Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NMSK B Test 1 > 1.3 The Detailed Neurologic Examination in Adults > Flashcards

1.3 The Detailed Neurologic Examination in Adults Flashcards

1
Q

What would you check to exam the Metal status of a patient?

A

Alert, oriented to person, place, time ( patient gives a cogent medical history).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is apraxia?

A
  • Ex. Idiomotor apraxia

- Can’t do a simple task when asked, but can do it involuntarily.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is visual spatial perception?

A
  • Relative when patient has difficulty losing objects (getting lost)
  • copy/draw (a clock, overlapping pentagons, etc.).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How do yo check executive function?

A

Goal directed behavior- a complex set of activities (involves, volition, planning, purpose, action, and effective performance). Activities of daily living affected. Depends on working memory, mental flexibility, design fluency, motor programming, ability to inhibit responses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How do you check Mood an thought content?

A

Eye contact, blunting, spontaneous speech, (ask family members for help here).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How would you check speech of the patient?

A

fluent, normal syntax, comprehension, repetition.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How would you check the (in general) cranial nerves for?

A

visual fields, extra ocular movements, fundoscopic exam, facial symmetry and facial sensation, and hearing is normal.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How would you check motor function for?

A

Mass, tone, and strength

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How would you check a patients sensory for?

A

light touch, pin prick and double simultaneous stimulation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How would you check a patients giant for?

A
  • Stepping, toe-heel walking, turning; be observant.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How would you check the patients cerebrallar for?

A

Finger nose finger, no involuntary movements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Where would you check the patients reflex

A

upper and lower extremities, toes planter bilaterally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What would you check for a patient’s cerebrovascular?

A

Carotid, orbital or cranial bruits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the general things you would look at during the musculo-skeletal exam?

A

range of motion axial and appendicular structures, normal Osteopathic exam.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What would you check to access the level of consciousness for a patient?

A
  • Arousal (alert, attentive, sleepy, lethargic, unresponsive)
  • Able to focus and direct cognitive processes, resist distraction, sustain attention (attention affects other areas including memory and executive functioning).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What would you do to check a patients short term memory?

A

Immediate: (short term; read a sentence and comprehend, digit span recall).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What would you do to check a patients long term memory?

A

i. Recent (new material as remembering three words in 5 minutes)
ii. Remote (Memories of TV shows, news events)
iii. Episodic (dates, events, personal experiences) vs. Semantic (word meaning, phrases, facts).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is implicit memory?

A

-Implicit memory (aka, non declarative, unconscious

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is explicit memory?

A

Declarative, factual

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is acalculia?

A

inability to calculate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is agraphia?

A

inability to write; couldn’t write name

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is Gerstmann syndrome?

A

Left posterior hemispheric lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is Finger agnosia?

A

Inability to recognize fingers, pinky? Index

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are examples of visuospatial issues?

A

R-L confusion, fingers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What areas do the clock drawing test cover?

A
  • single task- covers multiple cognitive domains)

- level of consciousness (alert), visual spatial perception, praxis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the name of Cr N II?

A

Optic Nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the first step after finding a patient has asymmetric pupils?

A

Finding which one is abnormal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is anisocoria?

A
  • Is a condition characterized by an unequal size of the eyes’ pupils.
  • Normal in 10-20% of the population
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are issues that can cause anisocoria?

A

1) Due to efferent pupillary defect (parasympathetics) carried in Cr N lll
2) Defect in sympathetics (carried in brainstem> upper cervical spinal cord then outside the CNS in cervical ganglion to eye).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is Horner’s syndrome?

A
  • droopy eyelid (ptosis)
  • Constriction of pupil of eye
  • SMALL pupil is the abnormal one and due to a lesion of Sympathetic tract.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is a pancoast tumor?

A
  • Apical lung mass
  • Can cause anisocoria on small pupil side with droopy eyelid (ptosis)
  • this is part of what is called Horner’s Syndrome. (small pupil with ptosis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Who is most likely to get a Pancoast tumor?

A

-Most common with smokers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What cranial nerves are involved in eye movement?

A

Cr N III,IV, VI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is internuclear Opthalmoplegia?

A

Produced by lesion of the medial longitudinal fasciculus (MLF); this pathway connects Cr. N. VI nucleus on one side with Cr.N. III nucleus on the other, allowing for conjugate horizontal gaze. A MLF lesion is manifest by impaired adduction on affected side, accompanied by nystagmus in the other, abducting eye.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What cranial nerve is involved with facial sensation?

A

Cr N V

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

How do you test Cr N V?

A

Touch with cotton, corneal reflex with cotton wisp when feasible,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What are the three branches of facial sensation?

A

-three braches; ophthalmic, maxillary and mandibular;

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is Bell’s palsy?

A

Peripheral weakness or paralysis of one side of the face causing a facial droop; drooling, eye issues with tearing (excessive, dry eye); loss of taste, pain behind ear a facial nerve (Cr N VII) lesion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What cranial nerve is involved with facial strength?

A

Cr N VII

40
Q

How do you test facial strength?

A

-close eyes tight, wrinkle forehead, smile

41
Q

What is the name of CN1?

A

Olfactory

42
Q

What is the name of CN2?

A

Optic

43
Q

What is the name of CN3?

A

Oculomotor

44
Q

What is the name of CN4?

A

Trochlear

45
Q

What is the name of CN5?

A

Trigeminal

46
Q

What is the name of CN6?

A

Abducens

47
Q

What is the name of CN7?

A

Facial

48
Q

What is the name of CN8?

A

Vestibulocochlear

49
Q

What is the name of CN9?

