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T3 - IPES > neurological examination > Flashcards

neurological examination Flashcards

1
Q

4 regions of the brain

A

cerebrum
diencephalon
brainstem
cerebellum

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2
Q

___: part of the brain that deals with motor and sensory, cognition, conscious perception/integrating

A

cerebrum

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3
Q

___: part of the brain that deals with thalamus, hypothalamus, internal capsule, reticular activating system, integration of functions of cortex, fight/flight, homeostasis, affect, arousal/wakefulness/attention

A

diencephalon

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4
Q

___: part of the brain that deals with respiration, HR regulation, BP

A

brainstem

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5
Q

___: part of the brain that deals with coordination of voluntary movement, balance, equilibrium

A

cerebellum

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6
Q

brain is divided into 4 lobes

A

frontal
parietal
occipital
temporal

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7
Q

____ ___: autoimmune; demyelination of CNS, peripheral nerves and brainstem; slower nerve conduction

A

multiple sclerosis

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8
Q

spinal cord is an extension of the ___ ___

A

medulla oblongata

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9
Q

spinal cord runs from the ____ ____ to the __/___ level

A

foramen magnum

L1/L2

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10
Q

dorsal roots are ___

A

sensory

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11
Q

ventral roots are ___

A

motor

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12
Q

ascending tracts are ____

A

sensory

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13
Q

descending tracts are ___

A

motor

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14
Q

lateral spinothalamic tract (LSTT) carries ___ and ___

A

pain

temperature

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15
Q

___ ____ ___: largest ascending tract

A

lateral spinothalamic tract

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16
Q

LSTT lesion carries ___ loss of sensation

A

contralateral

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17
Q

LSTT lesion happens at ___ or ___ levels below the level of the lesion

A

1/2

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18
Q

anterior spinothalamic tract (ASTT) carries sensations for ___ ___ and ___

A

light touch

pressure

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19
Q

ASTT lesion carries ___ loss of sensation

A

contralateral

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20
Q

ASTT lesion happens at ___ or ___ levels below the level of the lesion

A

3/4

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21
Q

dorsal columns carries senations for…

A

fine touch/discrimination
unconscious proprioception
vibration

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22
Q

dorsal columns:

lesions below the medulla result in ___ loss of sensation

A

ipsi

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23
Q

dorsal columns:

lesions above the medulla result in ___ loss of sensation

A

contra

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24
Q

dorsal columns in UE vs LE

A

fasciculus cuneatus

fasciculus gracilis

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25
Q

ASTT, LSTT and dorsal columns are all ____ tracts

A

ascending (sensory)

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26
Q

___/___ tract

  • motor pathway for contraction of skeletal muscles
  • upper motor neurons which correspond to spinal nerves
A

corticospinal/pyramidal

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27
Q

___ tracts respond to cranial nerves

A

corticobulbar

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28
Q

___: lesion to spinal nerve reulting in LMN lesion

A

radiculopathy

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29
Q

___: lesion to peripheral nerve resulting in LMN lesion

A

neuopathy

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30
Q

____: lesion or dysfunction of muscle fibers resulting in muscle weakness

A

myopathy

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31
Q

___ ___ ___ lesion: a lesion to the descending tracts and/or the cerebrum

A

upper motor neuron

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32
Q

___ ___ ___ lesion: lesion to the ventral gray matter of the spinal cord, ventral nerve root, spinal nerve, and/or peripheral nerve

A

lower motor neuron

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33
Q

signs of UMN lesipn

A 
spastic paralysis
hyperreflexia
clonus
presence of pathogical reflexes
diminished/absence of superficial reflexes
clasp knife rigidity
disuse atrophy
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34
Q

signs of LMN lesion

A 
flaccid paralysis
hyporeflexia
atrophy
decreased muscle tone
fasciculation
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35
Q

___: small, local, involuntary muscle contraction visible under the skin

A

fasciculations

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36
Q

___: numbness, tingling, “pins and needles” or “asleep”

A

parasthesia

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37
Q

look at mental staus

A

start on 19

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38
Q

delerium is ___

A

transient

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39
Q

dementia is ___

A

permanent

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40
Q

pain and temp assessment testing ____ ___ ___

A

lateral spinothalamic tract

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41
Q

light touch assessing ___ ___ ___

A

anterior spinothalamic tract

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42
Q

posterior columns assessing..

A 
position sense
movement sense
vibration
two pt discrimination
stereognosis
graphesthesia
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43
Q

lesions to the posterior columns typically results in sensory loss that is ___ to ___

