H & P

Question 1

CN I test

Answer 1

olfactory

close eyes and smell, ID odor

normal: pt will ID
Anosmia (inability to discriminate, age/trauma)

Question 2

CN II test

Answer 2

optic - visual acuity and field

Snellen and Rosenbaum chart
ophthalmoscopic exam
visual field

Question 3

CN III test

Answer 3

oculomotor – pupillary constriction, rise eyelid, extraoccular

pupillary size 
direct and consensual response 
accommodation 
inspect eyelid fro drooping
EOM

Question 4

CN IV

Answer 4

trochlear - downward + inward eye movement

test: EOM

Question 5

CN V

Answer 5

trigeminal - sensation of eye, forehead, nose, mouth, ear, skin… + movement of chewing

inspect atrophy, tremor
palpate jaw while pt clench teeth (tone and strength)
test superficial pain/touch in ea. branch
corneal reflex

Question 6

corneal reflex positive finding

Answer 6

both eyes blink in response to stimulation

Question 7

CN VI

Answer 7

abducens - lateral eve movement

EOM

LATERAL RECTUS

Question 8

CN VII

Answer 8

facial - secretion of salvia, tears, close eyes, facial expression, speech, taste

Question 9

CNVII test

Answer 9

symmetry of facial feature with facial expression

ability to ID sweet and salty taste bilaterally

Question 10

fxn of basal ganglia

Answer 10

regulation of motor activity and descending moron pathway

releases inhibitors to allow action of voluntary movement

enables gross motor movements (walking)

maintains muscle tone and posture

Question 11

limbic system fxn

Answer 11

controls autonomic functions

cardiac, respiratory, metabolic fxn

maintain consciousness

regulate sleep cited

Question 12

cerebellum fxn

Answer 12

coordinate motor activity

tweaks “fine” motor movements of descending pathway to make movements more adaptive

Question 13

dermatomes of upper extremity

Answer 13

C5 - skin over deltoid
C6 - thumb
C7- middle finger
C8 -little finger

Question 14

dermatomes of lower extremity

Answer 14

L4- medial ankle)
L5 - web space b/t big toe and second tow
S1 - lateral foot and heel

Question 15

dermatomes of trunk

Answer 15

T 4 (nipple) 
T 10 (umbilicus)
S 5 Anal Sphincter

Question 16

ascending pathway = which sensations?

Answer 16

pain 
temperature 
postion 
crude touch 
fine touch
vibratory

Question 17

two pathways for sensory cortex in brain

Answer 17

spinothalamic

posterior column

Question 18

sensory messages of posterior horn

Answer 18

crude touch
pain
temperature

cross over (contralateral) travel up in spinothalamic tract to thalamus

Question 19

sensations directly into posterior column

Answer 19

postion
fine touch
vinration

travel up posterior column cross over to contralateral at level of medulla then thalamus

Question 20

pyramidal pathways are damaged above crossover

Answer 20

opposite contralateral side impaired

Question 21

pyramidal motor pathways are damaged below crossover

Answer 21

motor impairment occurs on same side

Question 22

5 components of reflex arch (+fxn)

Answer 22

1. receptor (sensory site)
2. sensory neuron (carries impulse toward CNS)
3. Interneuron (within CNS)
4. Motor Neuron (away from CNS)
5. Effector (response)

Question 23

superficial reflexes (CRAP)

Answer 23

Cremasteric
Rectal/anal
Abdominal
Plantar reflex

Question 24

muscle tested in patellar reflex ( + dermatomes)

Answer 24

quadriceps

L4*, L2/L3

Question 25

muscle tested in achilles reflex ( + dermatomes)

Answer 25

gastrocnemius

S1*, S2

Question 26

GCS

Answer 26

grading of level of consciousness

measures eye opening, motor, and verbal responses

Question 27

MMSE

Answer 27

mental status exam (trump took it)

objectifies decline, good for looking over time

Question 28

MMSE score (normal, mild, moderate, severe)

Answer 28

normal: >24
mild impairment: 19-23
moderate impairment: 10-18
severe impairment: <9

Question 29

abducens tests which EOM

Answer 29

lateral rectus