Nervous Sytem / Musculoskeletal System Flashcards by Han La

This cranial nerve provides taste sensation to the posterior 1/3 of the tongue.
A.CNVI
B. CNVII
C. CNVIII
D. CNIX

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A 21 year old male has noticed gradual weakness of his legs and hands and is concerned because he has trouble gripping a pen or pencil and he has never
experienced such a problem before. He is recovering from cold-like symptoms and noticed the limb weakness shortly after. What information in his history would indicate that the root cause of this disease is not solely infectious?
A. History in the family of Parkinson’s Disease
B. History of inoculation
C. History of aspirin ingestion
D. History of gonorrhea or chlamydia

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This disease only affects the lower motor neurons and has a fecal-oral route of transmission.
A. ALS (Lou Gehrig's disease)
B. Werdnig-Hoffman disease
C. Brown-Sequard syndrome
D. poliomyelitis

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Homer's syndrome (ptosis, miosis, hemi anhidrosis) is related to this tumor found at the apex of the lung.
A. Pancoast's tumor
B. Ependymoma
C. Meningioma
D. glioblastoma multiforme (GBM)

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In your clinic, you witness the 6 year old daughter of one of your long-term clients trip and fall. During the fall, she bumps the side of her head and begins to cry. After the client consoles her daughter and rubs her head, the child begins to calm down and, exhausted from crying, starts to fall asleep. What is the most appropriate action you should take?
A. ask the patient to put ice on the girl’s head when they return home
B. refer the patient to a pediatrician
C. refer the patient to a neurologist
D. refer the patient to the ER

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A patient suffers an automobile accident and has damage to the left anterior spinal nerves between lumbar vertebrae L2 and L3. Which of the following
correctly matches the patient’s deficits and given symptoms?
A. The patient will have ipsilateral paralysis of the leg and ipsilateral loss of pain and temperature sensation in the leg.
B. The patient will have contralateral paralysis of the leg and ipsilateral loss of pain and temperature sensation in the leg.
c. The patient will have contralateral paralysis of the leg and contralateral loss of pain and temperature sensation in the leg.
D. The patient will have ipsilateral paralysis of the leg and contralateral loss of pain and temperature sensation in the leg.

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A 65 year old woman is at a restaurant, enjoying wine at the bar with her friends. The friends notice that the woman begins to slur her words and then slumps over. EMS is called and the woman is sent to the ER. It is later found that she had suffered a massive stroke of the left cerebral hemisphere (pons in specific). Which of the following correctly matches the patient’s deficits and given symptoms?
A. Left facial weakness, right body weakness
B. Right facial weakness, left body weakness
C. Left facial weakness, left body weakness
D. Right facial weakness, right body weakness

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While evaluating a patient, the doctor notices that the patient's scapula seems to protrude forward on one side. What muscle could be damaged?
A. deltoid
B. biceps brachii
C. subscapularis
D. serratus anterior

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Which cranial nerve affects balance?
A. IV
B. VII
C. I
D. VIII

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The test(s) for carpal tunnel syndrome include:
A. Tinel's &amp; Phalen's signs
B. Muller sign
C. Osler &amp; Oppenheim's signs
D. Soto-Hall sign

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A DEXA scan gives results on:
A. Heart functioning
B. Stomach prolapsed
C. Brain function
D. Bone density

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A goniometer measures
A. Testosterone levels in females
B. Androgen levels in males
C. Angles of joints and range of motion
D. Head circumference and growth in infants

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The Achilles tendon reflex tests which nerve root?
A. L5
B. L4
C. L3
D. S1

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A patient has a tingling sensation down the arm, weakness in the legs, problems with balance, hand clumsiness, and neck pain. The most probable diagnosis would be
A. Cervical stenosis
B. Brain tumor
C. Herniated cervical disc
D. Sciatica

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A soft musculoskeletal mass would best be evaluated by
A. MRI
B. CT scan
C. Contrast X-ray
D. Plain X-ray

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A 40 year old man has low back pain. The doctor's report states that the deep tendon reflex of the Achilles on the left is 0/+4. What does this indicate?
A. Possible osteoarthritis
B. Hyperreflexia
C. Possible herniated disc
D. Possible brain tumor

