Neuro Screeening

Question 1

observation

Answer 1

posture/general symmetry
muscle atrophy/fasciculations
involuntary movement, tremor, bradykinesia/hypokinesia

Question 2

mental status

Answer 2

A&O
memory screen (3 words)
subjective exam note (behavior/language/attention/affect)

Question 3

reflexes

Answer 3

UMN: brisk reflex, + special reflex (babinski/hoffmans), increase tone

LMN: decrease/ areflexia, decrease tone

** look for symmetry

Question 4

reflex grading

Answer 4

0 - absent
+1 - diminished
+2 - average
+3 - brisker (abnormal with asymmetry/difference between UE/LE)
+4 - very brisk, hyperactive (may be clonus)

+1 - 3: can be normal

Question 5

DTR

Answer 5

bicep: C5 - 6 (C5) elbow flex
brachioradialis: C6 - 7 (C6) elbow flex/supination
tricep: C6-8 (C7) elbow ext
patella: L3-4 (L4) knee ext
achilles: S1-2 (S1) ankle PF

Question 6

Babinski

Answer 6

UMN damage

swipe across bottom of foot in J shape with handle of reflex

+ upgoing toes - extension/ fanning of toes

Question 7

Hoffmans

Answer 7

UMN damage

apply quick stretch to distal phalanx of middle finger

+ thumb/other non-stretched fingers flexed and abducted

Question 8

Hypotonia

Answer 8

decrease resistance in PROM

LMN or cerebellum

Question 9

Hypertonia

Answer 9

increase resistance in PROM

UMN

Question 10

Rigidity

Answer 10

increase resistance of movement throughout entire range in both direction of movement

basal ganglia

Question 11

pronator drift test

Answer 11

quick screen for UMN weakness

shoulder flexion at 90, elbow ext and arm supinated with eyes closed

+ elbow flexion, pronation and arm drift downward

Question 12

myotomes

Answer 12

bicep ( C5)
wrist ext (C6)
tricep (C7)
finger flex (C8)
finger abd (T1)
hip flex (L2)
knee ext (L3)
ankle DF (L4)
GT ext (L5)
ankle PF (S1)