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%\usepackage{opensans}          % Can't make this work so far. Shame. Would be lovely.
\usepackage[normalem]{ulem}     % For underlining links
% Most of the following are not required for the majority
% of cheat sheets but are needed for some symbol support.
\usepackage{amsmath}            % Symbols
\usepackage{MnSymbol}           % Symbols
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%\usepackage[english,german,french,spanish,italian]{babel}              % Languages

% Document Info
\author{hjsdhaj}
\pdfinfo{
  /Title (cerebellar-examination.pdf)
  /Creator (Cheatography)
  /Author (hjsdhaj)
  /Subject (Cerebellar Examination Cheat Sheet)
}

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% Commands
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% Header and Footer
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\fancyhead[L]{
\noindent
\begin{multicols}{3}
\begin{tabulary}{5.8cm}{C}
    \SetRowColor{DarkBackground}
    \vspace{-7pt}
    {\parbox{\dimexpr\textwidth-2\fboxsep\relax}{\noindent
        \hspace*{-6pt}\includegraphics[width=5.8cm]{/web/www.cheatography.com/public/images/cheatography_logo.pdf}}
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\end{tabulary}
\columnbreak
\begin{tabulary}{11cm}{L}
    \vspace{-2pt}\large{\bf{\textcolor{DarkBackground}{\textrm{Cerebellar Examination Cheat Sheet}}}} \\
    \normalsize{by \textcolor{DarkBackground}{hjsdhaj} via \textcolor{DarkBackground}{\uline{cheatography.com/201639/cs/46237/}}}
\end{tabulary}
\end{multicols}}

\fancyfoot[L]{ \footnotesize
\noindent
\begin{multicols}{3}
\begin{tabulary}{5.8cm}{LL}
  \SetRowColor{FootBackground}
  \mymulticolumn{2}{p{5.377cm}}{\bf\textcolor{white}{Cheatographer}}  \\
  \vspace{-2pt}hjsdhaj \\
  \uline{cheatography.com/hjsdhaj} \\
  \end{tabulary}
\vfill
\columnbreak
\begin{tabulary}{5.8cm}{L}
  \SetRowColor{FootBackground}
  \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Cheat Sheet}}  \\
   \vspace{-2pt}Not Yet Published.\\
   Updated 3rd May, 2025.\\
   Page {\thepage} of \pageref{LastPage}.
\end{tabulary}
\vfill
\columnbreak
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  \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Sponsor}}  \\
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  \vspace{-5pt}
  %\includegraphics[width=48px,height=48px]{dave.jpeg}
  Measure your website readability!\\
  www.readability-score.com
\end{tabulary}
\end{multicols}}




\begin{document}
\raggedright
\raggedcolumns

% Set font size to small. Switch to any value
% from this page to resize cheat sheet text:
% www.emerson.emory.edu/services/latex/latex_169.html
\footnotesize % Small font.