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A patient complains of shoulder pain which started after falling in a ski accident in Colorado. Which muscles of the rotator cuff muscles involved?
A. Deltoid, supraspinatus, and infraspinatus
B. Supraspinatus, infraspinatus, teres minor and subscapularis
C. Trapezius, supraspinatus and infraspinatus
D. Deltoid and biceps

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Chronic elbow pain from playing tennis is diagnosed as
A. Lateral epicondylitis
B. Radio-ulnar synostosis
C. Medial epicondylitis
D. Olecranon bursitis

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The only sure way to determine the fracture risk for osteoporosis is to perform a
A. Bone mineral density test
B. Bone scan
C. Bone marrow biopsy
D. Bone X-ray

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From two years of age on. a positive Babinski reflex indicates
A. Central nervous system disorder
B. Normal reflex
C. Low back pain
D. Arthritis of the knee

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A patient with blood pressure of 210/130 with headache and blurred vision should be
A. Referred to emergency room immediately
B. Treat in office with acupuncture
C. Treat in office with Chinese herbs
D. Refer to physician for evaluation

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A. symptom of myasthenia gravis MOST likely could be
A. Dizziness
B. Sudden hearing loss
C. Tongue protrusion
D. Ptosis, drooping of the eyelids

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Which cranial nerve controls the tongue
A. III
B.V
C. X
D. XII

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Raising the arm above the shoulder with elicited pain at 90 degrees is used to test for
A. Thoracic outlet syndrome
B. Herniated disc
C. Rotator cuff injury
D. Acromio-clavicular injury

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The Babinski test is positive when A. The whole foot drops B. The big toe plantar flexes and the toes fan out C. The big toe dorsiflexes and the toes fan out D. The toes fan out

25. C

``` A person with a suspected herniated intervertebral disk could show signs of increased intensity of pain A. Upon urination B. While resting in a prone position C. When coughing or sneezing D. While eating a meal ```

26. C

An inflammation of the seventh cranial nerve allows the characteristic Bell's palsy trait to appear as A. Sudden loss of taste B. Paralysis, usually of one side of the face C. Sudden hearing loss D. Twitching muscles around the eyes

27. B

``` To slow the progress of osteoporosis it is BEST to ban the use of A. Alcohol B. Caffeine and smoking C. Dairy products D. Diet sodas with aspirin intake ```

28. B

``` Which type of image study is performed to evaluate muscle injury? A.MRI B. Bone scan C. Stress testing D. Regular X-ray ```

29. A

``` Which cranial nerve is NOT associated with eye movement A. II B. IV C. VI D. III ```

30. A

``` Common symptoms of meningitis include the following EXCEPT A. High fever B. Bloody diarrhea C. Stiffneck D. Drowsiness ```

31. B

``` Sympathetic nervous system B-receptors cause all the following physiological responses EXCEPT A. Vasoconstriction B. Heart rate increase C. Pupil constriction D. Bronchodilation ```

32. C

Which symptoms suggest an elderly person is having a TIA (transient ischemic attack)? A. Intermittent migraine headaches B. Brief episodes of profound sadness C. Brief experiences of sensitivity to light D. Short periods of unilateral weakness

33. D

``` Which peripheral nerve innervates the dorsal aspect of the Index, middle, and distal thumb? A. Radial nerve B. Median nerve C. Ulnar nerve D. Superficial ulnar nerve ```

34. B

McMurray test is to test for? A. Tear of the posterior cruciate ligament B. Tear of the medial collateral ligament C. Tear of the anterior cruciate ligament D. Tear of the lateral and medial meniscus

35. D

``` The dermatome of the nipples is? A. T12 B.T4 C.T7 D.T9 ```

36. B

``` When asking the patient to say "ah" and watching the movement of the soft palette and the pharynx, what cranial nerve are you testing? A. Cranial nerves V, VII B. Cranial nerves VII, X C. Cranial nerves IX, X D. Cranial nerves VII, IX ```

37. C

In older patients, benign essential tremors of the head are often confused with Parkinson's disease. Clinically, how would you distinguish benign tremors from Parkinson's disease? A. Tremors are associated with muscle rigidity B. Tremors are slower C. Tremors are slightly faster and disappear at rest D. Tremors are present at rest and activity

38. C

