Neuro Exam 1: Localization

Front 1

sudden deficit on one side of body. what are you thinking?

Back 1

stroke!

Front 2

Where is the stroke: Right homonymous hemianopia

Back 2

Left PCA

Front 3

Where is the stroke: Left homonymous hemianopia

Back 3

Right PCA

Front 4

Where is the stroke: Right leg weakness

Back 4

Left ACA

Front 5

Where is the stroke: Left leg weakness

Back 5

Right ACA

Front 6

Where is the stroke: Nonfluent (Broca's) aphasia with R face and arm weakness

Back 6

Left MCA

Front 7

Where is the stroke: Left hemineglect

Back 7

Right MCA

Front 8

Where is the stroke: contralateral paralysis, contralateral hemianopsia, no aphasia, neglect/inattention

Back 8

Right (non-dominant) MCA

Front 9

Where is the stroke: Dysarthria (slurred speech) and right hemiparesis, right Babinski's sign

Back 9

Lacunar infarction of left internal capsule (Left posterior limb of internal capsule)
Note: This is a pure motor stroke.

Front 10

Where is the stroke: Sudden onset of R face, arm, and leg numbess (no motor deficits)

Back 10

Lacunar infarct in left lateral thalamus
Note: This is a pure sensory stroke.

Front 11

Where is the lesion: Face and contralateral body numbness, hoarseness, horner's, ataxia

Back 11

Brain stem: PICA

Front 12

If the eyes aren't lined up, what are the possible involved structures?

Back 12

CNIII (and nucleus)
CN IV (and nucleus)
CN VI (and nucleus)
MLF

Front 13

Were is the lesion: Normal frontal gaze, on look right, left eye doesn't cross midline and right eyes moves right w/ nystagmus

Back 13

MLF area of Pons (seen w/ MS)

Front 14

unlined up eyes has to be what area of brain stem?

Back 14

midbrain or pons

Front 15

Where is the stroke: Sudden onset of unilateral ataxia (usually w/ nausea and vomiting)

Back 15

ipsilateral cerebellar artery infarct

Front 16

What does the medial cerebellum (vermis) control?

Back 16

medial body

Front 17

What do the lateral hemispheres of the cerebellum control?

Back 17

Programmed motor learning

Front 18

What do the intermediate hemispheres of the cerebellum control?

Back 18

complex movements of arms and legs

Front 19

Where is the lesion: unsteady gait, wide-based, falling to the left, HA, normal heel-shin

Back 19

cerebellar vermis (medial)

Front 20

Where is the lesion: Left leg weakness and R leg numbness

Back 20

Left hemicord lesion

Front 21

When should you suspect a spinal cord lesion?

Back 21

When it looks like you drew a line across the torso and all deficits are below the line.

Front 22

Falls, loss of balance, and positive Romberg (loss of position and vibration). What is this syndrome?

Back 22

Posterior cord syndrome (posterior columns are jacked up below the lesion)

Front 23

Motor deficit on same side and sensory deficit on opposite side. What is the syndrome?

Back 23

hemicord syndrome

Front 24

Loss of pain and temp and motor function below a certain level. What is the syndrome?

Back 24

anterior cord syndrome

Front 25

Damage to anterolateral (spinothalamic tract) and lateral corticospinal tract, but sparing the posterior columns. Where is the infarct?

Back 25

anterior spinal artery

Front 26

Bilateral flacid leg paralysis, decreased rectal tone, distended bladder, sensory level deficits to all modalities. What is the problem?

Back 26

transection of the spinal cord at area of deficit

Front 27

Pain and Temp loss in a stripe across the torso. What is the syndrome?

Back 27

Central cord lesion (small)

Front 28

What is the most common non-fracture spinal cord injury?

Back 28

central cord syndrome (large lesion)

Front 29

Gluteal pain, genital pain in a saddle, constipation, urinary retention, ED, loss of rectal tone. Where is the lesion?

Back 29

Cauda equina (common) or conus medularis (rare)

Front 30

T or F: Saddle problem assoc w pain is more likely to be cauda equina

Back 30

TRUE

Front 31

T or F: Saddle deficits w/o pain is more likely to be conus medularis

Back 31

TRUE

Front 32

Which nerve root: Decreased biceps and pectoralis reflexes

Back 32

C5

Front 33

Which nerve root: biceps and brachioradialis reflexes decreased

Back 33

C6

Front 34

Which nerve root: decreased triceps reflex

Back 34

C7

Front 35

Which nerve root: weakened deltoid, infraspinatus, biceps

Back 35

C5

Front 36

Which nerve root: weakened wrist extensors, biceps

Back 36

C6

Front 37

Which nerve root: weakened triceps

Back 37

C7

Front 38

Which nerve: extension of arm, wrist, finger joints, below shoulder, forearm supination, thumb abduction, in plane of palm

Back 38

radial nerve

Front 39

Which nerve: neuropathy of fingers 4 and 5

Back 39

ulnar

Front 40

Which nerve: neuropathy of fingers 1, 2, and 3

Back 40

median

Front 41

Which nerve: abduction of arm at shoulder beyond 15 deg

Back 41

axiallary

Front 42

Which nerve: flexion of arm at elbow, supination of forarm

Back 42

musculocutaneous

Front 43

Which nerve root: decreased patellar reflex

Back 43

L4

Front 44

Which nerve root: decreased foot dorsiflexion, big toe extension

Back 44

L5

Front 45

Which nerve root: foot plantar flexion

Back 45

S1

Front 46

Which nerve root: decreased ankle jerk reflex

Back 46

S1

Front 47

Which nerve: adduction of the thigh

Back 47

obturator

Front 48

Which nerve: leg flexion at the knee

Back 48

sciatic

Front 49

Which nerve: leg flexion at the hip, leg extension at the knee

Back 49

femoral

Front 50

Which nerve: foot plantar flexion and inversion, toe flexion

Back 50

tibial

Front 51

Which nerve: foot eversion

Back 51

superficial peroneal nerve

Front 52

Which nerve: foot dorsiflexion, toe extension

Back 52

deep peroneal nerve