neurological examination Flashcards
(131 cards)
1
Q
4 regions of the brain
A
cerebrum
diencephalon
brainstem
cerebellum
2
Q
___: part of the brain that deals with motor and sensory, cognition, conscious perception/integrating
A
cerebrum
3
Q
___: part of the brain that deals with thalamus, hypothalamus, internal capsule, reticular activating system, integration of functions of cortex, fight/flight, homeostasis, affect, arousal/wakefulness/attention
A
diencephalon
4
Q
___: part of the brain that deals with respiration, HR regulation, BP
A
brainstem
5
Q
___: part of the brain that deals with coordination of voluntary movement, balance, equilibrium
A
cerebellum
6
Q
brain is divided into 4 lobes
A
frontal
parietal
occipital
temporal
7
Q
____ ___: autoimmune; demyelination of CNS, peripheral nerves and brainstem; slower nerve conduction
A
multiple sclerosis
8
Q
spinal cord is an extension of the ___ ___
A
medulla oblongata
9
Q
spinal cord runs from the ____ ____ to the __/___ level
A
foramen magnum
L1/L2
10
Q
dorsal roots are ___
A
sensory
11
Q
ventral roots are ___
A
motor
12
Q
ascending tracts are ____
A
sensory
13
Q
descending tracts are ___
A
motor
14
Q
lateral spinothalamic tract (LSTT) carries ___ and ___
A
pain
temperature
15
Q
___ ____ ___: largest ascending tract
A
lateral spinothalamic tract
16
Q
LSTT lesion carries ___ loss of sensation
A
contralateral
17
Q
LSTT lesion happens at ___ or ___ levels below the level of the lesion
A
1/2
18
Q
anterior spinothalamic tract (ASTT) carries sensations for ___ ___ and ___
A
light touch
pressure
19
Q
ASTT lesion carries ___ loss of sensation
A
contralateral
20
Q
ASTT lesion happens at ___ or ___ levels below the level of the lesion
A
3/4
21
Q
dorsal columns carries senations for…
A
fine touch/discrimination
unconscious proprioception
vibration
22
Q
dorsal columns:
lesions below the medulla result in ___ loss of sensation
A
ipsi
23
Q
dorsal columns:
lesions above the medulla result in ___ loss of sensation
A
contra
24
Q
dorsal columns in UE vs LE
A
fasciculus cuneatus
fasciculus gracilis
25
ASTT, LSTT and dorsal columns are all ____ tracts
ascending (sensory)
26
___/___ tract
- motor pathway for contraction of skeletal muscles
- upper motor neurons which correspond to spinal nerves
corticospinal/pyramidal
27
___ tracts respond to cranial nerves
corticobulbar
28
___: lesion to spinal nerve reulting in LMN lesion
radiculopathy
29
___: lesion to peripheral nerve resulting in LMN lesion
neuopathy
30
____: lesion or dysfunction of muscle fibers resulting in muscle weakness
myopathy
31
___ ___ ___ lesion: a lesion to the descending tracts and/or the cerebrum
upper motor neuron
32
___ ___ ___ lesion: lesion to the ventral gray matter of the spinal cord, ventral nerve root, spinal nerve, and/or peripheral nerve
lower motor neuron
33
signs of UMN lesipn
```
spastic paralysis
hyperreflexia
clonus
presence of pathogical reflexes
diminished/absence of superficial reflexes
clasp knife rigidity
disuse atrophy
```
34
signs of LMN lesion
```
flaccid paralysis
hyporeflexia
atrophy
decreased muscle tone
fasciculation
```
35
___: small, local, involuntary muscle contraction visible under the skin
fasciculations
36
___: numbness, tingling, "pins and needles" or "asleep"
parasthesia
37
look at mental staus
start on 19
38
delerium is ___
transient
39
dementia is ___
permanent
40
pain and temp assessment testing ____ ___ ___
lateral spinothalamic tract
41
light touch assessing ___ ___ ___
anterior spinothalamic tract
42
posterior columns assessing..
