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Flashcards in Neuro Exam Deck (68):
1

What is the main question asked when doing a neurological exam?

Where is the lesion? (CNS, PNS)

2

What is the first sign of cauda equina?

Bladder retention

3

When should you consider a neurologic exam prior to performing OMM? (2)

-Pain in the axial skeleton
-Evaluating a joint problem that has neurologic symptoms associated with it

4

Is smooth or jagged ("give way") weakness more concerning?

Smooth

5

If a pt comes in with bilateral LE weakness, what should you ask?

Numbness/weakness in other parts of the body

6

LMN lesions have what type of paralysis?

Flaccid

7

UMN lesions have what type of paralysis?

Spastic

8

True or false: it is okay to skip sections of the neuro exam if there are no symptoms in that area

False

9

Fasciculations are indicative of UMN or LMN lesions? What are these?

UMN

Stimulation of motor units (LMN units)

10

What are parkinsonian symptoms?

Resting tremors

11

What are the characteristics of cerebellar walking?

Wide based gait

12

Heel walking is checking for what spinal level?

L5

13

Toe walking is checking which spinal level?

S1

14

Romberg test is checking for what function?

Proprioception

15

Sway and falling with closing eyes in Romberg is positive for what type problem?

Proprioception

16

Sway and falling withOUT closing eyes in Romberg is positive for what type problem?

Cerebellar

17

How do you test for Hoffman's reflex?

Flipping the dorsal surface of the middle finger, and observing for contraction of the thumb and second digit

18

What does Hoffman's reflex check for?

UMN lesions

19

What is clonus?

To and fro rhythmic oscillation of a body part. Hyperreflexia

20

True or false: any clonus in mature individuals is abnormal

False- only sustained clonus

21

What is abortive clonus?

Few oscillations when eliciting clonus

22

What is the grade for hyperactive or hyperreflexia?

3/4

23

What is the grade for hyperreflexia with sustained clonus?

4/4

24

What is the root level for the biceps reflex? What is the peripheral nerve?

C5
Musculocutaneous n

25

What is the root level for the brachioradialis reflex?

C6
Radial n

26

What is the root level for the triceps?

C7
Radial n

27

What is the root level for the quadriceps?

L4
Femoral n

28

What is the root level for the achilles tendon reflex?

S1
Tibial n

29

True or false: to test reflexes, you should flex or extend the joint to alter the tension

true

30

What is a Jendrassik maneuver?

Distracting the individual while assessing reflexes

31

What is a positive Babinski sign?

Extension of the great toe, and flaring of the remaining digits ("up going")

32

What is the appropriate way to document a babinski sign?

Flexor or extensor response

33

Which side of the foot should the babinski sign be started from? Why?

Lateral side of the plantar foot, otherwise may elicit the plantar grasp reflex, which may show as a down going Babinski

34

Grade this muscle strength: FROM against gravity only

3

35

Grade this muscle strength: FROM with gravity eliminated

2

36

Grade this muscle strength: no joint motion, but a slight muscle contraction can be palpated or observed

1

37

What causes the "give-way" weakness? (2)

-pain
-Not understanding physician

38

What are the four muscles that you should not be able to overcome?

-Trapezius
-Triceps
-Quad extension
-Gastrocnemius

39

What are the ASIA sensory points?

A series of points to test, to check for spinal cord injury

40

What are the common pitfalls of the neuro exam?

-Relying too much on the history
-Not having a reproducible way to elicit reflexes

41

What does Tandem walking test for?

Cerebellum

42

How do you ensure reproducibility with strength testing?

Overcome them for a few degrees

43

If a patient has full strength, but only to a certain degree of flexion/extension, how should this be documented?

5/5 strength at (__) degrees of whatever

44

Where is C3 sensation tested?

Supraclavicular fossa

45

Where is C4 sensation tested?

Top of AC joint

46

Where is C5 sensation tested?

Lateral antecubital fossa

47

Where is C6 sensation tested?

Dorsal, proximal thumb

48

Where is C7 sensation tested?

Dorsal, proximal middle finger

49

Where is C8 sensation tested?

Dorsal, proximal 5th finger

50

Where is T1 sensation tested?

Medial antecubital fossa

51

Where is L2 sensation tested?

Medial anterior thigh

52

Where is L3 sensation tested?

Medial, anterior knee

53

Where is L4 sensation tested?

Medial malleolus

54

Where is L5 sensation tested?

Medial dorsal foot

55

Where is S1 sensation tested?

Inferior lateral malleolus

56

Where is S3 sensation tested?

ITs

57

What spinal level: shoulder abduction/elbow flexion

C5

58

What spinal level: wrist extension

C6

59

What spinal level: elbow extension

C7

60

What spinal level: Long (3rd) finger flexion at the DIP

C8

61

What spinal level: Finger abduction

T1

62

What spinal level: hip flexion

L2

63

What spinal level: Knee extension

L3

64

What spinal level: ankle dorsiflexion

L4

65

What spinal level: big toe extension

L5

66

What spinal level: Ankle plantarflexion

S1

67

Which has more prominent atrophy: UMN lesion, or a LMN lesion?

LMN

68

Which has fasciculations: UMN or LMN lesions?

LMNs