Neurologic Exam Flashcards
list the 5 points of a neuro exam
- general observations (mentation, posture, gait)
- cranial nerves
- postural reaction
- segmental reflexes
- palpation
- if necessary/able, sensation
describe the types of mentations
bright and alert
obtunded (mild, moderate, severe)
- decreased response(s) to environment
stuporous
- semi-comatose
comatose
- completely unresponsive
opisthotonus
posture of the head, neck, and thoracic limbs
extensor rigidity of the limbs
head and neck extend dorsally
decerebrate posture
opisthotonus
comatose
extreme UMN signs
- rigid
- exaggerated reflexes
indicates damage at level of the midbrain
decerebellate posture
opisthotonus
conscious
- appropriate response to painful stimuli
capable of voluntary movement
often flexion of pelvic limbs
schiff-sherrington posture
indicates damage at level of the spinal cord
opisthotonus
paraplegia
- paralysis of pelvic limbs
gait abnormalities
ambulatory vs. not
paresis / paralysis
ataxia
circling
dysmetria
list the 5 postural reaction tests
proprioceptive positioning reaction
wheelbarrowing
extensor postural thrust
placing reaction: tactile or visual
hopping
classifications for reflexes
absent decreased normal exaggerated clonic
patellar reflex
femoral nerve
L4, 5, 6
gastrocnemius reflex
sciatic nerve
L6, L7, S1
perineal reflex
pudendal nerve
S1, 2, 3
flexion reflex
mostly sciatic nerve (PL)
mostly musculocutaneous (TL)
biceps reflex
musculocutaneous nerve
triceps reflex
radial nerve
cutaneous trunci reflex
bilateral, helpful for lesion localization along spinal cord
crossed extensor reflex
only abnormal in lateral recumbency
3 aspects of neurologic palpation
- hyperesthesia: increased sensitivity to stimuli
- muscle tone
- muscle mass
difference between superficial and deep pain sensation
deep = periosteal involvement
superficial = no periosteal involvement
pupillary light reflex
light = stimulus
CN II - afferent nerve
CN III - parasympathetic division - efferent nerve
- also controls constriction
bilateral reflex
menace response
menace = stimulus
CN II - afferent nerve
contralateral cerebral hemisphere
ipsilateral cerebellar hemisphere
CN VII - efferent nerves
blink = response
physiologic nystagmus
involuntary movements of the eye
CN VIII - afferent nerve
CN III, IV, VI - efferent nerves
spontaneous nystagmus
lesion of vestibular system
fast phase pulls eyeball away from the side with the lesion
trigeminofacial reflexes
corneal reflex (also involves CN VI)
palpebral reflex
lip pinch
vibrissae reflex
trigeminal - afferent nerve
facial - efferent nerve
