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PICU > Neurological Examination > Flashcards

Neurological Examination Flashcards

1
Q

Signs of upper motor neuron lesions

A

Spastic paralysis
Hyper-reflexia
Clonus
LMN findings at level of injury due to damage of ventral root/nerve

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2
Q

Signs of lower motor neuron lesions

A

Flaccid paralysis
Fasciculations
Atrophy
Hypo-reflexia and absent deep tendon reflexes

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3
Q

What is the significance of “frog-legged” posture in infants?

A

Abducted hips suggests hypotonia

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4
Q

What is the significance of the “cortical thumb sign” in infants?

A

Adduction and flexion posturing of the thumb with reduced spontaneous opening may be a sign of UMN lesion, especially if persisting beyond 4 months or in presence of other suggestive signs (essentially equivalent of upgoing plantar)

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5
Q

What is opisthotonus? What are some causes in infants?

A

Persistent arching of the neck and trunk (activation of extensor muscles)
Due to bilateral cerebral cortical dysfunction
Causes include meningitis, tetanus, kernicterus

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6
Q

What is athetosis? What are some causes?

A

Slow sinuous movement of the distal extremity (writhing movements)
Due to damage to basal ganglia
Causes include hypoxic-ischaemic encephalopathy (as in cerebral palsy), kernicterus

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7
Q

What is pseudohypertrophy? When is it seen?

A

Muscle bulk in setting of weakness

Seen in Duchenne muscular dystrophy

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8
Q

Normal motor development for newborn

A

Limbs flexed, symmetrical

Head lag on pulling up

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9
Q

Normal gross motor development 6-8 weeks

A

Raises head to 45 degrees when prone (tummy time)

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10
Q

Normal gross motor development 6-8 months

A

Sits without support (initially with a round back, then eventually with a straight back by 8 months)
Limit age: 9 months

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11
Q

Normal gross motor development 8-9 months

A

Crawling

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12
Q

Normal gross motor development 10 months

A

Cruises around furniture

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13
Q

Normal gross motor development 12 months

A

Walks unsteadily – a broad gait, with hands apart

Limit age: 18 months

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14
Q

Normal gross motor development 15 months

A

Walks steadily

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15
Q

Normal gross motor development 2.5 years

A

Runs and jumps

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16
Q

Normal vision and fine motor development 6 weeks

A

Fixes and follows

Limit age: 3 months

17
Q

Normal vision and fine motor development 4-6 months

A

Reaches out for toys
Palmar grasp
Limit age: 6 months

18
Q

Normal vision and fine motor development 7 months

A

Transfers toys from one hand to another

Limit age: 9 months

19
Q

Normal vision and fine motor development 10 months

A

Mature pincer grip

Limit age: 12 months

20
Q

Normal vision and fine motor development 16-18 months

A

Makes marks with crayons

21
Q

Normal vision and fine motor development for brick building over 14 months to 4 years

A 
18 months: tower of 3
2 years: tower of 6
2.5 years: tower of 8 or train with 4 bricks
3 years: bridge (from a model)
4 years: steps (after demonstration)
22
Q

Normal vision and fine motor development for pencil skills over 2 years to 5 years (refers to age they can draw without seeing it done; can copy from 6 months earlier)

A 
2 years: line
3 years: circle
3.5 years: cross
4 years: square
5 years: triangle
23
Q

Normal hearing, speech and language development for newborn

A

Startles to loud noises

24
Q

Normal hearing, speech and language development 3-4 months

A

Vocalises when alone or when spoken to, coos and laughs

25
Q

Normal hearing, speech and language development 7 months

A

Turns to soft sounds out of sight

Polysyllabic babble

26
Q

Normal hearing, speech and language development 7-10 months

A

Sounds used indiscriminately at 7 months

Sounds used discriminately to parents at 10 months

27
Q

Normal hearing, speech and language development 18 months

A

6-8 words

Is able to show two parts of the body (e.g. point to nose when asked)

28
Q

Normal hearing, speech and language development 20-24 months

A

Joins two or more words to make simple phrases

29
Q

Normal hearing, speech and language development 2.5-3 years

A

Talks constantly in 3-4 word sentences

Understands 2 joined commands

30
Q

Normal social, emotional and behavioural development 6 weeks

A

Smiles responsively

Limit age: 8 weeks

31
Q

Normal social, emotional and behavioural development 6-8 months

A

Puts food in their mouth

32
Q

Normal social, emotional and behavioural development 10-12 months

A

Waves goodbye, plays peek-a-boo

33
Q

Normal social, emotional and behavioural development 12 months

A

Drinks from a cup with two hands

34
Q

Normal social, emotional and behavioural development 18 months

A

Holds spoon and gets safely to mouth

35
Q

Normal social, emotional and behavioural development 18-24 months

A

Symbolic play

Limit age: 2-2.5 years

36
Q

Normal social, emotional and behavioural development 2 years

A

Toilet training: dry by day

Pulls off some clothing

37
Q

Normal social, emotional and behavioural development 2.5-3 years

A

Parallel play
Interactive play evolving
Takes turns

PICU (10 decks)

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