Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Neurology > Neurological exam - SA > Flashcards

Neurological exam - SA Flashcards

1
Q

Can you have the same disease of a different localisation?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Does lesion size = CS severity?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Does CS severity = prognosis?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Does location (anatomy) = function?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is using the loss of function to work out the location?

A

Neurolocalisation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How is the spinal cord divided?

A
  • C1-C5
  • C6-T2
  • T3 - L3
  • L4 - Cd
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Where might a neurological lesion be located?

A
  • BRAIN (forebrain, brainstem, cerebellum)
  • SC
  • Neuromuscular
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

2 aims of neuro exam

A
  • neurologically normal or abnormal?

- localisation of lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Tools for neuro exam

A
  • room
  • chair
  • yoga mat
  • reflex hammer
  • haemostats
  • Q tips (corneal reflex)
  • cotton balls
  • penlight
  • lens
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

State the 8 parts of the neuro exam

A
  1. mentation
  2. posture
  3. gait
  4. postural reactions
  5. spinal reflexes
  6. cranial nerves
  7. palpation
  8. nociception
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Define mentation

A
  • LEVEL of consciousness: alert, obtunded, stupor / semicoma, coma
  • QUALITY of consciousness: appropriate, inappropriate (compulsion, dementia/ delerium)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is assessed with posture?

A
  • head
  • limbs
  • body
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Outline head posture

A
  • Tilt (roll) suggests vestibular disease

- Turn (yaw) suggests forebrain disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Outline limb posture

A
  • wide based stance - proprioceptive loss
  • narrow based stance - weakness?
  • decreased weight bearing - evidence of pain?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the 3 different body postures?

A
  • decerebrate
  • decerebellate
  • Schiff-Scherrington
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Control of gait = ?

A

requires integration of proprioceptive and motor systems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is determined in gait analysis?

A
  • normal or abnormal
  • which limbs?
  • paresis, ataxia, lame, combination?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Define paresis

A
  • decreased voluntary movement
  • can be UMN or LMN
  • differentiation cannot be based on severity alone
  • also assess postural reactions, spinal reflexes, mm tone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Features - UMN paresis

A
  • MUSCLE TONE is normal to increased in limbs caudal to the lesions
  • SPINAL REFLEXES are normal to increased in limbs caudal to the lesion
  • STRIDE: length is normal to increased, spastic
    +/- ATAXIA (sensory) - swaying/ floating gait, knuckling
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Features - LMN paresis

A
  • MUSCLE TONE is decreased in limbs with a reflex arc containing a lesion
  • SPINAL REFLEXES are decreased to absent in limbs with a reflex containing the lesion
  • STRIDE: length is normal to decreased, stiff, ‘bunny hopping’, +/- collapse
    +/- ATAXIA (sensory) knuckling
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

3 types of ataxia

A
  1. sensory (proprioceptive)
  2. cerebellar
  3. vestibular
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Describe sensory ataxia

A

= loss of sense of limb/ body position

  • wide based stance
  • increased stride length
  • swaying/ floating gait
  • knuckling
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Describe cerebellar ataxia

A

= disorder of rate and range of movement

  • hypermetria
  • intention tremor
  • postural tremor
  • jerky movements
  • (high step thoracic gait)
24
Q

Describe vestibular ataxia

A
  • UNILATERAL: falling/ leaning/ circling to one side, head tilt
  • BILATERAL: wide excursions of the head, +/- head tilt, crouched posture
  • strabismus nystagmus commonly
25
Q

Outline the purpose of assessing postural reactions

A

= requires integration of proprioceptive and motor systems

  • similar pathways to gait
  • pathways are long (‘sensitive/ non-specific’, interpret with gait, spinal reflexes, mm tone)
26
Q

List some possible postural reactions to teat

A
  • paw positioning
  • hopping
  • wheelbarrowing
  • hemiwalking (tactile, visual)
  • extensor postural thrust
  • always look for symmetry*
27
Q

What does the biceps tendon reflex test?

A

Tendon reflex - musculocutaneous nn - C6-8

28
Q

What does the triceps tendon reflex test?

A

Tendon reflex - radial nn - C7-T2

29
Q

What does the patellar tendon reflex test?

A

Tendon reflex - Femoral nn - L4-6

30
Q

What does the gastrocnemius tendon reflex test?

A

Tendon reflex - sciatic nn - L6-S2

31
Q

Name 2 flexor (withdrawal) spinal reflexes

A
  • thoracic limb

- pelvic limb

32
Q

What does the thoracic limb withdrawal reflex test?

