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Flashcards in Neurological Exam Deck (15):

How do you test for olfactory nerve function?

Use of an aromatic substance like ginger or coffee


Discuss optic nerve testing.

Acuity, color, pupil function, visual fields and fundoscopic examination. Visual field analysis helps determine if there is a problem in the eye, optic nerve, chiasm etc.


Discuss Oculomotor, trochlear and abducens nerve testing

Horizontal diplopia implies a problem with lateral or medial recti. Vertical diplopia implies a lesion of superior or inferior oblique muscles.


Match the cranial nerve to the eye muscles

Lateral rectus = Cranial nerve 6
Superior oblique = Cranial nerve 4
All others = Cranial nerve 3


Discuss the Trigeminal nerve

1. Facial sensation
2. Tongue sensation (not taste)
3. Muscles of mastication


Describe Facial nerve testing in regards to UMN vs LMN

UMN lesions spares the superior face. LMN lesions involves the entire ipsilateral side of the face.


Describe the localization of cranial nerve lesions

1. 1st and 2nd cranial nerves are extensions of brain.
2. All others are peripheral nerves
3. Midbrain = 3rd and 4th
4. Pons = 5th thru 8th
5. Medulla = 9th thru 12th


Discuss Brainstem lesions

Usually cause crossed signs; The cranial nerve abnormality is ipsilateral to the lesion and the body abnormality is contralateral to the lesion.


Describe Motor function loss

1. Weakness in both legs associated with spasticity implies spinal cord lesion.
2. Involvement of face, arm and leg imply lesion in opposite hemisphere


How do you differentiate between UMN and LMN lesions?

UMN has spasticity, hyperreflexia and extensor toe sign.
LMN has flaccidity, atrophy and hyporeflexia


Describe the implications of Tremors.

A resting tremor implies basal ganglion/substantia nigra defect.
Intention tremor implies vestibulo-cerebellar lesion.


Describe the pathway for heat, cold, pain and touch

Crosses spinal cord immediately and then to the thalamus


Describe the pathway for motion, vibration, and position

Goes up the entire spinal cord before crossing at the lower medulla.


Discuss reflex testing

Achilles reflex = S1
Patellar reflex = L2-L4
Biceps reflex = C5-C6
Triceps reflex = C7


Discuss the toe sign

Babinski manuever should cause the big toe to plantar flex after age 1. Extensor toe sign implies UMN lesion of pyramidal system supplying that foot.