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2b > All That Neuro Stuff > Flashcards

All That Neuro Stuff Flashcards

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?

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?

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
Q

What tuning fork for rinne’s and weber’s tests

A

512Hz

26
Q

What do rinne’s and weber’s test for

A

to differentiate conductive and sensorineural hearing loss

27
Q

Tandem gait is particularly good at identifying what dysfunction?

A

cerebellar vermis

28
Q

What do you look for when assessing patient gait?

A
  • Stance
  • Stability
  • Turning
  • Arm swing
29
Q

What does rombergs test test for?

A
  • Tests for loss of proprioceptive or vestibular funciton
30
Q

What is positive Romberg’s sign and what does this indicate

A
  • positive sign: falling without correction
  • indicates unsteadiness is due to sensory ataxia (not cerebellar dysfunction)
31
Q

Romberg’s test: what does swaying with correction suggest? what is test result?

A
  • Not Romberg positive
  • often occurs in cerebellar disease due to truncal ataxia
32
Q

Rebound phenomenon back to original position is suggestive of what?

A

Healthy individual

33
Q

Exaggerated rebound phenomenons suggestive of what?

A

spasticity (stroke affecting cerebrum)

34
Q

Absence of rebound phenomenon is suggestive of what?

A

cerebellar disease

35
Q

CN exam: what is first thing you do do test CN II ?

A

Inspect!
- pupils (size + alignment)

36
Q

Should patient wear their glasses when checking visual acuity

A

yup

37
Q

What distance should the Snellen chart be when checking visual acuity?What if patient can’t read it there?

A

6m
Then if unable to read 3m
if still unable to read then 1m
if still unable assess ability to count fingers

38
Q

how many lines of Snellen chart should they be able to read

A

6/9

39
Q

how do you make sure that consensual light reflex is not biased?

A

put hand up in-between eyes to make sure light is only shining on one eye

40
Q

What does swinging light test test for?

A

may reveal a relative afferent pupillary defect

41
Q

how would you assess for colour vision?

A

using Ishihara chart

42
Q

What tests do you do for optic nerve? (5)

A
  • visual acuity
  • visual fields by confrontation
  • inattention/ visual extinction
  • light reflexes (direct and consensual)
  • accommodation
43
Q

what question do you ask after checking eye movement?

A

ask if the patient has any double vision

44
Q

what do you do after checking light sensation of the face (CNV)

A

pin-prick sensation with a neuro tip - same regions

45
Q

which muscles do you palpate for CNV

A
  • temporalis
  • masseter
46
Q

what question do you ask for CNVIII?

A

have you noticed a change in your hearing?

47
Q

How do you test the patients balance (CNVIII)

A

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
Q

What would you do to complete CN exam?

A
  • full neurological examination including upper and lower limbs
  • appropriate neuroimaging
49
Q

What is the point of tandem gait?

A

will exaggerate unsteadiness (cerebellar vermis dysfunction)

50
Q

What test to test for balance?

A

Romberg’s test

51
Q

what type of speech is characteristic of cerebellar disease?

A

slurred staccato speech

52
Q

cerebellar exam: what do you test for in the eyes?

A
  • ask if they have any double vision
  • H pattern (nystagmus)
  • overshooting
  • check for smooth pursuit
53
Q

Cerebellar exam: what do you test for in upper limb?

A
  • coordination
  • tone
  • rebound phenomenon
  • happy clappy
54
Q

cerebellar exam: what do you test for in lower limb?

A
  • tone: leg roll, leg drop
  • coordination: heel shin
  • reflexes: knee jerk
55
Q

how would knee jerk reflex change in cerebellar disease?

A

Hyporeflexia

2b (9 decks)

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