VIVA

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Author:
jessiekate22
ID:
156431
Filename:
VIVA
Updated:
2012-05-30 03:19:27
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Neurological examinations
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2020
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  1. What is neurological examination testing involve?
    • - conduction
    • - power
    • - reflex
    • - sensations
  2. What are you lower limb demratomes?
  3. Mytomomes
    • C3,4 and 5 supply the diaphragm (the large muscle between the chest and the belly that we use to breath).
    • C5 also supplies the shoulder muscles and the muscle that we use to bend our elbow .
    • C6 is for bending the wrist back.
    • C7 is for straightening the elbow.
    • C8 bends the fingers.
    • T1 spreads the fingers.
    • T1 –T12 supplies the chest wall & abdominal muscles.
    • L2 bends the hip.
    • L3 straightens the knee.
    • L4 pulls the foot up.
    • L5 wiggles the toes.
    • S1 pulls the foot down.
    • S3,4 and 5 supply the bladder. bowel and sex organs and the anal and other pelvic muscles.
  4. What is the order of neruological examinations
    • C3,4 and 5 supply the diaphragm (the large muscle between the chest and the belly that we use to breath).
    • C5 also supplies the shoulder muscles and the muscle that we use to bend our elbow .
    • C6 is for bending the wrist back.
    • C7 is for straightening the elbow.
    • C8 bends the fingers.
    • T1 spreads the fingers.
    • T1 –T12 supplies the chest wall & abdominal muscles.
    • L2 bends the hip.
    • L3 straightens the knee.
    • L4 pulls the foot up.
    • L5 wiggles the toes.
    • S1 pulls the foot down.
    • S3,4 and 5 supply the bladder. bowel and sex organs and the anal and other pelvic muscles.
  5. What is the order of neurological examinations
    • - screening test
    • - sensation- light touch, pin prick
    • - power- isometric strength test (mm @ mid range & try break the contraction), considr pain and wasting
    • - reflexes- test reflex arc
    • - babunski
    • -clonus
  6. What are the levels of relex grading?
    • - 1,2,3
    • - absent, fading, normal, exaggerated, clonus
    • (spasticity)
    • - ensure you compare to the other side
  7. What are neurodynamic tests?
    • Mobility of nerve tissue
    • is placing a nerve on tension and seein if it reproduces thepts pain
    • - SLR- eg torn hammie- fibrosis, mm spasm- piriformis
    • - PKB
    • - PNF
    • +ve test diff pian, compare ROM to other side and see where P comes on
    • - buldge disc, narrowing of spinal cannal
  8. Where do discs bulges usually occur?
    • L4
    • L5
    • S1
  9. How do you do a sensations test?
    • using a cotton ball- moving around in circles up and down the limb
    • Also foot and hand run down the fingers/ toes
    • Usually 2 or 3 levels are affected
    • If loss sensation pin prick only that area and map out area of loss sensation
  10. How do you test the power of the lumbar spine?
    • Pain can affect myotome strength
    • Pt does the movement and then you try to move it
    • L2- hip flexors- hold @ 90 degrees against ur resistance
    • L3- quads- pt knee on towel- hold straight leg
    • L4- DF/ IN- do separate and both feet together- compare side
    • L5- EHL- big toe
    • S1- evertors, PF in standing- walk on toes for quick screen- otherwise in supine
    • S2- toe flex- bend toes over fingers
  11. What are clearing tests?
    relex tests
  12. What are the reflexes of the LL and what nerve root do they test?
    • - knee jerk - L4
    • - ankle jerk- S1
  13. Perform a knee jerk
    • - over patella tendon
    • in gap
    • if pt resisting preoccupy them
  14. Perform an ankle jerk
    • - achilles tendon
    • - small DF
  15. With testing of sensation ect if pt presents with numbness of foot ensure you do the entire limb
  16. What is the babinski test?
    it is an upper motor neuron lesion test

    - going up the lateral side of the base of the foot and across the knuckles of the toe to under the big toe

    • - a positive
    • test if the toes are abduct and ext
  17. Conduct the clonus test
    • - UMNL test
    • - forced and hold DF
    • - +ve is that the foot will tremor when help and forced into DF
  18. What are the myotomes for the upper limb?
    • - C4- shoulder elevation
    • - C5- shoulder abduction
    • - C6- elbow flexion (biceps)
    • - C7- elbow ext (triceps)
    • - C8- thumb ext (EPL), DIP flexion
    • - T1- finger add/abduction
  19. How would you test the C4 myotome?
    Shrug- resisted shrug
  20. How would you test C5 myotome?
    - shoulder abduction- resist midway
  21. How would you test the power of C6?
    • - arm in sup
    • - elbow flexion
  22. How would you test the power of C7?
    • elbow ext triceps
    • arm in supination
  23. How would you test the power of C8?
    • Thumb ext
    • DIP flexion
    • - resisted
  24. How would you test the power of T1?
    • - duck position of hand
    • - add- pt keep fingers together
    • - abd- tryand push pts finers together
  25. Where would you test the reflexes of C5/6?
    • - biceps jerk- think how peter showed us
    • - ensure pts in a relaxed position
  26. How would you test reflexes of C7?
    • - triceps jerk'- arm across belly
    • - hit above olecranon
  27. How would you test the felexes of C6?
    • - brachioradialis
    • - lat of forearm
    • - 5-10cm down wrist
    • - looking for a twitch or elbow flex
  28. Describe the dermatome, the mm and the reflex for C4
    • Derm- clavical, supraspinatus fossa, prox deltoid
    • mm- elevation of shoulders
    • - reflex-none tested
  29. Describe the dermatome, the mm and the reflex for C5
    • Derm- upper traps, deltoid, lat arm to wrist
    • mm- deltoid
    • reflex- biceps jerk
  30. Describe the dermatome, the mm and the reflex for C6?
    • Derm- upper traps, lat arm and forearm, lat 2 digits
    • mm- biceps
    • reflex- biceps and brachioradialis jerk
  31. Describe the dermatome, the mm and the reflex for C7?
    • Derm- med scap, ant forearm, posterior arm to middle 3 digits
    • mm- triceps
    • reflex- triceps jerk
  32. Describe the dermatome, the mm and the reflex for C8?
    • Derm- scap, inner arm to medial 2 digits
    • mm- ext pollicus longus, flex digitorum prof, flex digitorum superficialis
    • reflex- none tested
  33. Describe the dermatome, the mm and the reflex for T1?
    • Dermatome- lower scap, inner arm to medial wrist
    • mm- interossei
    • reflex- none tested
  34. Dermatomes for upper limb

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