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neurophys exam Flashcards

1
Q

brown-sequard

A

lateral hemisection of the spinal cord

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2
Q

muscle disease does not have reflex changes

A

right

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3
Q

lacunar stroke

A

pure motor

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4
Q

thalamic stoke

A

pure sensory

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5
Q

lesion in the left lateral geniculate nuc

A

causes a right homonymous sectoranopia or incongruous right homonymous hemianopia

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6
Q

lesion in the left temporal lobe

A

pie in the sky

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7
Q

lesion in the parietal lobe

A

right homonymous defect denser inferiorly

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8
Q

lesion in the upper bank of the left occipital lobe

A

right homonymous lower quadrantanopsia (maculat sparing)

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9
Q

lesion in the lower bank of the left occipital lobe

A

right homonymous upper quandrantanopsia (macular sparing)

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10
Q

lesions in the upper or lower banks of the occipital lobe respect the horizontal

A

but lesions in the temporal or parietal do not

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11
Q

marcus gunn pupil

A

same as afferent pupillary defect

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12
Q

accomodation is preserved but light reflex is impaired

A

Argyll Robertson pupils

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13
Q

inability to look up and down

A

supranuc gaze palsy

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14
Q

what to look for with nystagmus

A

pursuit (following finger) and saccadic movemnts (looking to a target finger); look for dysmetria and overshoot on returning to primary gaze

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15
Q

SR

A

up and out

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16
Q

IR

A

down and out

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17
Q

SO

A

down and in

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18
Q

IO

A

up and in

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19
Q

LR

A

out

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20
Q

MR

A

in

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21
Q

how to look straight down

A

SO (down and in) and IR (down and out)

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22
Q

how to look straight up

A

IO (up and in) and SR (up and out)

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23
Q

what is neuralgia

A

pain, usually in the second or third division of the trigeminal nerve, wihtout sensory loss

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24
Q

the motor trigeminal fibers travel with what division of the trigeminal nerve?

A

mandibular (V3)

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25
Q

jaw deviates toward the side of the weakness

A

of the motor of the trigeminal

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26
Q

what innervates the masseter muscle

A

trigeminal nerve, motor divison

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27
Q

what muscle do you test by raising your eyebrows

A

frontalis

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28
Q

what muscle do you test by closing your eyes

A

orbicularis oculi

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29
Q

what muscle puffs out the cheeks

A

buccinator

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30
Q

what muscle purses the lips tightly

A

orbicularis oris

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31
Q

Weber test

A

with sensorineural hearing loss, the Weber localizes to the good ear; with conudction deafness, it localizes to the bad ear

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32
Q

how to test the trapezius

A

shoulder srug against resistance

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33
Q

test the SCM

A

turn chin forcefully against resistance

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34
Q

hpoglossal nerve weakness

A

tongue deviates toward the affected side

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35
Q

tremor at rest

A

basal gang

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36
Q

tremor on maintaining posture

A

essential tremor

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37
Q

tremor on action

A

localizes to the cerebellum

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38
Q

where does hemoballismus (violent flinging of limbs) localize

A

subthalamic nuc

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39
Q

rigidity (which is different from spasticity) localizes where?

A

basal gang

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40
Q

grading strength

A

0- none; 1-flicker; 2-with gravity eliminated; 3-against gravity; 4-against gravity with resistance; 5-normal strength

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41
Q

what does pronator drift tell you

A

with subtle CST weakness, arm in the supinated position will pronate;

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42
Q

when does a brainstem lesion spare the face?

