Lab Skills

Question 1

How to test for olfactory nerve?

Answer 1

Nostril patency
Smell

Question 2

Test for optic nerve II

Answer 2

confrontation (peripheral)
Snellen

Question 3

Tests for Occulomotor (III), Trochlear (IV), Abducens (VI)

Answer 3

Pupil size with light
Follow light
Cardinal positions 6

Question 4

Tests for Trigeminal V

Answer 4

Clench jaw, palpate clenched jaw, pull chin (pain = abnormal)
Touch 3 places on face with cotton ball - tell me when you feel it
Corneal reflex (we don’t do)

Question 5

Test for Facial VII

Answer 5

Smile, frown, close eyes tight, raise eyebrows, show teeth
Puff cheeks & pop
Anterior 2/3 taste - we don’t do

Question 6

Test for Acoustic VIII

Answer 6

Whisper test (2 syllables)

Question 7

Test for Glossopharyngeal IX and Vagus X

Answer 7

Tongue depresser - uvula “ahhh”
Posterior 1/3 taste - we don’t do

Question 8

Test for Spinal Accessory XI

Answer 8

Neck, turn head left
Hand to cheek
Raise shoulders against resistance

Question 9

Test for Hypoglossal XII

Answer 9

Stick tongue out - inspect, midline, how far?
“Light, tight, dynamite”

Question 10

We assess muscles in neuro for

Answer 10

Size
Strength
Tone
Involuntary movements

Question 11

Muscle size test

Answer 11

ROM of neck, shrug shoulders resistance, tighten stomach (can you feel in back), check posture
ROM in wrist, fingers, shoulders, ankles

Question 12

ROM of shoulders

Answer 12

Grab arm, lift arm above head
Lift arm towards back

Question 13

Strength test for arms

Answer 13

Bicep, triceps, hands in fist, push against my hands , now I’ll push against yours

Question 14

Strength test for legs

Answer 14

Hands around ankle, push against my hand, now I’ll push against you

Question 15

Test arms for tone

Answer 15

Palpate arms, hands, cap refill, squeeze my hands

Question 16

Balance test (cerebellum)

Answer 16

Gait (walking, tandem)
Romberg
Shallow knee bend (stand and bend both knees, then one)

Question 17

Assessing coordination and skilled movements

Answer 17

Rapid alternative movements (hands on legs flipping)
Finger to finger (touch my finger, thumb to each finger)
Finger to nose
Heel to shin

Question 18

Assess sensory system

Answer 18

Alert, oriented?

Question 19

Tests for spinothalamic tract

Answer 19

Pain - touching w sharp object, any pain? Sharp or dull (several spots)
Temperature - we don’t test
Light touch - cotton ball, where you feel?

Question 20

Test for posterior column tract

Answer 20

Vibration - tuning fork (ankles up, bony prom)
Position - kinaesthisa - toe up or down, finger up or down

Question 21

Tests for tactile discrimination (fine touch)

Answer 21

Stereognosis - identify object in hand
Graphesthesia - draw a # in hand/forearm
Two point discrimination - paper clip, poke hand 2 spots?
Extinction - same spot both sides, can you feel?
Point location - two parts of body (diff)

Question 22

Deep tendon reflexes

Answer 22

Biceps
Triceps
Patellar
Achilles

(Not testing):
Brachioradialis & clonus

Question 23

Superficial (cutaneous) reflexes

Answer 23

Abdominal - umbilicus out, back of hammer, 4 quads
Plantar - upside down J (end at big toe)

Cremasteric (we don’t do)

Question 24

Reflex scale

Answer 24

0 = no response
1 = diminished
2 + = normal
3 = higher than normal
4 = hyperactive