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OSCE > Neuro > Flashcards

Neuro Flashcards

1
Q

LMN signs?

A

Wasting / fasciculation
Hypotonia
Weakness
Reduced reflexes

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2
Q

UMN signs?

A

Increased tone
Spasticity
Weakness
Brisk reflexes / upgoing planter reflex

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3
Q

Hip flexion - which myotome?

A

L2/L3

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4
Q

Hip extension - which myotome?

A

L4/L5

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5
Q

Knee extension - which myotome?

A

L3/L4

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6
Q

Knee flexion - Which myotome?

A

L5/S1

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7
Q

Ankle dorsiflexion - Which myotome?

A

L4/L5

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8
Q

Ankle plantar flexion - Which myotome?

A

S1/S2

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9
Q

Big toe extension - Which myotome?

A

L5

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10
Q

Patellar reflex - which nerve root?

A

L3/L4

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11
Q

Ankle reflex - which nerve root?

A

S1/S2

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12
Q

Babinski reflex interpretation?

A

Big toe upwards - UMN
big toe curled in - normal

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13
Q

Which dermatome do you test at the knee (medial)?

A

L3

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14
Q

Which dermatome do you test at the pinky toe (lateral foot)?

A

S1

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15
Q

Where do you test for the L2 dermatome?

A

anterior lateral thigh

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16
Q

Where do you test for the L4 dermatome?

A

anterior medial calf

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17
Q

Where do you test for the L5 dermatome?

A

anterior lateral calf, or base of first and second toe
web spaces on dorsal aspect of foot

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18
Q

Where do you test for:
- S2
- S3
-S4/5
dermatomes?

A
  • S2 = Popliteal fossa
  • S3 = central bum
  • S4/5 = perianal area
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19
Q

Which tuning fork size to use to assess vibration sensation in lower limb?

A

518Hz

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20
Q

Causes of bilateral upper motor neurone lesion?

A
  • MS
  • motor neurone disease (normal sensation)
  • Myelopathy - cord compression
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21
Q

Shoulder abduction - Which myotome?

A

C5

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22
Q

Elbow flexion - Which myotome?

A

C6

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23
Q

Elbow extension - Which myotome?

A

C7

24
Q

Wrist extension - Which myotome?

A

C7

25
Q

Finger extension - Which myotome?

A

C7

26
Q

Finger flexion and thumb extension - Which myotome?

A

C8

27
Q

Finger abduction - Which myotome?

A

T1

28
Q

Thumb abduction - Which myotome?

A

T1

29
Q

Biceps reflex - which nerve root?

A

C5/6

30
Q

Supinator reflex - which nerve root?

A

C4/6

31
Q

Triceps reflex - which nerve root?

A

C7

32
Q

Which dermatome is the deltoid muscle badge zone?

A

C5

33
Q

Which dermatome is the palmer aspect of the thumb?

A

C6

34
Q

Which dermatome is the palmer aspect of the middle finger?

A

C7

35
Q

Which dermatome is the palmer aspect of the pinkie finger?

A

C8

36
Q

Which dermatome is the medial forearm?

A

T1

37
Q

Which tuning fork do you use to assess vibration sensation in upper limb?

A

128Hz

38
Q

What is CN II and how do you test it?

A

Optic

A - acuity (Snellen, ishihara etc)

F - Fields (inattention, fields, blind stop)

R - Reflexes (accommodation, direct/consensual, swinging)

O - Opthalmoscopy

39
Q

What are CN III, IV and VI and how do you test them?

A

Oculomotor, trochlear and abducens

  • inspect for strabismus, ptosis, nystagmus
  • H-test
  • Saccades test
40
Q

Which extra-ocular muscle does CN4 supply?

A

superior oblique

41
Q

Which extra-ocular muscle does CN6 supply?

A

lateral rectus

42
Q

if an eye cannot move laterally then there is a lesion in which CN?

A

CN 6

43
Q

if an eye cannot move inferiorly when facing medially then there is a lesion in which CN?

A

CN 4

44
Q

If the eye rests in an ‘down and out’ position then lesion may be where?

A

CN 3

45
Q

What is CN V and how do you test it?

A

Trigeminal

  • Sensory - opthalmic, maxillary and mandibular distributions
  • motor - clench jaw and feel bulk
  • power - open jaw against resistance
  • corneal reflex and Jaw jerk
46
Q

What is CN VII and how do you test it?

A

Motor - raise eyebrows, scrunch up eyes, purse lips, show teeth, puff out cheeks
Others - taste in anterior 2/3rds of tongue

47
Q

What is Webers test?

A

Use 512Hz tuning fork and place om patients forehead - ask if either side if lounder.

48
Q

What is Rinne’s test?

A

use 512Hz tuning fork and place at mastoid process - when patient cant hear then bring infront of ear (normal = air conduction is louder)

49
Q

Which cranial nerve root does uvula deviation indicate?

A

CN 10 (Vagus) - away from site of lesion.

50
Q

What is CN IX and X and how do you test it?

A

IX - glossopharyngeal
X - vagus

inspect - ask patient to say Ahh
Motor - assess speech, cough and swallow
other - gag reflex and taste on posterior 1/3rd of tongue

51
Q

What is CN XI and how do you test it?

A

Accessory

  • Inspect - sternocleidomastoid/trapezius wasting
  • motor - turn head against resistance + shrug shoulders
52
Q

What is CN XII and how do you test it?

A

Hypoglossal

  • tongue for muscle wasting / fasiculations
  • motor - stick out tone (deviates towards lesions)
  • power - tongue against cheek
53
Q

How do you differentiate between LMN and UMN lesions in cranial nerve exam?

A

UMN - spares the forehead as bilateral innervation

54
Q

Causes of unilateral facial nerve lesions?

A
  • Bells palsy
  • Ramsay Hunt
  • SOL
  • Lyme disease
  • Nerve infiltration (TB, sarcoid, lymphoma)
  • parotid tumour
55
Q

Causes of Bilateral Facial nerve lesions?

A

Lyme disease
Sarcoidosis
Guillain-Barre
Amyloidosis

56
Q

Clinical features of parkinsons?

A

Rigidity
Tremor
Bradykinesa
Postural instability

OSCE (9 decks)

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