Neurological Examination

Question 1

Oppenheim’s Sign

Answer 1

Scratching of inner side of leg leads to extension of the toes
> Sign of Cerebral Irritation

Question 2

Dermatomes - L and S Roots

Answer 2

L1 - Inguinal ligament - L for ligament, I for Inguinal

L4 - Knee Caps - Down on all fours - L4

L5 - Big toe, Dorsum of Foot (except lateral aspect) - L5 = Largest of 5 toes

S1 = Lateral foot, Small toe = S1 - the smallest one

S2,S3 = Genitalia

Question 3

Dermatomes - T Roots

Answer 3

T4 - Nipples! T4 at the Teat Pore

T5 - Inframammary fold

T7 - Xiphoid Process

T10 - Umbilicus - BellybuT-TEN

Question 4

Dermatomes - C Roots

Answer 4

C2 - Posterior half of skull

C3 - High turtle neck shirt

C4 - Low collar shirt

C5,C6 - THUMB and INDEX Finger - make a 6 with your L hand by touching tip of thumb and index finger together

C7 - MIDDLE finger and PALM of hand

C8 - RING and LITTLE finger

Question 5

Ring’s and Weber’s Tuning Fork Tests

Answer 5

Allows differentiation of CONDUCTIVE vs SENSORINEURAL Deafness

Rinne’s Test:

• Tuning fork placed over MASTOID process until sound no longer heard
• Tuning fork then repositioned just over external acoustic meatus
• AC is Normally better than BC
• If BC > AC = Conductive deafness

Weber’s Test:

• Tuning fork is placed in the middle of forehead equidistant from patient’s ears
• Patient is then asked which side is loudest
• Normal = equal volume both sides

Sensorineural deafness = In unilateral sensorineural deafness sound is localised to UNAFFECTED SIDE

Conductive Deafness = In unilateral conductive deafness, sound is localised to AFFECTED SIDE

Need both tests to work it out!