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Neuromuscular > Neurologic Examination > Flashcards

Neurologic Examination Flashcards

0
Q

General signs

A

Cognition

  • memory(new and old)
  • higher functions(mathematical problems, similarities and differences, interpret proverbs)
  • judgement
  • new memory test(write down 5 cities cited)
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1
Q

History

A
  • chief complaint
  • past medical history
  • family history
  • social history
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2
Q

Dysarthria

A

difficulty talking

  • flaccid = nasally, soft palate is floppy, consonants distorted, speak in short phases
  • cerebellar(ataxic) = scanning speech
  • spastic = poor respiration, hoarseness, hard to get words out, slow
  • hypokinetic = parkinson’s, poor articulation, progressively less clear, speaking very fast
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3
Q

dysphonia

A

hoarseness

  • usually due to upper respiratory problem
  • can occur when laryngeal nerve is affected
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4
Q

broca’s aphasia

A
  • frontal lobe damage
  • motor or expressive aphasia
  • fluency of language is lost(not cohesive)
    • pt’s know that they are speaking incorrectly
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5
Q

Wernicke’s aphasia

A
  • parietal lobe damage
  • sensory or receptive aphasia
  • can talk fluently, but does not make sense
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6
Q

Global aphasia

A

Broca’s and Wernicke’s

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7
Q

nuchal rigidity

A

menengitis sign

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8
Q

skin check

A
  • cafe-au-lait spots = brownish spots emerge suddenly
  • butterfly rash on face = evidence of lupus
  • tufts of hair = in spinal cord region(spina bifida occulta)
  • evidence of trauma
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9
Q

gait assessment

A
  • hemiparetic(stroke)
  • ataxic(cerebellar problem)
  • shuffling(PD)
  • steppage(stroke; peripheral neuropathy)
    - no dorsiflexion(increased hip flexion)
  • spastic/scissor(CP)
    - adductor and IR’s increased tone
  • antalgic(pain syndrome)
    - limping
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10
Q

CN 1

A

olfactory

  • test with something that has a significant odor
  • sometimes uses smell to wake up since direct connection to cerebral cortex
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11
Q

CN 2

A

optic

  • acuity = acute vision
  • visual fields
    • scotomas = little blind spots in visual field
    • blindness
    • hemianopsia
    • quadrantopsia = 1/4 of visual field lost
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12
Q

fundoscopic examination

A

looking at disk and blood vessels

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13
Q

papilloedema

A

increase in intracranial pressure

  • pushing disk out
  • decrease in blood vessels
  • normal color of disk is yellow-white
  • if Snow White, optic neuritis
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14
Q

CN 3

A

occulomotor

  • dysfunction could mean intracranial pressure pushing uncus into midbrain
  • if cut, could move eye laterally and “in and down”, pupils dilated, cannot lift eyelid
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15
Q

occulomotor complex

A 
adductor = MR
abductor = LR
elevators = IO and SR
depressors = SO and IR
- recti work best when eye is abducted
- obliques work best when eye is adducted
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16
Q

pupil reactions

A

constriction(parasypathetics)

  • light
  • accomodation = as object gets closer, pupil gets smaller
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17
Q

abnormal pupils

A
  • fixed and dilated
  • argyle robertson pupil = irregular small pupil, that doesn’t react to light(possible cause is syphillis of CNS)
  • adies pupil = slightly larger than normal
    - affected by ciliary ganglion dysfunction
    - doesn’t react light, but accomodates
18
Q

pupil dilation

A

sympathetics, not in CN 3

19
Q

Horner’s syndrome

A
  • miosis = pupil constriction
  • ptosis = droopy eyelid
  • anhydrosis = trouble sweating(dry eyes)
  • enophthalmos = eye is more sunken in
20
Q

saccadic eye movements

A

rapid jumps of eyes to look at new objects

21
Q

CN 5

A

sensory

motor = muscles of mastication

22
Q

CN 7

A

facial

  • motor to face
  • sensory = anterior 2/3 of tongue
23
Q

facial nerve lesion

A

central lesion = contralateral weakness on lower part

peripheral lesion = ipsilateral weakness of face(upper and lower)

24
Q

CN 8

A

vestibulocochlear

  • balance control
  • gaze control
    • Doll’s eye = eye lids move opposite of head(lay down–>eyes close, sit up–>eyes open)
25
Q

Calorics

A

CN 8

  • cold water = eyes deviate to the same side
  • warm water = eyes deviate to the opposite side
26
Q

nystagmus

A
  • normal response to cold and warm water calorics
  • normal response if spin someone
  • abnormal if occurs during smooth pursuit test
  • abnormal if occurs spontaneously
27
Q

whisper test

A

stand behind patient, say two syllable words

- cochlear

28
Q

Weber test

A
  • do if whisper test is abnormal
  • place tuning fork on vertex of cranium
  • pt should hear tuning fork equally in both ears
29
Q

Rinne test

A
  • screens one ear at a time
  • compares air and bone conduction
  • place stem on mastoid
  • when sound no longer heard place by ear
30
Q

CN 9 & 10

A

glossopharyngeal and vagus

  • gag reflex
  • uvula movement = moves to opposite side of lesion
31
Q

CN 11

A

spinal accessory

  • trapezius
  • SCM
32
Q

CN 12

A

hypoglossal

- tongue protrusion = deviates to weaker side

33
Q

cerebellar signs

A
  • finger to nose
  • heel to shin
  • gait = wider based gait
  • dysmetria
  • dysdiadochokinesia
  • intention tremor = action tremor that occurs as person is doing something
34
Q

sensation

A
  • touch = cotton ball
  • vibration
  • position sense = mirror test, up and down
  • pain = pin prick
  • parietal lobe function(2-point discrimination, stereognosis, graphesthesia)
35
Q

cremaster reflex

A

stroke inner thigh, testicle on same side should elevate

36
Q

abdominal reflex

A

stroke abdominal and umbilicus should deviate towards umbilicus

37
Q

fasciculations

A

bag of worms

  • tiny muscle contractions
    • sign of acute deinnervation
38
Q

tremors

A
  • resting = 3 cycles per second(“pill rolling” tremor)
  • essential = benign tremor(non-specific, familial)
    - not associated with neurologic condition
  • intention = occurs when doing something(intending to)
    - cerebellum over corrects actions
39
Q

choreiform

A
  • Huntington’s chorea
    • hereditary
    • dementia
  • Sydenham’s chorea
    • rhematic fever
40
Q

hemiballism

A

subthalamus

- flailing of entire limb

41
Q

athetosis

A

globus pallidus

- slow writhing movements

42
Q

dystonia

A

affects consistent attitude of posture

43
Q

motor system weakness

A
  • neuropathic: distal(foot/ankle, hand)
  • myopathic: proximal(hips, scapula/humeral)
  • pyramidal(corticospinal tract)
    - UE extensors
    - LE flexors

Neuromuscular (1 decks)

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