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Doctors
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Q.NO.1# SUMMARY OF NEUROLOGICAL HISTORY TAKING 1.
PRESENTING COMPLAINTS
·
Birth / pregnancy ·
Head and spine injury ·
Infections (meningitis,
encephalitis) ·
Surgical procedures ·
Drug therapy 3.
FAMILY HISTORY ·
Epilepsy, migraine, multiple
sclerosis, stroke, cerebral aneurism,muscle disorders, dementia, spinocerebellar
degenerations, and neuropathies 4.
SOCIAL HISTORY ·
Occupation ·
Marital status ·
Smoking habit ·
Alcohol consumption ·
Recreational drugs ·
Sexual orientation and habits Q.NO.2.
COMMON CAUSES OF HEADACHE 1.
EXTRACRANIAL DISORDERS §
Temporomendibular
joint(osteoarthritis) §
Cervical spine(cervical spondilosis) §
Opthalmological(glaucoma) §
Teeth(dental sepsis_) §
Middle ear(earache) §
Paranasal sinuses(sinusitis) Arteries(cranial
arthritis) 2.
INTRACRANIAL DISORDERS §
Migraine §
Meningitis §
Intracranial hypertension §
Tumour §
Subarachnoid bleed 3.
PSYCHOMOTOR DISORDERS § Tension headache QUESTION
. NO. 3 CLASSIFICATION OF SEIZURES
GENERALIZED SEIZ. §
Absence attacks--petit mal (3 hz
spike and wave) §
Myoclonic seizures--myoclonic jerks §
Tonic---clonic seizures of grand
mal or major fits §
Tonic seizures §
Atonic or akinetic seizures
PARTIAL SEIZURES §
Simple partial seiz.—no loss of
conciousness §
Complex partial seiz.--------loss
of conciousness §
Partial seiz. Evolving into
generalized seiz. §
Generalized seiz. With only EEG
evidence of local onset PSEDO SEIZURES-----------no
epileptic attacks Q
. NO. 4# CHECKLIST
FOR HISTORY OF FALLS WAS IT AN ACCIDENTAL
FALL.? §
Recall of event §
Trip or slip §
Walking surface §
Footware §
Illumination §
Visual acuity WAS IT A SPONTANEOUS
FALL? §
Preceding symptoms §
Onset with head movement or
standing upright §
Ass. Symptoms pf vertigo deafness
or tinnitus §
Ass. Chest pain or palpitation §
Awareness of hitting the ground §
Eyewitness account §
Resulting injuries or incontinence §
Recall of events att
the time §
Ability to regain erect posture §
Previous confusion , dementia. Or
parkinsonism §
Previous hypertension, blackout, or
epilepsy §
Dryg therapy----antidepressants,
hypnotics, hypotensive agents, §
Alcohol consumption Q.
NO. 5# THE
NERVOUS SYSTEM-GENERAL OBSERVATIONS §
Gait §
Rombergs, test §
Speech and handwriting §
Mental status §
Facial appearance §
Involuntary movements §
Movements of neck and soine Q. NO 6# CAUSES
OD DYSARTHRIA AND DYSTONIA
Q.NO.7# EXAMINTION OF SPEECH AND LANGUAGE
Q. NO.8# ETIOLOGICAL
CLUES IN THE HISTORY OF EPILEPSY
Q.NO.9# PATTERNS OF VERTIGO
AND THEIR CAUSES ACUTE
ACUTE AND RECURRENT
CHRONIC AND
PERSISTENT
Q
NO 10.# COMMON CAUSES OF
HEADACHE
INTRACRANIAL
DISORDERS §
Migraine §
Meningitis §
Intracranial hypertension §
Tumour §
Subarachnoid bleed PSYCHOMOTOR
DISORDERS §
Tension headache Q.NO.11# RELATION B/W CAUSE
AND SITE OF HEADACHE
Q.NO12# DRUGS AFFECTING THE
PUPIL
COMMON
FEATURES IN OPTIC NERVE LESIONS
Q. NO 13# COMMON
CAUSES OF VII NERVE PALSIES
UPPER MOTOR NEURON TYPE WEAKNESS
LOWER MOTOR NEURON TYPE WEAKNESS
Q.NO 14# COMMON
CAUSES OF DEAFNESS Conduction
Deafness
Q.NO 15# COMMON CAUSES OF IX AND X NERVE LSESIONS UNILATERAL
OF IX AND X §
Skull base neoplasms including
meningioma §
Skull base factures RECURRENT
LARYNGEAL §
Bronchial carcinoma
§
Mediastinal lymphoma §
Aortic aneurism §
BRONCHIAL carcinoma §
Mediastinal lymphoma §
Aortic arch aneurism BILATERAL X §
Progressive bulbar palsy §
Bilateral supranuclear lesions §
Cerbrovascular disease §
Multiple sclerosis Q. NO 16# PARALYSIS
OF MOTOR DYSFUCTION §
Paralysis or weakness §
Impairment of coordination §
Changes in tone and posture –dystonia §
Involuntary movements---dyskinesia §
Changes in the rate at wch
movements are performed—hypokinesia and bradykinesia §
Loss of learned movement pattern Q.
