Neurological examination.

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Neurological examination.
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2014-10-13 01:55:56
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  1. What are Cranial Nerves (CN)? What are dermatome?
    • CN: they govern motor, sensory, and specialized functions like smell, vision, and hearing. 
    • Dermatome: band of skin innervated by the sensory root of a single spinal nerve. 
    • Dermatomes relate to the degree and level of motor loss if spinal cord injured. 
  2. Obtundation pt? Stupor pt?
    • Obtundation: An obtunded pt opens the eyes and looks at you, but responds slowly and is somewhat confused. alertness and interest in the environment are decreased. (shoe the pt. gently) 
    • Stupor: Arouses from sleep only with pain.
  3. what does CN I and II stand for?
    • CN I: olfactory 
    • CN II: optic.
  4. What do CN III, IV, and VI?
    • CN: III oculomotor 
    • CN IV: Trochlear 
    • CN VI: abducens. 
    • They are responsible for the six cardinal fields of gaze. 
    • Pupil size, shape, response to light, and accommodation. 
    • Look at opening of upper eyelids (ptosis) 
    • Convergence of eyes: check for nystagmus.
  5. O-O-O-T-T-A-F-A-G-V-S-H
    what do they stand for?
    • O: olfactory
    • O: optic
    • O: Oculomotor
    • T: Trochlear 
    • T: trigeminal
    • A: abducens 
    • F: Facial 
    • A: Acoustic
    • G: glossopharyngeal 
    • V: vagus
    • S: spinal accessory 
    • H: Hypoglossal
  6. What is CN V?
    • CN V: trigeminal 
    • Palpate temporal and masseter muscles and ask pt to clench teeth. Note strength. 
    • Ask pt to move jaw from side to side. 
    • Corneal reflex. 
    • Check both pain and sensation on the cheeks.
  7. What is the CN VII?
    • CN VII: facial. check for 6 things. 
    • 1) Raise both eyebrows 
    • 2) frown 
    • 3) close both eyes tightly and examiner tries to open them. 
    • 4) Show both upper and lower teeth. 
    • 5) smile. 
    • 6) puff out both cheeks.
  8. What is CN VIII?
    • CN VIII: acoustic. 
    • Asses hearing with whispered voice. 
    • test lateralization with weber test. 
    • Test air and bone conduction with Rinne.
  9. What is CN IX and X?
    • CN IX: glossopharyngeal 
    • CN X: Vagus. 
    • Difficult swallowing? 
    • Ask pt to say "ah" and watch movements of the soft palate and pharynx move symmetrically. 
    • Test gag reflex.
  10. What is CN XII?
    • CN XII: hypoglossal. 
    • Stick out tongue and inspect for symmetry or any atrophy. 
    • Move tongue from side to side.
  11. What is the Robemberg test?
    • pt. stands with feet together and eyes open, then with eyes closed for 30 to 60 secs w/o support. 
    • Loss of balance when eyes closed is a POSITIVE TEST.
  12. Pronator drift test?
    • pt stands for 20-30 secs with both arms straight forward, palms up, and eyes closed; tap arm briskly downwards. 
    • Pronation and downward drift of the arm is a positive test. (arms come back to position)
  13. What is Brudzinski test?
    • leafing up head towards chin. 
    • Movement of knees up while leafing head up is a POSITIVE TEST. 
    • Used for meningeal irritation.
  14. What is Kernig test?
    Moving the leg up will move the knee up and will cause irritation.
  15. What are the deep tendon reflexes?
    • Biceps (C5-6) 
    • Triceps (c6-c7) 
    • Suspinator or branchioradialis (c5-6) 
    • Kneed/patellar refelx (l2-4) 
    • Ankle reflex (primarily s1)
  16. What is clonus?
    A hyperactive response (+4), continuos rhythm contractions.

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