A

Glossopharyngal

50
Q

What is the name of CN10?

A

Vagus

51
Q

What is the name of CN11?

A

Accessory

52
Q

What is the name of CN12?

A

Hypoglossal

53
Q

Which cranial nerves are sensory only?

A

CN 1, 2, 8

54
Q

Which cranial nerves are motor only?

A

CN 3, 4, 6, 11, 12

55
Q

Which cranial nerves are mixed actions?

A

CN 5, 7, 9, 10

56
Q

What is the function of CN1?

A
  • Olfactory

- Smells

57
Q

What is the function of CN2?

A
  • Optic

- Sees

58
Q

What is the function of CN 3, 4, and 6?

A
  • Moves eyes
  • CN3 Constricts pupils
  • Accommodates
  • CN3: Oculomotor
  • CN4: Trochlear
  • CN6: Abducens
59
Q

What is the function of CN5?

A
  • Chews and feels front of head

- Trigeminal

60
Q

What is the function of CN7?

A
  • Moves the face, tastes, salivates, cries

- Facial

61
Q

What is the function of CN8?

A
  • Hears, regulates balance

- Vestibulocochlear

62
Q

What is the function of CN9?

A
  • Tastes, salivates, swallows, monitors carotid body and sinus.
  • Glossopharyngeal
63
Q

What is the function of CN10?

A
  • Tastes swallows, lifts palate, talks, communication and from thoraco-abdominal viscera
  • Vagus
64
Q

What is the function of CN11?

A
  • Turns head, lifts shoulders

- Acessory

65
Q

What is the function of CN12?

A
  • Moves tongue

- Hypoglossal

66
Q

What Cranial nerve is involved with the gag reflex?

A
  • Vagus (Cr N 10)

- 20% of patients do not have gag reflex.

67
Q

What tests do you do to check Cr N VII?

A
  • Hearing (finger rub)

- Weber/ Rinne for conduction vs. sensorineural hearing loss

68
Q

What is dysarthria?

A

Articulation errors

69
Q

What nerves are involved in dysarthria?

A

Cr N VII, IX, X, XII

70
Q

What nerve causes tongue weakness?

A

CN XII- Hypoglossal Nerve

  • Atrophy and fasciculations are often prominent with peripheral lesions.
  • Tongue deviates to the side of the peripheral nerve lesion
71
Q

What is the grading system for muscle strength created by?

A

MRC- Medical Research Council

72
Q

What is the 0/5 on the muscle strength grading system?

A

no discernable muscle or muscle fiber contraction

73
Q

What is the 1/5 on the muscle strength grading system?

A

flicker/twitch of muscle fiber movements without movement of joint/limb

74
Q

What is the 2/5 on the muscle strength grading system?

A

weak contraction (cannot overcome gravity

75
Q

What is the 3/5 on the muscle strength grading system?

A

weak contraction (able to overcome gravity but no additional resistence)

76
Q

What is the 4/5 on the muscle strength grading system?

A

weak contraction (able to overcome minimal resistence

77
Q

What is the 5/5 on the muscle strength grading system?

A

Full Strength

78
Q

What are the limitations of the muscle grading system?

A

i. Difficult to conventionally assess large muscle groups or exceptionally powerful individuals
ii. Subjectivity between 4/5 and 5/5

79
Q

What muscles have deep tendon reflexes?

A

i. biceps C5-6
ii. triceps C 6-7
iii. brachioradialis C5-6
iv. knee (patellar) L3-4
v. ankle (gastrocsoleus
or Achilles) S1
vi. hamstrings L5

80
Q

What is clonus?

A

rhythmic series of contractions elicited by stretching the tendon

81
Q

What is the DTR grading system positive tests?

A

Asymmetry and sustained clonus ; the most important positives

82
Q

On the DTR grading system what is a 0/4?

A

0 or 0/4 = absent

83
Q

On the DTR grading system what is a 1/4?

A

1/4 = reduced (hypoactive)

84
Q

On the DTR grading system what is a 2/4?

A

2/4 = normal DTR

85
Q

On the DTR grading system what is a 3/4?

A

3/4= hyperactive

86
Q

On the DTR grading system what is a 4/4?

A

4/4= clonus (sustained or several beats)

87
Q

What cervical nerve goes to the thumb?

A

C6

88
Q

What cervical nerve goes to the pinky?

A

C8

89
Q

What lumbar nerve goes to the large toe and lateral thigh?

A

L5

90
Q

What sacral nerve goes to the small toe and sole?

A

S1

91
Q

What is Dysmetria?

A

inibility to perform point to point movements

92
Q

What is Dysdiadochokinesis?

A

an inability to perform rapid alternating movements slow or irregular: movement disorder

93
Q

What test do you do to check cerebellar/coordination?

A
  • Evaluate by testing patient’s ability to perform:
  • Rapid alternating movements (hands on thighs and rapidly supinate- pronate hands for 10 seconds).
  • Heel down Shin- slide down from knee to top of foot.
94
Q

What is the Romberg test?

A
  1. Patient stands still, feet together, then ask patient to close eyes
  2. Positive test-If significant and immediate loss of balance
95
Q

What are false positives for cerebrovascular brutus?

A

Anemia, hypermetabolic state or pressing too hard with stethoscope

96
Q

What are the false negatives for cerebrovascular bruits?

A

Total occlusions

97
Q

What is the grading system for Cerebrovascular bruits?

A

1/4 low grade, 2/4 more, 3/4 more, 4/4; if there’s an associated diastolic component

NMSK B Test 1 (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions