Neuro Practical Flashcards

1
Q

what is being tested during the

light touch: localization test?

A

dorsal column

ability to detect and localize a light touch stimulus

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2
Q

what is being tested during the pin prick test?

A

spinothalamic tract

ability to detect difference between sharp and dull sensation

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3
Q

what is being tested during the hot:cold test?

A

spinothalamic tract

ability to detect between a hot and cold stimulus

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4
Q

what is being tested during a vibration test?

A

dorsal column/medial lemniscus

ability to detect a vibration (when it starts and when it stops)

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5
Q

what is being tested during the extinction test?

A

test for unilateral neglect

specifically tactile neglect

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6
Q

what is being tested during the 2-point discrimination test?

A

dorsal column/medial lemnsicus tract

ability to accurately distinguish between 1 or 2 points of contact

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7
Q

what is the normative data/distances for the 2-point discrimination test?

A

fingertips = 2-5 mm

palms = 8-12 mm

hand, extremities, trunk = 20-30 mm

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8
Q

what is being tested in the proprioception test?

A

dorsal column/medial lemniscus tract

ability to detect position of limb when it is changed slightly (up/down)

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9
Q

what is being tested during the stereognosis test?

A

dorsal column → integrative ability of the parietal cortex

ability to accurately ID common objects based off of touch alone (eyes closed)

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10
Q

what is being tested during the graphesthesia test?

A

dorsal column → integration at parietal cortex

ability to accurately ID a letter/number that is drawn on your hand w/eyes closed

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11
Q

what is being tested during the kinesthesia test?

A

dorsal column → integration at parietal cortex → motor cortex

ability to detect movement in space and then match it with the contralateral limb (eyes closed)

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12
Q

how are all sensations tests graded?

A

5/5 = normal

1 - 4/5 = impaired

0/5 = absent

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13
Q

what are the deep tendon reflexes for the UE/LE testing for?

A

presence or absense of an UMN/LMN lesion

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14
Q

what nerve roots are responsible for the patellar tendon reflex?

A

femoral nerve (L2, 3, 4)

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15
Q

what nerve roots are responsible for the achilles reflex?

A

tibial neve (S1, 2)

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16
Q

what nerve roots are responsible for the biceps brachii tendon reflex?

A

musculocutaneous nerve ((C5, 6)

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17
Q

what nerve roots are responsible for the brachioradialis tendon reflex?

A

radial nerve (C5, 6)

18
Q

what nerve roots are responsible for the triceps tendon reflex?

A

radial nerve (C6, 7)

19
Q

what are the grades/scores for reflex testing?

A

0-1+ = LMN

2+ = norma

3+ = Brisk

4+ and 5+ = UMN lesion

20
Q

what is the purpose of the Hoffman’s sign?

A

it is a pathological reflex that indicates the presence or absence of an UMN/LMN

flexion of 1,2 phalanx = a positive sign

21
Q

what is the purpose and grading of the Babinski’s sign?

A

tests for the presence/absence of an UMN/LMN

splaying of toes and ext of hallux is a positive sign

22
Q

what is the UE and LE synergy test for?

A

it tests the corticospinal tract and isolation of movement at a joint

23
Q

what is considered an abnormal result for an UE and LE synergy test?

A

movement in two or more joints in compensatory/synergistic pattern

this indicates an UMN lesion

24
Q

what does dysmetria (for UE and LE) test for?

A

cerebellar coordination/functioning

25
Q

what are abnormal results for dysmetria UE/LE?

A

hypometria = undershooting

hypermetria = overshooting, varying course of movement, disintegration of pattern

26
Q

what does dysdiadochokinesia test for?

A

cerebellar coordination/functioning

27
Q

what is included in a spasticity test?

A
  1. shoulder FLX/EXT
  2. elbow FLX/EXT
  3. wrist FLX/EXT
  4. thumb flexors
  5. finger flexors
  6. hip FLX/EXT
  7. hip ABD/ADD
  8. knee FLX/EXT
  9. ankle DF/PF
  10. clonus
28
Q

what does spasticity test for?

A

velocity dependent tone

presense of an UMN lesion

29
Q

how are spasticity tests measured?

A

Modified Ashworth Scale

30
Q

what results indicate the presence of clonus?

A

repeated bouncing of foot (plantarflexors)

31
Q

what results are you looking for when testing the papillary reflexes?

A

direct and consensual constriction

accommodation

32
Q

what is considered an abnormal result when testing the papillary reflex?

A

absense of constriction (direct/consensual)

absense of accommodation

33
Q

what is tested when performing the big H test?

A

EOMs

pursuit eye movements

34
Q

what are considered abnormal results from the big H test?

A

any asymmetry in movement

gaze palsies

2 or more of the following: nystagmus, strabysmus, saccades, and double vision

35
Q

what gaze palsies can be observed as an abnormal result from a big H test?

A

UMN = same direction limitation

LMN = opposite direction limitation or in one eye

36
Q

what are the grades that can be assigned during a Weber and Rinne test?

A

normal

conductive loss

sensoryneuro loss

37
Q

what suggests conductive hearing loss during a Weber test?

A

positive is louder in affected ear

38
Q

what suggests neurosensory hearing loss during a Weber test?

A

positive weber = louder in unaffected ear

39
Q

what suggests conductive hearing loss during a Rinne test?

A

hear sound only in mastoid process

no sound heard when tuning fork is placed in front of auricle

40
Q

what suggests neurosensory hearing loss during a Rinne test

A

no sound hear at either the mastoid or in front of the ear

41
Q

when testing CN XI what indicates and UMN or LMN?

A

asymmetry in strength

UMN = trap is weak but SCM is spared

LMN = both are weak/absent