Neurological diagnosis Flashcards Preview

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Flashcards in Neurological diagnosis Deck (49)
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1
Q

direct light reflex, indirect light reflex

A

tests cranial nerves II and III
when the light is shined in one eye, CN II sends the signal to the brain and CN III sends the signal to constrict the pupil
CN III on the other side also sends the signal to constrict the other pupil

2
Q

L -< (o) (O) R
L (o) (o) >- R
Describe what is happening.

A

since the light is being shown in the left eye, we can say that CN II and CN III is working in the left eye.
since the pupil on the other side did not constrict when the light was on the left but did on the right, we can say that CN III is not working properly.

3
Q

L -< (o) (o) R

L (o) (O) >- R

A

when the light is shown in the left eye, both pupils constrict, which means that CN II and III are working on the left and CN III is working on the right
when the light is shown in the right eye, the right eye doesn’t constrict, but the left one does, which means CN II isn’t working on the right side.

4
Q

Six cardinal fields of gaze

A

in reference to the right eye: lateral rectus moves the eye laterally, which is innervated by CN VI, superior oblique moves the eye down and medial, which is innervated by CN IV, and the rest are innervated by CN III which are: the inferior oblique moves the eye upward and medial, the inferior rectus brings the eye down and lateral, the superior rectus brings the eye up and lateral, the medial rectus brings the eye medially, and the levator palpebrae lifts the eyelid

5
Q

sensory test for CN V (face)

A

have patient close their eyes, touch forehead, cheekbone and chin with cotton wisp and ask the patient to say yes when they can feel you touch their face
general sensation to the anterior 2/3 of the tongue

6
Q

corneal reflex

A

touch cornea with cotton wisp, eye will blink or tear

problem with CN V or CN X if this is not achieved

7
Q

oculocardiac reflex

A

press on closed eye and heart rate decreases

problem with CN V or CN X if this is not achieved

8
Q

tic douloureaux

A

extreme, sporadic, sudden burning or shock-like face pain that lasts anywhere from a few seconds to as long as 2 minutes per episode. lightening like, excruciating pain is repetitive, occurring several times per day. pain is typically felt on one side of the jaw or cheek
usually a result of dental work

9
Q

jaw jerk reflex

A

the mandible is tapped with hammer and masseter draws the jaw upward

10
Q

muscles of mastication

A
TIME
masseter
external pterygoid
internal pterygoid
temporalis
11
Q

sensory for CN VII

A

taste to anterior 2/3 of tongue (sweet, sour, salty)

12
Q

motor for CN VII

A

muscles of facial expression

13
Q

Bell’s palsy

A

unilateral facial paralysis caused by trauma, virus or immune mediated response and is not permanent. initial pain behind the ipsilateral ear, twitching, weakness or paralysis, drooping eyelid, drooping corner of mouth, drooling, dry eye, and impairment of taste

14
Q

bell’s palsy vs stroke

A

bell’s: LMNL of CN VII, ipsilateral motor loss of entire face, forehead does not wrinkle
stroke: UMNL of CN VII, contralateral motor loss below eye, forehead does wrinkle

15
Q

CN VIII sensory

A

vestibular: balance, mittelemeyer and romber’s. barany caloric test
cochlear: hearing, weber and rinne

16
Q

endolymphatic hydrops/central vertigo

A

meniere’s disease
cause is unknown, but probably results from an abnormality in the fluids of the inner ear. symptoms are episodic rotational vertigo, hearing loss, tinnitus, and fullness in the ear

17
Q

sensory CN IX

A

gag reflex and uvula reflex (CN IX afferent, CN X efferent (stroke uvula)
carotid reflex (CN IX afferent, CN X efferent) massage carotids and heart rate drops
taste to posterior 1/3 of tongue (bitter)

18
Q

motor CN IX

A

stylopharyngeus muscle elevates pharynx and larynx, dilates pharynx to permit swallowing