A

multiple nn - C6-T2

33
Q

What does the pelvic limb withdrawal reflex test?

A

Sciatic nn - L6 - S2

34
Q

What does the perineal spinal reflex test?

A

Pudendal nn (S1-3) - there should be a bilateral response to a unilateral stimulus

35
Q

How do you do the cutaneous truni mm spinal reflex test?

A

pinch skin in lumbar region with haemostats (not cats!)

36
Q

Interpretation - decreased/ absent spinal reflex

A
  • lesion within reflex arc
  • physical limitation of movement (joint fibrosis, mm contracture)
  • excitement/ fear
  • ‘spinal shock’
37
Q

Interpretation - exaggerated spinal reflex

A
  • lesion to UMN pathways cranial to the spinal cord segment tested (since UMN attenuates tone in reflex arc)
  • excitement/ fear (increased SNS tone)
  • ‘psuedohyperreflexia’ due to loss of antagonism form mm on other side of limb
38
Q

List the cranial nn

A 
1 olfactory
2 optic
3 occulomotor
4 trochlear
5 trigeminal
6 abducent
7 facial
8 vestibulocochlear
9 glossopharyngeal
10 vagus
11 accessory
12 hypoglossal
39
Q

Which CN is tested in a vision test?

A

CN2 –> forebrain

40
Q

Which CN is tested in a menace response?

A

CN2 –> forebrain –> cerebellum –> brainstem –> CN 7

41
Q

Which CN is tested in a PLR?

A

CN 2 –> brainstem –> CN 3

both direct and indirect

42
Q

Features of Horner’s syndrome

A

= sympathetic denervation of the orbit

  • miosis
  • ptosis
  • enopthalmos
43
Q

Which CNs give motor to the extraocular mm? 3

A

3 occulomotor
4 trochlear
6 abducent

44
Q

What controls strabismus (eye position)?

A

CN 8 –> central vestibular/ brainstem –> CN 3, 4, 6 (i.e. same as nystagmus)

45
Q

What controls nystagmus (eye movement)?

A

CN 8 –> central vestibular / brainstem –> CN 3, 4, 6 (i.e. same as strabismus)

46
Q

What causes palpebral reflex?

A

CN 5 –> brainstem –> CN 7

47
Q

What causes corneal relfex?

A

CN 5 –> brainstem –> CN 6 (globe reaction, any blinking is controlled by CN 7)

48
Q

Function - trigeminal - CN 5

A
  • motor to mm of mastication so signs of dysfunction include atrophy and inability to close jaw
49
Q

Function - facial - CN 7

A
  • motor to mm of facial expression
  • signs of dysfunction: facial paresis/ paralysis, facial asymmetry
  • palpebral reflex: 5 > brainstem > 7
  • menace response: 2 > forebrain > cerebellum > brainstem > 7
  • autonomic innervation of lacrimal glands (test with STT-1)
50
Q

Function - vestibulocochlear nn (CN 8)

A

COCHLEAR: auditory
VESTIBULAR: signs of dysfunction: ataxia (vestibular), head tilt, strabismus, nystagmus (abnormal)

PHYSIOLOGIC NYSTAGMUS: 8 > brainstem > 3, 4 and 6

51
Q

Describe the types of nystagmus

A
  • PHYSIOLOGIC: normal, decreased/ absent
  • SPONTANEOUS / PATHOLOGIC
  • DIRECTION: horizontal, rotary, vertical, fast-phase
  • CONJUGATE/ DYSCONJUGATE
  • POSITIONAL: inducible
52
Q

Function - vagus nn - CN10

A
  • sensory and motor to pharynx

- gag reflex: CN9 and 10 –> brainstem –> CN 9 adn 10

53
Q

Function - hypoglossal nn - CN 12

A
  • motor to tongue

- signs of dysfunction: paresis/ paralysis of tongue, atrophy/ asymmetry of tongue, seen as deviation of tongue

54
Q

What are the types of palpation?

A
  • LIGHT: swelling, atrophy
  • DEEP: pain
  • LOCATION: head, spine, limbs
  • determine if focal or diffuse
55
Q

Define nociception

A

= conscious perception of pain

  • receptors –> brain
  • SUPERFICIAL: skin
  • DEEP: bone (periosteum)
  • test cutaneous autonomous zones as necessary
56
Q

T/F: limb withdrawal does not equal pain perception

A

Ture

57
Q

Name 3 different types of lesion to then use to work out ddx

A
  • focal
  • multifocal
  • diffuse

Neurology (26 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions