ICM Test 4: Weeks 2, 4

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Things to check on neurologic exam
- Mental Status
- Cranial Nerves
- Motor
- Sensory
- Cerebellar
- Reflexes
- Gait
MR MC GCS
3 things to check on mental status
- Level of Consciousness (LoC)
- Speech (dysarthria) and language
- Memory
When testing sensory Always test from

Area of poor sensation to a region of normal or more normal sensation
Romberg, DSS test

Sensory
UMN vs. LMN:
Weakness
Spasticity
Hyperreflexia
Clonus
Spasms (most often flexor)

UMN
UMN vs. LMN:
Weakness
Flaccidity
Hyporeflexia
Fasiculations
Atrophy

LMN

*Note UMN initially produces flaccid weakness
Hemiparesis: Lesion location
- Cortex, subcortex or brainstem
- Lesion is opposite weak side
Follows hemiparesis

Facial weakness

(If above pons, expect sparing of upper face and weakness on same side as body weakness)
Lesion localization: Loss of vibration proprioception

Posterior column (spinal cord)
Lesion localization: Loss of pain/temp

Contralateral ALS
Lesion localization: Loss of sensation on side opposite weakness

Brainstem
Lesion localization: Loss of all sensory modalities on one side

Thalamus
Lesion localization: Weakness/sensory loss on same side

Cerebrum
Lesion localization: all modalities affected in dermatome

Peripheral nerve
Lesion localization: Distal symm sensory loss

Polyneuropathy
Cerebellar lesions result in

Ipsilateral ataxia (they cross 2x)
Waddling gait is result of

Severe proximal muscle weakness
Lesion localization: Spastic/scissor gate

Corticospinal tract lesions
Lesion localization: Magnetic gait/apractic gait

Frontal lobes
Cortical vs. Subcortical: Aphasia, apraxia, agnosia

Cortical
C vs. S: Equal involvement of face/arm/leg; sensory abnormalities; visual field cuts

Subcortical
Homonymous defect can only be

brain lesion

Author

BrookeNH10

201111

Card Set

ICM Test 4: Weeks 2, 4

Description

ICM Test 4 Weeks 2 and 4

Updated

2013-02-17T06:30:44Z

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