Professional Documents
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Semiología Neurológica II Parte
Semiología Neurológica II Parte
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3. The Neurological
Examination
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Motor exam ___________________________________
Posture / Tone
spasticity, rigidity,
flaccidity
Bulk atrophy,
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hypertrophy,
fasciculations
Abnormal
movements ___________________________________
Strength
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3. The Neurological
Examination
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Motor exam ___________________________________
Posture / Tone
spasticity, rigidity,
flaccidity
Bulk atrophy,
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hypertrophy,
fasciculations
Abnormal
movements ___________________________________
Strength
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3. The Neurological
Examination
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Motor exam ___________________________________
Bulk atrophy, hypertrophy,
fasciculations
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3. The Neurological
Examination
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Motor exam ___________________________________
Tone spasticity,
rigidity, flaccidity
Bulk atrophy, ___________________________________
hypertrophy,
fasciculations
Abnormal
movements ___________________________________
Strength
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3. The Neurological
Examination
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Motor exam ___________________________________
Tone spasticity,
rigidity, flaccidity
Bulk atrophy, ___________________________________
hypertrophy,
fasciculations
Abnormal
movements ___________________________________
Strength
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3. The Neurological
Examination
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Motor exam ___________________________________
Tone spasticity,
rigidity, flaccidity
Bulk atrophy, ___________________________________
hypertrophy,
fasciculations
Abnormal
movements ___________________________________
Strength
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3. The Neurological
Examination
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Motor exam ___________________________________
Tone spasticity,
rigidity, flaccidity
Bulk atrophy, ___________________________________
hypertrophy,
fasciculations
Abnormal
movements ___________________________________
Strength
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3. The Neurological
Examination
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Motor exam ___________________________________
Abnormal
movements
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3. The Neurological
Examination
134 Grading Motor Strength
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3. The Neurological
Examination
149 Deep Tendon Reflexes
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Reflex Main Spinal Nerve Roots Involved
Biceps C5, C6
Brachioradialis C6 ___________________________________
Triceps C7
Patellar L4
Achilles Tendon S1
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Troemner
Babinski-Rabiner
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Taylor
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Queen Square
Dejerine
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Buck Hammer
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List Price: $7.89
Price: $7.42
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3. The Neurological
Examination
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D.T.Reflexes
Tendon Reflex Grading Scale ___________________________________
Grade Description
0 Absent
1+ or + Hypoactive ___________________________________
2+ or ++ "Normal"
4+ or
++++
Hyperactive with clonus
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3. The Neurological
Examination
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Abnormal Plantar Response
157 Chaddock
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Babinski
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Oppenheim
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Gordon
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Signo de Babinski
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Signo de Hoffmann Signo de Tromner
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REFLEJOS ATÁVICOS
(Reflejos de liberación cortical)
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Hociqueo – Snout reflex ___________________________________
Succión
Prehensión
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Palmomentoniano
Myerson
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3. The Neurological
Examination
161 Sensory Exam
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Primary sensory Cortical sensory
Pin and thermal Two point ___________________________________
Touch discrimination
Joint position
Graphestesia
Stereognosis
Vibration sense ___________________________________
Extinction
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3. The Neurological
Examination
Sensory Exam
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Errores al examinar sensibilidad
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3. The Neurological
Examination
168 Sensory Exam
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3. The Neurological
Examination
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Cerebellum (coordination) ___________________________________
Finger-Nose-Finger
Heel-Knee-Heel ___________________________________
Thumb tapping
Rapid Alternating Movements
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3. The Neurological
Examination
173 Cerebellum (coordination)
Finger-Nose-Finger
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3. The Neurological
Examination
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Cerebellum (coordination) ___________________________________
Heel-Knee-Heel
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3. The Neurological
Examination
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Cerebellum (coordination) ___________________________________
Thumb tapping
Rapid Alternating Movements
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3. The Neurological
Examination
178
Neck/spine ___________________________________
Inspection
Auscultation
Special maneuvers: ___________________________________
Nuchal rigidity
Kerning
Brudzinski
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3. The Neurological
Examination
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Neck/spine ___________________________________
Auscultation
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3. The Neurological
Examination
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Neck/spine