\begin{multicols*}{2}

\begin{tabularx}{8.4cm}{p{0.88 cm} x{7.12 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{Introduction:}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{W}} & Wash Hands \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
{\bf{I}} & Introduce Yourself + Check Patient's Identity \tn 
% Row Count 4 (+ 2)
% Row 2
\SetRowColor{LightBackground}
{\bf{P}} & Permission \tn 
% Row Count 6 (+ 2)
% Row 3
\SetRowColor{white}
{\bf{P}} & Patient Position + Pain \tn 
% Row Count 8 (+ 2)
% Row 4
\SetRowColor{LightBackground}
{\bf{E}} & Explain \tn 
% Row Count 10 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{8.4cm}}{{\bf{Patient must be placed at 45° and {\emph{limbs}} exposed}} \{\{ac\}\}}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{8.4cm}}{\bf\textcolor{white}{Equipment:}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{Cotton Wool\{\{nl\}\}Neurotips\{\{nl\}\}Tendon Hammer\{\{nl\}\}128Hz Tuning Fork} \tn 
% Row Count 2 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{x{3.84 cm} x{4.16 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{General Inspection:}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{S}} & Symmetry (Posture - Truncal Ataxia)\{\{nobreak\}\} \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
{\bf{W}} & Wasting \tn 
% Row Count 4 (+ 1)
% Row 2
\SetRowColor{LightBackground}
{\bf{I}} & Involuntary Movements \tn 
% Row Count 6 (+ 2)
% Row 3
\SetRowColor{white}
{\bf{F}} & Fasiculations \tn 
% Row Count 7 (+ 1)
% Row 4
\SetRowColor{LightBackground}
{\bf{T}} & Tremors \tn 
% Row Count 8 (+ 1)
% Row 5
\SetRowColor{white}
{\bf{Speech Abnormalities}}\{\{nobreak\}\} & Cerebellar Disease = Slurred staccato speech \tn 
% Row Count 11 (+ 3)
% Row 6
\SetRowColor{LightBackground}
{\bf{Medical Paraphernalia}} \{\{nobreak\}\} & Waking/Hearing Aids \tn 
% Row Count 13 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{8.4cm}}{{\bf{Truncal Ataxia}} is associated with {\emph{midline cerebellar lesions}}\{\{ac\}\}}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{x{2.08 cm} x{5.92 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{Face:}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Nystagmus:}} & Tell patient to follow your finger in a "H" shape across 30° of their FOV - \textgreater{}30° can cause pathological nystagmus \tn 
% Row Count 4 (+ 4)
% Row 1
\SetRowColor{white}
{\bf{Speech:}} & Patient repeats the phrase "British Constitution" - Mention {\bf{{\emph{Scanning Speech}}}} \tn 
% Row Count 7 (+ 3)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{8.4cm}}{Ask patient to sit at side of bed\{\{ac\}\}}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{x{4 cm} x{4 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{Upper Limb Examination:}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{8.4cm}}{{\bf{{\emph{Check for pain}}}}\{\{ac\}\}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
{\bf{Rebound:}} & Patient puts both arms straight out, push down on one, observe for rebound \tn 
% Row Count 5 (+ 4)
% Row 2
\SetRowColor{LightBackground}
{\bf{Tone:}} & {\bf{Increased: }}Clasp Knife Rigidity, Cog Wheeling, Lead Pipe Rigidity\{\{nl\}\}{\bf{Decreased: }}LMN Lesion \tn 
% Row Count 10 (+ 5)
% Row 3
\SetRowColor{white}
{\bf{Dysdiadokinesis:}} \{\{nobreak\}\} & Rapidly alternating supination + pronation \tn 
% Row Count 13 (+ 3)
% Row 4
\SetRowColor{LightBackground}
{\bf{Past Pointing/Intention Tremor:}} \{\{nobreak\}\} & Finger to nose test \tn 
% Row Count 16 (+ 3)
% Row 5
\SetRowColor{white}
{\bf{Reflexes:}} & {\bf{Compare right to left}}\{\{nl\}\}Brachioradialis - {\emph{C5,6}}\{\{nl\}\}Biceps - {\emph{C5,6}}\{\{nl\}\}Triceps - {\emph{C7,8}}\{\{nobreak\}\} \tn 
% Row Count 22 (+ 6)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{x{2.204 cm} x{2.66 cm} x{2.736 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{3}{x{8.4cm}}{\bf\textcolor{white}{Lower Limb Examination:}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{3}{x{8.4cm}}{{\bf{{\emph{Check for Pain}}}}\{\{ac\}\}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
{\bf{Tone:}} & Roll the relaxed leg from side to side and watch foot\{\{nl\}\}\{\{nl\}\}Flex and extend knee quickly & Extra movement =\textgreater{} Decreased tone\{\{nl\}\}\{\{nl\}\}Less movement =\textgreater{} Rigidity \tn 
% Row Count 8 (+ 7)
% Row 2
\SetRowColor{LightBackground}
{\bf{Clonus:}} & {\bf{{\emph{Ensure no pain}}}}\{\{nl\}\}Relax foot\{\{nl\}\}Hold lower leg with one hand and extend the ankle joint with the other\{\{nl\}\}Suddenly dorsiflex ankle and hold in position\{\{nl\}\}{\bf{Compare with other leg}} &  \tn 
