Basic Neuro Exam Flashcards
crocodile tears syndrome?
due to aberrant regeneration of nerve after trauma. patient sheds tears when chewing!
Bilateral facial palsies can occur in what?
Miller-fisher variant of Guillain-Barre Syndrome
lesions of 3,4, and 6?
diplopia and weakness of muscles innervated by that specific cranial nerve
Babinski sign is critical for what?
what else would be seen in this pathology
UMN dysfunction
great toe extends in a pathology.. normally all toes flex.
cClonus
CN VI
1) what is it most commonly associated with? when is it most commonly seen in patients with clinically?
2) lesions result in?
CN palsy due to its long peripheral course –> subarachnoid hemorrhage, late syphilis, trauma
convergent strabismus (esotropia) (inability to abduct the eye due to lateral rectus muscle weakness)
horizontal diplopia –> maximally when looking lateral
What does AAO4 mean?
where do you put this on the objective?
Alert and oriented in person, place, time, and event.
general or the neuro
Asymmetrical abnormal gaits:
Hemiplegic
waddling pelvis
foot drop
circumducted gait –> leg swing in a circular type pattern
usually indicates muscle disease –> hips waddle
foot drop –> UMN or LMN lesions. usual LMN is L5 radiculopathy or perineal neuropathy
CNV lesions, what 4 things can be there?
what’s to note about something going to the ipsilateral side?
decreased sensation
loss of corneal reflex
weakness of muscles of mastication
jaw deviation TOWARD THE WEAK SIDE (unopposed action of opposite pterygoid)
Decorticate vs Decerebrate
decorticate –> arms flexed, legs are stiff and extended (lesion above brainstem)
decerebrate –> arms extended and legs stiff and extended –> midbrain lesion
Gag reflex
1) what are the efferent and afferent limbs of this?
2) how is it done?
***3) loss of gag reflex indicates what?
afferent –> CNIX (sensory)
efferent –> CNX (motor)
cotton tip applicator to the back.
ipsilateral CNIX problem!
Lesions of the cochlear division of CNVIII lead to what?
what are the two types of lesions for this and what are examples of each?
destructive lesions –> sensorineural hearing loss
irritative lesions –> cause tinnitus –> (meds and antibiotics do this)
CN VII, what four things are we testing?
Motor –> facial expressions, eye and mouth closure
Sensory –> taste on anterior 2/3 tongue
Parasympathetic –> secretion of saliva and tears
General sensation –> external ear
Cerebellar testing, what are the ones to know? (4 of them)
finger to nose
finger to finger
heel to shin
rapid alternating movements
UMN lesion ,what do you see?
1) what 2 things are we going to see on exam?
2) what pattern does it have of weakness?
3) What specialty test can we use to indicate this?
hypertonia, hyperreflexia
pyramidal –> weak extensors in arms and weak flexors in legs
pronator drift
Parkinson tremor is what?
essential tremor
pill rolling
essential tremor gets worse as you do more and more
Supranuclear (central) facial palsy does what?
what is this important for?
spares the upper face… associated with hemiplegia
determining if the weakness is CENTRAL or PERIPHERAL in nature
CNV
1) what 3 things do you check?
facial sensation of forehead, cheek, chin (v1-v3) to pinprick, light touch, hot/cold
motor function of jaw and lateral pterygoid
corneal reflex –> cotton wisp to cornea causes blinking so you’re testing 7 (blink) and 5 (touch to cornea)
CAM diagnostic algorithm
LOOK AT BOOK
How do we test proprioception on a patient?
grab the great toe and move it up and down and have them close their eyes and ask them what they think the direction is
CNXI: spinal division, what are we testing?
shrug shoulders, turn head right and left