Neuro Assessment Day 2 Flashcards Preview

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Flashcards in Neuro Assessment Day 2 Deck (60):
1

what is spasticity?

rate dependent rigidity
moving the limb faster causes it

2

what would spasticity indicate?

Upper motor neuron lesion
CP, stroke

3

what is rigidity?

non-rate dependent rigidity
lead pipe rigidity

4

what would rigidity indicate?

parkinsonism

5

what would flaccid muscles indicate?

lower motor neuron lesion

6

what is the thenar eminence?

pad of hand at the thumb

7

what would cause atrophy of the thenar eminence?

carpal tunnel syndrome

8

what is important to consider when evaluating muscle strength?

1. what would be "normal" for that person
2. symmetry

9

what the scale for evaluating muscle strenght?

0-no movement
1-flicker of muscle
2-moves but not against gravity
3-moves against gravity but not against resistnace
4-moves against some resistance
5-normal

10

what nerves does the grip test evaluate?

C7, C8, T1

11

what nerves does intrinsic hand muscle evaluate?

C8, T1, ulnar

12

what nerves does wrist flexion evaluate?

C7, C8, T1

13

what nerves does wrist extension evaluate?

C6, C7, C8

14

what does C6 innervate?

thumb and forefinger

15

what does elbow extension evaluate?

C7, C8

16

what does elbow flexion evaluate

C5, C6

17

what does shoulder adduction evaluate?

C5 through T1

18

what does shoulder abduction evaluate?

C5, C6

19

what does hip flexion evaluate (bringing the leg forward)?

L2, L3, L4

20

what does hip extension evaluate (bringing the leg backward)?

L5, S1

21

what does hip abduction evaluate?

L4, 5, S1

22

what does hip adduction evaluate?

L2, 3, 4

23

what does ankle dorsiflexion evaluate?

L4,5

24

what does ankle plantar flexion evaluate?

S1, 2

25

what is the usual progression of sensory deficits?

start distal and move proximal

26

what will help to evaluate where the nerve pathology is located?

combining muscle and sensory findings

27

what are possible causes of sensory neuropathy?

1. peripheral afferent nerve fibers (DM)
2. spinothalamic tract (crosses at the level of the spine) pain, temperature, crude touch
3. dorsal column (crosses at the level of the brain stem)-discriminate touch, vibration, pressure
4. cortex

28

what is stereognosis?

being able to identify an object with eyes closed

29

when testing sharp/dull which side is used as a control?

cotton side of the wooden cotton stick so that patients don't say sharp, sharp, sharp

30

when would you use temperature test?

if pain stimulus was abnormal

31

where do you test proprioception first?

toes and fingers and only if that is not in-tact would you go more proximal

32

what is graphesthesia?

ability to identify a number by feel alone when traced in the pt's hand

33

what is 2 point discrimination?

ability to identify 2 simultaneous stimuli

34

what is extinction?

you are touching both arms, but they only feel that you are touching one

35

what is a positive Romberg test?

pt can't stand still with eyes closed
-may indicate dorsal column problem

36

how would a cerebellar issue manifest itself?

can't stand without wobbling

37

what are the specific cerebellar tests?

finger to nose (point to point)
rapid alternating movements
gait

38

what is dysmetria

missing the mark

39

what is dysdiadokinesia?

inability to perform movements with speed and accuracy

40

absent reflexes would indicate

peripheral neural damage

41

normal reflexes with other problems could indicate

spinal cord damage

42

hyperreflexes would indicate

central neural damage

43

how would a normal reflex evaluation be documented?

2+

44

what is clonus?

reflex turns into muscle contraction and is documented as a 4+

45

what does patellar reflex test?

L2, 3, 4

46

what does achilles reflex test?

S1, 2

47

what does biceps reflex test?

C 5, 6

48

what does triceps reflex test?

C7, C8

49

what does brachioradialis relfex test?

C5, C6

50

what is asterixis?

sudden, brief, non-rythmic flexion of hands and fingers when holding out arms with wrists extend
-liver flap (metabolic encephalopathy)

51

what is winging of scapula?

scapula protrudes out
-may be seen in nerve injury or muscular dystrophy

52

what are meningeal signs?

1. nuchal rigidity
2. kernig's sign
3. brudzinskis sign

53

stroke is defined as...

death of brain tissue due to lack of oxygen

54

what is a thrombotic stroke?

blocks blood flow to the brain at a local area that creates a clot

55

what is an embolic stroke?

blocks blood flow to the brain that comes from a distant area
-common cause is plaque from the carotid artery
-afib

56

what are common causes of hemorrhagic stroke?

aneurysm (outpouching of a blood vessel)

57

what would decerebrate position indicate?

brain stem lesions

58

what would decorticate position indicate?

stroke

59

what would a positive pronator drift test indicate?

contralateral lesion in the corticospinal tract

60

what is the first sensation to be lost in PPN?

vibration

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