``` A myelogram provides a radiographic visualization of the A. Spinal cord B. Extremities C. Abdomen D. chest ```

39. A

``` The rotator cuff is composed of four muscles. Which of the following muscles is not part of the rotator cuff? A. Subscapularis B. Teres minor C. Infraspinatus D. Teres major E. Supraspinatus ```

40. D

``` In osteoarthritis, Bouchard's nodes are seen at the PIP joints, and which nodes are seen at the DIP joints? A. Colle's nodes B. Schmorle's nodes C. Heberden's nodes D. Dupuytren's nodes ```

41. C

``` A reflex scored as 2+ is considered A. No response B. Normal response C. Low normal D. Brisker than average ```

42. B

What is the most probable diagnosis with your patient with low back pain and the following symptoms: posture that became flexed and forward bent, motor weakness and hyporeflexia in the lower extremities, preferring to sit all of the time as opposed to standing? A. Back and leg pain from lumbar stenosis B. Mechanical low back pain C. Radicular low back pain D. Chronic persistent low back pain

43. A

``` McMurray test is to test for? A. patellar tendon injury B. ligament injury C. quadricep muscle injury D. meniscus injury ```

44. D

``` How many bones does the adult human body have? A. 206 bones B. 402 bones C. 360 bones D. 110 bones ```

45. A

``` Which type of membrane is composed completely of connective tissue? A. mucous membrane · B. serous membrane C. synovial membrane D. cutaneous membrane ```

46. C

``` You observe the gait of your 60 year old patient that has a wide base. After obtaining a history of no foot problems, you conclude? A. Spinal disease B. Hip disease C. Cerebral disease D. Cerebellar disease ```

47. D

A CT Brain Scan is useful in the diagnosis of all EXCEPT A. Multiple sclerosis and other degenerative diseases B. Brain tumors and abscesses c. Brain infarctions, bleeding, aneurysms, and hematomas D. Irregular brain wave activity

48. D

``` A Myelogram provides a radiographic visualization of the A. Chest B. Abdomen C. Spinal canal D. Extremities ```

49. C

``` In examining your patient from behind you notice that their trunk is lifting to the left dramatically, which the patient says is new. You most likely suspect? A. Herniated lumbar disc B. Ideopathic scoliosis C. Wedged L3 vertebrae D. Familial scoliosis ```

50. A

``` Testing the grip involves which spinal nerves? A. Cervical 7, 8, thoracic 1 B. Cervical 5, 6, 7 C. Cervical 7, 8 D. Cervical 8, thoracic 1 ```

51. A

Spondylolisthesis is? A. Commonly found newborns B. Forward slip of one vertebrae over another C. Inflammation of vertebral facets D. Arthritic changes associated with spinal facets

52. B

``` Which cranial nerve has three sensory divisions: ophthalmic, maxillary, and mandibular? A. Cranial nerve IV B · Cranial nerve III C. Cranial nerve V D. Cranial nerve VII ```

53. C

Ginger is a 16 year-old girl who developed a severe case of viral encephalitis during a trip to Japan with her parents. She was hospitalized in Kyoto and was diagnosed with Coxsackie encephalitis. She recovered well and returned home with her parents. She is coming to you for TCM treatment for her post-encephalitic headaches. She also states that she has an incessant thirst causing her to drink over 300 ounces of liquids per day. She urinates every half hour. She cannot travel far from the bathroom. She has no other symptoms. Her doctor checked her for urine glucose. The result was negative. Fasting blood sugar was 80mg/dL. What are the causes of this unusual condition? A. Cerebellar infarct B. Bladder ptosis C. Brain damage secondary to encephalitis D. Kidney damage secondary to encephalitis

54. C

Elizabeth comes to the office with her 63-year old husband Ron. She reports that he has poor memory and that he sits around not wishing to get out of bed. Sometimes he cannot remember her name. When he watches a comedy on TV he gets into a laughing fit and when watching something sad he cries for 10 minutes. Elizabeth says that once he could not talk for a couple of hours. He was once paralyzed on one side of his face but cleared up the next day. Lately, Ron has been walking with a limp. His BP is 170/1 00 and is not on any BP medication. The neurological exam reveals slight weakness of the cranial nerve VII and a foot drop on the left. The mental status exam shows that he cannot remember three objects after 30 seconds and cannot remember any of the US presidents. He is oriented in terms of person, place, and time. What referral would you make? A. Send to ER B. Cardiologist C. Neurologist D. Psychotherapist

55. C

