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Abnormal Gait Exam : Myopathic Gait Demonstration
 
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more medical videos on : http://medicofiles.com Myopathic Gait Demonstration With muscular diseases, the proximal pelvic girdle muscles are usually the most weak. Because of this the patient will not be able to stabilize the pelvis as they lift their leg to step forward, so the pelvis will tilt toward the non-weight bearing leg which results in a waddle type of gait.
Views: 401505 onlinemedicalvideo
Anatomy Motor Exam: Traps
 
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Visit Us on Http://onlinemedicalvideo.com for more free medical video Traps Hypertonia can be either spasticity or rigidity. Spasticity is from a UMN lesion. It is rate dependent resistance on range of motion with collapse of the resistance at the end of the range of motion. This is called the clasp-knife phenomena. Rigidity is from basal ganglia disease. The resistance to range of motion is not rate or force dependent and is constant throughout the range of motion. This is often referred to as lead pipe or plastic-like rigidity
Views: 72435 onlinemedicalvideo
Abnormal Gait Exam : Ataxic Gait Demonstration
 
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Complete Series in http://medicofiles.com Ataxic Gait Demonstration The patient's gait is wide-based with truncal instability and irregular lurching steps which results in lateral veering and if severe, falling. This type of gait is seen in midline cerebellar disease. It can also be seen with severe lose of proprioception (sensory ataxia)
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Abnormal Gait Exam : Hemiplegic Gait Demonstration
 
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more medical videos on : http://medicofiles.com Hemiplegic Gait Demonstration The patient has unilateral weakness and spasticity with the upper extremity held in flexion and the lower extremity in extension. The foot is in extension so the leg is "too long" therefore, the patient will have to circumduct or swing the leg around to step forward. This type of gait is seen with a UMN lesion.
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Abnormal Gait Exam : Diplegic Gait Demonstration
 
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more medical videos on : http://medicofiles.com Diplegic Gait Demonstration The patient has spasticity in the lower extremities greater than the upper extremities. The hips and knees are flexed and adducted with the ankles extended and internally rotated. When the patient walks both lower extremities are circumducted and the upper extremities are held in a mid or low guard position. This type of gait is usually seen with bilateral periventricular lesions. The legs are more affected than the arms because the corticospinal tract axons that are going to the legs are closest to the ventricles.
Views: 317294 onlinemedicalvideo
Abnormal Gait Exam : Ataxic Gait
 
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more medical videos on : http://medicofiles.com Ataxic Gait This woman's gait is wide-based and unsteady. She has to use a walker or hold on to someone in order to maintain her balance (note how hard she has to work with the hand that she's holding on with in order to maintain her balance). Her ataxia is even more apparent when she tries to turn.
Views: 97087 onlinemedicalvideo
Abnormal Gait Exam : Parkinsonian Gait Demonstration
 
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more medical videos on : http://medicofiles.com Parkinsonian Gait Demonstration This type of gait is seen with rigidity and hypokinesia from basal ganglia disease. The patient's posture is stooped forward. Gait initiation is slow and steps are small and shuffling; turning is en bloc like a statue.
Views: 324792 onlinemedicalvideo
Abnormal Gait Exam : Choreiform Gait Demonstration
 
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more medical videos on : http://medicofiles.com Choreiform Gait Demonstration This is a hyperkinetic gait seen with certain types of basal ganglia disorders. There is intrusion of irregular, jerky, involuntary movements in both the upper and lower extremities.
Views: 311867 onlinemedicalvideo
Anatomy Motor Exam: Decorticate vs. Decerebrate
 
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Visit Us on Http://onlinemedicalvideo.com for more free medical video Decorticate vs. Decerebrate A UMN lesion above the level of the red nucleus will result in decorticate posture (thumb tucked under flexed fingers in fisted position, pronation of forearm, flexion at elbow with the lower extremity in extension with foot inversion) while a lesion below the level of the red nucleus but above the level of the vestibulospinal and reticulospinal nuclei will result in decerebrate posture (upper extremity in pronation and extension and the lower extremity in extension). The reason for this is that the red nucleus output reinforces antigravity flexion of the upper extremity. When its output is eliminated then the unregulated reticulospinal and vestibulospinal tracts reinforce extension tone of both upper and lower extremities. If there is a lesion in the medulla then all the brainstem motor nuclei as well as the direct corticospinal tract would be out and the patient would be flaccid acutely. If the patient were to survive, tone would return because of interneuronal activity at the spinal cord level
Views: 53992 onlinemedicalvideo
Pediatric-Neuro Exam 6 month: Cranial Nerves
 
