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Flashcards in Neurologic Exam Deck (26)
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1

list the 5 points of a neuro exam

1. general observations (mentation, posture, gait)

2. cranial nerves

3. postural reaction

4. segmental reflexes

5. palpation

6. if necessary/able, sensation

2

describe the types of mentations

bright and alert

obtunded (mild, moderate, severe)
- decreased response(s) to environment

stuporous
- semi-comatose

comatose
- completely unresponsive

3

opisthotonus

posture of the head, neck, and thoracic limbs

extensor rigidity of the limbs
head and neck extend dorsally

4

decerebrate posture

opisthotonus

comatose

extreme UMN signs
- rigid
- exaggerated reflexes

indicates damage at level of the midbrain

5

decerebellate posture

opisthotonus

conscious
- appropriate response to painful stimuli

capable of voluntary movement

often flexion of pelvic limbs

6

schiff-sherrington posture

indicates damage at level of the spinal cord

opisthotonus

paraplegia
- paralysis of pelvic limbs

7

gait abnormalities

ambulatory vs. not

paresis / paralysis

ataxia

circling

dysmetria

8

list the 5 postural reaction tests

proprioceptive positioning reaction

wheelbarrowing

extensor postural thrust

placing reaction: tactile or visual

hopping

9

classifications for reflexes

absent
decreased
normal
exaggerated
clonic

10

patellar reflex

femoral nerve

L4, 5, 6

11

gastrocnemius reflex

sciatic nerve

L6, L7, S1

12

perineal reflex

pudendal nerve

S1, 2, 3

13

flexion reflex

mostly sciatic nerve (PL)

mostly musculocutaneous (TL)

14

biceps reflex

musculocutaneous nerve

15

triceps reflex

radial nerve

16

cutaneous trunci reflex

bilateral, helpful for lesion localization along spinal cord

17

crossed extensor reflex

only abnormal in lateral recumbency

18

3 aspects of neurologic palpation

1. hyperesthesia: increased sensitivity to stimuli

2. muscle tone

3. muscle mass

19

difference between superficial and deep pain sensation

deep = periosteal involvement

superficial = no periosteal involvement

20

pupillary light reflex

light = stimulus

CN II - afferent nerve

CN III - parasympathetic division - efferent nerve
- also controls constriction

bilateral reflex

21

menace response

menace = stimulus

CN II - afferent nerve

contralateral cerebral hemisphere

ipsilateral cerebellar hemisphere

CN VII - efferent nerves

blink = response

22

physiologic nystagmus

involuntary movements of the eye

CN VIII - afferent nerve

CN III, IV, VI - efferent nerves

23

spontaneous nystagmus

lesion of vestibular system

fast phase pulls eyeball away from the side with the lesion

24

trigeminofacial reflexes

corneal reflex (also involves CN VI)

palpebral reflex

lip pinch

vibrissae reflex

trigeminal - afferent nerve
facial - efferent nerve

25

facial paresis or paralysis

CN VII

26

gag reflex

CN IX and X - afferent nerves

CN IX, X, XII - efferent nerves