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Minor Injuries 🦴 > Neurological Assessment > Flashcards

Neurological Assessment Flashcards

1
Q

What are the characteristics of cluster headaches?

A

Sharp unilateral periorbital pressure

Cluster headaches are in a cluster, repeat attacks. They also have autonomic features and are rare.

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2
Q

What are the characteristics of migraines?

A

More commonly affects women

Migraines are recurrent and typically diagnosed before 40. They usually last 4 - 72 hours, are unilateral with nausea and vomiting. They may include aura, reversible speech/ visual disturbance/ sensory aura/ auditory aura, and can be severe and debilitating.

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3
Q

Are migraines unilateral or bilateral?

A

Unilateral always and if they have a bilateral headache it’s not a migraine

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4
Q

What is occipital neuralgia

A

Fire sensation at the back of the head and definitive treatment is neuralgic block!

You can palpate the back of the head and change/alter how the headaches feels you know that this is occipital neuralgic

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5
Q

What does neoplastic refer to ?

A

Cancer

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6
Q

Temporal arthritis: is common in people who are young, middle or old

A

Old

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7
Q

What is a specific symptom
of temporal ateritis

A

Tiredness chewing

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8
Q

Name a psycostimulant!
People have it everyday in everything

A

Caffeine
- sudden withdrawal can cause severe migraine type of headaches, fatigue, nausea and vomiting

SACRED C: caffeine
Question your patients such as are there changes in their routes to work where you used to buy coffee and now you don’t? For example

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9
Q

What are classic signs of sinusitis

A

Increased pressure sneezing
Headache etc

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10
Q

What’s the most common type of headache

A

Tension headaches

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11
Q

What does PRN mean in medication world ?

A

Take when required

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12
Q

Why is headaches a problem in pregnancy ? What can it be a sign of?

A

Eclampsia

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13
Q

What is a dermatone

A

Areas of the body that are triggered by afferent nerves from one spinal route

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14
Q

Why would you be worried if a headache after injury?

A

Sign of ICP, sub arach

But we are particularly worried about, if there a delay on the onset or getting worse over time.

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15
Q

Cranial nerves:
Where is the olfactory, and optic nerve located

A

Forebrain

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16
Q

How to test the olfactory nerve?

A

Ask them about abnormalities/ smell senses

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17
Q

How to test the Optic and occulomotor nerve

A

Shine a light on the eye
If you shine a light on the eye that’s fully dilated eye you can check the oculumotor nerve

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18
Q

Testing the occultomotor, trochlear, abducens. How to test the trochlear nerve

A

Ask them to go cross eyed

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19
Q

Oculomotor, trochlear and Abducens. What does the abducens nerve control and how to test it ?

A

Eye looking outwards and move the eye outward

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20
Q

Which nerve is a sensory and motor nerve

A

TRIGEMINAL NERVE

Maxillary
Mandibular branch

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21
Q

How to test the facial nerve

A

Big Smile
Frown and raise eyebrows
Puff out cheeks
Screw eyes tightly and resist them being open

Fun Fact:
Cva pt can move there eyebrows up
Bell’s palsy can’t move their eyebrows

22
Q

How to test the Glossopharyngeal and vagus nerve

A

Get them to say AHHHH - does uvula move upwards

23
Q

How to test the Vestibularcochlear nerve

A

Whisper test
Rinnes test with tuning fork

24
Q

What are the accessory muscles

A

Trapezius
Sternoclomastoid process

25
Q

How to test the accessory nerve

A

Shrug the shoulders and turn their heads with resistance

26
Q

How to assess for dysdiadochokinesia and dysmetria

A

Place their pointer to their Nose to HCP finger Back and forth

27
Q

How to do the rhombergs test?

A

Pt to stand with their eyes closed and stand still without toppling over

Tests your visual, vestibular (inner ears) and proprioceptive (positional senses)

For pts with Hx of falls, dizziness or imbalance, uncoordinated balance, head injury.

Positive tests mean:
- sensory, vestibular, proprioceptive system

28
Q

What are the 4 tests that a pt must complete in order to sufficiently assess their gait

A

Heel to toe
Walk on their toes
Walk on their heels
Walk normally

29
Q

How to test your pt vision

A

Snellen chart
Read small paragraphs

30
Q

For an Abbreviation mental test how would you assess for confusion?

A

HOW OLD ARE YOU?
• WHAT TIME ISIT?
• WHAT YEAR IS IT?
Where are we now
Who am I and who is this person
WHAT IS YOUR DATE OF BIRTH
• WHEN DID WII START COR OTHER APPROPRIATE EVENTI
• WHO IS THE PRIME MINISTER?
• COUNT BACKWARDS FROM 20.

31
Q

What is the normal motor response for the planter reflex ?

Dorsal flexsion
Planter flexision

A

Planter flexision

32
Q

Symptoms of temporal arteritis?

