Clinical Approaches

Question 1

What to assess in pt neck

Answer 1

Stiffness
Kernigs test
Carotid bruits

Question 1

What to assess in pt generally

Answer 1

Appearance
Speech
Mental function
Posture and movement of limbs
Ask if right or left handed
Gait

Question 2

MOTOR assessment

Answer 2

Limbs
Wasting
Fasciculation
Abnormal posture
Tone
Power
Co-ordination
Tendon reflexes
Abdominal reflexes
Plantar response

Question 3

What to assess in pt eyes

Answer 3

Fundoscopy

Question 4

Sensory assessment

Answer 4

Numbness
Pinprick
Cotton wool
Joint position
Vibration
2 point discrimination
Temperature

Question 5

Stoke gait abnormality

Answer 5

Spastic / hemiparetic

Question 6

Parkinson gait abnormality

Answer 6

Shuffling / fesitinant

Question 7

Cerebellar ataxia gait

Answer 7

Broad based

Question 8

Sensory neuropathy gait

Answer 8

Stamping

Question 9

Position sensory loss gait

Answer 9

High stepping

Question 10

Distal weakness / foot drop gait

Answer 10

Slapping

Question 11

Proximal weakness gait

Answer 11

Waddling

Question 12

Normal pressure hydrocephalus gait

Answer 12

Hesitant

Question 13

Arthritis and muscle pain gait

Answer 13

Antalgic

Question 14

Clonus

Answer 14

Involuntary extensor rhythmic leg jerking

Question 15

Gait apraxia vs Parkinson’s gait

Answer 15

Shuffling with small steps but unlike parkinsons, arm swing and posture are normal.

Question 16

Dizziness

Answer 16

vague feeling of unsteadiness to severe acute vertigo

Question 17

Vertigo

Answer 17

Illusion of movement, a sensation of rotation or tipping

Question 18

Excitatory neurotransmitters

Answer 18

Acetylcholine, noradrenaline, adrenaline, 5-HT, dopamine, glutamate, aspartate

Question 19

Inhibitory neurotransmitters

Answer 19

GABA
Histamine
Glycine

Question 20

Neuropeptides and Purines

Answer 20

Vasopressin
ACTH
ATP
AMP

Question 21

Muscle power MRC scale

Answer 21

5 - normal
4 - active movement against gravity and resistance
3- Active movement against gravity only
2- Active movement with gravity eliminated
1 - Flickr of contraction
0- no contraction

Question 22

10 part neuro exam

Answer 22

1. State of consciousness, arousal and appearance
2. mental state
3. Cognitive function
4. gait and balance
5. Neck
6. Cranial nerves
7. Motor systems
8. Co-ordination and fine movements
9. Sensory system
10. Specialised tests