``` Leslie is a 42 year-old housewife. She has severe pain in her neck, shoulders, and hips. She also has developed frontal headaches which are worse in the morning. The headaches are different than her previous tension headaches, which were mostly in the back of her head and neck and occurred later in the day. Leslie has trouble with her balance. She feels depressed and says that she hurts all over. The physical exam shows no sign of arthritis or other connective tissue inflammation. She has tenderness when she is palpated at the base of the neck, on inside of both knees, and also on the epicondyles of both elbows. Urinalysis, CBC, CRP, ANA, and test for RF are normal. What Is your presumptive diagnosis? A. Fibromyalgia B. Degenerative disc disease C. Chronic fatigue syndrome D. Rheumatoid arthritis ```

56. A

You are observing in an emergency room with Dr. Adams. One evening a 34 year-old comatose woman is brought in by ambulance in the ER. Her anxious husband relates to Dr. Adams and you that his wife, Mary, was preparing dinner when she complained of dizziness and inability to use her right arm. She then complained of a sudden severe headache and, a moment later, became unconscious. He tells you that she is on no medication, has no allergies, no high blood pressure, is not a smoker, does not drink, and is no a diabetic. Mary is given an IV infusion of 50% glucose and thiamine but this does not improve her level of unconsciousness. A CBC, prothrombin time, and a Chem 18 blood panel has been drawn. An in-dwelling catheter has been placed. Her urinalysis is negative. What is your presumptive diagnosis? A. Hypertensive crisis B. Right sided glioblastoma C. Hemorrhagic stroke from ruptured berry aneurysm D. Diabetic coma

57. C

Mike is a 3 year-old child. His mother relates that he has been complaining of dizziness when awake and mostly sleeping during the day as well as night. He is fully toilet trained but now is wetting the bed again. The mother has to change the sheets on an hourly basis. He eats and drinks constantly the last few weeks, yet he has lost weight. Mike is fretful and distracted. Examination is basically normal. The neurological exam shows that cranial nerves, sensation and motor are normal. DTR's are 2+. Mike has trouble standing on one foot and not falling. He does not say that the room is spinning. What diagnostic test is not needed? A. Glucose tolerance test B. HgbAlC C. Fasting blood glucose D. MRI of the brain

58. D

``` Which cranial nerves are involved with the movement of the eye? A. Cranial nerves IX, X, and XI B. Cranial nerve II C. Cranial nerves I and II D. Cranial nerves Ill, IV, and VI ```

59. D

``` Which cranial nerve provides sensory information for taste from the anterior 2/3rds of the tongue? A. Cranial nerve VII B. Cranial nerve VIII C. Cranial nerve XII D. Cranial nerve V ```

60. A

Which cranial nerve senses carotid blood pressure? A. Cranial nerve VI (abducens) B. Cranial nerve X (vagus) C. Cranial nerve VIII (vestibulocochlear) D. Cranial nerve IX (glossopharyngeal)

61. D

``` Which cranial nerve controls pupillary constriction opening of the eye and most of the extra ocular movements? A. Cranial nerve III B. Cranial nerve VI C. Cranial nerve IV D. Cranial nerve V ```

62. A

``` Which cranial nerve controls facial movements including those involved in facial expression, closing the eye, and opening the mouth? A. Cranial nerve X B. Cranial nerve VII C. Cranial nerve VIII D. Cranial nerve V ```

63. B

``` Which cranial nerve controls secretion of tears and saliva? A. Cranial nerve V (trigeminal) B. Cranial nerve VII (facial) C. Cranial nerve XI (spinal accessory) D. Cranial nerve X (vagus) ```

64. B

``` Which cranial nerve controls pupillary constriction opening of the eye and most of the extra ocular movements? A. Cranial nerve III B. Cranial nerve VI C. Cranial nerve IV D. Cranial nerve V ```

