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Jack's Phase 2B Cards > Neurological Examination > Flashcards

Neurological Examination Flashcards

1
Q

What is the order for an Upper Limb Neuro Examination?

A

Inspection, Tone, Power, Reflexes, Coordination, Sensation

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2
Q

What are you looking for on inspection?

A

Scars, Wasting, Involuntary Movements, Fasciculations, Tremor

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3
Q

Upper Limb Inspection Extra Test?

A

Pronator Drift

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4
Q

Which Upper Limb Movements should Power be assessed for?

A

Shoulder Abduction (C5)
Shoulder Adduction (C6/7)
Elbow Flexion (C5/6)
Elbow Extension (C7)
Wrist Extension (C6)
Wrist Flexion (C6/7)
Finger Extension (C7)
Finger Abduction (T1)
Thumb Abduction (C8/T1)

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5
Q

Which upper limb reflexes should be assessed?

A

Biceps (C5/6)
Triceps (C6/7)
Supinator (C5/6)

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6
Q

Where should sensation be assessed in the upper limb (Dermatome)?

A

Lateral Upper Limb (C5)
Lateral Forearm + Dorsal Aspect of the Thumb (C6)
Palmar Middle Finger (C7)
Palmar Little Finger (C8)
Medial Forearm + Upper Limb (T1)

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7
Q

What elements are involved in sensation testing?

A

Soft Touch (Cotton Wool)
Vibration (128 Hz Tuning Fork DIP)
Proprioception (Thumb Movement)
Pain (Neurotip) OFFER ONLY
Temperature OFFER ONLY
Also, tests the ability to write, and identify a coin by touch and two-point discrimination.

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8
Q

Neurological Examination Concluding Offers

A

Other Neuro Exams e.g Lower Limb and CN

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9
Q

What should be included in the beginning of an Lower Limb Neuro Exam?

A

Rombergs (Stood Up, Eyes Closed, Arms Supinated).
Gait Assessment

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10
Q

How to assess tone in Lower Limbs?

A

Leg Roll, Leg Lift, Ankle Clonus

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11
Q

Assessment of Power in Lower Limb?

A

Hip Flexion (L1/2)
Hip Extension (L5/S1)
Adduction (L2/3)
Abduction (L4/5)
Knee Flexion (S1)
Knee Extension (L3/4)
Dorsiflexion (L4)
Plantar Flexion (S1/2)
Ankle Inversion (L4)
Ankle Eversion (L5/S1)
Great Toe Plantarflexion (L5)
Great Toe Dorsiflexion

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12
Q

Lower Limb Reflexes

A

Knee Jerk (L3/4)
Ankle Jerk (L5/S1)

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13
Q

Where to assess lower limb sensation (Dermatomes)?

A

Upper Thigh (L2)
Above Patella (L3)
Below Patella (L4)
Medial Foot (L5)
Lateral Foot (S1)

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14
Q

Upper Limb Coordination

A

Finger to Nose - Move Your finger
Fine Finger Movements - Thumb to Fingertips
Dysdiadochokinesia

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15
Q

Lower Limb Coordination

A

Heel-Shin Test

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16
Q

CN I Examination

A

Olfactory - Have you noticed any changes in your sense of smell?

17
Q

CN II Examination

A

Optic - ARIFA
- Acuity - Snellen Chart 2m (Ask Patient to Cover one eye)
- Reflexes (Light)
- Inattention
- Fields (Red Pin)
- Accommodation (Focus on Wall then finger)

18
Q

CN III, IV, VI Examination

A

Oculomotor, Trochlear, Abducens
H Pattern Follow Finger - Ask about diplopia.
- CN IV - Downward
- CN VI - Abduction

19
Q

CN V Examination

A

Trigeminal -
Sensation - Forehead, Cheeks, Chin (Both sides)
Assess Muscle Bulk of Masseter and Temporalis
Assess Jaw opening power
Jaw-Jerk Reflex

20
Q

CN VII

A

Facial - Test Facial Expressions
- Close eyes - don’t let you open them.
- Puff out cheeks
- Raise eyebrows
- Show teeth

21
Q

CN VIII

A

Vestibulocochlear
- Cover one ear and whisper a number for them to repeat.
If an abnormality is suspected perform Rinne’s and Webers Tests

22
Q

Rinne’s & Webers Tests

A

Rinne’s - 512 Hz Tuning Fork is held on the mastoid until the sound is no longer heard then it is brought outside the ear. And should be heard again unless there is conductive hearing loss.
Webers - 512Hz is held on the forehead in the midline - the sound is heard louder in the conductive hearing loss ear.

23
Q

CN IX, X Examination

A

Glossopharyngeal and Vagus
- Note Uvula deviation
- Ask about swallowing difficulty -test.
- Ask the patient to cough.

24
Q

CN XI Examination

A

Accessory
Ask the patient to shrug and turn their head against resistance.

25
Q

CN XII

A

Hypoglossal
Observe tongue at rest and note deviation upon protrusion.
Assess power by pressing against the tongue pressed into the cheek.

26
Q

Cerebellar Lesion Examination

A

VANISHED
V - Vertigo
A - Ataxia
N - Nystagmus
I - Intention Tremor
S - Slurred Speech - British Constitution X3
H- Hypotonia
E- Exaggerated Past Pointing
D -Dysdiadochokinesia

Jack's Phase 2B Cards (19 decks)

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