Neurology Exam Flashcards
Lesion in the brain
unilateral or bilateral UMN signs (tetra/hemi-paresis/paralysis), seizures, behavioural changes, CN deficits, decreased consciousness, cerebellar and vestibular signs, UMN bladder
Lesion in C1-C5
upper signs in all 4 limbs, UMN bladder, hyper reflexia (lack of inhibition), paralysis/paresis
Lesion in C6-T2
lower signs in forelimbs (hyporeflexia, atrophy), upper signs in hind limbs (intact/hyperactive reflexes, paresis/paralysis), UMN bladder
Lesion in T3 - L3
normal forelimbs, upper signs in hind limbs (intact reflex, paresis/paralysis), UMN bladder
Lesion in T4 - S3
normal forelimbs, lower signs in hind limbs (hypo/areflexia, paresis/paralysis), LMN bladder
Overview of neuro exam
observe mental status, gait and posture palpate muscular and skeletal system evaluate postural reactions evaluate cranial nerves evaluate spinal nerves evaluate sensation
lack of responsiveness
depression
depressed but can be aroused with pain
stupor
severely depressed, cannot be aroused with stimuli
coma
What is responsible for arousal of the cerebrum?
reticular activating system, deals with intelligence, lethargy, cranial nerves
What deals with intelligence and goal directed behaviour
thalamocortex
What is ataxia and what 3 aspects tie into coordination?
ataxia is incoordination or lack of awareness of limb position. conscious proprioception (crossing over of affected limb, scuffing of toes), cerebellum (broad based stance), vestibular
What are some postural reactions?
hopping, placing, wheelbarrowing, extensor postural thrust, hemi walking
pupillary light reflexes test which CNs?
optic and oculomotor
Menace response tests which CNs?
optic and facial
Oculocephalic reflex tests?
vestibulocochlear
jaw tone indicates
trigeminal
tongue tone indicates
hypoglossal
a gag reflex tests
vagus and glossopharyngeal
Hind limb nerve innervation + reflexes
flexor - sciatic and femoral
patellar - femoral
cranial tibial - sciatic
forelimb nerve innervation + reflexes
flexor - musculocutaneous, median, ulnar
extensor carpi radialis - radial
perineal reflex tests which nerve?
pudendal
What is a crossed extensor reflex?
There are long spinal reflexes between limbs that are usually suppressed by UMNs. Damage to the UMNs releases this inhibition and flexion of one limb in response to a noxious stimulus is accompanied by extension of the contralateral limb.
Describe an “upper motor neuron” bladder
small
reflex incomplete emptying
difficult to express
Describe a “lower motor neuron” bladder
dilated, atonic, easily expressed
What nerve does the panniculus reflex involve?
lateral thoracic nerve
how can you test deep pain?
digit clamping
