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Flashcards in Cerebellar Deck (17)
1

What are the steps to a cerebellar examination?

Introduction
General inspection
Face
Focused Upper limb
Focussed lower limb
Complete

2

What needs to be done on general examination?

General appearance and accoutrements
Gait Ax
Postural Ax

3

What general signs of cerebellar disease might be observed on general inspection?

-Wheelchair
-Neurological signs
-Sigs of neglect
-Posture

4

How can gait assessment give us clues about cerebellar disease?

Walk with them.
Sit in chair to standing with arms folded.
Walk away then back, heel to toe if possible.

5

What does DANISH stand for?

Dysdiadochokinesia
Ataxia
Nystagmus
Intention tremor
Slurred/staccato speech
Hypotonia

6

How should posture be assessed?

Romberg test - ask pt to close eyes and assess stability (offer your hands to steady them if they are nervous)

7

What are the types of ataxia?

How do we test them?

Sensory (Romberg’s test)
Truncal (sit to stand with arms crossed)
Ataxic gait (watch them walk)

8

What cerebellar signs are tested in the face?

-H test for nystagmus and saccades
-Look from one target to another (hypometric saccades)
-Speech

9

How does the H test look for nystagmus?

Pause at the lateral gaze and watch for eye beats indicating nystagmus

10

What are saccades?

A quick simultaneous movement of both eyes between 2 or more phases of fixation in the same direction.

11

What speech tests are done in a cerebellar examination?

-Ask pt to say “west register street” , “baby hippopotamus”, and “british constitution”
-Move tongue side to side

12

What are the focussed upper limb tests or cerebellar examination?

-Pronator drift with rebound test
-Test for tone (hypotonia)
-Co-ordintion

13

How is co-ordination tested in upper limb?

-Finger-nose test
-Hand slapping

14

What does finger-nose test examine for?

Intention tremor
Dysmetria (past pointing)

15

What does hand slapping test check for?

Dysdiodochokinesia

16

What is examined for in lower limbs in cerebellar examination?

-Hypotonia
-Co-ordination with heel-shin test

17

What are the main causes of cerebellar disease?

MAVIS:

Multiple sclerosis
Alcohol
Vascular
Inherited
Space occupying lesions