A good neurological assessment includes:
Decorticate: notice the FLEXION of the arms toward to cor (center of the body). deCORticate
Decerebrate: notice the EXTENSION of the arms. dEcErEbratE has lots of “E’s” like ExtEnsion.
Newborns have several reflexes that are critical for their survival and development. These reflexes are automatic and involuntary responses to certain stimuli. They include:
The upper motor neuron descends in the spinal cord to the spinal nerve root. The upper motor neuron synapses with the lower motor neuron in the ventral horn of the spinal cord. The lower motor neuron then innervates the skeletal muscle.
Lower motor neuron lesions present with muscle atrophy, fasciculations (muscle twitching), decreased reflexes, decreased tone, and flaccid paralysis. Think Lower = Low tone (flaccid paralysis), low reflexes, and atrophy (low muscle tone)
Upper motor neuron lesions present with weakness, spasticity (spastic paralysis), clonus, and hyperreflexia. Upper = high tone, hyper (high reflexes) and spastic (high tone paralysis),
Upper motor neuron damage: cerebral palsy, traumatic head injuries, and spinal cord injuries.
Lower motor neuron damage: muscular dystrophy, spinal muscular atrophy, and peripheral nerve injuries.Â
Kernig Sign = Knee Extension is painful
BrudziNsKi Sign = Neck Flexion leads to Knee Flexion
Meningitis is a serious and potentially life-threatening infection of the protective membranes that cover the brain and spinal cord. The signs and symptoms of meningitis include fever, headache, nausea or vomiting, stiff neck, sensitivity to light, confusion, and seizures.
Other signs that may indicate meningitis include a rash of tiny, red or purple spots that appear anywhere on the body, irritability, drowsiness, and difficulty waking up. In infants, meningitis may present with a bulge in the soft spot on the top of the head, a high-pitched cry or moaning, and poor feeding.
All the other reflexes disappear around 3 to 6 months. Babinski reflex may be present up 12 months or a little longer.
Kernig's sign is used to diagnose meningitis
This is important to know: Upper motor neuron damage= weakness, spasticity (spastic paralysis), clonus, and hyperreflexia. Lower motor neuron lesions present with muscle atrophy, fasciculations (muscle twitching), decreased reflexes, decreased tone, and flaccid paralysis. Positive Romberg's test is an inability to maintain an erect posture over 60 seconds with eyes closed (important in multiple sclerosis).
Nystagmus is a condition where the eyes move rapidly and uncontrollably. They can move: side to side (horizontal nystagmus), up and down (vertical nystagmus), in a circle (rotary nystagmus).
I did not tell you about this. Did you choose the right answer. We are talking about motor neurons so motor cortex makes sense.
One of my students had this quesion on her NCLEX, so I just wanted to surprise you. Duchenne Muscular Dystrophy (DMD) is a genetic disorder that affects the muscles. Children with DMD have decreased muscle strength and progressive muscle weakness, which leads to difficulty walking and eventually requires a wheelchair.