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Cranial Nerves The baby is able to visually track an object throughout the horizontal and vertical planes. An interesting or colorful object is most helpful. To test visual fields, have the baby focus on an object in front of him and then bring a second object from behind him until he sees the object in his peripheral vision. He should turn toward the new object. Saccadic eye movements are tested by using interesting toys and sounds and watching the eyes jump from object to object. To test hearing, produce a sound out of the babys sight and then watch the baby turn and localize the sound. Facial movements are noted as the baby smiles or cries.
Views: 44293 onlinemedicalvideo
Abnormal Gait Exam : Neuropathic Gait Demonstration
 
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more medical videos on : http://medicofiles.com Neuropathic Gait Demonstration This type of gait is most often seen in peripheral nerve disease where the distal lower extremity is most affected. Because the foot dorsiflexors are weak, the patient has a high stepping gait in an attempt to avoid dragging the toe on the ground.
Views: 264081 onlinemedicalvideo
Normal Sensory Exam :Pain -- Upper Extremities
 
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Pain -- Upper Extremities Pain is one of the principle sensory modalities of the spinothalamic system. The sharp end of a broken wooden cotton tip applicator can be used then discarded. It is important for the patient to be able to identify the sensation as sharp and then compare between dermatomes, distal versus proximal and right versus left for the upper extremities.
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Normal Sensory Exam ; Stereognosis
 
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Stereognosis Stereognosis is the ability to identify objects that are placed in the hand when the eyes are closed. The patient is given common objects and asked to identify them without looking at them. The inability to do this called astereognosis and indicates parietal lobe dysfunction
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Abnormal Sensory Exam : Pain -- Upper Extremities
 
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Visit Us on http://onlinemedicalvideo.com Pain -- Upper Extremities A sharp wooden stick is used to delineate the area of decreased sharp sensation. There is loss over the ulnar side of the right hand as well as the ulnar aspect of the forearm but the arm is normal. This loss is constant with a C8-T1 dermatome distribution.
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Normal Sensory Exam ; Tactile Movement
 
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Tactile Movement Tactile movement as well as the remaining sensory tests are discriminatory sensory tests that examine cortical somatosensory (parietal lobe) function and require an intact DCML system. Tactile movement tests the patient's ability to detect the direction of a 2-3 cm cutaneous stimulus.
Views: 35720 onlinemedicalvideo
Abnormal Coordination Exam ; Finger-to-nose
 
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Finger-to-nose Under (hypometria) and over (hypermetria) shooting of a target (dysmetria) and the decomposition of movement (the breakdown of the movement into its parts with impaired timing and integration of muscle activity) are seen with appendicular ataxia.
Views: 84130 onlinemedicalvideo
physical exam -Newborn Normal:Behavior
 
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Visit http://goo.gl/grqwY for complate series This 5-day-old infant is in the alert, quiet state. He has spontaneous movements, which have a smooth flowing quality to them and are not excessive, jerky or asymmetric. He seems to be attentive to the environment. He makes attempts to organize and comfort himself by sucking on his fists, which is a favorable behavioral response. When a bright light is directed towards his eyes he has a definite response, which consists of blinking and avoiding the light. With repeated stimulus there is habituation, a diminished response to the stimulus. He responds to sound by quieting and even turning is head and eyes toward the sound. The above observations are the baby equivalent to the adult mental status exam
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Motoric System Exam : Strength testing
 
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Strength testing Muscle strength is tested from the proximal to the distal part of the extremity so that all segmental levels for the extremity are tested (for the upper extremity that is C5 to T1 -- see table). Muscle power is graded on a scale of 0-5 (see table) Strength Testing C5 -- Shoulder extension C6 -- Arm flexion C7 -- Arm extension C8 -- Wrist extensors T1 -- Hand grasp Muscle Strength Grading 0 -- No contraction 1 -- Slight contraction, no movement 2 -- Full range of motion without gravity 3 -- Full range of motion with gravity 4 -- Full range of motion , some resistance 5 -- Full range of motion, full resistance
Views: 47323 onlinemedicalvideo
NeuroLogic Exam: Mental Status-AbNormal: Expressive language
 
