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OSCE Neuro COPY > Neuro Tests > Flashcards

Neuro Tests Flashcards

1
Q

Visual Acuity

A

Ask pt to read sentence on card or identify shapes and colors.

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2
Q

Apraxia

A

Ask pt to pretend brushing hair or brushing teeth.

Test BOTH sides. Do NOT demonstrate

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3
Q

Graphesthesia

A

Ask pt to close eyes.
Draw number or letter on pt’s palm and ask to identify.

Testing- Somatosensory Cortex

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4
Q

Light Touch

A

Ask pt to close eyes.
Touch several spots on pt with cotton wisp and ask them to let you know when they are being touched.

Testing- Dorsal Column

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5
Q

Hoffman

A

Flick tip of index finger into extension.

Fingers and thumb should flex and adduct.

Sustained clawing would indicate UMNL.

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6
Q

Babinski Reflex

A

Pathological Reflex- Dorsiflexion of big toe and splaying of other toes.

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7
Q

Plantar Reflex

A

Swipe sole of foot.
Looking for curling of toes.

afferent and efferent- tibial n
integrating- S1/S2 spinal cord

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8
Q

Ankle Clonus

A

Rest hand on calf.
Quickly Dorsiflex foot.

Pathological Reflex- continued involuntary contraction (sustained plantar flexion) of foot.

Indicates: UMNL

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9
Q

Glabella

A

Tap pt btwn eyes @ supraorbital ridge

Normal- contraction of orbicularis occuli muscle (closing eyes).

Pathological- sustained contraction (clonus)
Indicates- UMNL

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10
Q

McCarthy

A

Tap pt btwn eyes @ supraorbital ridge

Normal- contraction of orbicularis occuli muscle (closing eyes).

Pathological- sustained contraction (clonus)
Indicates- UMNL

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11
Q

Stereognosis

A

Ask pt to close eyes.
Put object on each of pt’s hands (key, pen, paperclip) and ask them to identify.

Evaluates- Somatosensory Cortex

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12
Q

Pain (Pinprick)

A

Ask pt to close eyes.
Ask them to let you know when they feel you touch them with the sharp end of a neurotip.

Evaluates- Spinothalamic Tract

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13
Q

Forced Gait

A

Ask pt to walk on heels 6 steps the toes 6 steps the outside of foot. walk with pt!

Evaluates- Coordination and gait - Cerebellum

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14
Q

Crude Touch

A

Ask pt to close eyes.
“Let me know if you feel this.”
Touch them several times with dull end of neurotip.

Evaluates- Spinothalamic Tract

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15
Q

Rhomberg Test

A

Ask pt to stand, close eyes, and stand there for 30 sec.
Watch them sway.

Evaluates- Dorsal Column

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16
Q

Vibration - Pallesthesia

A

Use 128hz tuning fork.
Ask pt to close eyes.
Touch various areas on palm finger with vibrating tuning fork.
Ask them when they feel the vibration and when it stops.

Evaluates- Dorsal Column

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17
Q

Confrontation Test

A

Ask pt to cover one eye and look at your face.
Ask them to let you know when they can see your finger and if it is wiggling or still.
Do 8 fields of gaze on each eye.

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18
Q

Joint Position Sense

A

Ask pt to close eyes.
Demonstrate feeling of joint in flexion and extension.
Then…
Move jts (MCP-PIP-DIP) into flexion/extension… ask pt to identify if their joint has been stopped in flexion or extension.

Evaluates- Dorsal Column

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19
Q

Whisper Test

A

Ask pt to close eyes and cover other ear.

Move 2 feet from patient and whisper asking them a question. (What is your name? etc)

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20
Q

Mental Status- Language

A

Ask pt to read sentence on note card, name 3 objects/shapes from table, or repeat sentence you say to them.

21
Q

Tandem Gait

A

Ask pt to walk heel to toe. walk with pt!

Evaluates- Coordination and Gait - Cerebellum

22
Q

Gordon Sign

A

Squeeze pt’s calf
Looking for pathological babinski reflex (dorsiflex of big toe and splaying of toes)

Indicates- UMNL

23
Q

Mental Status- Abstraction

A

Ask pt to explain proverb or colloquialism

Ex- “The early bird gets the worm.”

24
Q

Sharp vs Dull Discrimination

A

Ask pt to close eyes.
Tell them to let you know when being touched and if sharp or dull.

Evaluates- Somatosensory Cortex

25
Q

Finger to Nose Test

A

Ask pt to touch their nose then touch your finger. Evaluate 4 areas.

Looking for intention tremor or lack of coordination (Dysmetria)

Evaluates- Coordination - Cerebellum

26
Q

Heel Shin

A

Ask pt to lie down, touch knee with heel and slide it down to tip of big toe.

Looking for intention tremor or lack of coordination (Dysmetria)

Evaluates- Coordination - Cerebellum

27
Q

Mental Status- Alertness, Attention, Cooperation

A

Spell WORLD forward and backward.

28
Q

Tromner

A

Flick tip of 3 fingers into extension or tap palm

Fingers and thumb should flex and adduct.

Sustained clawing would indicate UMNL.

