The Clinical Neurological Exam Flashcards Preview

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Flashcards in The Clinical Neurological Exam Deck (24)
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1
Q

what are upper motor neurons?

A
  • descending axons from cortex to brainstem to SC

- brain, SC

2
Q

what are lower motor neurons?

A
  • axons exiting the CNS and innervating peripheral targets

- motor divisions of cranial nerves

3
Q

signs of UMN lesions

A
  • weakness
  • increased reflexes
  • increased tone
4
Q

signs of LMN lesions

A
  • weakness
  • atrophy
  • fasciculations
  • decreased reflexes
  • decreased tone
5
Q

tests for olfactory nerve (CN I)

A
  • tests for discrimination (contrast odorants)

- tests for arousal (noxious stimulant)

6
Q

if CN I is impaired, this is called…

A

anosmia (loss of smell)

7
Q

tests for optic nerve (CN II)

A
  • visual acuity
  • visual field cuts
  • pupillary response to light accommodation (II, III)
  • accommodation (II, III)
  • color discrimination
8
Q

what CNs are tested by the big H test?

A

oculomotor (III), trochlear (IV), abducens (VI)

9
Q

if your pt has a dysconjugate gaze in both eyes in the same direction, is this an UMN or LMN lesion?

A

UMN

10
Q

if your pt has a dysconjugate gaze in one eye in a specific direction, is this an UMN or LMN lesion?

A

LMN

11
Q

tests for trigeminal nerve (CN V)

A
  • light touch and sharp/dull to face (V1, V2, V3)

- bite strength

12
Q

tests for motor division of facial nerve (CN VII)

A

smile, raise your eyebrows, puff out cheeks, purse your lips, close your eyes tightly

13
Q

tests for sensory division of facial nerve (CN VII)

A
  • taste (don’t typically test this)

- secretomotor function

14
Q

corneal reflex test includes what 2 CNs?

A

V and VII

15
Q

how to differentiate UMN and LMN facial weakness

A
  • UMN: forehead is not affected

- LMN: forehead is affected

16
Q

tests for vestibulocochlear nerve (CN VIII)

A
  • Weber and Rinne tests

- these tests identify auditory loss and differentiate b/w conductive and sensorineural hearing loss

17
Q

tests for glossopharyngeal nerve (CN IX)

A
  • palatal activation
  • look for symmetry
  • involved side will fail to rise
18
Q

how to differentiate UMN and LMN lesion when testing CN IX

A
  • UMN: uvula will deviate towards involved side

- LMN: uvula will deviate away from involved side

19
Q

gag reflex test includes what 2 CNs?

A
  • sensory (afferent) limb: CN IX

- motor (efferent) limb: CN X

20
Q

voice hoarseness could indicate problems with what CNs?

A

IX and X

21
Q

tests for spinal accessory nerve (CN XI)

A
  • shoulder shrug (upper trap)

- side bend and rotate (SCM)

22
Q

how to differentiate UMN and LMN lesion when testing CN XI

A
  • UMN: contralateral trap weakness, can see sparing of SCM

- LMN: ipsilateral, impacts both

23
Q

tests for hypoglossal nerve (CN XII)

A

stick out tongue

24
Q

how to differentiate UMN and LMN lesion when testing CN XII

A
  • UMN: tongue will deviate away from involved side

- LMN: tongue will deviate towards involved side, will also see atrophy and fasciculations