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Expressive language This patient with expressive aphasia has normal comprehension but her expression of language is impaired. Her speech output is nonfluent and often limited to just a few words or phases. Grammatical words such as prepositions are left out and her speech is telegraphic. She has trouble saying no ifs , ands or buts. Her ability to write is also effected. Patients with expressive aphasia are aware of their language deficit and are often frustrated by it. Recovery can occur but is often incomplete with their speech consisting of short phrases or sentences containing mainly nouns and verbs.
Views: 21654 onlinemedicalvideo
Normal Sensory Exam : Light Touch
 
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Light Touch Light touch (thigmesthesia) is used as a screening test for touch. Both the spinothalamic and DCML systems serve this sensation so it is not specific for either one. A cotton tip applicator or fine hair brush is used. Select areas from different dermatomes and peripheral nerves and compare right versus left.
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Abnormal Sensory Exam : Pain -- Lower Extremities
 
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Visit Us on http://onlinemedicalvideo.com Pain -- Lower Extremities This patient has a sensory level at T3 with decreased pain sensation below the level including the leg. The sensory level is one to two spinal cord segment levels below the actual anatomical cord lesion because the spinothalamic axons ascend several spinal cord levels prior to crossing. The left sided T3 sensory level combined with this patient's upper extremity sensory finding indicates a lesion of the right side of the spinal cord at the C8-T1 level.
Views: 8714 onlinemedicalvideo
neurology exam: newborn-abnormal: Reflexes - Deep Tendon Reflexes
 
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Complete Series in http://goo.gl/LjZrt or http://medicofiles.com Reflexes - Deep Tendon Reflexes Testing deep tendon reflexes on this baby demonstrates that they are present. This is important in trying to sort out if the baby has low tone from an upper motor neuron lesion or if he has a lower motor neuron or muscle disorder. In older children and adults, an upper motor lesion causes spasticity but in babies an upper motor neuron lesion can cause hypotonia. A disease of the lower motor neuron is unlikely with the deep tendon reflexes being present. The baby could still have a muscle disorder but inspection of the muscles does not show diminished mass and the babys behavior and the rest of the neurological exam indicates an upper motor neuron problem.
Views: 38347 onlinemedicalvideo
NeuroLogic Exam: Mental Status-Normal:  Orientation, Memory
 
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Orientation, Memory Asking questions about month, date, day of week and place tests orientation, which involves not only memory but also attention and language. Three-word recall tests recent memory for which the temporal lobe is important. Remote memory tasks such as naming Presidents, tests not only the temporal lobes but also heteromodal association cortices.
Views: 12576 onlinemedicalvideo
Abnormal Coordination Exam ; Hand Rapid Alternating Movements
 
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Hand Rapid Alternating Movements Movements are slow and irregular with imprecise timing. Inability to perform repetitive movements in a rapid rhythmic fashion is called dysdiadochokinesia.
Views: 51680 onlinemedicalvideo
Neurologic Exam Cranial Nerves Normal : Cranial Nerve 8- Auditory Acuity, Weber & Rinne Tests
 
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more medical video and 3d medical animation visit Http://onlinemedicalvideo.com Cranial Nerve 8- Auditory Acuity, Weber & Rinne Tests The cochlear division of CN 8 is tested by screening for auditory acuity. This can be done by the examiner lightly rubbing their fingers by each ear or by using a ticking watch. Compare right versus left. Further screening for conduction versus neurosensory hearing loss can be accomplished by using the Weber and Rinne tests. The Weber test consists of placing a vibrating tuning fork on the middle of the head and asking if the patient feels or hears it best on one side or the other. The normal patient will say it is the same in both ears. The patient with unilateral neurosensory hearing loss will hear it best in the normal ear while the patient with a unilateral conductive hearing loss will hear it best in the abnormal ear. The Rinne test consists of comparing bone conduction (placing the tuning fork on the mastoid process) versus air conduction (placing the tuning fork in front of the pinna). Normally, air conduction is greater than bone conduction. For neurosensory hearing loss air conduction is still greater than bone conduction but for conduction hearing loss bone conduction will be greater than air conduction
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Normal Sensory Exam ; Position Sense
 
