CNS 3 (Meningeal)

Question 1

Flexion of both the hips and knees is a positive

Answer 1

Brudzinski sign

Question 2

Pain and increased resistance to knee extension are a

Answer 2

positive Kernig sign

Question 3

If the patient has low back pain that radiates down the thigh and leg, commonly called __if in the sciatic nerve distribution

Answer 3

sciatica

Question 4

Pain radiating into the ipsilateral leg is a positive straight leg test for

Answer 4

lumbosacral radiculopathy

Question 5

Increased pain when the contralateral healthy leg is raised is a positive

Answer 5

crossed straight-leg raise sign

Question 6

It suggests metabolic encephalopathy in patients whose mental functions are impaired. It is caused by abnormal function of the diencephalic motor centers that regulate agonist and antagonist muscle tone and maintain posture.

Answer 6

Asterixis

Question 7

A state of impaired arousal and awareness, signals a potentially life-threatening event affecting the two hemispheres, the brainstem, or both

Answer 7

Coma

Question 8

“Don’ts” When Assessing the Comatose Patient

Answer 8

● Don’t dilate the pupils, the single most important clue to the underlying cause
of coma (structural vs. metabolic).
● Don’t flex the neck if there is any question of trauma to the head or neck.
Immobilize the cervical spine and get an x-ray first to rule out fractures of the
cervical vertebrae that could compress and damage the spinal cord.

Question 9

This patient arouses from sleep only after painful stimuli. Verbal responses are slow or even absent. The patient lapses into an unresponsive state when the stimulus ceases. There is minimal awareness of self or the environment.

Answer 9

Stupor

Question 10

This patient opens the eyes, looks at you, and responds fully and appropriately to stimuli (arousal intact)

Answer 10

Alertness

Question 11

This patient opens the eyes and looks at you but responds slowly and is somewhat confused. Alertness and interest in the environment are decreased.

Answer 11

Obtundation

Question 12

The patient appears drowsy but opens the eyes and looks at you, responds to questions, and then falls asleep.

Answer 12

Lethargy

Question 13

Patient remains unarousable with eyes closed. There is no evident response to inner need or external stimuli. Repeated painful stimuli needed.

Answer 13

Coma

Question 14

In irritative lesions from epilepsy or a unilateral pontine lesion, the eyes ___ from the affected hemisphere.

Answer 14

“look away”

Question 15

Pattern of movement:

The patient purposefully pushes the stimulus away or withdraws.

Answer 15

Normal–avoidant

Question 16

Pattern of movement:

the stimulus evokes abnormal postural responses of the trunk and extremities.

Answer 16

Stereotypic

Question 17

A flaccid arm drops ___, like a rock.

Answer 17

rapidly

Question 18

In acute hemiplegia, the flaccid leg falls more ___.

Answer 18

rapidly

Question 19

Reflex withdrawal of sympathetic tone and increased vagal tone causing drop in blood
pressure and heart rate but no vagal surge or drop in heart rate. Baroreflexes normal

Answer 19

Vasodepressor Syncope

Question 20

The ability to focus or concentrate over time on a particular stimulus or activity—an inattentive person is easily distractible and may have difficulty giving a history or responding to questions.

Answer 20

Attention

Question 21

The logic, coherence, and relevance of the patient’s thought as it leads to selected goals; how people .think

Answer 21

Thought processes

Question 22

Process of comparing and evaluating alternatives when deciding on a course of action; reflects values that may or may not be based on reality and social conventions or norms

Answer 22

Judgment

Question 23

The process of registering or recording information, tested by asking for immediate repetition of material, followed by storage or retention of information. Recent or short-term memory covers minutes, hours, or days; remote or long-term memory
refers to intervals of years.

Answer 23

Memory

Question 24

Awareness of personal identity, place, and time; requires both memory and attention

Answer 24

Orientation

Question 25

Awareness that symptoms or disturbed behaviors are normal or abnormal; for example, distinguishing between daydreams and hallucinations that seem real.

Answer 25

Insight

Question 26

What the patient thinks about, including level of insight and judgment

Answer 26

Thought content

Question 27

Sensory awareness of objects in the environment and their interrelationships (external stimuli); also refers to internal stimuli such as dreams or hallucinations.

