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ECOS Exam 2 > Neurology Exam > Flashcards

Neurology Exam Flashcards

1
Q

Ptosis

A

CN3
Dropping eyelid past the upper margin of the pupil
= levator palpebrea weak

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2
Q

Pupillary Dilation or asymmetry

A

CN3
Due to disruption of the ciliary plexus
(Parasympathetic to pupil = constriction [miosis] lost) = dilation and fixed

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3
Q

Ophthalmoplegia

A

CN 3 to major extraocular muscles lost

DOWN AND OUT

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4
Q

Presentation of CN 3 lesion

A

Sudden, unilateral ptosis + ophthalmoplegia

Diplopia can be masked if ptosis is severe

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5
Q

Esotropia

A

CN 4

Eye shifts medially

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6
Q

CN 4 lesion

A

Weak down gaze
Superior oblique is weak
EYE DRIFT UP

(Vertical diplopia, difficult reading plus walking down, head tilting can cause torticollis)

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7
Q

CN 4

Vertical diplopia

A

Double vision that increases when looking down

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8
Q

CN 4

Head tilting

A

To opposite side of lesion

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9
Q

CN 6 lesions

Convergent (medial) strabismus (esotropia):

Horizontal diplopia:

A

Most common palsy
Seen in patients often with subarachnoid hemorrhage, late syphilis, and trauma

Inability to abduct eye (lateral Rectus lost)

Looking to the side that is effected causes maximum separation

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10
Q

CN 5 lesions

A

Decreased face sensation and mucus membranes

Lost CORNEAL REFLEX

weak of mastication muscles

Jaw deviation toward weak side (weak pterygoid muscle)

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11
Q

Trigeminal Neuralgia

CN 5

A

(90% due to to artery or vein compressing the nerve)

Brief episodes of unilateral shock like pain along one or more of the CN 5 dermatomes

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12
Q

CN 7 lesions

A

Facial muscle paralysis (Bells Palsy)
COREAL REFLEX lost
Hyperacusis (sensitive to sounds)
Crocodile tear syndrome (damaged nerves regenerate and cause tears while chewing), usually when surgery on parotid gland

Bilateral facial palsy(Guillain-Barre Syndrome)
Supranuclear (central) facial palsy : lower face droop due to CBC neurons and hemiplasia

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13
Q

CN 8 Vestibular lesions

A

Disequilibrium (imbalances)

Nystagmus (rapid involuntary and rhythmic movement of eye

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14
Q

CN 8 Cochlear

A

Destructive leasion: sensorineural hearing loss (Acoustic Neuroma)

Irritative lesion: tinnitus (ringing in ear)
(Medications like aspirin and some ABs)

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15
Q

CN 9 and 10

A

Lite to voice and nasal tone (palatal weakness)
Gag
Say ahhh (palate raised)

Lesion 9:
No gag
No sensation in posterior 1/3 tongue
Some dysphagia

Lesion 10:
No gag or cough 
Dysphonia 
Dysphasia 
Dyspnea
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16
Q

CN 11 lesions

A

Can turn head to side that is effected

Shoulder drop

17
Q

Documenting CN test if lazy

A

CNs gossly intact

I didn’t spend time doing the test only I also didn’t notice anything that made me think I would need to go though them

18
Q

Documenting CN test after doing it

A

CNs 2-12 intact to testing

19
Q 
Sensory dermatomes  
C4
C6
C7
C8
T1
T4
T10
L4
L5
S1
A

T4:

20
Q

Pain and temp

Vibration and proprioception

A

Spinothalamic Tract

Posterior column

21
Q

Stereognosis

A

Able to identify shapes of objects or what is in my hand

22
Q

Graphesthesia

A

Can identify numbers written on the palm

23
Q

Two point discrimination

Double simultaneous stimulation

A

Distinguish if being touched by one amid two points

Can fell 2 locations being touched at the same time

24
Q

Sensory loss patterns

A

Single nerve
Root (many nerves)

Spinal cord
Brain stem= crossed findings face and body opposite ()

Thalamic: hemiplasia pall over
Cortical loss: loss of cortical sensation still functional primary sensations
Functional loss: no anatomical distribution it’s by function

25
Q

Cerebellum testing

A 
Rapid alternating movement (dynsenmeteinuys)
Finger to nose
(Dysmetria)
Heel to shin
Gait
Get up and go
Romberg test
Pronator drift
26
Q

Reflex

A

0
1 low to normal
2 normal
3 brisker then average only doesn’t have to be a disease
4 very brisk and clonus (flex and ext oscillations)

27
Q

Motor grading

A

0 no muscle contraction
1 flicker or trace of contraction
2 actively move however not against gravity
3 move against gravity no resistance
4 move agains t gravity and some resistance
5 normal

28
Q

Cerebellar Ataxia

A

Staggering, unsteady, feet wide apart

29
Q

Sensory ataxia

A

Unsteady, feet wide apart, feet thrown forward and down heel to forefoot and looks down when walking

30
Q

Parkinsonian gait

A

Stooped forward, shuffling with some hesitation and less swinging of arms

31
Q

Plantar babinski reflex

A

UMNs

32
Q

Nuchal Rigidity

A

84% meningitis
21-86% subarachnoid hemorrhage

Utilize imaging to rule out any trauma

33
Q

Brudzinski sign

A

Patient lays down and physician flexes neck causing pain and knees and hips flex up in response

34
Q

Kernigs sign

A

Flex patients hip and leg while laying down

If patient lifts neck due to pain it is positive

ECOS Exam 2 (6 decks)

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