 5 - big toe

Question 17

what myotome innervates ankle plantar flexion?

Answer 17

S1

Question 18

what myotome innervates bladder and rectum motor supply?

Answer 18

S4

Question 19

what is the scoring of GCS?

Answer 19

MoVE
6, 5, 4

Question 20

what is the eye response scale in GCS?

Answer 20

4 - spontaneous
3 - to verbal stimuli
2 - to pain
1 - none

Question 21

what is the verbal response scale in GCS?

Answer 21

5 - orientated
4 - confused
3 - inappropriate words
2 - incomprehensible sounds
1 - none

Question 22

what is the motor response in GCS?

Answer 22

6 - normal and obeys commands
5 - localises to pain
4 - withdraws from pain
3 - abnormal flexion to pain
2 - abnormal extension
1 - no response

Question 23

what is examined in a cerebellar exam?

Answer 23

DANISH

Dysdiadochokinesia
Ataxia - gait, romberg’s
Nystagmus
Intention tremor
Slurred staccato speech
Hypotonia/Heel shin test

PLUS KNEE JERK REFLEX

Question 24

what are the criteria for urgent CT in head injury?

Answer 24

GCS <12
GCS <15 at 2 hours after the injury
Suspected open or depressed skull fracture
Sign of basal skull fracture (haemotympanum, ‘panda’ eyes, cerebrospinal fluid leakage from the ear or nose, Battle’s sign)
Post-traumatic seizure
Focal neurological deficit
>1 episode of vomiting

Question 25

what are 4 criteria for an urgent CT head in head injury PLUS LOC/amnesia?

Answer 25

> 65 years
Bleeding/clotting disorders
Dangerous mechanism
30 mins retrograde amnesia for events before injury

Question 26

who gets a non-urgent CT in head trauma?

Answer 26

blood thinners but no LOC or amnesia