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Position Sense Position sense (proprioception), another DCML sensory modality, is tested by holding the most distal joint of a digit by its sides and moving it slightly up or down. First, demonstrate the test with the patient watching so they understand what is wanted then perform the test with their eyes closed. The patient should be able to detect 1 degree of movement of a finger and 2-3 degrees of movement of a toe. If the patient can't accurately detect the distal movement then progressively test a more proximal joint until they can identify the movement correctly.
Views: 74117 onlinemedicalvideo
Abnormal Cranial Nerve Exam : Cranial Nerve 5- Sensory
 
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Visit us on http://onlinemedicalvideo.com for more free medical video and animation Cranial Nerve 5- Sensory There is a sensory deficit for both light touch and pain on the left side of the face for all divisions of the 5th nerve. Note that the deficit is first recognized just to the left of the midline and not exactly at the midline. Patients with psychogenic sensory loss often identify the sensory change as beginning right at the midline.
Views: 14135 onlinemedicalvideo
Pediatric-Neuro Exam 6 month: Motor - Hand
 
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Motor - Hand The baby is able to reach out and pick up an object and bring it to the midline, usually to his mouth. He reaches equally well with either hand. Hand preference before one year of age is always abnormal and indicates a motor deficit in the non-preferred hand. At this age, the baby is able to transfer an object from hand to hand. By 5 to 6 months, a baby grasps objects that are the size of a cube. An ulnar or palmer grasp is a raking motion with the fingers trapping the object against the palm. The next stage of hand development is to use the thumb in concert with the fingers to grasp an object. This is called a whole hand grasp. The baby is starting to use the thumb so has developed a whole hand grasp. A thumb-finger pincer grasp develops at 7 to 9 months.
Views: 23916 onlinemedicalvideo
Pediatric-Neuro Exam 6 month: Position - Prone
 
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Position - Prone In the prone position, the baby brings his chest all the way off the mat and supports his weight on his hands, not his forearms. He works for toys out of his reach. He is close to crawling. He can roll over from front to back and back to front.
Views: 12641 onlinemedicalvideo
physical exam -Newborn Normal: Tone-Popliteal Angle
 
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visit http://goo.gl/grqwY for more complete series The popliteal angle is an assessment of the tone of the hamstring muscles. It is done one leg at a time. The thigh is flexed on the abdomen with one hand and then the other hand straightens the leg by pushing on the back of the ankle until there is firm resistance to the movement. The angle between the thigh and the leg is typically about 90 degrees. Extension of the leg beyond 90 to 120 degrees would be seen in hypotonia.
Views: 35412 onlinemedicalvideo
Pediatric-Neuro Exam 6 month: Reflexes - Deep Tendon Reflexes
 
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Reflexes - Deep Tendon Reflexes It is hard to get the baby relaxed and cooperative enough to get the limb in the optimal position for obtaining deep tendon reflexes. At this age, all the deep tendon reflexes tested in an adult exam should be obtainable.
Views: 15460 onlinemedicalvideo
NeuroLogic Exam: Mental Status-Normal: Expressive language
 
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Expressive language In assessing expressive language it is important to note fluency and correctness of content and grammar. This can be accomplished by tasks that require spontaneous speech and writing, naming objects, repetition of sentences, and reading comprehension.
Views: 7003 onlinemedicalvideo
Normal Sensory Exam ; Two-Point Discrimination
 
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Two-Point Discrimination Two-point discrimination is tested by using calipers or a fashioned paper clip. The smallest and most dense sensory units are located in those areas that have the greatest somatosensory cortical representation. The patient should be able to recognize two-point separation of 2-4 mm on the lips and finger pads, 8-15 mm on the palms and 3-4 cm on the shins.
Views: 130268 onlinemedicalvideo
NeuroLogic Exam Videos : Introduction
 
