NEUROLOGICAL EXAMINATION Flashcards
Patients who have expressive aphasia have a lesion in
the ____________.
dominant frontal lobe
Patients who have alexia or dyslexia have a problem in
the _____________.
dominant occipital lobe
Apraxia or inability to do common daily tasks like
washing the face, drinking, dressing up is due to a
_____________.
nondominant parietal lobe lesion
Mental status abnormalities suggest a __________.
Cortical lesion
Ammonia stimulates _____.
CN V
Anosmia in BOTH nostrils:
Blocked nasal passage
Trauma
Ageing
Parkinson’s disease
Unilateral anosmia:
Blocked nostril
Frontal brain lesion
Corrected by pinhole:
Error of refraction
Monocular Field Defects
Anterior to Optic
Chiasm
Bitemporal Field Defects
Optic Chiasm
Homonomous Field Defects
Behind optic chiasm
Congruous homonomous field defects
Behind lateral geniculate bodies
Lateral rectus is supplied by:
CN VI
Superior oblique is supplied by:
CN IV
BC > AC
Conductive
AC > BC
Sensori-neural
Deaf Ear
Conductive
Good Ear
Sensori-neural
Does not move at all
0/5
Moves a little (flickers)
1/5
Moves when gravity is eliminated
2/5
Moves against gravity
3/5
Moves against resistance but weak
4/5
Normal
5/5
One arm pronates and drifts downwards
Weakness
Both arms drift downwards
Bilateral weakness
Arm rises
suggests Cerebellar disease
Fingers continuously move up and down
Deficit of joint position sense
Increased tone (spasticity)
Upper motor neuron
Increased reflexes + babinski
Upper motor neuron
Decreased tone
Lower motor neuron
Decreased absent reflexes wasting/fasciculation
Lower motor neuron
C5
Elbow flexion
Biceps
C6
Elbow flexion (semipronated) Brachioradialis
C7
Wrist flexors
Elbow extension
Triceps
C8
Finger flexors
No reflex
T1
Small muscles of hand
No reflex
L1, L2
Hip flexion
No reflex
L3, L4
Knee extension
Knee reflex
L5
Extension of great toe
No reflex
S1
Hip extension, knee flexion, plantar flexion
Ankle reflex
Absent fasciculation
Muscle diseases
No babinski
Neuropathy
Muscle diseases
Reflexes usually normal, occ. depressed
Muscle diseases
+/- Sensory Abnormality
Neuropathy
No Sensory Deficit
Muscle diseases
Fasciculation
Neuropathy
Intact CNS
Muscle diseases
Atrophy
Neuropathy
Proximal weakness»_space; Distal weakness,
usually symmetrical
Muscle diseases
Hypo to Areflexia
Neuropathy
Distal weakness»_space; Proximal weakness
Neuropathy
Hypoactive
1
Normal
2
Hyperactive w/o
clonus
3
Unsustained Clonus
4
Sustained Clonus
5
Pinprick
Spinothalamic tract
Proprioception
Posterior column tract
Touch sensation
Both tracts
Ipsilateral cerebellar syndrome
Unilateral incoordination
Midline cerebellar syndrome
Truncal & Gait Ataxia, without limb inco-ordination
Spontaneous
4
To speech
3
To pain
2
Orientated
5
Confused
4
Inappropriate
3
Incomprehensible
2
Obeying
6
Localizing
5
Withdrawal
4
Flexion
3
Extension
2
Decerebrate
1
Evaluation of the pupils
CN 2
Evaluation of extraocular muscles
CN 3
Corneal reflex testing
CN 5
Gag reflex testing
CN 9, 10
Ice calorics testing
CN 8
Small unilateral
Normal
Large bilateral supratentorial
Cheyne-stokes
Large unilateral
Cheyne=stokes variant
Large bilateral partial
Central neurogenic hyperventilation
Large bilateral midpontine
Apneustic
Large bilateral posterior fossa
Ataxic