Neuro Practical Flashcards
what is being tested during the
light touch: localization test?
dorsal column
ability to detect and localize a light touch stimulus
what is being tested during the pin prick test?
spinothalamic tract
ability to detect difference between sharp and dull sensation
what is being tested during the hot:cold test?
spinothalamic tract
ability to detect between a hot and cold stimulus
what is being tested during a vibration test?
dorsal column/medial lemniscus
ability to detect a vibration (when it starts and when it stops)
what is being tested during the extinction test?
test for unilateral neglect
specifically tactile neglect
what is being tested during the 2-point discrimination test?
dorsal column/medial lemnsicus tract
ability to accurately distinguish between 1 or 2 points of contact
what is the normative data/distances for the 2-point discrimination test?
fingertips = 2-5 mm
palms = 8-12 mm
hand, extremities, trunk = 20-30 mm
what is being tested in the proprioception test?
dorsal column/medial lemniscus tract
ability to detect position of limb when it is changed slightly (up/down)
what is being tested during the stereognosis test?
dorsal column → integrative ability of the parietal cortex
ability to accurately ID common objects based off of touch alone (eyes closed)
what is being tested during the graphesthesia test?
dorsal column → integration at parietal cortex
ability to accurately ID a letter/number that is drawn on your hand w/eyes closed
what is being tested during the kinesthesia test?
dorsal column → integration at parietal cortex → motor cortex
ability to detect movement in space and then match it with the contralateral limb (eyes closed)
how are all sensations tests graded?
5/5 = normal
1 - 4/5 = impaired
0/5 = absent
what are the deep tendon reflexes for the UE/LE testing for?
presence or absense of an UMN/LMN lesion
what nerve roots are responsible for the patellar tendon reflex?
femoral nerve (L2, 3, 4)
what nerve roots are responsible for the achilles reflex?
tibial neve (S1, 2)
what nerve roots are responsible for the biceps brachii tendon reflex?
musculocutaneous nerve ((C5, 6)
what nerve roots are responsible for the brachioradialis tendon reflex?
radial nerve (C5, 6)
what nerve roots are responsible for the triceps tendon reflex?
radial nerve (C6, 7)
what are the grades/scores for reflex testing?
0-1+ = LMN
2+ = norma
3+ = Brisk
4+ and 5+ = UMN lesion
what is the purpose of the Hoffman’s sign?
it is a pathological reflex that indicates the presence or absence of an UMN/LMN
flexion of 1,2 phalanx = a positive sign
what is the purpose and grading of the Babinski’s sign?
tests for the presence/absence of an UMN/LMN
splaying of toes and ext of hallux is a positive sign
what is the UE and LE synergy test for?
it tests the corticospinal tract and isolation of movement at a joint
what is considered an abnormal result for an UE and LE synergy test?
movement in two or more joints in compensatory/synergistic pattern
this indicates an UMN lesion
what does dysmetria (for UE and LE) test for?
cerebellar coordination/functioning
what are abnormal results for dysmetria UE/LE?
hypometria = undershooting
hypermetria = overshooting, varying course of movement, disintegration of pattern
what does dysdiadochokinesia test for?
cerebellar coordination/functioning
what is included in a spasticity test?
- shoulder FLX/EXT
- elbow FLX/EXT
- wrist FLX/EXT
- thumb flexors
- finger flexors
- hip FLX/EXT
- hip ABD/ADD
- knee FLX/EXT
- ankle DF/PF
- clonus
what does spasticity test for?
velocity dependent tone
presense of an UMN lesion
how are spasticity tests measured?
Modified Ashworth Scale
what results indicate the presence of clonus?
repeated bouncing of foot (plantarflexors)
what results are you looking for when testing the papillary reflexes?
direct and consensual constriction
accommodation
what is considered an abnormal result when testing the papillary reflex?
absense of constriction (direct/consensual)
absense of accommodation
what is tested when performing the big H test?
EOMs
pursuit eye movements
what are considered abnormal results from the big H test?
any asymmetry in movement
gaze palsies
2 or more of the following: nystagmus, strabysmus, saccades, and double vision
what gaze palsies can be observed as an abnormal result from a big H test?
UMN = same direction limitation
LMN = opposite direction limitation or in one eye
what are the grades that can be assigned during a Weber and Rinne test?
normal
conductive loss
sensoryneuro loss
what suggests conductive hearing loss during a Weber test?
positive is louder in affected ear
what suggests neurosensory hearing loss during a Weber test?
positive weber = louder in unaffected ear
what suggests conductive hearing loss during a Rinne test?
hear sound only in mastoid process
no sound heard when tuning fork is placed in front of auricle
what suggests neurosensory hearing loss during a Rinne test
no sound hear at either the mastoid or in front of the ear
when testing CN XI what indicates and UMN or LMN?
asymmetry in strength
UMN = trap is weak but SCM is spared
LMN = both are weak/absent