NO 17# CAUSES
OF MUCLE WEAKNESS
Q. NO 18# TYPES
PF TREMOR
Q/NO.19# MRC
SCALE FOR MUSCLE POWER
Q. NO 20# ONE
METHOD OF TESTING MOTOR SYSTEM 1)TEST
IN A PROXIMO DISTAL DIRECTION IN UPPER LIMB EXAM
FOR §
Abd. And add. Of shoulder §
Flex. And ext. of shoulder §
Flex. And ext. of elbow §
Flex. And ext. of wrist §
Sup. And pron. Of forearm §
Extension of fingers at both MP AND
IP joints §
test abdominal muscles
BY ASKING THE SUPINE pt to flex neck or sit forward IN LOWER LIMB EXAM.
FOR §
Hip flex. And ext. add. And abd. §
Knee flex. And ext. §
Foot dorsiflex. Planter flexion ,
inv. And eversion , toe planter
flex. And dorsiflexion Q. NO 21# SIGNS
ATTRIBUTABLE TO LESIONS IN DIFF. PARTS AND PATHS OF NERVOUS SYSTEM 1)UPPER MOTOR NEURON
LESIONS §
Weakness and paralysis of movement §
Inc. in tone of clasp knife type §
Inc. amplitude o ftendon
reflexes §
An extensor planter response 2)LOWER MOTOR NEURON
LESIONS §
Weakness and paralysis of muscles §
Wasting of muscles and
fasciculations §
Red. In tone §
Loss of tendon reflexes 3)EXTRAPYRAMIDAL
LESIONS ·
Resting tremor ·
Rigidity cogwheel or lead pipe ·
Bradykinesia ,expressionless face,
festinent gait i)CEREBELLAR LESIONS ·
Ataxia ·
Intension tremor of limbs ·
Jerking nystagmus ·
Dysarthria of staccato or scanning
type ·
Dysmetria and past pointing ·
Hypotonia and pendular
tendon reflexes ·
Smooth movements may be replaced
wth jrking movements 1)GEN. NEUROPATHIES ·
Dim. Of superf. Sensation affecting
the distal aspect of limbs wth
stocking and gloves distribution ·
Wasting and weakness of distal limb
musculature ·
Early loss of tendonreflexes 2)SENSORY TRACTS DORSAL COLOUMNS ·
ataxia of gait and limb movement
aggravated by eye closure +ve
roomberg test ·
impaired position sense ·
dim. Appreciation of vibration 1.
LAT. SP. THALMIC TRACT ·
Impaiment of pain and temperature
sense 2.
MUSCLES ·
Wasting and weakness usually
proximal ·
Red. In reflexes when muscle
wasting is marked 3.
CEREBRAL CORTEX DYSFUNCTION ·
Dysphasia and dyscalculia ·
Rt and Lt disorientation ·
Astereognosis sensory attention ·
Apraxia ·
Amnesia and cognitive disorder ·
Visual field homonymous defects ·
Hemiparesis , monoparesis ABNORMALITIES
OF INTENSITY OF IST HEART SOUND QUIET §
Low cardiac output §
Poor left ventricular function §
Long P R interval §
Ist degree heart block §
Rheumatic mitral regurgitation LOUD §
inc cardiac output §
Large st. vol §
Mitral stenosis §
Short P R interval §
Atrial myxoma §
VARIABLE §
Atrial fibrillation §
Extrasystoles §
Comp. heart block ABNORMALITIES
OF SECOND HEART SOUND QUIET § Low card. Output § Calcific aortic stenosis § Aortic incompetent LOUD §Systemic hypertension §Pulm. Hypertension §SPLIT §Widens in inspiration §RBBB §Pulm. Stenosis §Pulm. Hypertension §VSD §Fixed splitting §ASD §Widens in expiration §Aortic stenosis §Hypertrophic cardiomyopathy §LBBB §Vent. Pacemaker --------------------------------------------------------------------------- CAUSES
OF 3RD HEART SOUND 1)PHYSIOLOGICAL §
healthy young adults §
athletes §
pregnancy §
fever 2)PATHOLOGICAL §
large poor contracting
left ventricle §
mitral reflux GRADES
OF INTENSITY OF MURMUR §
heard by an expert in optimum
conditions §
same by
a non expert §
easily heard , no thrill §
a loud murmur wth a thrill §
very loud often heard over a large
area with a thrill §
extremely loud heard with a steth. CAUSES
OF A SYSTOLIC MURMUR EJECTION SYSTOLIC
MURMUR §
Inc. flow through normal valves §
Innocent systolic murmur §
Fever §
Athletes §
Pregnancy §
ASD NORMAL OR REDUCED
FLOW THROUGH STENOTIC VALVE § Aortic and pulm. Stenosis OTHER CAUSES OF FLOW
MURMUR §
Hypertrophic obst. Cardiomyopathy §
Acute regurgitation PANSYSTOLIC MURMUR §
All caused by a systolic leak from
a high to a low pressure chamber §
Mitral reg. §
Tricuspid reg. §
VSD §
Leaking tricuspid or mitral
prosthesis §
Mitral valve prolapse COMMON
VENOUS ABNORMALITIES DVT §
varicose veins §
superficial thrombophlebitis §
chronic venous insufficiency
and ulceration DEEP
VENOUS THROMBOSIS Ask
about §
recent bed rest or operation §
recent travel esp. long air travel §
previous trauma to leg , esp . long
bones fractures, plaster of paris splintage,and immobilization §
pregnancy §
previous DVT §
family history of thrombosis §
recent central venous
cathetrisation injections of
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