Introduction

Question 1

What are the 7 factors that comprise the neuro exam?

Answer 1

• mental status
• CNs
• Motor
• Sensory
• Reflexes
• Coordination
• Gait

Question 2

What are DTRs?

Answer 2

Reflexes– no such thing as “deep”

Question 3

What are the three factors that are used to evaluate mental status?

Answer 3

1. Alertness and orientation
2. Language and speech/function
3. Memory, knowledge, concentration

Question 4

What are the four levels of mental status?

Answer 4

• Alert
• Drowsy
• Stupor
• Coma

Question 5

What is a normal MME exam score?

Answer 5

30

Question 6

What is aphasia?

Answer 6

Disorder of language (brain issue)

Question 7

What is Dysarthria?

Answer 7

Disorder of speech/motor function

Question 8

What percent of left handed people are left brain dominant?

Answer 8

60%

Question 9

What percent of right handed people are left brain dominant?

Answer 9

99% ish

Question 10

What are the two categories of aphasia?

Answer 10

• Fluent

- Non-fluent

Question 11

What is the general cause of most aphasias (generally)?

Answer 11

Cortical disturbances

Question 12

What is expressive and receptive aphasia?

Answer 12

Expressive = fluent
Receptive = non-fluent

Question 13

What are the three steps of determining the aphasia in a patient?

Answer 13

• Listening
• Three step command
• Ability to name and repeat

Question 14

What in particular should be noted with the fundoscopic exam for neurology?

Answer 14

Lateral margin for evidence of elevation

Question 15

Defects in CNs point toward what type of problem?

Answer 15

Brainstem lesions

Question 16

Do you wiggle the fingers with visual field exams?

Answer 16

No

Question 17

What is the best way to evaluate for consensual response to light?

Answer 17

Swinging light test

Question 18

What are the two types of nystagmus?

Answer 18

• Horizontal or rotatory

- vertical

Question 19

What type of nystagmus is almost always pathologic?

Answer 19

Vertical

Question 20

Why is the forehead spared with a stroke, but not Bell’s palsy?

Answer 20

Dual innervation of the CN VII to the forehead, and Bell’s palsy is a lesion in the LMN

Question 21

How is bulk assessed in testing motor function?

Answer 21

Visual inspection (atrophy or not)

Question 22

What are the three factors that should be inspected for muscle weakness?

Answer 22

• Tone
• Bulk
• Strength

Question 23

What does pronator drift assess for?

Answer 23

Slight weakness

Question 24

What are the 3 and 2 of the motor scale?

Answer 24

3 = FROM against gravity
2 = FROM with gravity eliminated

Question 25

What are the three pathways of sensation?

Answer 25

• Light touch
• Pinprick/temp
• Proprioception/vibration

Question 26

What is the romberg test? What does it assess for?

Answer 26

Feet together with hands out—proprioception

Question 27

What should only be looked at with the Babinski? What is the normal response?

Answer 27

Great toe–up or down going

Down is normal

Question 28

What are 0-4 grades of reflexes?

Answer 28

4 = hyperreflexia with clonus
3 = hyperactive w/o clonus
2 = normal
1 = diminished
0 = absent

Question 29

What are the three major tests for coordination?

Answer 29

• FNF
• H2S
• RAM

Question 30

What is the role of the physical exam in neurology (or anything, really)?

Answer 30

Corroborate your suspected diagnosis

Question 31

What is the general way to report a history?

Answer 31

Just the facts, without framing

Question 32

What is the appropriate way to describe people who are between alert and coma?

Answer 32

Describe their responses and general appearance.

Question 33

Defects in visual fields usually point to a lesion where?

Answer 33

Hemispheric area

Question 34

If diplopia resolves with covering an eye, what is the likely etiology?

Answer 34

EOM dysfunction