Neuro localisation Flashcards
What are the two big goals of neuro-localisation?
- Is this a neurological problem (vs. orthopedic, metabolic)
- Where in the nervous system can you pinpoint the problem?
The locations include brain, spinal cord, and peripheral nervous system.
List the components used to assess neuro-localisation (6).
- Sensorium/Mentation
- Cranial nerves
- Gait
- Postural reactions
- Spinal reflexes
- Pain sensation
Each component helps in identifying the neurological issue.
What does QAR and BAR stand for in sensorium/mentation assessment?
QAR: Quiet Alert Responsive
BAR: Bright Alert Responsive
These terms describe the level of awareness and responsiveness of the patient.
Define stuporous in the context of sensorium/mentation.
Responds only to strong stimulus
This indicates a severe level of dullness in response.
What is the function of the Olfactory nerve (CN1)?
Sense of smell
This nerve is typically not tested clinically.
What does the Optic nerve (CN2) assess? and how to test?
- Vision
- Tracking with cotton ball drop
- Menace response (+ CN7)
- PLR (Pupillary Light Reflex) (+CN3)
The menace response involves both the optic and facial nerves.
What does the Occulomotor nerve (CN3) control? and how to test?
Eye position and movement,
PLR
(tests both CN3 and CN2)
Works in conjunction with CN2.
Which cranial nerve checks for physiological nystagmus?
Trochlear nerve (CN4)
Physiological nystagmus indicates normal eye movement responses.
What are the three branches of the Trigeminal nerve (CN5)?
- Ophthalmic
- Mandibular
- Maxillary
Each branch has specific sensory and motor functions.
What is the primary function of the Abducens nerve (CN6)? how to test?
Eye position and movement
corneal reflex.
What roles does the Facial nerve (CN7) serve? (x 3)
- Motor function of superficial muscles of face/head
- Sensory (taste)
- Parasympathetic (lacrimal and salivary glands)
It also plays a role in facial symmetry.
What are the two roots of the Vestibulocochlear nerve (CN8)?
- Vestibular
- Cochlear
The vestibular root transmits information about head position, while the cochlear root transmits sound impulses.
What is the function of the Glossopharyngeal nerve (CN9)? how to test?
Motor function of pharynx, glands, taste
Gag reflex
What does the Vagal nerve (CN10) control?
- Sensory and motor functions of palate, pharynx, larynx, trachea, esophagus, thoracic and abdominal organs
Key functions include gag reflex and dysphonia.
What is the primary role of the Accessory nerve (CN11)?
Motor to neck muscles- movement of head/neck
Muscle atrophy may occur but it’s very rare.
What is the function of the Hypoglossal nerve (CN12)? how to assess?
Motor to tongue
Atrophy and difficulty in prehending food can indicate issues.
What are common postural reactions to assess? (x 5)
- Standing paw placements
- Hopping
- Hemi walking
- Wheelbarrowing
- Extensor postural thrust
Deficits can indicate lesions in the nervous system pathways.
how would you assess gait and posture?
- Ambulatory status
- Normality of gait
- Ataxia
- Lameness
- Exercise intolerance/weakness (plegia/paresis)
What are the spinal reflexes assessed? (x 5)
- Thoracic withdrawal reflex (C6-T2)
- Cutaneous trunci
- Patellar reflex (L4-L6), femoral nerve
- Pelvic limb withdrawal (L4-S1)
- Perineal reflex, pudendal nerve, (S1-S3)
other FL reflexes are unreliable
Each reflex tests different spinal cord segments.
What are some clinical signs associated with forebrain lesions? x6
- Postural reaction deficits
- Blindness
- Seizures
- Behaviour changes/Changes in mentation
- Circling
- Head turn
These signs help in localizing the lesion.
What are the signs of cerebellar lesions?
- Spasticity
- Hypermetria
- Ataxia
- Nystagmus - vertical, horizontal, diagonal
- Decerebellate rigidity
These indicate cerebellar dysfunction.
What are the spinal cord regions?
- C1-C5
- C6-T2
- T3-L3
- L4-S1
- S1-S3
Each region corresponds to specific neurological functions.
