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Year 3 > Periphere Neurological Examination > Flashcards

Periphere Neurological Examination Flashcards

1
Q

What do you look for in Inspection of peripheral neurological Exainsation?

A

SWIFT

  • Scars
  • Wasting
  • Involuntary movements
  • Fasciculations
  • Tremor
  • Specific signs e.g neurofibromas
  • Face (hypomimia, ptosis, ophthalmoplegia)
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2
Q

What things could you notice around the patients bedside in a peripheral neurological examination?

A
  • Walking aid
  • Wheelchair
  • Catheter bag
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3
Q

How do you test the pronator drift?

What does in indicate?

A

Let patient stretch out arms supine

See if one arrm drops / pronates

Indicates UMN lesion on the contralateral side

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4
Q

How can you differnetiate Hypertonia?

A

In

  • Spacticity (Velocoty dependant = the faster you move the harder)
  • Rigidity (not velocoty dependant)
    • e.g. parkinsons
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5
Q

Which Myotomes do you test when testing for power of the shoulder

A

Chicken wings

  • Adduction = C6/7
  • Abduction = C5
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6
Q

Which Nerve routes do you test when testing for power of the elbow?

A

Boxer Position

Elbow flexion (C5/6)

•Elbow extension (C7)

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7
Q

Which nerve routes do you test when testing for writst power?

A
  • Wrist flexion (C6/7)
  • Wrist extension (C6)
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8
Q

Which Nerve routes do you test when testing for the power in fingers?

A

Fingers

  • Abduction (T1)
  • Adduction (C8/t1)
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9
Q

What is the Muscle Power Scale (MPS)?

A

Scale of classifiying muscle power

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10
Q

Which reflexes do you test in an upper limb exam?

Which nerve route do they test?

A

Supinator reflex (C5/6)

Biceps reflex (C5/6)

Triceps reflex (C6/7)

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11
Q

What does hypo/hyperreflexia indicate?

A

Hyper = UMN lesion

Hypo = LMN lesion

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12
Q

Which dermatomes do you test in an Upper limb exam?

A
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13
Q

How do you test vibration sensation in an Upper limb exam?

A

128 Hz tuning fork

  • hold on most distal joint (humans interphalangeal joint of thumb)
  • ask w exes closed when they can feel vibration + when does it stop
  • if abnormal move closer until can feel
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14
Q

What is the Rapid alternating movement test?

A

Dysdiodokinesia - cerebellar pathology

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15
Q

How do you test coordination in the upper limb?

A
  1. Finger - Nose test
    1. Past pointing
    2. Intention Tremor
      1. Cerebellar Pathology
    3. Rapid alternating movement test
      1. Cerebellar Pathology
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16
Q

What are signs of Cerebellar Pathology?

A
  • Dysdiodokinesia
  • Ataxia
  • Nystagmus
  • Intention Tremor
  • Slurred Speech (dysarthria)
  • Hypotonia/Heel-shin test
17
Q

What additional examinations could you reccomend on completion of an upper limb neurological examination?

A
  • Full neurological examination (upper/lower limbs & cranial nerves)
  • Mini mental examination
  • Assessment of gait and balance
18
Q

How would you test the gait in a lower limb neurological examinaiton?

A

Let patient walk

Turn around

Come back with

  • Heel toe
  • Tip toe and
  • Heel walk
19
Q

What would you look for in the gait assessmeent of a patient?

A
  • •Speed
  • •Symmetry
  • •Stance
  • •Stability
  • •Arm swing
  • •Steps
  • •Turning
    *
20
Q

What is an Ataxic gait?

What does it indicate?

A
  • Incoordination
  • Swaying of body
  • and poor balance

Might be due to

  • Cerebellar ataxia
  • Sensory ataxia
21
Q

What are the characteristics of an parkisonian gait?

A
  • Bradikinesia
  • Lean forward
  • Reduced arm movement
  • Feet barely lifted from ground
22
Q

What does an high stepping gait indicate?

A

peroneal nerve palsy and L5 radiculopathy

23
Q

How do you conduct the Rhomberg’s test?

A

Balance requires 2 out of the following 3:

  • proprioception
  • vestibular function
  • vision

•Positive Romberg’s - Patient is more unsteady w eyes closed indicates :

  • sensory ataxia

If there is no difference with eyes closed/open indicateds

  • Cerebellar ataxia (negative rhombers)
24
Q

Which myotomes do you test whith Hip power?

A
  • Hip flexion (L1/2)
  • Hip extension (L5/S1)
  • +/- Abduction (L2/3)

+/- Adduction (L4/5)

25
Q

Which nerve routes do you test with knee power/movements?

A
  • Knee flexion (S1)
  • Knee Extension (L3/4)
26
Q

Which nerve routes do you test with ankle movements?

A
  • Ankle Dorsiflexion (L4)
  • Ankle Plantar flexion (S1/2)
27
Q

Which nerve routes do you test whith big toe movements?

A
  • Big toe extension (L5)
  • Big toe flexion
28
Q

Which nerve routes does the Babinski Reflex test?

A

S1

29
Q

How can you differentiate between an UML and a LMNL

A
30
Q

Which dermatomes do you test in sensation testing of lower limbs?

A
31
Q

What does an abnormal heel chin test suggest?

A
  • Dysmetria
    • Cerebellar pathology
  • Weakness
    • apparent incoordination

Year 3 (52 decks)

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