Neuro Exam Flashcards by Chris Ponichtera

What is the berg balance scale

Sitting unsupported, sit-to-stand, transfers

, standing on one leg, turning, pick object off floor

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What is opisthotonos

Prolonged severe spasm of muscles causing head, back, and heels to arch backward… arms and hands are flexed

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What is stupor

Patient can be aroused from sleep only with painful stimulus

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What is myelography

X-rays of spine after injection of air or dye into subarachnoid space

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What is myelography used for

Finds abnormalities impinging on subarachnoid space

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What is paralysis

Loss of voluntary motion

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What is ventriculography used for

Localized tumors, increased intracranial pressure

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What is Obtundation

Patient can open eyes, look at examiner, but responds slowly and is confused

Decreased alertness and interest in environment

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What is dyssynergia

Impaired ability to associate muscles together for complex movement

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What is Ventriculography

X-rays of skull after injection of air into lateral ventricles

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Flaccidity and hypotonia are indicative of

LMN lesion

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What is paresis

Weakness

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what is agnosia

Inability to recognize familiar objects with one sensory modality while retaining ability to recognize same object with other sensory modalities

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What is dysmetria

Impaired ability to judge the distance or range of movement

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What is Poor balance

Requires hand-hold support and mod/max A to maintain position

Unable to accept challenge or move without loss of balance

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What is decerebrate posture

Extension in all four limbs

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Ranking of Functional Balance Grades from best to worst

Normal
Good
Fair
Poor
0 Absent

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What is homonymous hemianopsia

Loss of half of visual field in each eye

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Contraindications to MRI

Metal implants

Pacemakers

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What portion of the brain is MRI ZBEST FOR

Superior image

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What is CT good for

Hemorrhage, edema , cerebral infarction

What is Brudzinski’s Sign

Patient in supine, flex neck to chest

Positive: causes flexion of hips and knees

What is computed tomography (CT)

X-ray beams through tissues, gives cross sections of the brain for 3D localization

What is myoclonus

Single, quick jerk

What is Echoencephalogram (ultrasound) used for

lumen of carotid artery

What is Normal balance grade

Can stand without hand held support Accepts maximal challenge and can shift weight easily at full range in all directions

What is rigidity

Increased resistance to PROM that is independent of the velocity of movement

What is Fair balance

Maintains balance with hand held support, may require min A Accepts minimal challenge, can maintain balance while turning head/trunk

define each score on Reflex Scoring Scale

0: absent 1+: tone change, no visible movement of extremities 2+: visible movement of extremities 3+: exaggerated, full movement of extremities 4+: obligatory and sustained movement lasting over 30 seconds

What is cerebral angiography

X-rays of skull after injection of dye into carotid or vertebral arteries of both

What is the Times Up and Go test

Walk 3m turn and return to chair

What is Electroencephalography used for

Structural disease of brain Seizures Intracranial lesions

What does Lumbar puncture do

Measures protein, glucose, immunoglobulin content, cell count

Scoring range of GCS and how are scores broken down

3-15 1-8: severe brain injury 9-12: moderate brain injury 13-15: minor brain injury

What is tremor

Continuous quivering movements; rhythmic oscillatory movement observed at rest

What is Kernig’s Sign

Patient in supine, flex hip and knee fully to chest, then extend knee Positive: causes pain and increased resistance to extending knee due to spasm of hamstring

What is cogwheel rigidity

Interrupted by a series of jerks

What are tics

Spasmodic contractions of specific muscles, commonly involving face, head, neck, or shoulder muscles

What is MRI called for for the brain

tumors demyelination vascular abnormalities

What is decorticate posture

Flexion UE Extension LE

What is Positron Emission Tomography used for (PET)

Major clinical tool for cerebral blood flow and brain metabolism

What is Cheyne-Stokes respiratoration

a period of apnea lasting 10-60 seconds followed by gradually increasing depth and frequency of respirations

What are the three elements of response on the Glasgow Coma Scale

Eye opening Motor response Verbal response

What is dysdiadochokinesia

Impaired ability to perform rapidly alternating movements

What does each grade in the Modified Ashworth Scale represent

0: no increase in muscle tone 1: slight increase in muscle tone, minimal resistance at end of ROM 1+: slight increase in muscle tone, minimal resistance through less than half of ROM 2: more marked increase in muscle tone, through most of ROM, affected part easily moved 3: considerable increase in muscle tone, passive movement difficult 4: affected part rigid in flexion or extension

What is the romberg test

Patient stands with feet in normal stance position, first with eyes open, then with eyes closed

What is athetosis

Slow, irregular, twisting, sinuous movements, occurring especially in UEs

What is Good Functional Balance Grade

Able to maintain balance without hand-held support, limited sway Accepts moderate challenge, can maintain balance while picking object off floor

What is chorea

Relatively quick twitches or “dancing” movements

What is lead pipe rigidity

Uniform throughout the range

What is apneustic breathing

Abnormal respiration marked by prolonged inspiration