Page 2 of 2: OSCE-Buster: Cerebellar Examination

kanikadua · Credits: 9353 My Scrapbook

CEREBELLAR SYSTEM EXAMINATION
1.coordination
2.test for dysarthria
3.nystagmus
4.stance and gait
5. tone

1TEST FOR COORDINATION
a.rebound phenomena
b.finger nose test
c.heel shin test
d.rapid alternating movement

2.TEST FOR DYSARTHRIA
a. listen to patients spontaeous speech
b.ask him to repaet; british constitution, yellow lorry, baby hippopotumus
( cerebellar lesion leads to slow and slurred spech)

3.NYSTAGMUS
assesed whie checking eye movements by holding finger at the horizontal ends of the imaginary H
cerebellar lesion leads to biderectinal nystagmus

4.STANCE AND GAIT
a. swaying and lurching with eyes open
b. broad based unsteady gait.

githika · Credits: 1154 My Scrapbook

CEREBELLAR SYSTEM EXAMINATION

Dysarthria: The muscles of voice production and the muscles of speech lack coordination so this causes sudden irregular changes in volume and timing of speech,i. e scanning or staccatospeech.

Gait and stance ataxia, especially if the pt is asked to walk heel to toe, or to stand still on one leg.

dip · Credits: 248 My Scrapbook

Thank you all. well done. very iformative and essy to remember.

githika · Credits: 1154 My Scrapbook

CEREBELLUM IS A COMPUTER: Input comes from
1.proprioceptors throughout the body
2.From the Inner ear
3.From the cerebral hemispheres

It should be analysed properly in the cerebellum, then

Output to be given to Medulla & spinal cord via superior cerebellar peduncle.

Improper Analysis of information in the cerebellum causes Incoordination of muscle activity.Cerebellar function can be assessed by the following tests.

1.Coordination
2.Tone
3.Gait
4.Speech
5.Eye movements

1.COORDINATION:

UPPER LIMB

a)past pointing: Finger nose test, Where pt moves his index finger backwards & Forwards from his nose to the examiner's finger.Cerebellar disease leads to the inaccuracy in this test(past pointing) because of inability to judge distances(Dysmetria). As the finger appoaches the target, it may oscillate increasingly wildly(Intention tremor).

b)dysdiadochokinisis:Ask pt to prformRapid alternating movements(e.g by taping the dorsum of one hand with the palmar then the dorsal aspect of the fingers of the opposite hand repeatedly), which may be jerky and in accurate in cerebellar disease.

c)cerebellar rebound:Dysmetria may also be assessed by gently taping the pt's out stretched hands,Rather than immediately returning to the intial position, the pt's arm may overshoot and oscillate a few times.

LOWERLIMB:

Heel knee test, the pt being asked to place one heel on the opp knee then slide it accurately dwon the shin.

2. TONE:In cerebellar disease pendular reflexes are seen. Hypotonia, though a feature of cerebellar lesions, is not very useful in clinical practice.

3.GAIT: WIDE BASED gait, staggering, unable to walk heel to toe or to stand still on one leg.

4.SPEECH: Slurred speech with an irregular staccato or scanning quality.

5.EYE MOVEMENTS: CEREBELLAR lesion leeds to bidirectional nystagmus. Cerebellar representation is ipsilateral, so a left cerebellar hemisphere lesion produces nystagmus which of greater amlitude when the pt looks to the lt.

simba7ligo · Credits: 305 My Scrapbook

some doctors in Ireland do not like the mnemonic DANISH and prefer SPINDAR

Slurred speech
Past pointing
Nystagmus
Dysdiadokinesis
Ataxia
Rebound

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