basic neuro exam Flashcards
(47 cards)
anosmia
olfactory (cn1): loss of sensory of smell
pupils assymeticral/uneven
aniscoria
parasympathetic stimulation, light, looking at a near object
miosis
direct pupillary rxn to light
light show on the retina (afferent CNII) results in constriction of the ipsilateral pupil (efferent CNIII)
indirect pupillary rxn to light
light show on the retina (afferent CNII) results in constriction of the contralateral pupil (efferent CNIII)
pupillary rxn to accomodation***
pupils constrict when focused on a near object
what causes relative afferent pupillary defect? (aka marcus gunn pupil) characteristic?
due to optic nerve or severe retinal disease
direct pupillary resposne to light absent, but indirect response is intact because CNII is intact
whats the hallmark of neurosyphilis**
intact to accommodation but not to light*
“prostitute pupil”
nonresponse to light but do constrict when looking at near object
Signs and symptoms of horner’s syndrome
loss of sympathetic tone, ptosis, miosis, anhydrosis
CN IV palsy
what does this lead to?
and how does it often develop?
inability to bring the eye in and down
often leads to vertical diplopia with reading or near vision
often develop head tilt AWAY from affeected eye
normal jumping movements of the eye with voluntary scanning (reading)
Saccades
involuntary movement of eye; slow drift away from the focus with fast beat correlation back to the focus.
nystagmus
named for the fast phase twitching back
what CN is hypersensitivity to sound
CNVII
bells palsy characteristic
LMN lesion: cause facial drooping involving forehead (forehead has unilateral LMN involvement–therefore it involves the forehead)
One sided face droop
if patient had a stroke, how would the patient look
UMN lesion will cause facial drooping but spare the forehead because the forehead has BILATERAL UMN involvement (and stroke only involves one side)
hearing loss is due to inefficient conduction from the outer ear to the ear drum to ossicles from fluid in middle ear, perforated ear drum cerumen, foreign body
conductive hearing loss
damage to the inner ear apparatus or CN VIII
sensorineural hearing loss
what should the normal rxn of Rinne test should be
Normal rinne test is positive or negative? abnormal?
the sound should be louder on air conduction than bone conduction
positive ; negative
what is abnormal for webber test vs normal response?
normal: sound heard equally in both ears
abnormal: loud in one ear is considered lateralising to that side
spinal level: back of the head dermatome
C2
spinal level: nipple line dermatome (derm)
T4
spinal level: anterior axilla (derm)
T1
spinal level: thumb (dermatome)
C6
spinal level: index and middle finger
C7
