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All That Neuro Stuff Flashcards

(55 cards)

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1
Q

What exposure is required for a lower limb exam?

A

Shorts of underwear

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2
Q

What do you look for in inspection of lower limb neuro

A

SWIFT
- Scars
- Wasting of muscles
- Involuntary movements
- Fasciculations
- Tremor
Objects
- walking stick

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3
Q

In what position should the patient be for inspection of lower limb neuro?

A

Lying on bed (45)

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4
Q

What do you look for when assessing gait?

A
  • Speed
  • Symmetry
  • Balance
  • Arm swing
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5
Q

What does walking on tip toes test?

A

power of plantar flexion

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6
Q

What does heel walking test?

A

Power test of dorsiflexion

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7
Q

What does rombergs test test for?
And what does positive test suggest?

A

Assessment of proprioception
positive test suggests that ataxia is sensory in nature

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8
Q

How do you check tone in legs?

A
  • Leg roll
  • Leg lift
  • ankle clonus
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9
Q

Which way is dorsiflexion of the foot?

A

lifting toes up

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10
Q

What reflexes do you test in lower limb neuro?

A
  • Knee jerk
  • Ankle jerk
  • Plantar reflex
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11
Q

Describe the dermatomes of the leg

A
  • L2 (upper thigh)
  • L3 (lower thigh)
  • L4 (knee)
  • L5 (lateral shin)
  • S1 (lateral foot)
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12
Q

what tuning fork is used to test vibration sensation in leg?

A

128Hz

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13
Q

What do you do to test coordination of lower limb?

A
  • heel shin test
  • ask patient to tap your hands asap with their feet
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14
Q

What would you do to complete examination of lower limb neuro?

A
  • Cranial nerve examination
  • Examination of upper limb
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15
Q

What exposure is required for examination of upper limb?

A

Remove top (can keep bra on)

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16
Q

What do you look for on inspection of upper limb neuro exam?

A
  • Posture
  • Pronator drift
  • SWIFT
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17
Q

Tone: what does cog-wheeling and rigidity suggest?

A

Parkinsons disease

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18
Q

Tone: what does increased tone suggest?

A

UMN lesions

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19
Q

Example of UMN lesion

A

Stroke

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20
Q

Where are the dermatomes in upper limb? (where test sensation) describe where

A
  • upper inner and outer arm
  • inner and outer forearm
  • finger tip
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21
Q

Upper limb neuro: testing coordination (finger to nose): what would suggest cerebellar disease?

A
  • Intention tremor
  • Past pointing
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22
Q

What does dysdiadokinesia suggest? and what is it?

A
  • Parkinsons
  • Inability to perform rapidly alternating movements
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23
Q

To which side will uvula deviate in glossopharyngeal nerve palsy? why?

Study These Flashcards
A

Away

Train tracks: Palsy side doesn’t pull up when normal side does => pulled to opposite side than lesion

24
Q

To which side will tongue deviate in hypoglossal nerve lesion? why?

Study These Flashcards
A

Toward

Train tracks: trying to stick tongue out straight ahead, lesion side doesn’t move, normal side works and pushes to side of lesion

25
What tuning fork for rinne's and weber's tests
512Hz
26
What do rinne's and weber's test for
to differentiate conductive and sensorineural hearing loss
27
Tandem gait is particularly good at identifying what dysfunction?
cerebellar vermis
28
What do you look for when assessing patient gait?
- Stance - Stability - Turning - Arm swing
29
What does rombergs test test for?
- Tests for loss of proprioceptive or vestibular funciton
30
What is positive Romberg's sign and what does this indicate
- positive sign: falling without correction - indicates unsteadiness is due to sensory ataxia (not cerebellar dysfunction)
31
Romberg's test: what does swaying with correction suggest? what is test result?
- Not Romberg positive - often occurs in cerebellar disease due to truncal ataxia
32
Rebound phenomenon back to original position is suggestive of what?
Healthy individual
33
Exaggerated rebound phenomenons suggestive of what?
spasticity (stroke affecting cerebrum)
34
Absence of rebound phenomenon is suggestive of what?
cerebellar disease
35
CN exam: what is first thing you do do test CN II ?
Inspect! - pupils (size + alignment)
36
Should patient wear their glasses when checking visual acuity
yup
37
What distance should the Snellen chart be when checking visual acuity?What if patient can't read it there?
6m Then if unable to read 3m if still unable to read then 1m if still unable assess ability to count fingers
38
how many lines of Snellen chart should they be able to read
6/9
39
how do you make sure that consensual light reflex is not biased?
put hand up in-between eyes to make sure light is only shining on one eye
40
What does swinging light test test for?
may reveal a relative afferent pupillary defect
41
how would you assess for colour vision?
using Ishihara chart
42
What tests do you do for optic nerve? (5)
- visual acuity - visual fields by confrontation - inattention/ visual extinction - light reflexes (direct and consensual) - accommodation
43
what question do you ask after checking eye movement?
ask if the patient has any double vision
44
what do you do after checking light sensation of the face (CNV)
pin-prick sensation with a neuro tip - same regions
45
which muscles do you palpate for CNV
- temporalis - masseter
46
what question do you ask for CNVIII?
have you noticed a change in your hearing?
47
How do you test the patients balance (CNVIII)
get the patient to stand up, cost their eyes and march on the spot. the patient will rotate towards the side of the lesion.
48
What would you do to complete CN exam?
- full neurological examination including upper and lower limbs - appropriate neuroimaging
49
What is the point of tandem gait?
will exaggerate unsteadiness (cerebellar vermis dysfunction)
50
What test to test for balance?
Romberg's test
51
what type of speech is characteristic of cerebellar disease?
slurred staccato speech
52
cerebellar exam: what do you test for in the eyes?
- ask if they have any double vision - H pattern (nystagmus) - overshooting - check for smooth pursuit
53
Cerebellar exam: what do you test for in upper limb?
- coordination - tone - rebound phenomenon - happy clappy
54
cerebellar exam: what do you test for in lower limb?
- tone: leg roll, leg drop - coordination: heel shin - reflexes: knee jerk
55
how would knee jerk reflex change in cerebellar disease?
Hyporeflexia

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