A

distal proximal

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44
Q

___: sensitivity to pain

A

algesia

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45
Q

____: loss of sensation to pain

A

analgesia

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46
Q

___: decreased sensibility of pain

A

hypoalgesia

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47
Q

___: increased sensibility to pain

A

hyperalgesia

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48
Q

___: loss of temp sense

A

thermoanesthesia

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49
Q

___: diminished perception of temperature differences

A

thermohypoesthesia

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50
Q

___: exaggerated sensation of temperature differences

A

thermohypersthesia

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51
Q

____: loss of light touch sense

A

thigmanesthesia

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52
Q

___: total or partial loss of sensation

A

anesthesia

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53
Q

____/___: abnormally diminished sensitivity

A

hypesthesia

hypoesthesia

54
Q

___: abnormally increased sensation

A

hyperesthesia

55
Q

___: sensation of tingling, pricking or numbness

A

paresthesia

56
Q

___: burning sensation to skin

A

dysesthesia

57
Q

___: ability to feel vibration

A

pallesthesia

58
Q

___: not feeling vibration

A

pallanesthesia

apallesthesia

59
Q

___: awareness of the position of the body or its parts in space

A

statognosis

60
Q

___: failure of awareness of the position of the body or its parts in space

A

astatognosis

61
Q

____: ability to identify objects proprioceptively

A

stereognosis

62
Q

____: inability to identify objects proprioceptively

A

astereognosis

63
Q

___: ability to recognize writing on the skin purely by the sensation of touch

A

graphesthesia

64
Q

___: inability to recognize writing on the skin purely by the sensation of touch

A

agraphesthesia

65
Q

grade 5 muscle strength

A

complete ROM against gravity with full resistance

66
Q

grade 4 muscle strength

A

complete ROM against gravity with some resistance

67
Q

grade 3 muscle strength

A

complete ROM against gravity

68
Q

grade 2 muscle strength

A

complete ROM with gravity eliminated

69
Q

grade 1 muscle strength

A

evidence of slight contractility; no joint motion

70
Q

grade 0 muscle strength

A

no evidence of contractility

71
Q

DTR: UMN lesion

A

hyperreflexia

CNS involvement

72
Q

DTR: LMN lesion

A

hyporeflexia

PNS involvement

73
Q

L4 DTR

74
Q

L5 DTR

A

semitendinosis

75
Q

S1 DTR

76
Q

C5 DTR

77
Q

C6 DTR

A

brachioradialis

78
Q

C7 DTR

79
Q

wexler reflex scale

grade 0

A

no response

80
Q

wexler reflex scale

grade 1

A

hyporeflexia

81
Q

wexler reflex scale

grade 2

82
Q

wexler reflex scale

grade 3

A

hyperreflexia

83
Q

wexler reflex scale

grade 4

A

hyperreflexia with transient clonus

84
Q

wexler reflex scale

grade 5

A

hyperreflexia with sustained clonus

85
Q

if you get an abnormal DTR retest using a ___ maneuver

A

jendrassik

86
Q

DTRs might diminish with ___

87
Q

superficial reflexes

  • absensce
  • presence
A

NORMAL

UMNL lesion, LMN lesion or normal

88
Q

pathologic reflexes

- presence

A

UMNL

may be normal in babies

89
Q

___: flick 2nd or 3rd digit up on hand

90
Q

positive findings of tromners

A

clawing of the fingers

adduction of the thumb

91
Q

___: flick 2nd or 3rd digit down on hand

92
Q

positive findings of hoffmans

A

clawing of the fingers

adduction of the thumb

93
Q

___: dr holds wrist and rapidly extends or flexes it; oscillations indicates positve finding; hold calcaneus and rapidly dorsiflexes ankle and hold

94
Q

___: flick 4th or 5th digit down on foot

95
Q

positive findings of gonda

A

babinski sign

96
Q

___: squeeze achilles tendon

97
Q

positive finding of schaeffer

A

babinski sign

98
Q

___: stroke medial sides of tibial shaft with butt end of reflex hammer or knuckle

A

oppenheims

99
Q

positive findings of oppenheims

A

babinski sign

100
Q

___: squeeze calf

101
Q

positive finding of gordons

A

babinski sign

102
Q

___: stoke around lateral maleolus, over dorsum of the foot to big toe

103
Q

positive finding of chaddocks

A

babinski sign

104
Q

___ ___: stroke lateral aspect of cuboid

A

mendel bechterew

105
Q

positive findings of mendel bechterew

A

plantar flexion of toes

toe clawing

106
Q

___: dr taps metacarpal/metatarsal heads with reflex hammer

A

rossolimos

107
Q

positive findings of rossolimos

A

plantar flexion of toes/fingers

108
Q

___: measurement of muscle bulk for the entire extremity

A

mensuration

109
Q

mensuration for UE

A

arm

forearm

110
Q

mensuration for LE

A

thigh

calf

111
Q

what is the significant difference for mensuration

112
Q

___: increased size and strength

A

hypertrophy

113
Q

___: reduced size and strength

114
Q

___: look for increased size with decreased strength

115
Q

indications of hypertrophy

A

exercise

muscle injury or pathology

116
Q

indications of atrophy

A

nerve lesion
muscle pathology
disuse

117
Q

C5 muscle exam muscles

A

deltoid

biceps

118
Q

C6 muscle exam muscles

A

brachioradialis

wrist extensors

119
Q

C7 muscle exam muscles

A

triceps
wrist flexors
finger extensors

120
Q

C8 muscle exam muscles

A

flexor digitorum

121
Q

T1 muscle exam muscles

A

finger adductors/abductors

122
Q

L1/L2 muscle exam muscles

123
Q

L2/L3 muscle exam muscles

A

quadratus femoris

124
Q

L4 muscle exam muscles

A

tibialis anterior

125
Q

L5 muscle exam muscles

A

extensory hallucis longus
extensor digitorum longus and brevis
gluteus medius

126
Q

S1 muscle exam muscles

A

peroneus longus

peroneus brevis

127
Q

heel walking tests:
2 nerve roots
1 peripheral nerve
1 muscles

A

L4/L5
common peroneal nerve
tibialis anterior

128
Q

repetitive claf raising and toe walking tests:
1 nerve root
1 peripheral nerve
2 muscles

A

S1
tibial
gastrocnemius
soleus

129
Q

beevors sign tests for ___ ___ ___ lesion involving the rectus femoris

A

lower motor neuron

130
Q

beevors sign

- if lesion at T10 or below…

A

weakness of lower rectus

umbilicus moves UPWARD

131
Q

beevors sign

- if lesion at T8/T9

A

weakness of upper rectus

umbilicus moves DOWNWARD

T3 - IPES (5 decks)

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