Neuro Practical Flashcards by John Gonzales

what is being tested during the

light touch: localization test?

dorsal column

ability to detect and localize a light touch stimulus

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what is being tested during the pin prick test?

spinothalamic tract

ability to detect difference between sharp and dull sensation

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what is being tested during the hot:cold test?

spinothalamic tract

ability to detect between a hot and cold stimulus

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what is being tested during a vibration test?

dorsal column/medial lemniscus

ability to detect a vibration (when it starts and when it stops)

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what is being tested during the extinction test?

test for unilateral neglect

specifically tactile neglect

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what is being tested during the 2-point discrimination test?

dorsal column/medial lemnsicus tract

ability to accurately distinguish between 1 or 2 points of contact

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what is the normative data/distances for the 2-point discrimination test?

fingertips = 2-5 mm

palms = 8-12 mm

hand, extremities, trunk = 20-30 mm

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what is being tested in the proprioception test?

dorsal column/medial lemniscus tract

ability to detect position of limb when it is changed slightly (up/down)

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what is being tested during the stereognosis test?

dorsal column → integrative ability of the parietal cortex

ability to accurately ID common objects based off of touch alone (eyes closed)

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what is being tested during the graphesthesia test?

dorsal column → integration at parietal cortex

ability to accurately ID a letter/number that is drawn on your hand w/eyes closed

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what is being tested during the kinesthesia test?

dorsal column → integration at parietal cortex → motor cortex

ability to detect movement in space and then match it with the contralateral limb (eyes closed)

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how are all sensations tests graded?

5/5 = normal

1 - 4/5 = impaired

0/5 = absent

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what are the deep tendon reflexes for the UE/LE testing for?

presence or absense of an UMN/LMN lesion

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what nerve roots are responsible for the patellar tendon reflex?

femoral nerve (L2, 3, 4)

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what nerve roots are responsible for the achilles reflex?

tibial neve (S1, 2)

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what nerve roots are responsible for the biceps brachii tendon reflex?

musculocutaneous nerve ((C5, 6)

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what nerve roots are responsible for the brachioradialis tendon reflex?

radial nerve (C5, 6)

what nerve roots are responsible for the triceps tendon reflex?

radial nerve (C6, 7)

what are the grades/scores for reflex testing?

0-1+ = LMN

2+ = norma

3+ = Brisk

4+ and 5+ = UMN lesion

what is the purpose of the Hoffman’s sign?

it is a pathological reflex that indicates the presence or absence of an UMN/LMN

flexion of 1,2 phalanx = a positive sign

what is the purpose and grading of the Babinski’s sign?

tests for the presence/absence of an UMN/LMN

splaying of toes and ext of hallux is a positive sign

what is the UE and LE synergy test for?

it tests the corticospinal tract and isolation of movement at a joint

what is considered an abnormal result for an UE and LE synergy test?

movement in two or more joints in compensatory/synergistic pattern

this indicates an UMN lesion

what does dysmetria (for UE and LE) test for?

cerebellar coordination/functioning

what are abnormal results for dysmetria UE/LE?

hypometria = undershooting hypermetria = overshooting, varying course of movement, disintegration of pattern

what does dysdiadochokinesia test for?

cerebellar coordination/functioning

what is included in a spasticity test?

1. shoulder FLX/EXT 2. elbow FLX/EXT 3. wrist FLX/EXT 4. thumb flexors 5. finger flexors 6. hip FLX/EXT 7. hip ABD/ADD 8. knee FLX/EXT 9. ankle DF/PF 10. clonus

what does spasticity test for?

velocity dependent tone presense of an UMN lesion

how are spasticity tests measured?

Modified Ashworth Scale

what results indicate the presence of clonus?

repeated bouncing of foot (plantarflexors)

what results are you looking for when testing the papillary reflexes?

direct and consensual constriction accommodation

what is considered an abnormal result when testing the papillary reflex?

absense of constriction (direct/consensual) absense of accommodation

what is tested when performing the big H test?

EOMs pursuit eye movements

what are considered abnormal results from the big H test?

any asymmetry in movement gaze palsies 2 or more of the following: nystagmus, strabysmus, saccades, and double vision

what gaze palsies can be observed as an abnormal result from a big H test?

UMN = same direction limitation LMN = opposite direction limitation or in one eye

what are the grades that can be assigned during a Weber and Rinne test?

normal conductive loss sensoryneuro loss

what suggests conductive hearing loss during a Weber test?

positive is louder in affected ear

what suggests neurosensory hearing loss during a Weber test?

positive weber = louder in unaffected ear

what suggests conductive hearing loss during a Rinne test?

hear sound only in mastoid process no sound heard when tuning fork is placed in front of auricle

what suggests neurosensory hearing loss during a Rinne test

no sound hear at either the mastoid or in front of the ear

when testing CN XI what indicates and UMN or LMN?

asymmetry in strength UMN = trap is weak but SCM is spared LMN = both are weak/absent