A

at pons or below

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43
Q

shoulder abduction first 90 degrees

A

supraspinatus; suprascap nerve; C5

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44
Q

shoulder abduction the second 90 deg

A

deltoid; axillary nerve; c5

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45
Q

shoulder adduction

A

latissimus dorsi (nerve to lat dors); pec major (dual innerv); both are C7

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46
Q

shoulder external rotation

A

infraspinatus; suprascap nerve; c5

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47
Q

shoulder internal rotation

A

subscapularis (subscapular nerve); also teres minor; these are all c5

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48
Q

elbow flexion when it is supinated

A

biceps (musculo-cutaneous nerve); roots C5 and C6

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49
Q

elbow fleixion when it is pronated

A

brachioradialis (radial nerve); roots C5, C6

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50
Q

elbow extenstion

A

triceps (radial nerve); c7

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51
Q

elbow supination

A

supinator (radial nerve); c6

52
Q

elbow pronaton

A

pronator teres (median nerve); pronator quadratus (anterior interosseus branch of medial)

53
Q

wrist flex

A

all forearm muscles (median); flexor carpi ulnaris (ulnar)

54
Q

wrist extension

A

all extension muscles (radial); brachioradialis (radial); root is C6/7

55
Q

finger flexion

A

flexor digitorum profundus (median and ulnar); C8 root

56
Q

thumb abduction

A

abductor policis brevis- median nerve (T1)

57
Q

finger extension

A

all extensors (radial nerve); c8 nerve root

58
Q

finger abduction

A

interossei and abductor digitorum minimi (ulnar nerve); T1

59
Q

Pinhcing movemnet

A

nerve root C8; long flexor of thumb, long flexor of index (both anterio interosseus nerve)

60
Q

hip flex

A

iliopsoas (L2/3- direct nerve supply and femoral twigs)

61
Q

knee extension

A

quadricpes (L2,3,4); femoral nerve

62
Q

hip extenson

A

glutei (L4, L5), gluteal nerves

63
Q

knee flex

A

hamstrings (L5, S1); tibial nerve, peroneal nerv; lateral head of biceps femoris

64
Q

hip adduction

A

adductor group (L2, 3,4); obturator nerve

65
Q

what are the hamstrings

A

any one of five tendons controlled by one of three muscles (semitendinous, semimembraneous, and biceps femoris)

66
Q

what are the adductors of the hip?

A

adductor longus, brevis, magnus, minimus; pectineus; gracilis;

67
Q

plantar flexion

A

tibial nerve; gastroc; tibialis posterior; S1, S2

68
Q

inversion of the foot

A

tibialis anterior and tibialis posterior work together; tibial and peroneal nerves; L4

69
Q

dorsiflex the foot

A

tibialis anterior, long extensors, peroneus tertius, extensor dig brevis; L4,L5

70
Q

eversion of the foot

A

peronei longus and brevus; peroneal nerve; S1 nerve root

71
Q

most freq involved roots in cervical spondylosis

A

C5 and C6

72
Q

acute cervical disk lesion usually occurs at wht level

A

C7

73
Q

what nerve gets injured with fracture of the humeral neck, dislocation of the humerus, or IM injections

A

axillary nerve

74
Q

pancoast tumor of the lung ape involves which nerves

A

lower trunk of the brachial plexus

75
Q

incorrect use of a crutch damages what nerve?

A

radial nerve in the axilla

76
Q

fracture of the humerus hits what nerve

A

radial nerve in the spiral groove

77
Q

what else besides midshaft fracture of the humerus hits the radial nerve in the spiral groove?

A

Saturday night palsy (when drunk)

78
Q

trauma to the heel of the hand damages what?

A

deep branch of the ulnar nerve; no sensory loss in typical causes

79
Q

sciatic nerve splits into

A

common peroneal (aka common fibular) and tibial nerve

80
Q

which nerve is subject to trauma at the fibula neck

A

peroneal nerve

81
Q

what is the saphenous nerve

A

cutaneous branch of the femoral nerve

82
Q

what is subject to damage during varicose vein surgery

A

saphenous nerve

83
Q

grading of tendon reflexes

A

0-absent; 1-hypoactive; 2-normal; 3-hyperactive but prob not pathological; 4- pathological increase with clonus

84
Q

jaw jerk reflex

A

tests trigeminal nerve

85
Q

biceps jerk

A

tests c5,c6

86
Q

brachioradialis reflex- how to test

A

rest patient’s arm on his lap; briskly tap the distal radius, looking for flex and supination of the forearm

87
Q

what roots does brachioradialis DTR test

A

supinatory, C5/C6

88
Q

triceps reflex- how do you do it?

