Neuro Assessment Day 2

Question 1

what is spasticity?

Answer 1

rate dependent rigidity

moving the limb faster causes it

Question 2

what would spasticity indicate?

Answer 2

Upper motor neuron lesion

CP, stroke

Question 3

what is rigidity?

Answer 3

non-rate dependent rigidity

lead pipe rigidity

Question 4

what would rigidity indicate?

Answer 4

parkinsonism

Question 5

what would flaccid muscles indicate?

Answer 5

lower motor neuron lesion

Question 6

what is the thenar eminence?

Answer 6

pad of hand at the thumb

Question 7

what would cause atrophy of the thenar eminence?

Answer 7

carpal tunnel syndrome

Question 8

what is important to consider when evaluating muscle strength?

Answer 8

1. what would be “normal” for that person

2. symmetry

Question 9

what the scale for evaluating muscle strenght?

Answer 9

0-no movement
1-flicker of muscle
2-moves but not against gravity
3-moves against gravity but not against resistnace
4-moves against some resistance
5-normal

Question 10

what nerves does the grip test evaluate?

Answer 10

C7, C8, T1

Question 11

what nerves does intrinsic hand muscle evaluate?

Answer 11

C8, T1, ulnar

Question 12

what nerves does wrist flexion evaluate?

Answer 12

C7, C8, T1

Question 13

what nerves does wrist extension evaluate?

Answer 13

C6, C7, C8

Question 14

what does C6 innervate?

Answer 14

thumb and forefinger

Question 15

what does elbow extension evaluate?

Answer 15

C7, C8

Question 16

what does elbow flexion evaluate

Answer 16

C5, C6

Question 17

what does shoulder adduction evaluate?

Answer 17

C5 through T1

Question 18

what does shoulder abduction evaluate?

Answer 18

C5, C6

Question 19

what does hip flexion evaluate (bringing the leg forward)?

Answer 19

L2, L3, L4

Question 20

what does hip extension evaluate (bringing the leg backward)?

Answer 20

L5, S1

Question 21

what does hip abduction evaluate?

Answer 21

L4, 5, S1

Question 22

what does hip adduction evaluate?

Answer 22

L2, 3, 4

Question 23

what does ankle dorsiflexion evaluate?

Answer 23

L4,5

Question 24

what does ankle plantar flexion evaluate?

Answer 24

S1, 2

Question 25

what is the usual progression of sensory deficits?

Answer 25

start distal and move proximal

Question 26

what will help to evaluate where the nerve pathology is located?

Answer 26

combining muscle and sensory findings

Question 27

what are possible causes of sensory neuropathy?

Answer 27

1. peripheral afferent nerve fibers (DM) 2. spinothalamic tract (crosses at the level of the spine) pain, temperature, crude touch 3. dorsal column (crosses at the level of the brain stem)-discriminate touch, vibration, pressure 4. cortex

Question 28

what is stereognosis?

Answer 28

being able to identify an object with eyes closed

Question 29

when testing sharp/dull which side is used as a control?

Answer 29

cotton side of the wooden cotton stick so that patients don't say sharp, sharp, sharp

Question 30

when would you use temperature test?

Answer 30

if pain stimulus was abnormal

Question 31

where do you test proprioception first?

Answer 31

toes and fingers and only if that is not in-tact would you go more proximal

Question 32

what is graphesthesia?

Answer 32

ability to identify a number by feel alone when traced in the pt's hand

Question 33

what is 2 point discrimination?

Answer 33

ability to identify 2 simultaneous stimuli

Question 34

what is extinction?

Answer 34

you are touching both arms, but they only feel that you are touching one

Question 35

what is a positive Romberg test?

Answer 35

pt can't stand still with eyes closed | -may indicate dorsal column problem

Question 36

how would a cerebellar issue manifest itself?

Answer 36

can't stand without wobbling

Question 37

what are the specific cerebellar tests?

Answer 37

finger to nose (point to point) rapid alternating movements gait

Question 38

what is dysmetria

Answer 38

missing the mark

Question 39

what is dysdiadokinesia?

Answer 39

inability to perform movements with speed and accuracy

Question 40

absent reflexes would indicate

Answer 40

peripheral neural damage

Question 41

normal reflexes with other problems could indicate

Answer 41

spinal cord damage

Question 42

hyperreflexes would indicate

Answer 42

central neural damage

Question 43

how would a normal reflex evaluation be documented?

Answer 43

2+

Question 44

what is clonus?

Answer 44

reflex turns into muscle contraction and is documented as a 4+

Question 45

what does patellar reflex test?

Answer 45

L2, 3, 4

Question 46

what does achilles reflex test?

Answer 46

S1, 2

Question 47

what does biceps reflex test?

Answer 47

C 5, 6

Question 48

what does triceps reflex test?

Answer 48

C7, C8

Question 49

what does brachioradialis relfex test?

Answer 49

C5, C6

Question 50

what is asterixis?

Answer 50

sudden, brief, non-rythmic flexion of hands and fingers when holding out arms with wrists extend -liver flap (metabolic encephalopathy)

Question 51

what is winging of scapula?

Answer 51

scapula protrudes out | -may be seen in nerve injury or muscular dystrophy

Question 52

what are meningeal signs?

Answer 52

1. nuchal rigidity 2. kernig's sign 3. brudzinskis sign

Question 53

stroke is defined as...

Answer 53

death of brain tissue due to lack of oxygen

Question 54

what is a thrombotic stroke?

Answer 54

blocks blood flow to the brain at a local area that creates a clot

Question 55

what is an embolic stroke?

Answer 55

blocks blood flow to the brain that comes from a distant area - common cause is plaque from the carotid artery - afib

Question 56

what are common causes of hemorrhagic stroke?

Answer 56

aneurysm (outpouching of a blood vessel)

Question 57

what would decerebrate position indicate?

Answer 57

brain stem lesions

Question 58

what would decorticate position indicate?

Answer 58

stroke

Question 59

what would a positive pronator drift test indicate?

Answer 59

contralateral lesion in the corticospinal tract

Question 60

what is the first sensation to be lost in PPN?

Answer 60

vibration