Exam Mistakes Flashcards
What do you do after assessing gait in lower limb neuro?
Romberg’s test (!)
What do you do to test tone in lower limb neuro
- leg roll
- leg drop
- Passively move each joint
- Ankle clonus (!)
what actions to test power in lower limb neuro (movement of each joint)
- Hip: flexion, extension, abduction, adduction
- Knee: flexion, extension
- Ankle: dorsiflexion, plantar flexion, eversion (!), inversion (!)
- Big toe: plantar flexion, dorsiflexion
Completion of lower limb neuro?
- Cranial nerve examination
- Upper limb neuro
Upper limb neuro: what do you do to start?
ask which dominant hand (!)
What do you do for inspection of upper limb neuro?
- Posture
- SWIFT
- Pronator drift (!)
What do I keep forgetting to inspect in abdo exam?
- Chest wall inspection (!)
GALS: after hand inspection, what do you do with hands?
- Screening movements (arms up, and behind back)
- Hand out, fingers spread
- Turn over
- Make a fist
- Grip strength
- MCP joint squeeze (!)
- Piano fingers (!)
GALS: What actions do you do to check tone in legs?
- Fully flex and extend
- internally and externally rotate hip (!)
GALS: What do you do with the feet?
- Inspect well (!)
- MTP joint squeeze (!)
GALS completion?
- focused exam of joints with suspected pathology
- further imaging if indicated
Completion of upper limb neuro?
- Cranial nerve examination
- Lower limb neuro
Completion of GI exam?
- Inguinal lymph nodes
- Stool sample
- Hernial orifices
- Rectal exam
- Urine sample
- Genital (external) exam
Knee exam: What do you do for feel?
- Temperature
- Palpate borders
- Palpate behind (popliteal fossa)
- Effusions (bulge + swipe)
- flex knee to (90)
- Measure and compare quadricep circumference (!)
Completion of knee exam?
- Hip exam
- Ankle exam
- Neurovascular examination of both exams
Spine exam: what do you do after inspecting the person standing?
Assess gait
Spine exam: Where do you feel on palpation?
- Whole length of spine
- Paraspina muscles
- Supraclavicular fossa (!)
- Sacroilliac joints (!)
What movements do you do for lower spine exam?
- Lumbar: flexion, extension (!), lateral flexion
- Thoracic: Rotation
Spinal exam completion
- Full neurological exam
Hip exam: What do you do for feel?
- Temp
- Palpate joint
- Apparent vs actual leg length (!)
Thyroid exam: what do you look for on hand inspection?
- Just look: sweating, palmar erythema…
- Clubbing (!)
- Fine tremor
Thyroid exam completion?
- Thyroid function test
- ECG (!)
What do test CN VIII ?
- Has your hearing changed?
- Clicking in ears
- Rinne’s + weber’s (!)
What do you do on completion of Cerebellar exam?
- Full neurological exam including CN and upper + lower limbs
- Any appropriate neuroimaging
- Formal hearing assessment
