Neurological Exam Flashcards
What are some basic components of a medical case history?
Chief complaint
History of illness
Past medical and surgical history
Family history
Social history
Medications
Allergies
Review of systems
What is the most important aspect of a neurologic exam?
History of present illnesses
What does ROS mean?
Review of systems
Why is the ROS important for audiology?
Need to know how the whole body affects the ear
Can we review the mental status of a patient?
We can administer a screening (such as cognivue) to refer
What is the MMSE?
Mini-mental status exam
What does the MMSE do?
Helps us examine the mental status of a patient
How do you measure orthostatic/postural blood pressure?
Measure BP and heart rate with change in positioning
How can you tell if someone has orthostatic hypertension?
If the BP drops when they stand up
How can someone assess CN I?
Smelling pungent substance one nostril at a time
How can someone assess CN II?
Visual acuity chart, visual fields test, and fundoscopic exam
How can someone assess CN III, IV, and VI?
Evaluate for nystagmus, consensual eye reflex, extraocular movement test, opening and closing eyelids
How can someone assess CN V?
Touching with cotton wisp and cold tuning fork
Corneal reflex
Jaw movement
(sensory and motor)
How can someone assess CN VII?
Ask patient to smile, grimace, and raise eyebrows
Taste anterior 2/3 of tongue
(motor and sensory)
How can someone assess CN VIII?
Test hearing
Tuning fork test (weber and rinne)
Otoscopic exam
Caloric
How can someone assess CN IX and X?
Test gag reflex
Inspection of palate, uvula, and pharynx
Assess voice quality
(sensory and motor)
How can someone assess CN XI?
Shrug shoulders
Turn head against pressure
(motor)
How can someone assess CN XII?
Tongue out and to both sides
(motor)
What is a motor systems exam?
Seeing if the patient has normal muscle tone and movement
What does a motor systems exam include?
Observation (inspect muscles)
Muscle tone (passive flexion and extension)
Muscle strength
Abnormal movements
What are the two components of a sensory system exam?
Primary sensory modalities
Cortical sensory modalities
What do primary sensory modalities include?
Test each sensory dermatome
Sharp vs dull
Light touch
Position
Temperature
What are the cortical sensory modalities?
Two point discrimination
Stereognosis (object recognition)
Graphesthesia (trace symbols on skin)
What scale are reflexes graded on?
0-4 (0 being no contraction and 4 being repetitive muscle shortening)
2 is normal
What does a positive romberg test indicate?
Proprioceptive and vestibular dysfunction
What does pronator drift indicate?
UMN lesion
What does a positive finger to nose test indicate?
Dysmetria
What does a positive RAM indicate?
Dysdiadochokinesia