% Row Count 22 (+ 14)
% Row 3
\SetRowColor{white}
{\bf{Dysdiadokinesis:}} \{\{nobreak\}\} & Heel-Shin Test\{\{nl\}\}\{\{nl\}\}Foot Tapping &  \tn 
% Row Count 25 (+ 3)
% Row 4
\SetRowColor{LightBackground}
{\bf{Reflexes:}} & Ankle Reflex - {\emph{S1,2}}\{\{nl\}\}Patellar Reflex - {\emph{L3,4}} &  \tn 
% Row Count 29 (+ 4)
\hhline{>{\arrayrulecolor{DarkBackground}}---}
\SetRowColor{LightBackground}
\mymulticolumn{3}{x{8.4cm}}{Clonus is seen in {\bf{UMN lesions }}\{\{ac\}\} \newline Reflexes may be {\bf{present/absent}}, or {\bf{reduced/brisk}}}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}---}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{x{2.96 cm} x{5.04 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{Gait Examination:}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{8.4cm}}{{\bf{{\emph{Ask if the patient experiences trouble walking}}}} \{\{ac\}\}} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
{\bf{Walk to end of bed:}} & Observe:\{\{nl\}\}• Arm Swing \{\{nl\}\}• Patient Turning \tn 
% Row Count 5 (+ 3)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{8.4cm}}{{\bf{Heel-Toe Walk}}} \tn 
% Row Count 6 (+ 1)
% Row 3
\SetRowColor{white}
{\bf{Romberg's Test:}} & {\emph{Stand Close to Patient}}\{\{nl\}\}Falling without correction = {\bf{Positive}}\{\{nl\}\}Swaying with correction = {\bf{Negative}} but could be due to truncal ataxia \tn 
% Row Count 12 (+ 6)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{8.4cm}}{{\bf{Romberg's Test: }}Patient stands with {\bf{{\emph{feet together and eyes closed}}}} with arms by their side}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{8.4cm}}{\bf\textcolor{white}{tsdytasdy}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{} \tn 
% Row Count 0 (+ 0)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{p{1.12 cm} x{6.88 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{Cerebelllar Signs:}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{8.4cm}}{{\bf{DANISH}} \{\{ac\}\}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
{\bf{D}} & Dysdiadochokinesia \{\{nobreak\}\} \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
{\bf{A}} & Ataxia \tn 
% Row Count 3 (+ 1)
% Row 3
\SetRowColor{white}
{\bf{N}} & Nystagmus \tn 
% Row Count 4 (+ 1)
% Row 4
\SetRowColor{LightBackground}
{\bf{I}} & Intention Tremor \tn 
% Row Count 5 (+ 1)
% Row 5
\SetRowColor{white}
{\bf{S}} & Slurred Speech \tn 
% Row Count 6 (+ 1)
% Row 6
\SetRowColor{LightBackground}
{\bf{H}} & Hypotonia/Hyporeflexia \tn 
% Row Count 7 (+ 1)
% Row 7
\SetRowColor{white}
\mymulticolumn{2}{x{8.4cm}}{{\bf{SPINDAR}} \{\{ac\}\}} \tn 
% Row Count 8 (+ 1)
% Row 8
\SetRowColor{LightBackground}
{\bf{S}} & Staccato Speech \tn 
% Row Count 9 (+ 1)
% Row 9
\SetRowColor{white}
{\bf{P}} & Past Pointing \tn 
% Row Count 10 (+ 1)
% Row 10
\SetRowColor{LightBackground}
{\bf{I}} & Intention Tremor \tn 
% Row Count 11 (+ 1)
% Row 11
\SetRowColor{white}
{\bf{N}} & Nystagmus \tn 
% Row Count 12 (+ 1)
% Row 12
\SetRowColor{LightBackground}
{\bf{D}} & Dysdiadochokinesia \tn 
% Row Count 13 (+ 1)
% Row 13
\SetRowColor{white}
{\bf{A}} & Ataxia \tn 
% Row Count 14 (+ 1)
% Row 14
\SetRowColor{LightBackground}
{\bf{R}} & Rebound \tn 
% Row Count 15 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{p{0.76 cm} x{1.824 cm} x{5.016 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{3}{x{8.4cm}}{\bf\textcolor{white}{Causes of Cerebellar Dysfunction:}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{3}{x{8.4cm}}{{\bf{PASTRIES}}\{\{ac\}\}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
{\bf{P}} & \seqsplit{Paraneoplastic} &  \tn 
% Row Count 3 (+ 2)
% Row 2
\SetRowColor{LightBackground}
{\bf{A}} & Alcohol &  \tn 
% Row Count 5 (+ 2)
% Row 3
\SetRowColor{white}
{\bf{S}} & \seqsplit{Sclerosis} &  \tn 
% Row Count 7 (+ 2)
% Row 4
\SetRowColor{LightBackground}
{\bf{T}} & Tumour &  \tn 
% Row Count 9 (+ 2)
% Row 5
\SetRowColor{white}
{\bf{R}} & Rare & Fredrich's Ataxia, MSA, Ataxia Telangiectasia \{\{nobreak\}\} \tn 
% Row Count 12 (+ 3)
% Row 6
\SetRowColor{LightBackground}
{\bf{I}} & \seqsplit{Iatrogenic} & Phenytonin \tn 
% Row Count 14 (+ 2)
% Row 7
\SetRowColor{white}
{\bf{E}} & Endo & Hypothyroidism \tn 
% Row Count 16 (+ 2)
% Row 8
\SetRowColor{LightBackground}
{\bf{S}} & Stroke & Vertebrobasilar \tn 
% Row Count 18 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}---}
\SetRowColor{LightBackground}
\mymulticolumn{3}{x{8.4cm}}{MSA = Multiple Systems Atrophy}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}---}
\end{tabularx}
\par\addvspace{1.3em}


% That's all folks
\end{multicols*}

\end{document}