Neurologic Examination Flashcards
(44 cards)
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)
1
Q
History
A
- chief complaint
- past medical history
- family history
- social history
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
3
Q
dysphonia
A
hoarseness
- usually due to upper respiratory problem
- can occur when laryngeal nerve is affected
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
5
Q
Wernicke’s aphasia
A
- parietal lobe damage
- sensory or receptive aphasia
- can talk fluently, but does not make sense
6
Q
Global aphasia
A
Broca’s and Wernicke’s
7
Q
nuchal rigidity
A
menengitis sign
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
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
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
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
12
Q
fundoscopic examination
A
looking at disk and blood vessels
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
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
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
16
Q
pupil reactions
A
constriction(parasypathetics)
- light
- accomodation = as object gets closer, pupil gets smaller
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
CN 8
vestibulocochlear
- balance control
- gaze control
- Doll's eye = eye lids move opposite of head(lay down-->eyes close, sit up-->eyes open)
25
Calorics
CN 8
- cold water = eyes deviate to the same side
- warm water = eyes deviate to the opposite side
26
nystagmus
- 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
whisper test
stand behind patient, say two syllable words
| - cochlear
28
Weber test
- do if whisper test is abnormal
- place tuning fork on vertex of cranium
- pt should hear tuning fork equally in both ears
29
Rinne test
- screens one ear at a time
- compares air and bone conduction
- place stem on mastoid
- when sound no longer heard place by ear
30
CN 9 & 10
glossopharyngeal and vagus
- gag reflex
- uvula movement = moves to opposite side of lesion
31
CN 11
spinal accessory
- trapezius
- SCM
32
CN 12
hypoglossal
| - tongue protrusion = deviates to weaker side
33
cerebellar signs
- finger to nose
- heel to shin
- gait = wider based gait
- dysmetria
- dysdiadochokinesia
- intention tremor = action tremor that occurs as person is doing something
34
sensation
- touch = cotton ball
- vibration
- position sense = mirror test, up and down
- pain = pin prick
- parietal lobe function(2-point discrimination, stereognosis, graphesthesia)
35
cremaster reflex
stroke inner thigh, testicle on same side should elevate
36
abdominal reflex
stroke abdominal and umbilicus should deviate towards umbilicus
37
fasciculations
bag of worms
- tiny muscle contractions
- sign of acute deinnervation
38
tremors
- 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
choreiform
- Huntington's chorea
- hereditary
- dementia
- Sydenham's chorea
- rhematic fever
40
hemiballism
subthalamus
| - flailing of entire limb
41
athetosis
globus pallidus
| - slow writhing movements
42
dystonia
affects consistent attitude of posture
43
motor system weakness
- neuropathic: distal(foot/ankle, hand)
- myopathic: proximal(hips, scapula/humeral)
- pyramidal(corticospinal tract)
- UE extensors
- LE flexors
