Neurological Exam Flashcards
What is the purpose of a neuro screening?
identify/rule out lower or upper motor neuron pathology, neurological dysfunction, assist w/ differential dx
What are the components of a basic neuro screen?
Myotomal test (motor), dermatome test (sensory), reflex testing, CNS screen (Babinski, Inverted supinator, clonus)
What myotome(s) are associated with a step up?
L3-L4
What myotome(s) are associated with heel walking?
L4-L5
What myotome(s) are associated toe walking w/ raised heel?
L5-S1
What myotome(s) are associated with neck flexion?
C1, C2
What myotome(s) are associated with neck sidebending?
C3
What does C4 function to provide?
Shoulder elevation
What does C5 function to provide?
shoulder abduction
What myotome(s) are associated elbow flexion?
c6
What myotome(s) are associated elbow extension?
c7
What does C8 function to provide?
thumb abduction
What does T1 function to provide?
finger abduction
What movement does L2-L3 provide?
hip flexion
What myotome(s) are associated knee extension?
L3-L4
What myotome(s) are associated ankle dorsiflexion?
L4, L5
What does L5 alone function to provide?
Great toe Ext
What myotome(s) are associated with ankle plantar flexion?
S1-S2
What region does C5 provide sensory for?
mid-deltoid
What dermatome provides sensory to the radial aspect of the 2nd metacarpal?
C6
What region does C7 provide sensory for?
dorsal aspect of middle finger
What dermatome provides sensory to the ulnar aspect of the 5th metacarpal?
C8
What region does T1 provide sensory for?
medial forearm
What region does L1 provide sensory for?
inguinal area
What dermatome provides sensory for the anterior mid-thigh?
L2
What region does L3 provide sensory for?
medial knee
What dermatome provides sensory for the medial malleolus?
L4
What region does L5 provide sensory for?
Distal medial dorsum of foot
What dermatome provides sensory for the lateral border of the foot?
S1
What region does S2 provide sensory for?
posterior/medial calcaneus
A hypo-reflexive response indicates what?
lower motor neuron (possible neerve root compression/neuropathy)
A hyper-reflexive response indicated what?
upper motor neuron (CNS pathology)
What is the C5 reflex?
biceps brachii
What spinal level(s) provide reflex for the brachioradialis?
C6
What is the c7 reflex?
triceps
What spinal level(s) provide reflex for the patella?
L2-4
What is the S1-2 reflex?
Achilles
What grade is a normal reflex response?
2+
What grade on a reflex test indicates a very brisk response, maybe clonus?
4+
What grade on a reflex test indicates no response?
0
A grade of 3+ indicates what on a reflex test?
brisk response, possibly hyperreflexive
A grade of 1+ indicates what on a reflex test?
low-normal response
What does a grade of 1+R indicate on a reflex test?
absent response but appeared with reinforcement
What does a grade of 0R indicate on a reflex test?
no response even with reinforcement
What is clonus?
series of unvoluntary muscular contractions due to sudden stretching of the muscle
What does clonus indicate?
CNS disorders
What is clonus most commonly tested on?
ankles and wrists
What indicates a positive babinski?
Extension of hallux and fanning of toes
Does toes curling indicate a positive babinski?
no
What indicates a positive Hoffman’s test?
thumb and first finger come together
What is normal BP?
> 120/80
What is prehypertension?
120-129/<80
What is stage 1 hypertension?
130-139/80-89
What is stage 2 hypertension?
> =140/90
What is hypertensive crisis?
> = 180/120
What does a 0-0.4 gait speed indicate?
a household ambulator
What gait speed indicates a limited community ambulator?
0.4-0.8
What does a 0.8 indicate for gait speed?
community ambulator
What range indicates a likeliness to be d/c to SNF over home?
0-0.1
What range of gait speed indicated higher fall risk?
0-0.6
What gait speed range indicates dependent in ADLs?
0-0.6
What gait speed range indicates independent in ADLs?
1-1.4
What is the appropriate location to measure waist circumference?
just superior to the iliac crest, around/just below umbilicus
What waist circumference indicates a high risk for cardiac disease in males?
> 40 in (102 cm)
What waist circumference indicates a high risk for cardiac disease in females?
> 35 in (88 cm)
What BMI score classifies as underweight?
<18.5
What is the normal BMI range?
18.5-24.9
What is the BMI range indicated overweight?
25-29.9
What BMI range classifies as obesity class 3?
> =40
What BMI range classifies as obesity class 1?
30-34.9
What BMI range classifies as obesity class 2?
25-39.9