19
Q

sensory CN X

A

epiglottis and laryngeal muscles of swallowing (palate, pharynx, contracting muscles

20
Q

motor CN X

A

gag reflex and carotid reflex

uvular reflex: palate and uvula deviate to opposite side of lesion when patient says Ahhh

21
Q

CN IX

A

trapezius and SCM muscles: shoulder shrug (traps) and lateral flexion with head rotation (SCM)

22
Q

wry neck

A

torticollis

spasm of SCM muscle

23
Q

CN XII

A

tongue muscles: stick out tongue. deviation to side of lesion

24
Q

graphesthesia

A

with patient’s eyes closed the doctor draws a letter in the patient’s open palm and asks them to identify the letter. repeat on the other side

25
Q

sterognosis

A

with the patient’s eyes closed the doctor places a familiar object into the patient’s open palm and asks them to identify it. repeat on other side

26
Q

how do you tests reflexes (generally)?

A

bilaterally, starting with normal side first

27
Q

bicep nerve and nerve root

A

C5

28
Q

brachioradialis nerve and nerve root

A

C6

29
Q

triceps nerve and nerve root

A

C7

30
Q

patellar nerve and nerve root

A

L4

31
Q

medial hamstring nerve and nerve root

A

L5

32
Q

Achilles nerve and nerve root

A

S1

33
Q
UMNL: 
definition
paralysis
DTR
path reflex
clonus
tone
reaction of degeneration
atrophy
fasciculation
superficial reflexes
A
lesion of the brain and spinal cord not including the anterior horn cells
spastic
hyperactive
present
present
hypertonic
absent
absent
absent
absent
34
Q
LMNL: 
definition
paralysis
DTR
path reflex
clonus
tone
reaction of degeneration
atrophy
fasciculation
superficial reflexes
A
lesion of the anterior horn cells out to the myoneural junction
flaccid
hypoactive/absent
absent
absent
hypotonic
present
present
present
present
35
Q

ciliospinal reflex

A

pinch neck wile noting dilation of the eyes
sensory from neck
cervical sympathetics

36
Q

oculocardiac reflex

A

press on eye, note slowing of the heart by 10BPM
CN V
CN X

37
Q

carotid sinus reflex

A

press on carotid sinus note slowing of heart and decreased pressure
CN IX
CN X

38
Q

conditions of UMNL

A
meningitis
MULTPLE SCLEROSIS
cerebral palsy
CVA
BRAIN TUMOR
ALS (lower extremity)
39
Q

conditions of LMNL

A
SUBLUXATION
MYASTHENIA GRAVIS
DISC PROTRUSION
polio
bell's palsy
ALS (upper extremity)
40
Q

babinski

A

stroke up lateral aspect of foot to great toe

dorsiflexion of great toe with slaying of other toes

41
Q

chaddock

A

stroke down lateral malleolus to 5th toe

dorsiflexion of great toe with slaying of other toes

42
Q

oppenheim

A

stroke down tibial crest to ankle

dorsiflexion of great toe with slaying of other toes

43
Q

Gordon’s calf

A

squeeze calf below knee

dorsiflexion of great toe with slaying of other toes

44
Q

schaefer

A

squeeze Achilles tendon

dorsiflexion of great toe with slaying of other toes

45
Q

rossolimo

A

tap ball of foot

plantar flexion of great toe with curling of the other toes

46
Q

hoffman

A

examiner extends middle phalanx and flicks distal phalanx inferior
flexion and adduction of the thumb and flexion of the fingers

47
Q

tromner

A

examiner sharply taps the tips of the middle 3 fingers

flexion and adduction of the thumb and flexion of the fingers

48
Q

Gordon’s finger

A

examiner strokes the pisiform of the patient

flexion of wrist and fingers or thumb and index finger

49
Q

chaddock’s wrist

A

examiner strokes the distal ulnar side of the forearm near the wrist
flexion of wrist with extension and fanning of fingers