A

with patient’s arm flexed, tap the tricpes tendon, which lies just above the olecranon process

89
Q

tricpes reflex tests which nerve root

A

C7

90
Q

finger jerks are what nerve roots

A

C8, T1

91
Q

knee jerk is what nerve roots

A

L3, L4

92
Q

ankle jerk (achilles) is what nerve root?

A

S1

93
Q

upper quadrants of abdomen are what dermatomes

A

T8, T9

94
Q

lower quadrants of abdomen are what dermatome

A

T10, T11

95
Q

cremasteric reflex

A

L1, L2; stoke medilal thigh with a pin and note contraction of cremasteric wth elevation of ipsilateral testical

96
Q

anal wink reflex tests what nerve root

A

S5; stroke medial buttock and look for anal contraction

97
Q

back of head is which dermatome

A

C2-3

98
Q

subclavicular dermatome

A

transition from C4 to T2

99
Q

thumb dermatome

A

C6

100
Q

nipples dermatome

A

T4

101
Q

waist dermatome

A

T10

102
Q

groin dermatome

A

T1

103
Q

Lateral border of foot dermatome

A

S1

104
Q

medial aspect of leg

A

saphenous nerve

105
Q

light touch

A

goes with pain and temp in the anterolateral system (spinothalamic tract)

106
Q

anterior versus posterior brain

A

action versus perception

107
Q

left vs right brain;

A

left is language and praxis; right is spatial representation, attention, and prosody

108
Q

dorsal vs ventral

A

where vs what

109
Q

aprosodias

A

right hemisphere

110
Q

what is the papez circuit involved in?

A

memory

111
Q

what is the papez circuit

A

hippocamp->fornix–>mamillary bodies–>ant thalamic nuc (via mammlothalamic tract)–>cingulate gyrus

112
Q

papez circuit mnemonic

A

heman ate cat

113
Q

right parietal lobe lesion

A

hemineglect, anosagnosia, extinction

114
Q

praxis localizes where

A

left fronto-parietal circuit

115
Q

alien hand syndrome

A

corticobasalar (i.e. involving the cerebral cortex and basal gang), degeneration or mesial frontal lesions

116
Q

what happens in alien hand syndrome?

A

unintentional hand postures and apraxis

117
Q

anterograde amnesia

A

can’t lay down new memories; lesion in bilateral mesdial temporal lobe lesions (esp hippocampus)

118
Q

hippocampus

A

consolidation of info from short term to long term memory and also spatial navigation

119
Q

Anton’s syndrome/blindsight lesion where

A

bilateral occipital lesions

120
Q

Anton’s syndrome

A

coritcal blindness with confabulation

121
Q

Blindsight

A

intact visual responses despite cortical blindness

122
Q

Balint’s syndrome

A

lesion in the bilateral parieto-occipital regions

123
Q

what are the symptoms of Balint’s syndrome

A

optic ataxia (clumsy visually guided movements), ocular aprazia (unable to get eyes to look to the right place), simultagnosia (can’t see the forest through the trees)

124
Q

Gerstmann syndrome

A

left inferior parietal lesion

125
Q

symptoms of Gerstmann syndrome

A

right/left confusion, finger agnosia, dysgraphia, dyscalculia

126
Q

prosopagnosia localizes where

A

occipito-temporal lesions

127
Q

pure alexia (aka alexia without agraphia) localizes where

A

left occipital and splenum of corpus callosum; can write but cannot read

Neuro (43 decks)

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