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Neuro B1 - WLB > Week 1 - Intro to Neurologic Examination > Flashcards

Week 1 - Intro to Neurologic Examination Flashcards

0
Q

What are the 8 parts of assessing mental status?

A
  1. Level of consciousness
  2. Orientation
  3. Attention/Concentration
  4. Calculation
  5. Language
  6. Speech
  7. Memory
  8. Fund of Knowledge
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1
Q

What are the 8 basic components of a neurologic exam?

A
  1. Mental status
  2. Cranial nerves
  3. Motor
  4. Strength
  5. Sensory
  6. Reflexes
  7. Coordination
  8. Gait & Station
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2
Q

What are some ways to describe a patient’s Level of Consciousness?

A

Awake, Drowsy, Somnolent, Lethargic, Coma

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3
Q

How do you test a patient’s orientation?

A

Ask patient their name. Do they know where they are? What day/time is it?

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4
Q

How do you assess a patient’s Attention/Concentration?

A

Ask pt to spell “world” backwards.

Ask pt to say months of the year backwards.

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5
Q

How do you assess a patient’s Calculation abilities?

A

Serial 7’s

Calculate change after hypothetical purchase

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6
Q

How do you assess a patient’s Language?

A

Listen to them!

Naming, fluency, vocabulary

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7
Q

How do you assess a patient’s memory?

A

Ability to comprehend

Recall 5 words after distraction

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8
Q

How do you assess Fund of Knowledge?

A

Current president, recent events

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9
Q

What abnormalities does a physician look for in fundoscopic exam?

A
  • blurring of disk margins
  • loss of venous pulsations
  • color of optic nerve head
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10
Q

How do you test CN I?

A

Olfactory - smell

  • Pass odors under nose with patient’s eyes closed
  • More important to perceive stimulus than to identify correct odor
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11
Q

How do you test CN II?

A

Optic - visual acuity, visual fields, pupils
Pocket card/wall chart
Confrontation or threat (wiggle fingers in periphery)

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12
Q

How do you test CN III?

A

Oculomotor - pupils, eye movements

  • Direct, consensual, accomodation
  • Swinging flash light
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13
Q

How do you test CN IV?

A

Trochlear - superior oblique eye muscle

-“H” movement, follow finger

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14
Q

How do you test CN V?

A

Trigeminal - facial sensation, corneal response, muscles of mastication

  • Cotton, pin, tuning fork to compare side by side
  • Bite down, open jaw, feel TMJ
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15
Q

How do you test CN VI?

A

Abducens - lateral rectus eye muscle

“H” movement

16
Q

How do you test CN VII?

A

Facial - facial muscle movements

  • At rest observe palpebral fissures and nasolabial folds
  • Squeeze eye shut
  • Smile, puff out cheeks
17
Q

How can you tell Peripheral vs. Central facial weakness?

A

Forehead is spared in a central lesion (i.e. stroke)

18
Q

How do you test CN VIII?

A

Vestibulocochlear - inner/middle ear

  • Test for dizziness/vertigo, abnormal nystagmus, or coma
  • Fine finger rubbing or watch ticking
  • Weber and Rinne tests
19
Q

How do you test CN X?

A

Vagus - pharynx, oropharynx, & larynx

  • Palate elevation, gag, swallow
  • Listen for hoarseness
20
Q

How do you test CN XI?

A

Accessory - sternocleidomastoid & trapezius muscle

-Turn head against resistance at chin

21
Q

How do you test CN XII?

A

Hypoglossal - tongue muscles

  • Listen to articulation, slurring
  • Observe at rest for fasciculations
  • Observe for protrustion and movement for deviation to one side/slowness
22
Q

How do you assess patient’s Motor control?

A
  • Observe for atrophy

- Disuse

23
Q

How do you assess a patient’s Tone?

A
  • Passive motion about a joint
  • Decreased tone = flaccid
  • Increased tone = spastic, rigid “lead pipe”, or paratonia (can’t relax)
24
Q

What does an arm drift or pronator drift test?

A

Strength:

  • Upper motor neuron weakness
  • Drifts downward on contralateral side to stroke occurrence
25
Q

What CNS component is a physician testing when assessing Sensory response to Vibration and Proprioception?

A
  • Dorsal columns

- Large fibers

26
Q

In what conditions are reflexes Hyporeflexive?

A

Radiculopathy & Neuropathy

27
Q

In what conditions are reflexes Hyperreflexive?

A

Brain lesion & Spinal Cord Lesion

28
Q

What gait is typical with cerebellar damage?

A

Wide base, ataxic

29
Q

What gait is typical with Neuropathy?

A

Wide base, slapping feet

30
Q

What gait is typical in basal ganglia damage/parkinson’s?

A

Shuffling, stooped, multistep turns, fenestrating

31
Q

What gait is typical in upper motor neuron damage?

A

Spastic movements

32
Q

What gait is typical in myopathy/proximal weakness?

A

Circumducting

33
Q

What gait is typical with distal weakness?

A

Steppage gait

34
Q

What gait is typical with pain?

A

Antalgic

35
Q

What is astasia-abasia?

A

Inability to either stand or walk in a normal matter. BIZARRE!

Neuro B1 - WLB (8 decks)

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