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11 Cards in this Set
- Front
- Back
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Big picture components of the Neuro Exam:
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-CN testing
-Motor function testing upper/lower body -Sensation testing general/pain/vibration/proprioception -Cerebellar/gait -Reflexes |
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Describe CN testing for I, II, III, IV, and VI:
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I: use coffee/cinnamon and see if they can ID it.
II: Check direct/consensual pupil response. Check outer upper/lower visual fields by confrontation. III, IV, VI: Check H-pattern EO mvmts stabilizing chin. Check accommodation. |
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Describe CN V testing:
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-Have pt clench teeth; check masseter and temporalis.
-Check light touch/pain sensation bilaterally. |
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Describe CN VII testing:
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-Have pt raise eyebrows.
-Have pt shut eyes and resist opening. -Have pt smile, frown, show teeth, puff cheeks. |
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Describe CN VIII testing:
Describe CN IX testing: |
-Test gross hearing near and far w/ finger rub.
-Weber test (forehead) -Rinne test (mastoid/air) -Say "ah" and look for symmetric soft palate raise. |
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Describe CN XI testing:
Describe CN XII testing: |
-Have pt shrug superiorly against you.
-Have pt turn head into your hand; feel SCM flex. -Stick tongue out; look for weird mvmts. -Push tongue against cheek; press to assess strength. |
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Describe Neuro exam Motor Function testing:
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-First, check muscle tone by passively moving arms and palpating muscles.
-Deltoid wings: resist me pushing down, push down, push out, pull in, squeeze fingers hard. -Splay fingers testing--out and squeeze. -Flex hip up against resistance, kick out, pull in, hit the gas, point toes up. -Perform pronator drift test! |
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Describe Neuro exam Sensory Function testing:
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-Test light touch for even sensation in arms, legs, & feet.
-Test sharp/dull in arms/legs/feet. -Test vibration sense on 1st metatarsal and knuckle. -Test position sense on big toe and thumb. |
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Discuss the Cerebellar exam:
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-Rapid alternating: fingers and dysdiadodo test.
-Finger to nose test. -Heel to shin; while seated, run heel down front of shin. -Gait: normal, tiptoe, on heels, heel to toe. -Romberg test |
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Discuss reflex testing:
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-Biceps: flex to feel tendon, hit thumb placed over tendon.
-Triceps: flex to feel, hold arm and strike directly. -B.R.: look for thumb flexion. -Patellar: use flat end of hammer. -Achilles: use flat end of hammer. -Plantar: Make an L toward the big toe. |
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Give the normal oral presentation for the neurologic exam:
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*AOx3.
I: Able to detect odor of coffee. II, III, IV, VI: Visual fields full to confrontation, PERRLA. EOMI. MOVEMENTS: V: Clenches temporal and masseter muscles. VII: Able to raise both eyebrows, squeeze eyelids shut against resistance, frown, puff out cheeks, and smile. XI: Turns face against hand, shrugs shoulders. VIII: Gross hearing is intact. Weber doesn't lateralize, Rinne demonstrates air better than bone conduction bilaterally. Response to light touch and sharp/dull testing is symmetric on the F/A/L bilaterally. *Good muscle bulk and tone. 5/5 strength in all extremities, proximally and distally. *Distal proprioception and vibration sense intact in fingers and toes bilaterally. *Finger to nose, heel to shin, and rapid alternating movements are coordinated, maintains balance with eyes closed. No pronator drift. Heel to toe and tandem walk both steady without evidence of ataxia. *Biceps, triceps, brachioradialis, patellar and achilles reflexes are 2+ and symmetric and plantar reflexes are downgoing. |