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"Window" to the Brain Anatomy and pathology of the nervous system is understood by directly visualizing it. This is best accomplished by handling the brain (or model of the brain as the case may be) and dissecting or taking it apart for direct examination. The purpose (for the clinician) of understanding neuroanatomy and neurophysiology is to be able to use that knowledge to solve clinical problems. The first step in solving a clinical problem is anatomical localization. So, if one cannot directly inspect the patient's brain, how is this localization accomplished? The "window" to the patient's brain is the neurological examination. The neuro exam is a series of tests and observations that reflects the function of various parts of the brain. If the exam is approached in a systematic and logical fashion that is organized in terms of anatomical levels and systems then the clinician is lead to the anatomical location of the patient's problem.
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Abnormal Motoric Exam : Strength testing
 
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Visit Us http://onlinemedicalvideo.com for more medical video collection Strength testing With an UMN lesion the fine, fractionated movements of the fingers and hand are lost. Distal extremity weakness is greater than proximal weakness. With greater effort to move the paretic hand, there is overflow activation of proximal muscles and even of the contralateral hand, which produces mirror or synkinetic movements.
Views: 7532 onlinemedicalvideo
Motoric System Exam : Strength testing
 
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Strength testing Muscle strength is tested from the proximal to the distal part of the extremity so that all segmental levels for the extremity are tested (for the lower extremity that is L2 to S1 -- see table). Muscle power is graded on a scale of 0-5 (see table) Strength Testing L2 -- Hip flexion L3 -- Knee extension L4 -- Knee flexion L5 -- Ankle dorsiflexon S1 -- Ankle plantar flexion Muscle Strength Grading 0 -- No contraction 1 -- Slight contraction, no movement 2 -- Full range of motion without gravity 3 -- Full range of motion with gravity 4 -- Full range of motion, some resistance 5 -- Full range of motion, full resistance
Views: 25885 onlinemedicalvideo
Neurologic Exam Cranial Nerves Normal : Cranial Nerve II- Visual fields
 
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Cranial Nerve II- Visual fields There are several different screening tests that can be used to assess visual fields at the bedside. First hold up both hands superiorly and inferiorly and ask the patient if they can see both hands and do they look symmetric. Then test each eye individually using your fingers in the four quadrants of the visual field and ask the patient to count fingers held up or point to the hand when a finger wiggles using yourself as a control. A second screening test is to use a grid card. Have the patient focus on the dot in the center of the grid then ask if any part of the grid is missing or looks different. A third method is to use a cotton tip applicator. Testing one eye at a time ask the patient to say "now" as soon as they see the applicator come into their side vision as they focus on the examiner's nose. All of these tests are screening tests. Formal perimetry is the most accurate way of assessing visual fields
Views: 61043 onlinemedicalvideo
NeuroLogic Exam: Mental Status-Normal: Gnosis
 
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Gnosis Gnosis is the ability to recognize objects perceived by the senses especially somatosensory sensation. Having the patient (with their eyes closed) identify objects placed in their hand (stereognosis) and numbers written on their hand (graphesthesia) tests parietal lobe sensory perception.
Views: 7166 onlinemedicalvideo
Normal Sensory Exam ; Graphesthesia
 
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Graphesthesia Graphesthesia is the ability of the patient to identify characters that are written on the skin using a dull pointed object. The examiner demonstrates the test by writing single numbers on the palm of the hand while the patient is watching. The patient then closes their eyes and identifies numbers that are written by the examiner.
Views: 35904 onlinemedicalvideo
NeuroLogic Exam: Mental Status-Normal: Non-dominant parietal lobe function
 
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Non-dominant parietal lobe function The non-dominant parietal lobe is important for visual spatial sensory tasks such as attending to the contralateral side of the body and space as well as constructional tasks such as drawing a face, clock or geometric figures.
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Motoric System Exam : Stretch or Deep Tendon Reflexes
 
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Stretch or Deep Tendon Reflexes A brisk tap to the muscle tendon using a reflex hammer produces a stretch to the muscle that results in a reflex contraction of the muscle. The muscles tested, segmental level, and grading of DTR's is listed below. Levels for DTR's Biceps -- C5-6 Brachioradialis -- C5-6 Triceps -- C7 Finger Flexors -- C8 Grading DTR's 0 -- Absent 1 -- Decreased but present 2 -- Normal 3 -- Brisk and excessive 4 -- With clonus
Views: 48556 onlinemedicalvideo
neurology exam: newborn-abnormal: Reflexes - Plantar Reflex
 
