Pm Neurologic Screening Exam

Front 1

Neurological screening exam consists of?

Back 1

1. Cranial nerves 2-12 are routinely tested (taste and smell are not tested unless some aberration is found)
2. Proprioception and cerebellar function
3. Sensory function
4. Deep tendon reflexes

Front 2

Proprioception

Back 2

used to describe the sensory information that contributes to the sense of position of self and movement.

Front 3

Cerebellar function

Back 3

Maintenance of balance and posture. The cerebellum is important for making postural adjustments in order to maintain balance. Patients with cerebellar damage suffer from balance disorders, and they often develop stereotyped postural strategies to compensate for this problem (e.g., a wide-based stance).

Front 4

What tests are administered for proprioception and cerebellar function?

Back 4

One test is administered for each of the following
1. Rapid rhythmic alternating movements
2. accuracy of moments
3. balance
4. gait

Front 5

Which tests are used for the rapid rhythmic alternating movements?

Back 5

1. Ask patient to pat knees with both hands, alternating with Palms of both hands and then the back of the hands.

Alternatively
2. Ask the patient to touch the thumb to each finger of the same hand, sequentially from the index finger to the little finger and back , one hand at a time

Front 6

Which tests are done for accuracy of movement?

Back 6

1. finger to finger test
2. Finger to nose test
3. Heel to shin test

Front 7

What is done to evaluate balance?

Back 7

Balance and gait test

Front 8

What are the balance tests?

Back 8

1. Romberg test
2. Recovery balance test (Explain to patient that you will push them first, have them spread their feet slightly and push shoulders)
3. Standing & hopping (5 sec on each foot without losing balance)

Front 9

What are the gait tests?

Back 9

1. Walking
2. Heel to toe walking

Front 10

Finger to nose test?
Type of test?

Back 10

Accuracy of movement

Ask patient to CLOSE BOTH EYES and touch his or her nose with index finger of each hand while gradually increasing speed. Repeat with other hand.

Front 11

Heel to shin test?
Type of test?

Back 11

Accuracy of movement

Ask patient to run heel of 1 foot along the shin from knee to ankle of opposite leg, and then repeat with the other heel

Front 12

Finger to finger test?
Type of test?

Back 12

Accuracy of movement

WITH EYES OPEN
Position your index finger 40-50 cm from patient. Ask pt to alternately touch his or her nose and your index finger with the index finger of one hand. Change location of your index finger several times.
Repeat with patients other hand.

Front 13

What's tested in sensory function?

Back 13

1. Primary sensory functions
2. Cortical sensory functions

Front 14

How are the primary sensory functions tested?

Back 14

Close eyes for all tests
1. Superficial touch
2. Superficial pain
3. Temperature and deep pressure
4. Protective sensation
5. Vibration
6. Position of joints

Front 15

How are the cortical sensory functions tested?

Back 15

1. Stereognosis
2. Two-point discrimination
3. Extinction phenomenon
4. Graphesthesia
5. Point location

Front 16

Stereognosis

Back 16

ask patient to close eyes

Hand patients familiar objects (key, coin), and ask patient to identify

inability to recognize object is called TACTILE AGNOSIA

Front 17

Two-point discrimination

Back 17

ask patient to close eyes

Using two sterile needles, alternately touch patient's skin with one or both points simultaneously at various locations. Find distance at which patient can no longer distinguish two points.

Front 18

Extinction phenomenon

Back 18

ask patient to close eyes

Simultaneously touched pt's hand, or other area on each side of body with a medi pin (sterile needles). Ask patient the number of stimuli and locations.

Front 19

Graphesthesia

Back 19

ask patient to close eyes

With blunt pen/ applicator stick, draw letter or number on palm of patients hand, and ask patient to identify it. Repeat with different figure on other hand.

Front 20

Point location

Back 20

ask patient to close eyes

Touch area patient's skin and withdrew a stimulus. Ask patient to point the area touch

Front 21

DTRs?

Back 21

1. Biceps
2. Brachioradial
3. Triceps
4. Patellar
5. Achilles

Front 22

Superficial reflexes?

Back 22

1. Abdominal
2. Cremaster in (Male patients)
3. Plantar

Front 23

Normal deep tendon reflexes score?

Back 23

2

Front 24

Sluggish or diminished DTR score?

Back 24

1

Front 25

Brisk, hyperactive, with intermittent transient clonus DTR score?

Back 25

4

Front 26

0 DTR score means?

Back 26

No response

Front 27

Deep tendon reflexes scores?

Back 27

O= no response
1= sluggish or diminished
2= active or expected response
3= more brisk than expected, slightly hyperactive
4= brisk, hyperactive, with intermittent or transient clonus

Front 28

Muscle Strength Scores?

Back 28

0 – No contraction
1 – Slight contraction, no movement
2 – Full range of motion without gravity
3 – Full range of motion with gravity
4 – Full range of motion, some resistance
5 – Full range of motion, full resistance

Front 29

Strength Testing
Flexion and Extension of hip- ankle correspond to which spinal level?

Back 29

L2 – Hip flexion
L3 – Knee extension
L4 – Knee flexion
L5 – Ankle dorsiflexon
S1 – Ankle plantar flexion