```
position sense
movement sense
vibration
two pt discrimination
stereognosis
graphesthesia
```
43
lesions to the posterior columns typically results in sensory loss that is ___ to ___
distal proximal
44
___: sensitivity to pain
algesia
45
____: loss of sensation to pain
analgesia
46
___: decreased sensibility of pain
hypoalgesia
47
___: increased sensibility to pain
hyperalgesia
48
___: loss of temp sense
thermoanesthesia
49
___: diminished perception of temperature differences
thermohypoesthesia
50
___: exaggerated sensation of temperature differences
thermohypersthesia
51
____: loss of light touch sense
thigmanesthesia
52
___: total or partial loss of sensation
anesthesia
53
____/___: abnormally diminished sensitivity
hypesthesia
| hypoesthesia
54
___: abnormally increased sensation
hyperesthesia
55
___: sensation of tingling, pricking or numbness
paresthesia
56
___: burning sensation to skin
dysesthesia
57
___: ability to feel vibration
pallesthesia
58
___: not feeling vibration
pallanesthesia
| apallesthesia
59
___: awareness of the position of the body or its parts in space
statognosis
60
___: failure of awareness of the position of the body or its parts in space
astatognosis
61
____: ability to identify objects proprioceptively
stereognosis
62
____: inability to identify objects proprioceptively
astereognosis
63
___: ability to recognize writing on the skin purely by the sensation of touch
graphesthesia
64
___: inability to recognize writing on the skin purely by the sensation of touch
agraphesthesia
65
grade 5 muscle strength
complete ROM against gravity with full resistance
66
grade 4 muscle strength
complete ROM against gravity with some resistance
67
grade 3 muscle strength
complete ROM against gravity
68
grade 2 muscle strength
complete ROM with gravity eliminated
69
grade 1 muscle strength
evidence of slight contractility; no joint motion
70
grade 0 muscle strength
no evidence of contractility
71
DTR: UMN lesion
hyperreflexia
| CNS involvement
72
DTR: LMN lesion
hyporeflexia
| PNS involvement
73
L4 DTR
patellar
74
L5 DTR
semitendinosis
75
S1 DTR
achilles
76
C5 DTR
biceps
77
C6 DTR
brachioradialis
78
C7 DTR
triceps
79
wexler reflex scale
| grade 0
no response
80
wexler reflex scale
| grade 1
hyporeflexia
81
wexler reflex scale
| grade 2
normal
82
wexler reflex scale
| grade 3
hyperreflexia
83
wexler reflex scale
| grade 4
hyperreflexia with transient clonus
84
wexler reflex scale
| grade 5
hyperreflexia with sustained clonus
85
if you get an abnormal DTR retest using a ___ maneuver
jendrassik
86
DTRs might diminish with ___
age
87
superficial reflexes
- absensce
- presence
NORMAL
| UMNL lesion, LMN lesion or normal
88
pathologic reflexes
| - presence
UMNL
| may be normal in babies
89
___: flick 2nd or 3rd digit up on hand
tromners
90
positive findings of tromners
clawing of the fingers
| adduction of the thumb
91
___: flick 2nd or 3rd digit down on hand
hoffmans
92
positive findings of hoffmans
clawing of the fingers
| adduction of the thumb
93
___: dr holds wrist and rapidly extends or flexes it; oscillations indicates positve finding; hold calcaneus and rapidly dorsiflexes ankle and hold
clonus
94
___: flick 4th or 5th digit down on foot
gonda
95
positive findings of gonda
babinski sign
96
___: squeeze achilles tendon
schaeffer
97
positive finding of schaeffer
babinski sign
98
___: stroke medial sides of tibial shaft with butt end of reflex hammer or knuckle
oppenheims
99
positive findings of oppenheims
babinski sign
100
___: squeeze calf
gordons
101
positive finding of gordons
babinski sign
102
___: stoke around lateral maleolus, over dorsum of the foot to big toe
chaddocks
103
positive finding of chaddocks
babinski sign
104
___ ___: stroke lateral aspect of cuboid
mendel bechterew
105
positive findings of mendel bechterew
plantar flexion of toes
| toe clawing
106
___: dr taps metacarpal/metatarsal heads with reflex hammer
rossolimos
107
positive findings of rossolimos
plantar flexion of toes/fingers
108
___: measurement of muscle bulk for the entire extremity
mensuration
109
mensuration for UE
arm
| forearm
110
mensuration for LE
thigh
| calf
111
what is the significant difference for mensuration
2.5cm/1in
112
___: increased size and strength
hypertrophy
113
___: reduced size and strength
atrophy
114
___: look for increased size with decreased strength
edema
115
indications of hypertrophy
exercise
| muscle injury or pathology
116
indications of atrophy
nerve lesion
muscle pathology
disuse
117
C5 muscle exam muscles
deltoid
| biceps
118
C6 muscle exam muscles
brachioradialis
| wrist extensors
119
C7 muscle exam muscles
triceps
wrist flexors
finger extensors
120
C8 muscle exam muscles
flexor digitorum
121
T1 muscle exam muscles
finger adductors/abductors
122
L1/L2 muscle exam muscles
iliopsoas
123
L2/L3 muscle exam muscles
quadratus femoris
124
L4 muscle exam muscles
tibialis anterior
125
L5 muscle exam muscles
extensory hallucis longus
extensor digitorum longus and brevis
gluteus medius
126
S1 muscle exam muscles
peroneus longus
| peroneus brevis
127
heel walking tests:
2 nerve roots
1 peripheral nerve
1 muscles
L4/L5
common peroneal nerve
tibialis anterior
128
repetitive claf raising and toe walking tests:
1 nerve root
1 peripheral nerve
2 muscles
S1
tibial
gastrocnemius
soleus
129
beevors sign tests for ___ ___ ___ lesion involving the rectus femoris
lower motor neuron
130
beevors sign
| - if lesion at T10 or below...
weakness of lower rectus
| umbilicus moves UPWARD
131
beevors sign
| - if lesion at T8/T9
weakness of upper rectus
| umbilicus moves DOWNWARD
