Peripheral Neuro Exam Flashcards
What do you look for around the bed?
Walking aids, wheelchairs
What do you look for in inspection of upper limb
Wasting, fasciculations, tremors, hypertophy, asymmetry, abnormal movements
Pronator drift
What do you do after inspection for upper limb?
Tone
Flex elbow, supinate slow then fast for catch, wrist circumduction
Power
Chicken, boxer, wrists, squeeze fingers, spread fingers, thumb & opposition
Reflexes
What’s after reflexes in upper limb?
Co-ordination (cerebellar rebound, finger nose, dysdiadokinesia)
Sensation (light touch, proprioception, pain, vibration, temp)
Name the upper limb reflexes and nerve roots
Biceps (C5)
Brachioradialis/supinator (C6)
Triceps (C7)
What dermatome is the middle finger?
C7
Dermatomes of arm
C5-T1
Upper motor neuron lesion
Pronator drift Increased tone Increased reflexes Clonus Upgoing planter reflexes
Lower motor neuron lesion
Muscle wasting/fasciculation
Decreased tone and reflexes
Down going plantar reflexes (normal)
What muscles in the hand are supplied by the median nerve?
LOAF, thenar eminence Lumbricals (1st and 2nd) Opponens pollicis Abductor pollicis brevis Flexor pollicis brevis
Inspection of lower limb
Walking aids, wheelchairs, shoes
Wasting
Posture
Abnormal movements, tremor, fasciculations
What is done after inspection of lower limb?
Gait (festinant->parkinson’s, atacic->cerebellar, antalgic->OA of hip, foot slapping->sensory neuropathy)
Tone (leg roll, ankle drag)
Power
How do you test power w/nerve root
Hip flexion (L1, L2) Hip extension (L5, S1) Knee flexion (L5, S1) Knee extension (L3, L4) Ankle plantar flexion (S1) Ankle dorsiflexion (L4, 5) Hallux extension (L5)
Reflexes w/nerve roots
Knee (L3/4)
Ankle (S1/2)
Ankle clonus
What is tested after reflexes in lower limb
Coordination (heel-knee)
Sensation (L2-S2) (light touch, pain, vibration, proprioception)
