Lecture 2 - Neurologic Exam Flashcards Preview

Intro to Physical Exam - 2016 > Lecture 2 - Neurologic Exam > Flashcards

Flashcards in Lecture 2 - Neurologic Exam Deck (37)
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1

What are the 4 regions of the brain?

Cerebrum
Diencephalon
Brainstem
Cerebellum

2

What brings white matter together from the cortex to descend into the brainstem?

Internal capsule

3

What is the role of the thalamus?

Regulates sensory impulses

4

What is the role of the hypothalamus?

Regulates body temperature, pulse, BP, endocrine function, emotions

5

___ ____ mediates reflex activity

spinal cord

6

Anterior (ventral) root contains ___ fibersPosterior (dorsal) root contains ___ fibers

Ventral root = motor fibersDorsal root = sensory fibers

7

What are the 5 areas of examination in a neurologic exam?

-mental status
-cranial nerves
-motor system
-sensory system
-deep tendon, abdominal, plantar reflexes

8

How is CN I tested?

Sense of smell; test by presenting familiar odors (rarely tested in a routine exam)

9

How is CN II tested?

visual acuity, pupillary reflexes, visual fields

10

How are CN III, IV, and VI tested?

the six cardinal directions of gaze

11

How is the motor function of CN V tested?

Cheek contraction of temporal and masseter muscles

12

How is the sensory function of CN V tested?

Test the forehood, cheeks, and jaw on each side for pain sensation
-use a sharp object; compare sharp and dull and compare sides
-test again for light touch
-test corneal reflexes

13

How is CN VII tested?

-inspect face for symmetry
ask patient to:
-raise both eyebrows
-close eyes tightly so you can't open them
-show both upper and lower teeth
-smile-puff out both cheeks

14

How is CN VIII tested?

Assess for hearing loss; compare air and bone conduction

15

How is CN IX and X tested?

Assess quality of voice; watch for palate elevation, check gag

16

How is CN XI tested?

Shoulder shrug
turn head against hand

17

How is CN XII tested?

tongue movements

18

In a right CN XII palsy, which side of the face does the tongue go?

Goes to the right side (tongue moves to side of lesion)

19

What are the 3 types of involuntary movements?

Tremors
Tics
Fasciculations

20

What is the scale of grading for muscle strength?

0 - no muscular contraction detected
1 - barely detectable trace of contraction
2 - active movement with gravity eliminated
3 - active movement against gravity
4 - active movement against gravity and some resistance
5 - active movement against resistance; normal

21

What 4 areas are integrated for coordination?

Motor system for motor strength
Cerebellar system for rhythmic movement and steady posture
Vestibular system for balance and coordinating eye, head, body
Sensory system, for position sense

22

What does the Romberg test assess?

Position sense

23

How is a Romberg test conducted?

Have patient stand with feet together and eyes open, then close both eyes

24

What is affected if during a Romberg test the patient sways eyes open and eyes closed?

Cerebellar disease

25

What is affected if during a Romberg test the patient sways with eyes closed only?

Loss of position sense

26

What tract conducts information about pain and temperature?

spinothalamic tract

27

What tract conducts information about position and vibration?

Posterior columns

28

What tract conducts information about light touch?

both spinothalamic tract and posterior columns

29

What patterns of testing are necessary in sensory testing?

-comparison of symmetric areas
-compare distal with proximal areas of extremities
-when testing position and vibration, first test fingers and toes; if ok, then it is ok everywhere
-vary the pace of testing

30

What spinal nerve roots control biceps reflex?

C5 and C6