Neurology Podcast Flashcards
Corneal relfex and where is lesion
Sensation of CN 5 and motor of CN 7
Lesion of pons
Make sure to touch cornea and not sclera
Doll’s eyes
BS, semicircular canals, and CN8 (at pontine-medullary junctions)
Romberg test
Truncal proprioception mediated by post columns of spinal cord
Abnormal if pt unstable after 20-30 secs
Pts with cerebellar dz are unstable with eyes OPEN…can’t say Romberg is positive
Cortical vs. lacunar
Cortical - unlateral in MCA most common…combined motor and sensory with leg spared
Lacunar - occlussion in white matter projections…pure motor or sensory that may involve leg, hand and face
BOTH spare motor fxn of forehead, jaw, and tongeu (vs. Bell’s palsy)
TIA less than 24 hours
Pronator drift
Supination is weaker than pronation so test for subtle motor weakness (UMN lesion)
If arm rises, then cerebellar dz
If malingering, then pscyhiatric
Discriminative sensation
Gross must be present
MUst not see
Stereognosis - object in hand
Hraphestheia - numebr on palm
2 pt dis
All of these test CONTRAlateral sensory fxn
Dysarthria
Expressive aphasia
Receptive aphasia
Anomic
Dys - coordination of muscle of speech - stroke, cerebellar or peripheral nueropathy
Expressive - diff forming words with preserved understanding - inf frontal cortex (Broca’s_
Receptive - fluent speech devoid of meaning due to lack of comprehension - superior temporal (Wernicke)
Anomic - primary naming object
Deep tendon reflexes with gradent
Hyper - loss of UMN inhibiton
HYpo - neruoapthy, motor neurnon dz or NMJ dz
0 - absent 1 - diminshed 2 - normal 3 - brisk with 1-3 beats of clnus 4 - brisk with clonus
Ankle Knee Brachioradialis Biceps Trceips
S1 L2-L4 C5-6 C5-6 C6-7
PLantar reflex
L5/S1 level
UMN, spinal cord dz (B12 def), severe intox or post-ictal state
Grading weakness
Uni - stroke
Generalized - toxin, electrolyte, cervical cord, neurpapthy, myasthenia, ALS
0 - none detected 1 - can't move joint 2 - can't move gravity 3 - oppose gravity 4 - subnormal but some resistacne 5 - normal
Palmomental
Suck
Snout
Grasp
Frontal lobe patholoy
Stroke thenar imminence - contraction of mentalis
Sucking movement with touchign or storking lips
Puckering or protrusion of lips with percussion
Unrecognized storking of palm leads to grasp
Resting
Intention
Postural trmoer
Pill-rolling…suprressed with activity or sleep
Intention - cerebellar dz,….worsens as goal reached…test for dysmetira and dysdiadockokinesis
Post - finer and hyperadrenergic…evident with action
Cerebellar
Sensory
Festinating gait
Steppage
Wide based - MS, tumor
Sensory - Stamp and stick, looing at ground - B12 def, tabes dorsalis, post column)
Festinaitng - Parks
Inability to dorsifelx - CMT or peroneal truama