Answer 27

Perceptions

Question 28

A more pervasive and sustained emotion that colors the person’s perception of the world. (Affect is to mood as weather is to climate.) Mood may be euthymic (in the normal range), elevated, or dysphoric (unpleasant, possibly as sad, anxious, or
irritable), for example.

Answer 28

Mood

Question 29

Assessed by vocabulary, fund of information, abstract thinking, calculations, construction of objects that have two or three dimensions

Answer 29

Higher cognitive functions

Question 30

A fluctuating pattern of observable behaviors that expresses subjective feelings or emotions through tone of voice, facial expression, and demeanor. Disturbed affect may be flat, blunted, labile, or inappropriate.

Answer 30

Affect

Question 31

A complex symbolic system for expressing, receiving, and comprehending words; as with consciousness, attention, and memory, language is essential for assessing other mental functions

Answer 31

Language

Question 32

Characteristic Behavior Patterns

Odd or Eccentric Disorders
● Paranoid
● Schizoid
● Schizotypal

Answer 32

Odd or Eccentric Disorders
● Paranoid - Distrust and suspiciousness
● Schizoid - Detachment from social relations with a restricted emotional range
● Schizotypal - Eccentricities in behavior and cognitive distortions; acute discomfort
in close relationships

Question 33

Characteristic Behavior Patterns

Characteristic Behavior Patterns

Dramatic, Emotional or Erratic Disorders
● Antisocial
● Borderline
● Histrionic
● Narcissistic

Answer 33

Dramatic, Emotional or Erratic Disorders
● Antisocial - Disregard for, and violation of, the rights of others
● Borderline - Instability in interpersonal relationships, self-image and affective regulation; impulsivity
● Histrionic - Excessive emotionality and attention seeking
● Narcissistic - Persisting grandiosity, need for admiration and lack of empathy

Question 34

Characteristic Behavior Patterns

Anxious or Fearful Disorders
● Avoidant
● Dependent
● Obsessive–compulsive

Answer 34

Anxious or Fearful Disorders
● Avoidant - Social inhibition, feelings of inadequacy and hypersensitivity to negative
evaluation
● Dependent - Submissive and clinging behavior related to an excessive need to be
taken care of
● Obsessive–compulsive - Preoccupation with orderliness, perfectionism, and control

Question 35

Two common kinds of aphasia—expressive (__) and receptive (___)

Answer 35

• Broca aphasia

- Wernicke aphasia

Question 36

The mildest thought disorder, consisting of speech with unnecessary detail, indirection, and delay in reaching the point. Some topics may have a meaningful connection. Many people without mental disorders have circumstantial speech

Answer 36

Circumstantiality

Question 37

“Tangential” speech with shifting topics that are loosely connected or unrelated. The patient is unaware of the lack of association.

Answer 37

Derailment (loosening of associations)

Question 38

An almost continuous flow of accelerated speech with abrupt changes from one topic to the next. Changes are based on understandable associations, plays on words, or distracting stimuli, but ideas are not well connected.

Answer 38

Flight of Ideas

Question 39

Invented or distorted words, or words with new and highly idiosyncratic meanings.

Answer 39

Neologisms

Question 40

Speech that is incomprehensible and illogical, with lack of meaningful connections, abrupt changes in topic, or disordered grammar or word use. Flight of ideas, when severe, may produce incoherence.

Answer 40

Incoherence

Question 41

Sudden interruption of speech in midsentence or before the idea is completed, attributed to “losing the thought.” Blocking occurs in normal people.

Answer 41

Blocking

Question 42

Fabrication of facts or events in response to questions, to fill in the gaps from impaired memory.

Answer 42

Confabulation

Question 43

Persistent repetition of words or ideas.

Answer 43

Perseveration

Question 44

Repetition of the words and phrases of others.

Answer 44

Echolalia

Question 45

Speech with choice of words based on sound, rather than meaning, as in rhyming and punning. For example, “Look at my eyes and nose, wise eyes and rosy nose. Two to one, the ayes have it!”

Answer 45

Clanging