Pemeriksaan Fisik Neurologis

Question 1

Babinski positive pada pasien dewasa menunjukkan

Answer 1

Lesi / disfungsi pada Upper Motor Neuron, yaitu tractus corticospinal (piramidal) antara cortex Dan lumbar spinal cord

Question 2

Full triple flexion pada Babinski

Answer 2

Tambahan pada Babinski sign dengan ankle dorsiflexi, knee fleksi, hip fleksi

Question 3

Crossed abductor sign

Answer 3

: merupakan tanda lesi UMN
;Saat reflek patella, terdapat adduksi tungkai (bergerak medial Dari panggul).
Menunjukkan penyebaran reflek diatas level L4 ke segmen L2 Dan L3 , menunjukkan disinhibisi arcus reflek.

Question 4

Tilt table examination

Answer 4

Tilt table examination is used to assess changes in heart rate and
blood pressure that occur with changes in posture, increased vagal
tone (as occurs with Valsalva), and sometimes, in response to the
administration of pharmacologic agents such as the β-agonist
isoproterenol
In normal
individuals, during the tilt table test, at 60 to 80 degrees of tilting
for 10 minutes, there is a brief 5 to 15 mm Hg reduction in systolic
blood pressure, a 5 to 10 mm Hg increase in diastolic blood
pressure, and a 10 to 15 bpm increase in heart rate. If there is
early, gradual, and sustained hypotension (>20 mm Hg reduction
in systolic blood pressure) without compensatory tachycardia, this
is an indication of insufficient sympathetic tone and impaired
baroreceptor function. Hypotension with compensatory tachycardia
suggests hypovolemia. If hypotension is delayed for several
minutes but then occurs abruptly with bradycardia, this is more
suggestive of a neurocardiogenic mechanism. Most neurogenic
causes of syncope lead to hypotension that occurs within the first 5
to 10 minutes of tilting, without a compensatory tachycardia

Question 5

thermoregulatory sweat test

Answer 5

thermoregulatory sweat test : qualitative test of sweating in which an indicator powder is
applied to the subject who is then exposed to elevated
temperatures. Sweat interacts with the powder, and the
distribution pattern of the powder indicates areas of normal
sweating and identifies areas of absent or reduced sweating.
Different patterns of hypo- or anhidrosis can be identified that
correspond to different autonomic disorders. In large and small
fiber neuropathies, distal anhidrosis occurs. In patients with
multiple system atrophy, pure autonomic failure
, and autonomic neuropathies, global
hypohidrosis or anhidrosis occurs

Question 6

quantitative sudomotor axon reflex

Answer 6

The quantitative sudomotor axon reflex test is another test of
sudomotor function. A sweat cell is applied to the skin and an
electric current is then applied. Acetylcholine is iontophoresed into
the skin, stimulating sweat glands. Sweat production is measured
from adjacent sweat glands that are stimulated via an axon reflex.
If there is a low or absent response following application of the
electric current,

Question 7

Schirmer’s test

Answer 7

Schirmer’s testdetermines whether theeyeproduces enough tears to keep it moist.
Negative : normal (>. 10 mm Dalam 5 menit)
Positif : Mata kering (< 10 mm Dalam 5 menit) (pada Bell’s palsy , Ramsay Hunt, sjorgen syndrome)
Cara :
this test consists of placing a small strip of filter paper inside the lower eyelid (inferior fornix). The eyes are closed for 5 minutes.