Learn: H&P Final Cram Sheet

What are the four domains of the Mental Status Exam?

Cognitive function, emotional state, thought process, and perception.

What is the purpose of screening tools in neurology?

To assess cognitive function and identify potential neurological issues.

How many cranial nerves are there?

There are 12 cranial nerves.

What is a key feature of high-yield clinical patterns?

They help identify common neurological conditions quickly.

What distinguishes normal from abnormal findings in a neurological exam?

Normal findings align with expected physiological responses, while abnormal findings indicate potential pathology.

What are common history red flags in neurology?

Sudden onset of symptoms, progressive weakness, and changes in mental status.

What tests assess coordination and fine motor skills?

Finger-to-nose test and rapid alternating movements.

What is the significance of balance and position sense in a neurological exam?

They help evaluate the integrity of the vestibular system and proprioception.

What are pathophysiologic gait patterns?

Patterns of walking that indicate specific neurological disorders.

What does the MRC grading scale assess?

Muscle strength.

What is the difference between upper motor neuron (UMN) and lower motor neuron (LMN) lesions?

UMN lesions show spasticity and hyperreflexia, while LMN lesions show flaccidity and hyporeflexia.

What is the purpose of a localization cheat-sheet in neurology?

To help determine the anatomical level of neurological deficits.

What is the structure of a musculoskeletal exam?

It includes inspection, palpation, range of motion, and strength testing.

What are the regions and curvatures of the spine?

Cervical, thoracic, lumbar, sacral, and coccygeal regions with normal lordosis and kyphosis.

What are the normal range of motion (ROM) norms for major joints?

Specific degrees of movement expected for each joint, varying by joint type.

What is Cauda Equina Syndrome?

A serious condition caused by compression of the cauda equina, leading to severe neurological deficits.

What are the Ottawa Knee Rules?

Criteria used to determine if an X-ray is needed for knee injuries.

What are common conditions affecting the lower extremities?

Osteoarthritis, rheumatoid arthritis, and ligament injuries.

What is the purpose of adult well-visits?

To assess overall health, screen for diseases, and provide preventive care.

What considerations are important for patients with disabilities?

Tailored assessments and accommodations for their specific needs.

What are key assessment tools in neurology?

Neurological exams, imaging studies, and laboratory tests.

What does the neuromuscular differential diagnosis schema help with?

It aids in localizing symptoms by anatomic level.

What is the focus of this condensed study guide?

High-yield facts for exam review, including grading scales and differential diagnoses.

What does 'A&O x4' stand for in a mental status exam?

Alert and oriented to person, place, time, and situation.

What is the wakefulness spectrum in mental status examination?

Alert → lethargic → obtunded → stuporous → comatose.

What is the purpose of using a validated screening tool like MMSE?

To assess cognitive function quickly when time is limited.

What does the MMSE score indicate?

Scores 24-30 are normal, 18-23 mild impairment, 10-17 moderate, and

What is the Mini-Cog used for?

To screen for dementia using a 3-item recall and clock drawing.

What is the function of the Olfactory nerve (CN I)?

Sensory function for smell.

How is the Optic nerve (CN II) tested?

By assessing visual acuity and visual fields.

What does the Oculomotor nerve (CN III) control?

Most extraocular movements, lid elevation, and pupil constriction.

Which cranial nerve is responsible for facial expression?

Facial nerve (CN VII).

What does the Glossopharyngeal nerve (CN IX) control?

Taste from the posterior 1/3 of the tongue and pharyngeal sensation.

What is a key test for the Vagus nerve (CN X)?

Assessing uvula and palate symmetry.

What does a deviated tongue indicate in relation to the Hypoglossal nerve (CN XII)?

The tongue deviates toward the side of the lesion.

What does 'dysdiadochokinesia' indicate?

Inability to perform rapid alternating movements, suggesting cerebellar dysfunction.

What does a positive Romberg test indicate?

Loss of balance with eyes closed, suggesting sensory ataxia.

What is the significance of pronator drift?

Indicates contralateral corticospinal tract involvement (UMN lesion).

What is the clinical significance of facial droop with forehead involvement?

Indicates a peripheral (LMN) lesion of CN VII.

What does a 'down and out' pupil indicate?

CN III involvement with pupil involvement, often due to compressive lesions.

What does a 'down and out' pupil with spared pupil indicate?

Diabetic or ischemic microvascular palsy affecting CN III.

What is the typical gait pattern for a patient with hemiparetic/spastic gait?

Stiff extended leg, circumduction, and arm flexed with no swing.

What does 'dysmetria' refer to?

Overshooting or undershooting a target, indicating cerebellar dysfunction.

What is the definition of proprioception?

The sense of body position and movement.

What are common red flags in history taking for neurological examination?

Headache, dizziness, weakness, numbness, syncope, seizures, tremor.

What does the term 'antalgic gait' refer to?

A gait pattern that minimizes stance time on the affected leg due to pain.

What is the role of the cerebellum in motor function?

Coordination, balance, and fine motor control.

What is the significance of a wide-based gait?

Indicates cerebellar dysfunction or sensory ataxia.

What is required for cortical discrimination?

Intact primary sensation first.

What does extinction indicate?

Unilateral parietal lobe/basal ganglia lesion.

What does a 5/5 on the MRC Grading Scale indicate?

