Principles Of Neurological Examinations

Question 1

What are the different type of tremors? (6)

Answer 1

Physiologic tremor
Essential tremor
Cerebellar or intention tremor
Parkinsonian tremor
Dystonic tremor
Orthodontic tremor (shaky leg syndrome)

Question 2

What is a physiologic tremor?

Answer 2

A tremor of no clinical significants. The sort of tremor that is normal like when you’re scared ect

Question 3

What is an essential tremor?

Answer 3

This mostly affects the hands, voice, tongue, legs, and trunk.
They may be accompanied by mild gait disturbances

Question 4

What is a cerebellar tremor?

Answer 4

A slow, broad tremor of the extremities that occur at the end of a purposeful movement.
Caused by lesions in or damage of the cerebellum, MS or chronic alcoholism.

Question 5

What is a parkinsonian tremor?

Answer 5

A tremor classic of pill-rolling action in the hands

Question 6

What is a dystonic tremor?

Answer 6

This is a sustained involuntary muscle contraction cause twisting and repetitive motions and or painful / armorial postures

Question 7

What is orthostatic tremor ?

Answer 7

Fast rhythmic muscle contrations that occur in the legs and trunk immediately after standing.

The shaking stops then the patient sits down

Question 8

What is a cause of symmetry muscle wasting ?

Answer 8

Duchenne muscual dystrophy

Question 9

What is a cause for muscle wasting asymmetrical?

Answer 9

Polio

Question 10

What can cause proximal muscle wastage?

Answer 10

LGMD (Limb girdle muscular dystrophy)

Question 11

What can cause general muscle wastage ?

Answer 11

Motor neurone disease

Question 12

What are the 4 main characteristics of symptomatic muscle tone ?

Answer 12

Paratonia
Hypotonia (LMD)
Spasticity (UMN)
Rigidity

Question 13

Muscle strength is graded 0-5. Is 0 high or low in this case?

Answer 13

0 is low mean no muscle detection. 5 is active movement against full resistance (normal strength).

Question 14

Muscle strength is graded 0-5. Is 0 high or low in this case?

Answer 14

0 is low mean no muscle detection. 5 is active movement against full resistance (normal strength).

Question 15

What does myotonia mean?

Answer 15

Slow muscle relaxation after a voluntary contraction

Question 16

Where are the deep tendon reflexes ? (5)

Answer 16

Bicept
Brachioradials
Triceps
Patella
Ankle

Question 17

What is a overflowing of a reflex?

Answer 17

When a reflex is hyperactive, nearby muscles respond

Question 18

What scale are reflexes graded by? What is normal?

Answer 18

0 - +4

Normal is +1- +3. 0 is no response and +4 is an elicit a reacting reflex

Question 19

Define hyporeflexes

Answer 19

An absent or diminished response to tapping and a sign of lower motor neuron

Question 20

Define hyperreflexia

Answer 20

A hyperactive or repeating reflexes.
A sign of upper motor neuron.

Question 21

What is clonus?

Answer 21

A series of involuntary muscular contractions due to a sudden stretching of the muscle.

Particularly associated with UMN lesions.

> 5 beats is considered abnormal

Question 22

Grading muscle strength - what does a 3 mean?

Answer 22

Active movement against gravity

Question 23

Grading muscle strength - what does a 2 mean

Answer 23

Active movement of the body with gravity eliminated

Question 24

Grading muscle strength - what does a 5 mean

Answer 24

Active movement against full resistance without evidence of fatigue

Question 25

Grading muscle strength - what does a 4 mean?

Answer 25

Active movement against gravity and some resistance

Question 26

Grading muscle strength - what does a 0 mean

Answer 26

No muscle contraction

Question 27

Grading muscle strength (power) - what does a 1 mean

Answer 27

A barletta detectable flicker of contraction