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NeuroPE
Neuro Physical Exam
| Question | Answer |
|---|---|
| Language expression | Inferior frontal lobe, anterior motor strip, dominant hemisphere |
| Impaired memory | Bilateral mesial temporal lobe lesions or bilateral medial thalamic lesions |
| Impaired attentiveness | Diffuse mild cortical dysfunction, right parietal lesion |
| Homonymous hemianopsia | Lesion to the contralateral visual pathway posterior to optic chiasm |
| Ptotic lid + larger pupil (poorly responsive to light) | Third nerve lesion |
| Ptotic lid + smaller pupil (responsive to light) | Horner's syndrome |
| Diplopia keys (2) | 1. Diplopia worsens in the gaze direction of the action of the paretic muscle 2. The outer image is always the false image |
| Corneal reflex | CN V-VII polysynaptic reflex |
| Most common cause of progressive unilateral hearing loss | Acoustic neuroma |
| Slowed speech | Spastic (upper motor neuron) process |
| Irregular speech rates | Ataxic (cerebellar) process |
| Deltoid muscle | C5 > C6, axillary nerve |
| Triceps muscle | C7 > C6 & C8, radial nerve |
| Interossei muscles | C8 & T1, ulnar nerve (also requires C7 & C8 radial nerve finer extensors to have normal strength) |
| Iliopsoas muscle | L2 & L3 > L4, femoral nerve |
| Dorsiflexor muscles | L4 & L5, peroneal nerve |
| Biceps reflex | C5 > C6, musculocutaneous nerve |
| Triceps reflex | C7 > C6 & C8, radial nerve |
| Quadriceps reflex | L2, L3 & L4, femoral nerve |
| Achilles reflex | S1 > S2, tibial nerve |
| Slowing of rapid alternating movements | Upper motor lesions |
| Positive Babinski response | Injury to the corticospinal tract |
| Triple flexion: 1. Extension of the great toe & dorsiflexion of the ankle 2. Flexion of the knee 3. Hip flexion | The BIG BABINSKI, signifies major upper motor neuron injuries |
| Dysmetria | Ipsilateral cerebellar (hemispheres) dysfunction |
| Fiber type: Vibration, joint position sense, light touch | Large myelinated fibers |
| Fiber type: Pain and temperature | Small myelinated and small unmyelinated fibers |
| Tract type: Pain and temperature | Spinothalamic tract |
| Tract type: Vibration and joint position sense | Posterior columns |
| Joint position sense, stereognosis, graphesthesia, touch localization, two-point discrimination | Cortical sensations; the contralateral parietal cortex is essential for their perception |
| Spastic gait muscle imbalances | Increased plantar flexor, knee extensor and hip extensor tone with inability to flex hip, knee and ankle (stiff leg with toes dragging and some circumduction) |
| Parkinsonian gait characteristics | 1. Flexion of the neck, trunk and arms 2. Short steps 3. Poor arm swing 4. Difficulty turning |
| Ataxic gait characteristics | Inability to perform tandem gait is the first manifestation then irregularity of stride rate and length with imprecise foot placement and leg control |
Created by:
megankirch
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