Normal strength with full range of motion against gravity and resistance.

What is the myotome for shoulder abduction?

C5.

What reflex is associated with the biceps?

C5, C6.

What does a positive Babinski sign indicate?

Upper motor neuron lesion in individuals over age 2.

What is the grading scale for deep tendon reflexes?

0 absent, 1+ hypoactive, 2+ normal, 3+ brisk, 4+ hyperactive with clonus.

What does Kernig's sign indicate?

Meningeal irritation.

What is the difference in tone between UMN and LMN lesions?

UMN: increased (spastic); LMN: decreased (flaccid).

What are the key features of radiculopathy?

Dermatomal sensory loss, myotomal weakness, diminished reflex at that root.

What is the normal curvature of the cervical spine?

Lordosis (concave).

What does a straight leg raise test indicate?

Lumbar disc herniation or nerve root irritation.

What is the technique for the FABER test?

Figure-4 position with external rotation.

What does a positive Adam's forward bend test indicate?

Scoliosis.

What are the symptoms of cauda equina syndrome?

Saddle anesthesia, new bladder dysfunction, bilateral leg weakness/pain.

What is the role of the Jendrassik maneuver?

To reinforce deep tendon reflexes if difficult to elicit.

What are the red flags for urgent referral in back pain?

Fever/chills, unexplained weight loss, trauma with new pain, progressive focal deficit.

What does a positive Speed's test indicate?

SLAP tear.

What is the normal range for cervical spine flexion?

45°.

What does the term 'gibbus' refer to?

Sharp angular kyphosis from vertebral collapse.

What is the significance of a negative straight leg raise?

Dull/sharp localized pain, worse with movement, no leg radiation.

What does a positive O'Brien's test indicate?

Rotator cuff tear if pain improves with thumb-up position.

What is the normal range for thoracic spine extension?

30°.

What does the term 'myopathy' refer to?

Muscle disease characterized by symmetric proximal weakness and normal sensation.

What is the primary indication of a positive Neer's test?

Biceps tendinopathy or SLAP lesion.

What is the technique for the modified Schober test?

Measure increase in lumbar flexion after marking a 15 cm span at the iliac crest.

What does the term 'polyneuropathy' describe?

Distal sensory loss and weakness, often associated with diabetes or vitamin deficiencies.

What does the term 'mononeuropathy' refer to?

Loss in one peripheral nerve's territory, such as carpal tunnel syndrome.

What does Cozen's test assess?

Lateral epicondylitis (tennis elbow) through resisted wrist extension.

What indicates a positive result in Mill's test?

Lateral epicondyle pain during passive pronation, wrist flexion, and elbow extension.

What condition does Tinel's test at the elbow indicate?

Cubital tunnel syndrome (ulnar nerve involvement) if tingling occurs in the ring/little finger.

What does a positive Phalen's test indicate?

Carpal tunnel syndrome if pain, tingling, or numbness occurs.

What is the significance of a positive Finkelstein's test?

Indicates De Quervain's tenosynovitis through radial wrist/thumb pain.

What does the FABER test assess?

SI joint dysfunction or hip pathology through pain in the groin or posterior hip.

What does Gower's sign indicate?

Proximal lower extremity weakness, often seen in muscular dystrophy.

What does a positive McMurray test suggest?

A meniscal tear in the knee.

What does the Lachman test assess?

Anterior cruciate ligament (ACL) integrity, with a positive result indicating a tear.

What is the Ottawa Knee Rule?

Criteria for determining the need for X-ray in knee injuries, including age ≥55 or inability to bear weight.

What does the anterior drawer test of the ankle assess?

An ATFL tear or Achilles rupture through excess translation.

What are Heberden's and Bouchard's nodes associated with?

Hand osteoarthritis, with Heberden's at the DIP and Bouchard's at the PIP.

What does the term 'swan-neck deformity' indicate?

A late deformity in rheumatoid arthritis characterized by specific finger joint positioning.

What does a positive Thompson test indicate?

An Achilles tendon rupture if there is no plantar flexion when squeezing the calf.

What is the grading scale for ankle sprains?

Grade I = stretch/microtear, Grade II = partial tear, Grade III = complete rupture.

What is the purpose of the Glasgow Coma Scale (GCS)?

To assess traumatic brain injury based on eye, verbal, and motor responses.

What does the Modified Ashworth Scale measure?

Muscle spasticity from 0 (none) to 4 (rigid).

What are common pressure sore sites for wheelchair users?

Occiput, sacrum, ischial tuberosities, elbows, greater trochanters.

What does the glabellar reflex test indicate?

Frontal release sign if persistent blinking occurs after repeated tapping.

What does a positive Homan's sign suggest?

Possible deep vein thrombosis (DVT) if calf pain occurs during passive dorsiflexion.

What is the significance of the Ottawa Ankle/Foot Rules?

Criteria for determining the need for X-ray in ankle/foot injuries based on tenderness and weight-bearing ability.

What does the term 'crepitus' indicate in knee osteoarthritis?

Chronic pain and decreased range of motion associated with joint degeneration.

What does the term 'trigger finger' refer to?

Catching or locking of a digit, often associated with a nodule at the A1 pulley.

What does the term 'patellar apprehension' test for?

Patellar instability through pain or guarding when the patella is laterally translated.