Practical 1 Cerebellar/ Proprioceptive Flashcards
What is Abadie’s
Deep pain exam, squeezing the Achilles
What is Rombergs test
Patient stand with heels together, have patient close eyes and stand still
If lose balance test is positive
What does Romberg test?
Falls with eyes open and closed- Cerebellar deficit, vestibular mechanism deficit
Falls with eyes ONLY closed- Dorsal column pathology
Hopping on one foot tests?
Cerebellar and proprioceptive exam
Ideally land in same spot
Eyes open and closed problem indicate-cerebellar or vestibular mechanism deficit
Eyes closed only- dorsal column pathology
Squatting on one foot tests
GOOD way to assess minor weakness of lower extremity!!!!!!
Open and closed problem- indicated cerebellar or vestibular mechanism deficit
Eyes closed only- dorsal column pathology
Finger to nose test is
Arms straight out to side touch tip of nose. PERFORM EYES OPEN AND CLOSED.
Dyssynergia: uncoordinated movement
Dysmetria: inaccuracy in measuring distance
What is hypometria
Undershooting during finger to nose test
What is hypermetria
Overshooting during finger to nose test
Finger to finger test tests
Movement should be smooth and accurate
Cerebellar and proprioceptive exam
Finger to nose to finger test
MAKE SURE YOU HAVE PATIENT DO BOTH HANDS!!!!!
Tests cerebellar and proprioceptive
Heel to shin test is
Perform bilaterally with eyes open and closed!
Tests cerebellar and proprioceptive
Diadochockinesia is
Rapid alternating movements
Tests cerebellar and proprioceptive
Abnormal- Dysdiadochoknesia indicates cerebellar dysfunction
What is the Holmes Rebound Phenomenon
Patient contracts forearm against doctors resistance, doc randomly lets go
DO WITH EYES OPEN AND CLOSED
Cerebellar problem
Tandem gait
Walk in straight line heel to toe
Performed eyes open and closed
Cerebellar and proprioceptive
SHOES OFF
Joint position test
Exam one digit or toe and move up or down with patients EYES closed
Can’t pinpoint where joint is indicates POSTERIOR column disease
What is pitre’s
Pinching the testicles
Deep pain
Dorsal columns
Biernacki’s is
Pinching or striking the ulnar nerve
Deep pain exam
Mediated by the dorsal columns
What does deep pain exams test
Dorsal columns
NOT CEREBELLUM
Multimodal exams are
Combined superficial and deep sensations which are subject to higher function of memory
What is stereognosis
Place a common object in the hand with eyes closed patient must identify
Perform bilaterally
What is Barognosis
Assess relative weight of similarly sized and shaped objects that have different weights eye closed
What is topognosis
Touch patient somewhere and have patient identify eyes closed and point to area
What is Graphognosis
Test by writing letter or number on palm, chest or back, patients eyes closed bilaterally examine
2 point discrimination is
Fingertips 2-4mm dorsum of fingers 4-6mm
Test with toothpicks until patient says feels like 1
Multi-modal exam!!!`
Sensory Exam touch patient in same area on both sides with same instrument
- Posterior aspect of shoulder (C4)
- Lateral aspect of upper arms (C5)
- Medial aspect of lower arms (T1)
- Tip of thumb (C6)
- Tip of middle finger (C7)
- Tip of the pinky finger (C8)
Light touch examination tests
The anterior/ lateral columns of the cord to the thalamus (SPINOTHALAMIC) tract
Problem indicates nerve compression or peripheral nerve lesions
Pain exam for the sensory examination aka sharp touch
Lateral Spinothalamic tract if problem present
Pallanathesia we are testing
Loss of vibration
Cuneatus for= upper extremity
Gracilis for= lower extremity