A

•Abnormalities of vision
•Tiredness whilst chewing
•Pain whilst chewing
•Thickening/redness/tortured temporal artery
•Headache
•Malaise
•Anorexia
•Weight loss
•Anaemia
•Pyrexia
•Polymyalgia rheumatica

  • The cause of polymyalgia rheumatica is unknown. It’s more common in people over 70 and very rare in people under 50.

Most people with polymyalgia rheumatica have very stiff muscles when they wake up. You may also feel tired or depressed and lose your appetite.The main treatment for polymyalgia rheumatica is STEROID tablets. These ease the symptoms by reducing the inflammation in your body.

Temporal arteritis (also known as giant cell arteritis), is where the arteries in the head and neck become inflamed.

33
Q

Trigeminal nerve controls what other three nerves in the face?

A

Ophthalmic zone
Maxillary zone
Mandibular zone

34
Q

How to test the motor aspect of the trigemenal nerve ?

A

Ask the patient to clench their teeeth and open jaw with slight resistance

35
Q

What does a positive babinskis reflex mean?

A

PLANTAR FLEXION- NORMAL RESPONSE

DORSIFLEXION- ABNORMAL RESPONSE.
This is a positive BABINSKI’S REFLEX AND INDICATES A DISTURBANCE IN THE MOTOR RESPONSE OF THE CNS, EXCEPT IN CHILDREN UNDER 2 FOR WHOM IT IS A NORMAL RESPONSE.m

the test they conduct to babies to see if their little toes flex when they have a sharp object run from the bottom to the top

36
Q

CNIV - i Innervate the
superior oblique muscle

What nerve am I ?

A

Trochlear nerve

37
Q

CNVI - i Innervate the lateral
rectus

What nerve am i ?

A

The abducens

38
Q

List an accronym you know that helps you remember all the cranial nerves and whether they’re are sensory, motor or both

A

Oh Olfactory Some: Sensory

Oh Optic Say: Sensory

Oh Ocul- Marry: Motor

To Trochlear Money: Motor

Touch Trigeminal But: Both

And Abducens My: Motor

Feel Facial: Brother Both

Very Vestibulo- Says: Sensory

Good Glosso— Big: Both

Velvet vagus Brains: Both

Ah Accessory Matters: Motor

Heaven Hypoglos- Most: Motor

39
Q

Hard question from Google but good to know:

What happens if the lateral spinothalamic tract is damaged?

A

ipsilateral paralysis (inability to move), paresis (decreased motor strength), and hypertonia (increased tone)

40
Q

Fun Q not from canvas (uni page) - from Google:

What does damage to the anterior cingulate cortex do?

A

Attention deficit occurs as the inability to maintain attention when distractions are present

41
Q

Hard question o from Google: so fun to know facts:
What happens if the pyramidal tract is damaged?

A

What happens if the pyramidal tract is damaged?

42
Q

Hard question o from Google: so fun to know facts:
What happens if the pyramidal tract is damaged?

A

Pyramidal tract lesions will present very similarly to upper motor lesions with symptoms such as hyperreflexia, weakness, spasticity, and a Babinski sign. Damage to the corticobulbar tract can present with additional symptoms of lower facial weakness and changes to speech

43
Q

What is occipital neuralgia ?

A

Distributive pain along the right occipital nerves

44
Q

In regards to the a head what has a rapid onset ? This can include headaches but the answer is something that happens in “1% if headaches presenting to the Ed” - quoted directly from slides

A

Sub arachnoid haemorrhage

45
Q

In regards to the a head what has a rapid onset ? This can include headaches but the answer is something that happens in “1% if headaches presenting to the Ed” - quoted directly from slides

A

Sub arachnoid haemorrhage

46
Q

What is neoplastic headaches ?

A

Headache caused by a brain tumour

Canvas (uni page)
- knwn Hx to intracranial tumour, new onset headache requires review

  • consider possible rise to ICP (tumour growth, metastatic lesions, bleeding or hydrocephalus m

What about undiagnosed tumours:
- severe, constant progressive pain worsening on waking plus nausea and vomiting

47
Q

Ways to realise the patient has environmental headaches?

A

Occurs at night
Dissipates during the day
Waking up with headaches

48
Q

What headache is known to cause pain when they lean forward ?

A

Sinus headache

49
Q

Revision card:
Red flags of headaches
History and physical signs

A

Hx::
Recent trauma
New or worsening headaches
Sudden onset with max intensity
Triggered with exertion
Prgnancy
Fever
Immunocomprimose
Headache woke patient up from sleep
Hx of any cranial surgery

Physical Signs:
Fever
Head injury - vomiting
Seizures focal neurological seizures
Weakness
Altered mental state
Stiff neck
Battle signs (bruising outside ears)
Visible scalp / skull trauma

50
Q

From the headache and neuro assessment slides:

Which nerve supplies/ allows sensation of S1 and S2 from dermatones

A

Sacral lumber: s1 & 2

51
Q

What cranial nerve is C1

A

Olfactory

52
Q

What cranial nerve is CII and CIII

A

Optic and Oculmotor

Minor Injuries 🦴 (6 decks)

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