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Complete Series in http://goo.gl/LjZrt or http://medicofiles.com Reflexes - Plantar Reflex On stroking the lateral aspect of the plantar surface of the foot the toes are up going which is a normal finding for the baby.
Views: 46060 onlinemedicalvideo
physical exam -Newborn Normal: Primitive Reflexes - Grasp
 
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visit http://goo.gl/grqwY for more complete series Primitive Reflexes - Grasp Placement of the examiners finger in the palm of the hand or on the sole of the foot will cause flexion and grasping of the fingers or toes. One should avoid touching the dorsum of the hand while eliciting the grasp reflex because stimulating the back of the hand causes a hand opening reflex to occur. With the two competing reflexes, the grasp response will be incomplete or inconsistent. You can actually see this happen with the baby that is being examined. The grasp reflex can be reinforced by applying traction on the arm. http://medicofiles.com
Views: 66576 onlinemedicalvideo
NeuroLogic Exam: Mental Status-AbNormal: Attention-working memory
 
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Attention-working memory The patient has difficulty with digit span backwards, spelling backwards and giving the names of the months in reverse order. This indicates a problem with working memory and maintaining attention, both of which are frontal lobe functions
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NeuroLogic Exam: Mental Status-Normal: Judgement-abstract reasoning
 
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Judgement-abstract reasoning These frontal lobe functions can be tested by using problem solving, verbal similarities and proverbs
Views: 7476 onlinemedicalvideo
physical exam -Newborn Normal: Tone - Scarf Sign
 
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visit http://goo.gl/grqwY for more complete series The tone of the shoulder girdle is assessed by taking the babys hand and pulling the hand to the opposite shoulder like a scarf. The hand should not go past the shoulder and the elbow should not cross the midline of the chest.
Views: 31227 onlinemedicalvideo
Neurologic Exam Cranial Nerves Anatomy : an introduction
 
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Introduction Examination of the cranial nerves allows one to "view" the brainstem all the way from its rostral to caudal extent. The brainstem can be divided into three levels, the midbrain, the pons and the medulla. The cranial nerves for each of these are: 2 for the midbrain (CN 3 & 4), 4 for the pons (CN 5-8), and 4 for the medulla (CN 9-12). It is important to remember that cranial nerves never cross (except for one exception, the 4th CN) and clinical findings are always on the same side as the cranial nerve involved. Cranial nerve findings when combined with long tract findings (corticospinal and somatosensory) are powerful for localizing lesions in the brainstem.
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Neuro exam 12 Month: Motor/Coordination - Pincer Grasp
 
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Motor/Coordination - Pincer Grasp Fine motor coordination of the hand progresses in a definite pattern. At 6-7 months the hand is used as a rake and objects are raked into the palm with the fingers. At 8-9 months the thumb and the radial fingers are used to grasp an object and smaller objects are picked up. At 10-12 months, the fine pincer grasp is developed. This enables an infant to pick up a small object between the distal thumb and index finger. Both infants in this exam have developed a pincer grasp. The first infant uses the pincer grasp to feed himself a cheerio. The second infant demonstrates a pincer grasp by grabbing the tip of a measuring tape and pulling the tape out. The pincer grasp should be equal in either hand. Handedness does not develop until after 12 months of age. Early handedness and asymmetric fine motor skills are seen with a hemiparesis.
Views: 18920 onlinemedicalvideo
Normal Sensory Exam ; Temperature
 
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Temperature Temperature is the other sensory modality that is used to test the spinothalamic system. Tubes or vials of hot and cold water can be used but this is usually impractical. Using a tuning fork, which is normally perceived as cool or cold to the touch, compare between dermatomes and right versus left.
Views: 31960 onlinemedicalvideo
Neurologic Exam Cranial Nerves Anatomy :  Cranial nerves 9 and 10
 
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Cranial nerves 9 and 10 These two nerves are clinically lumped together. Motor wise, they innervate pharyngeal and laryngeal muscles. Their sensory component is sensation for the pharynx and taste for the posterior one-third of the tongue.
Views: 2321 onlinemedicalvideo

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