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2 Neuroanatomy > Practical Final Exam > Flashcards

Practical Final Exam Flashcards

1
Q

Deep Tendon Reflex steps

A

tendon should be in a slight stretch, pt should be relaxed
assess bilaterally
can use jendrassik maneuver if no reflex

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2
Q

Jendrassik maneuver

A

link fingers as shaking your own hands, pull apart
cross legs and squeeze them together

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3
Q

Neuroanatomy being testing w/deep tendon reflex

A

UMN: hyperreflexia
LMN: hyporeflexia

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4
Q

Documentation of Deep tendon reflexes

A

note reflex being tested
describe with grading system

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5
Q

Biceps

A

C5, C6

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6
Q

Brachioradialis

A

C6

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7
Q

Triceps

A

C7

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8
Q

Patellar

A

L4

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9
Q

Achilles tendon

A

S1

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10
Q

Grading scale for deep tendon reflexes

A

0: absent
1: trace
2: normal
3: brisk
4: nonsustained clonus
5: sustained clonus

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11
Q

Hearing screen test

A

pt should have closed eyes
pt should verbalize when they hear you

rub fingers together near ear. vary side, speed, rhythm

document as intact, impaired, absent

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12
Q

Neuroanatomy of hearing screen

A

CN VIII, special somatic sensory

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13
Q

Rinne Test

A

using tuning fork, tell pt that youre going to be placing it next to their ear

strike tines against hand
place tuning fork on mastoid process, ask pt if they can hear it. Ask when they cannot hear it anymore

move the fork to the front of the ear, see if they can hear it and for how long
repeat with other ear

document: intact or impaired

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14
Q

Neuroanatomy of Rinne test

A

CN VIII, cochlear
Mastoid: cochlear, inner ear
Outer ear: tympanic membrane, ossicles

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15
Q

Visual Fields test

A

pt looking at the tip of your nose
they cover one eye with thier hand
test each 4 quadrants, start FAR away

pt responds when they see your finger wiggle

document which eye and visual field/quadrant showed impairment

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16
Q

Neuroanatomy of visual fields

A

CN II
LGN
Optic radiations
Visual cortex

17
Q

Pupillary light reflex

A

Both eyes open, dimly lit room
pt focuses on target in distance
shield contralateral eye from light

check ipsilateral eye and then view contralateral eye

document: normal/impaired/absent for ipsilateral and contralateral respones

18
Q

Neuroanatomy of pupillary light reflex

A

CN 2: visual pathways
CN 3: motor pathways, brainstem nuclei, parasympathetic pathway

19
Q

Eye movements/Ocular ROM

A

Ask if the pt has difficult with eye movement or gaze, blurry vision, double vision

notice any asymmetry at rest
pt follows pen with eyes, movement is in a H pattern

document asymmetry in rest and in movement, with which direction

20
Q

Neuroanatomy of eye movements

A

CN 3, 4, 6

21
Q

Smooth pursuit test

A

Assessing coordination of eye movements
PT holds target with point perpendicular to pt’s eyes
pt maintains focus on target as head stays still
should be about 20 in from pt face

move pen in + pattern. Eyes should move without any sudden starts, skips, stops

document: normal or saccadic, direction of saccadic intrusions

22
Q

Neuroanatomy of Smooth Pursuit

A

Cerebellum–Flocculonodular lobe, vermis

23
Q

Saccades Test

A

pt should have intact oculomotor innervation
pen adjacent to your ear, should be same height as nose
ask pt to shift gaze from nose to your pen
vary the timing of cues

ear to top of head
opposite ear, below chin

normal should be 1-2 saccades

documentation: normal, hypermetric, hypometric & direction

24
Q

Neuroanatomy for saccades

A

cerebral cortex (frontal eye fields)
basal ganglia (impaired initiation/suppression)
cerebellar vermis (dysmetria)

25
Q

Gaze holding nystagmus

A

Target is 20” from face
move target in + sign
maintain gaze for 10 s on each target

don’t move them into end range

gaze holding = intact or impaired
direction of impaired, which eye, symptoms

26
Q

Neuroanatomy for gaze holding nystagmus

A

vestibular
cerebellum

27
Q

Facial sensation

A

ask if pt has noticed numbness or tingling
ask pt to close eyes, and tell you when they feel cotton ball
touch forehead, cheekbone, lower jaw

document: diminished/absent, note location and side

28
Q

Neuroanatomy of facial sensation

A

CN V
opthalmic, maxillary, mandibular

29
Q

Muscles of mastication

A

ask if there are difficulty w/chewing or eating
palpate muscles of mastication in rest

view muscle without resistance
provide resistance to jaw
ask pt to bite down, so you can palpate

document: asymmetries, weakness, atrophy

30
Q

Neuroanatomy of mastication

A

CN V
branchia motor, special visceral efferent

31
Q

Facial expression

A

Ask pt for difficulties
observe resting positions

raise eyebrows (frontalis)
close eyes tightly (orbicularis oculi)
smile widely (zygomaticus)
purse lips (orbicularis oris
draw corners of mouth down (platysma

document asymmetries or weakness

32
Q

Neuroanatomy of facial expression

A

CN VII
branchial motor, special visceral efferent

33
Q

Pharynx/Palate Testing

A

ask if there is any problems swallowing
ask pt to do “ahhh”
observe soft palate for symmetrical movement, uvula should be midline (deviates to non-affected side)

document: intact or impaired

34
Q

Neuroanatomy for pharynx/palate

A

CN IX motor to pharynx
CN X motor to muscles of soft palate

35
Q

Tongue movement test

A

testing strength of the muscles of their tongue
ask the pt to stick their tongue straight out
observe for tongue deviations (goes to weaker side)
press on side of cheek to provide resistance

document any observed weakness and which side

36
Q

Neuroanatomy of tongue movement

A

CNXII, somatic motor

37
Q

Coordination testing

A

Finger to nose (5x)
Heel to shin (5x)
Hands on lap (10s) = discoordination indicates cerebellum
Toe tapping (10s)
Finger Tapping (10s)

observe rhythm, accuracy, speed
document as intact or impaired

38
Q

Neuroanatomy for coordination

A

cerebellum = overshoot/undershoot
basal ganglia = speed, amplitude

2 Neuroanatomy (14 decks)

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