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Special
maneuvers:
Nuchal rigidity ___________________________________
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3. The Neurological
Examination
181
Neck/spine ___________________________________
Especial maneuvers:
Kernig’s sign
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3. The Neurological
Examination
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Neck/spine
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Especial
maneuvers:
Brudzinski ___________________________________
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3. The Neurological
Examination
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Station and gait ___________________________________
Observe posture
Romberg test
Observe gait and arm swing ___________________________________
Heel walk
Toe walk
Tandem gait ___________________________________
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3. The Neurological
Examination
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Station and gait ___________________________________
Observe posture
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3. The Neurological
Examination
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and gait
Station ___________________________________
Romberg test
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3. The Neurological
Examination
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Station and gait ___________________________________
Observe gait and arm swing
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3. The Neurological
Examination
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Marcha
Parética
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Atáxica
Espástica
Hemiparesia
Paraparesia
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Parkinsoniana: propulsión – festinación
Distrófica
Steppage
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191
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Signo de Gowers
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4. Neurological localization
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Upper Vs Lower
motor neuron
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Cortical Vs
Subcortical ___________________________________
UMN Level of lesion
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4. Neurological localization
Upper Vs Lower MN
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Upper Lower ___________________________________
•Flaccid weakness
Spastic weakness
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4. Neurological localization
196 Cortical Subcortical
Dense unilateral
Aphasia motor or sensory ___________________________________
Apraxia deficit
Agnosia Face/arm and leg
equally affected
Hemi sensory –
Clumsy hand –
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motor deficit
dysarthria
Face/arm > leg :
MCA Unilateral motor +
ipsilateral ataxia
Leg > arm/face : ___________________________________
ACA
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4. Neurological localization
197
UMN Level of lesion ___________________________________
Brainstem
Midbrain III, IV
Pons V, VI, VII, VIII
Medulla IX, X, XII,
corticospinal decussation ___________________________________
Cerebellum/peduncles ipsi, tremor,
ataxia
Spinal cord bilateral sensory and ___________________________________
motor, level
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4. Neurological localization
198 UMN Level of lesion
Brainstem ___________________________________
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4. Neurological localization
199 UMN Level of lesion
Cerebellum/peduncles ___________________________________
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4. Neurological localization
200 UMN Level of lesion
Spinal cord bilateral sensory and motor,
level ___________________________________
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4. Neurological localization
201 LMN level of lesion
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Anterior horn cell motor neuron
Muscle
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4. Neurological localization
LMN level of lesion
202
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5. Diagnostic tests
203 Imaging CT, MR
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EEG
EP ___________________________________
EMG
CSF
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5. Diagnostic tests
204
Imaging ___________________________________
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5. Diagnostic tests
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Imaging ___________________________________
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5. Diagnostic tests
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Imaging
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5. Diagnostic tests
207
ElectroEncephaloGraphy ___________________________________
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5. Diagnostic tests
208
Evoked
Potentials
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Visual
Auditory/brain
stem ___________________________________
Somatosensory
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5. Diagnostic tests
209
ElectroMyoGraphy ___________________________________
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5. Diagnostic tests
210
Cerebro-Spinal-Fluid ___________________________________
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Where is the lesion?
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Where is the lesion?
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Where is the lesion?
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Where is the lesion?
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Where is the lesion?
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Conclusiones
227
El éxito del examen ___________________________________
neurológico radica en:
Buena historia clínica
Saber extenderse o no en detalles
según lo amerite la historia clínica
Ser ORDENADO ___________________________________
Tener conocimientos de neuroanatomía
Correlacionar los hallazgos del examen
desde el punto de vista anatomo-
funcional
Tener coherencia y sentido común en ___________________________________
dicha correlación
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Adams and Victor's
Principles of
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Neurology
Allan Ropper and Martin
Samuels
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230
Clinical Neurology
(LANGE Clinical
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Medicine)
Michael Aminoff ,
Robert Simon,
David Greenberg ___________________________________
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Practical Neurology
José Biller
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