neuro exam

Question 1

what are cafe au lait blotches a sign of

Answer 1

neurofibromatosis

Question 2

why is it useful to shake hands with the patient

Answer 2

assess myotonia

Question 3

which muscles should be palpated for muscle bulk

Answer 3

quadriceps and calves

Question 4

what does a flexed upper limb and extended lower limb suggest

Answer 4

hemiplegia

Question 5

what does a wrist drop suggest

Answer 5

radial nerve palsy

Question 6

what is chorea

Answer 6

abrupt involuntary movements

Question 7

what is a postural tremour

Answer 7

tremour when the limb is maintained in a position

Question 8

what does a fasciculation with weakness suggest

Answer 8

LMN degeneration

Question 9

what lesion does clonus suggest

Answer 9

UMN

Question 10

how is power assesed

Answer 10

scale of 0-5

0- no muscle contraction 
1-flicker of contraction 
2- joint moves when gravity is eliminated
3- movement against gravity 
4- movement against resistance but weak 
5- normal power

Question 11

what nerves are used in hip abduction

Answer 11

L4/5/S1

glut medius and minimus, sartorius, tensor fascia latae

Question 12

what nerves does knee flexion use

Answer 12

L5/S1

Question 13

shoulder abduction

Answer 13

C5

Question 14

elbow flexion

musculocutaneous nerve

Answer 14

C5,6

Question 15

elbow extension (triceps)

Answer 15

c6/7/8

Question 16

wrist extension

Answer 16

c6,7,8

Question 17

wrist flexion

Answer 17

c6,7,8

Question 18

finger flexion

Answer 18

T1

Question 19

how do you classify reflexes

Answer 19

0 absent
\+ normal but reduced
\++ normal 
\+++ increased, could be normal 
\++++ greatly increased

Question 20

brachioradialis reflex

Answer 20

C6

Question 21

triceps reflex

Answer 21

C7

Question 22

biceps reflex

Answer 22

C5

Question 23

knee jerk reflex

Answer 23

L3/4

Question 24

ankle jerk reflex

Answer 24

S1

Question 25

babinski reflex

Answer 25

L5, S1, S2

Question 26

what is sensory ataxia

Answer 26

loss of coordination caused by loss of sensory input into the control of movement (not cerebellar dysfunction)

Question 27

how can you tell if an ataxia is sensory rather than cerebellar

Answer 27

movement is near normal when eyes are open but much worse when closed

Question 28

what lesions could cause a sensory ataxia

Answer 28

sensory peripheral neuropathies dorsal column dysfunction

Question 29

what is a positive Romberg's test

Answer 29

swaying with eyes closed indicates proprioceptive or sensory defect

Question 30

what are the signs of cerebellar disease

Answer 30

``` nystagmus dysarthria dysdiadokinesia intention tremor past pointing cerebellar drift and rebound hypotonia ```

Question 31

what does the acronym DANISH stand for

Answer 31

``` Dysdiadokinesia ataxia nystagmus intention tremor slurred speech hypotonia ```

Question 32

light touch, vibration, proprioception

Answer 32

dorsal columns

Question 33

pain and temp

Answer 33

spinothalamic

Question 34

what is Kernig's sign

Answer 34

hip flexion further knee extension is painful indicates meningeal irritation

Question 35

how do you test for nerve root irritation

Answer 35

straight leg raising a test done during the physical examination to determine whether a patient with low back pain has an underlying herniated disk, patient lies down and legs are lifted in the air