29
Q

Faduka Step Test

A

Ask pt to stand, put arms out in front, and march in place for 50 steps.

Looking for pt to turn to side of vestibular lesion.

30
Q

Mental Status- Sequencing tasks

A

Ask pt to perform paper, rock, scissors as quickly as possible.

31
Q

Mental Status- Memory

A

Recent-Ask pt to recall 3 items after 5 min

Remote- Ask pt historical facts- Ex- Where did you go to school?

32
Q

Finger Rub Test

A

Ask pt to close eyes and cover other ear.

Rub fingers near EAM and find max distance finger rubbing can still be heard.

33
Q

Oppenheim Sign

A

Stroke downward on pt’s anterior tibia.

Looking for pathological babinski reflex (dorsiflex of big toe and splaying of toes)

Indicates- UMNL

34
Q

Vestibulo-Occular Reflex

A

Hold pt’s head, have them look at you and move their head through ROM.

Normal- should maintain eye contact. Eyes moving at same speed and in opposite direct as head motion.

Path- Inability to maintain eye contact or spontaneous nystagmus

Indicates- Vestibular lesion

35
Q

Extra Occular Eye Movements

A

6 cardinal fields of gaze.
Looking for normal conjugate or parallel movements of the eyes and nystagmus.

Do H pattern

Superior Oblique- Down & In - Trochlear
Lateral Rectus- Lateral - Abducens
Superior Rectus - Up & Out - CN III
Inferior Rectus - Up & In - CN III

SO4LR6 All over 3

36
Q

Ciliospinal Reflex

A

Look at pt’s eyes. Pinch base of neck and watch their eyes.

Normal- Pupil should Dilate.

A- Cervical Sympathetic Chain
Int- T1-T2 Spinal Cord
E- Cervical Sympathetic Chain

37
Q

Carotid Sinus Reflex

A

Take pt’s radial pulse… Note pulse rate lowers with pressure on carotid sinus.

A- Glossopharyngeal (IX)
Int- Medulla
E- Vagus (X)

38
Q

Uvular/Palateal Reflex

A

Shine light in back of throat and ask pt to say “ahh.”

Looking for uvular to raise symmetrically upon phonation. (it would deviate to the strong side if there were paralysis)

A- Glossopharyngeal (IX)
Int- Medulla
E- Vagus (X)

39
Q

Abdominal Reflex

A

Stroke 4 areas around pt’s navel.

Umbilicus should deviate to the side stroked. Absence is normal only if bilateral.

A- Upper- T7-T10 Spinal Nerves, Lower- T11-T12 Spinal Nerves
Int- T7-T12 Spinal Cord
E- Upper T7-T10 Spinal Nerves, Lower- T11-T12 Spinal Nerves

40
Q

Two Point Discrimination

A

Pt closes eyes.
Dr uses bent paper clip and asks pt if being touched with 2 or 1 point.

Evaluates- Somatosensory Cortex

41
Q

Indirect Light Reflex

A

Shine light in pt’s eye while watching the pupil of the opposite eye.

Looking for opposite pupil to contract.

A- Optic N (II) (Ipsilateral)
Int- midbrain
E- Occulomotor (III) (contralateral)

42
Q

Point Localization (Topognosis)

A

Ask pt to close eyes. Touch them at diff spots with cotton wisp and ask the to touch where they felt it.

Evaluates- Somatosensory Cortex

43
Q

Baragnosis

A

Ask pt to close eyes and hold hands out. Place objects in their hands and ask them to “Identify the difference between the 2 objects”

(note- objects should be of different weights)
Evaluates- Somatosensory Cortex

44
Q

Chaddock Sign

A

Stroke down pt’s lateral leg around lateral malleolus

-Looking for babinski (positive wold indicate UMNL)

45
Q

Direct Light Reflex

A

Shine light in pt’s eyes.
Looking for pupil constriction.

A- Optic (II) ipsilat
Int- Midbrain
E- Occulomotor (IV) ipsilat

46
Q

Rinne Test

A

512hz fork on mastoid, time how long until pt can no longer hear vibration then move form to in front of ear and time how long it can be heard.

Normal- air conduction 2x as long as bone

Abnormal- Conductive deafness- air conduction absent, = to, or less than bone.

Abnormal- Sensorineural deafness- air + bone conduction both radically decreased or absent.

47
Q

Accomodation Reflex

A

Pt look at light, bring light close to nose

Look for convergence of eyes with pupillary constriction

A- Optic
Int- Occipital Cortex
E- Occulomotor

48
Q

Weber Test

A

512 Fork
Place mid skull and ask pt to compare sound intensity.

Normal- sound equal in both ears.
Conductive deafness- Sound lateralizes to bad ear (mechanical)
Sensorineural - Sound lateralizes to good ear (nerve damage)

49
Q

Double Simultaneous Stimulation

A

Close eyes… Do you feel this? How many? Where?
Touch each shoulder one at a time the together

Extinction- one side felt
Displacement- One side normal, other side displace toward midline
Synesthesia- One side normal, other side felt and vague burning

Somatosensory Cortex

OSCE Neuro COPY (1 decks)

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