Flashcards in Neuro Deck (103):
Most part of the neuro exam are objective/subjective?
Testing of the neuro system is predicated on what?
Normal function of cognition, AND other organ systems
What are the "special" senses?
What are somato sensory fibers?
Senses for pain, cold etc
True or false: right and left are divisions of the neuro system?
What is the opposite of supratentorial?
What are the three embryonic divisions of the brain?
What cranial nerves are associated with the parasympathetic system?
III, VII, Ix, and X
What are the sacral levels of the para symp division?
S2, 3, 4
What spinal levels comprise the sympathetic nervous system?
How do you name spinal cord tracts?
From the origin of the signs, to its terminus
What is the other name for the afferent signals?
What is the other name for the efferent signals?
True or false: mood and physical appearance are not part of the mental status assessment
What does obtunded mean?
Obtundation refers to less than full alertness (altered level of consciousness), typically as a result of a medical condition or trauma.
What are the components of AVPU?
responds to Pain
U = unresponsive
What are the three major components of the Glasgow coma scale?
What is the mini cog recall test?
Repeat 3 words back after some time
When is a Folstein's mini-mental status exam performed?
During a full H & P
What is praxis?
Knowing how to use an object appropriately
How do you check for CN 1 dysfunction?
Have pt occlude nostril, and identify scents
How do you check for CN II dysfunction?
Confrontation by fields
What are muscles are you testing with eye movements?
III, IV, and IV (oculomotor, trochclear, and abducens)
What is the innervation of the lateral recti?
LR6 (CN VI)
What is the innervation of the superior oblique muscle?
SO4 (CN 4)
What is the innervation of the majority of the eye muscles?
What CN that innervates the eye, also supplies parasympathetic function?
Internal torsion of the eye = what CN?
Lateral eye movement = which CN?
Lateral deviation of the eye = what muscle?
medial deviation of the eye = what muscle?
Up and out movement of the eye = what muscle?
Up and in movement = what eye muscle?
Down and out = what eye muscle?
Down and in = what eye muscle?
Straight up eye movement = what eye muscle (s)?
Superior rectus and inferior oblique
Straight down eye movement = what eye muscle (s)?
Inferior rectus and superior oblique
PERRLA = which CN?
What does the swinging flashlight test look for?
Marcus gun pupil (afferent vs efferent defect)
Accommodation tests which eye muscle?
What are the three spots to test for the three division of the trigeminal nerve?
What are the muscles that are innervated by the trigeminal nerve?
The four muscles of mastication (the masseter, the temporal and the medial and lateral pterygoids. The other four muscles are the tensor veli palatini, the mylohyoid, the anterior belly of the digastric and the tensor tympani.
What are the four muscles of mastication?
Medial and lateral pterygoids
Besides the muscles of mastication, what other muscles does the trigeminal nerve supply motor function to?
Tensor veli palatini
What does CN VII supply sensory innervation to?
anterior 2/3 of the tongue
What supplies the motor innervation to all of the facial muscles?
How can you distinguish between stroke and Bell's palsy?
unlike Bell's palsy, a stroke will usually let patients control the upper part of their faces. A person with a stroke will usually have some wrinkling of their forehead--**Bell's Palsy will NOT**
What does CN VIII do?
hearing and balance
How do you test CN VIII?
What supplies tast innervation to the posterior 1/3 of the tongue?
What is the muscle that receives innervation from CN IX?
Posterior pharyngeal muscle
What supplies parasympathetic fibers to the parotid gland?
How do you test for CN IX?
Damage to the recurrent vagus nerve produces what?
Hoarseness of the voice
What is the motor supply to the posterior part of the tongue, pharynx, larynx?
What does CN XI innervate?
What does CN XII innervate?
Motor to the tongue
In a central lesion, the tongue will deviate toward or away from the side of the lesion?
In a peripheral lesion, the tongue will deviate toward or away from the side of the lesion?
How do you test for CN XII?
Push tongue towards each cheek
What are the tests for motor function of the upper extremities?
1. Shoulder ab/adduction
2. Elbow flex/extend
3. Wrist extend/felx
4. Finger flexe/xtend
What are the tests for motor function of the lower extremities?
1. Hip flexion/extension
2. Knee flexion/extension
3. Ankle flexion
What is the nerve root for dorsiflexion of the ankle?
What is the nerve root for plantarflexion of the ankle?
What is the nerve root for inversion of the ankle?
What is the nerve root for eversion of the ankle?
What is the nerve root for dorsiflexion of the great toe?
What is the nerve root for planterflexion of the great toe?
Review muscle grading in the clin med foot lecture
Paresis = what?
Plegia or paralysis = ?
What is the bulk examination for muscles?
Palpate for atrophy
Upper motor neuron lesions = ?
Biceps reflex = what Cervical nerve level?
Triceps reflex = what Cervical nerve level?
Brachioradialis reflex = what Cervical nerve level?
Patellar reflex = what Cervical nerve level?
Calcaneal tendon reflex = what Cervical nerve level?
What is 4/4 reflex called?
What is clonus?
Rhythmic series of muscle contractions induced by stretching the tendon
What is the babinski sign? Who is this normal in? How do you describe it in a note?
Normal for infants
Upgoing or downgoing
What are primary sensory modalities? What does this test?
Light touch, pain, temp etc
Tests afferent pathways
What are secondary modalities?
Point localization, extinction, two point discrimination test
Vit B12 deficiency affects which sensory modality?
Where are the primary sensory modalities housed?
Posterior dorsal columns
How do you test for Primary modalities?
Vibrating tuning fork
What is stereognosis?
the ability to perceive and recognize the form of an object in the absence of visual and auditory information, by using tactile information
Superficial pain fibers are of what type? Superficial touch?
Superficial pain = small
Superficial touch = semi-myelinated
How do you test for proprioception?
Close eyes, move their limb for them. Ask them which way it was moved
What is Graphesthesia? What does this test?
the ability to recognize writing on the skin purely by the sensation of touch
What is cerebellar testing?
Assessment of coordination
Is cerebellar specific/sensitive?
Sensitive, but not specific
How do you assess cerebellar? How many tests do you need?
Rapid alternating movement
Need one test in each of four areas
What is the result of a normal cerebellar test?
What is the result of a ABnormal cerebellar test?
What are the "point to point" movements of the cerebellar test?
Finger to nose
What does the Romberg test, test for?
Proprioception (NOT cerebellar)
Look up forward and retropulsion in Parkinsons
What is tandem gait?
What is the cerebellar gait?
Wide gait, swaying trunk,
fall toward side of lesion
Which side is affected in pronator drift (the affected or unaffected side)
What is Brudzinski's sign?
With pt supine, passive flexion of the neck causes involuntary flexion of the hips