65. A

``` Which cranial nerve controls facial movements including those involved in facial expression, closing the eye, and opening the mouth? A. Cranial nerve X · B. Cranial nerve VII C. Cranial nerve VIII D. Cranial nerve V ```

66. B

``` Which cranial nerve provides sensory input for balance? A. Cranial nerve IX B. Cranial nerve VIII C. Cranial nerve VII D. Cranial nerve V ```

67. B

``` Which cranial nerve controls smell? A. Cranial nerve V (trigeminal) B. Cranial nerve XI (spinal accessory) C. Cranial nerve I (olfactory) D. Cranial nerve X (vagus) ```

68. C

Which cranial nerve controls hearing and equilibrium sensation? A. Cranial nerve VIII (vestibulocochlear or auditory) B. Cranial nerve VI (abducens) C. Cranial nerve V (trigeminal) D. Cranial nerve X (vagus)

69. A

``` Which cranial nerve provides sensory to the maxillary, mandibular, and ophthalmic areas of the face? A. Cranial nerve V B. Cranial nerve VIII C. Cranial nerve IV D. Cranial nerve IX ```

70. A

``` Which cranial nerve controls the eyelid and eyeball movement ? A. Cranial nerve II (optic) B. Cranial nerve III (oculomotor) C. Cranial nerve XI (spinal Accessory) D. Cranial nerve X (vagus) ```

71. B

``` Which cranial nerve slows heart rate? A. Cranial nerve X (vagus) B. Cranial nerve IX (glossopharyngeal) C. Cranial nerve XI (spinal accessory) D. Cranial nerve VIII (vestibulocochlear) ```

72. A

``` A 22-year old male has Acute Bacterial Meningitis. How is the diagnosis confirmed? A. CBC B. Lumbar puncture with CFS analysis C. Clinical symptoms and exams D. White blood count with CFS analysis ```

73.B

A 64 year-old female has Bell's Palsy. What are her symptoms? A. Fever, sore mouth or throat, painful blisters, lesions or sores, swollen glands and neck pain B. Numb face, limited ability to wrinkle forehead, blink, and grimace on one side of face C. Pain triggered by a chewing, speaking, face washing and toothbrushing, cold winds D. Inability to smile, droopy corner of mouth, Incoherent speech, tnabthty to raise arm

74. B

``` An 82-year old male has Alzheimer Disease. What is the treatment? A. Anti-virals (Valtrex) B. SSRI (Elavil) c. Cholinesterase inhibitors {Tegretol) D. Anti-depressants (Welbutrin) ```

75. C

A 63 year-old male is having a Hemorrhagic Stroke. What are his symptoms? A. Sudden headache, nausea, vomiting, impairment of consciousness, hemiperesis B. Severe headache, sensitivity to noise or odors; nausea or vomiting, dizziness, blurred vision, nausea C. Unconsciousness, clenched jaws and fingers, increased salivation, increased bronchial secretion, apnea D. Severe epistaxis, confusion, cold-pale skin, rapid heartbeat, dizziness

76. A

``` A 63 year-old male has had a Hemorrhagic Stroke. How is the diagnosis confirmed? A.CT B. Ultrasound C.MRI D.EEG ```

77. A

``` A 12 year-old male has Parkinson's Disease. What is the treatment? A. Levadopa B. Imuran C. Prednisone D. Tetracycline ```

78. A

``` A pinprick reveals numbness on the patella and medial malleolus. This indicates a lesion at A. S1 B. L4 C. L3 D. L5 ```

79. B

``` Thenar atrophy is due to? A. Brachial plexus compression B. Median nerve compression C. Radial nerve compression D. Brachial radialis compression ```

80. B

``` In osteoarthritis, Bouchard's nodes are seen at the PIP joints and which nodes are seen at the DIP joints? A. Heberden's nodes B. Dupuytren's nodes C. Colle's nodes D. Dequervain's nodes ```

81. A

In testing the shoulder muscles, you have the patient resistance. Which muscle does this test for? A. Supraspinatus B. Teres minor C. Biceps brachii D. Infraspinatus E. Subscapularis

82. A

``` Which of the following test for carpal tunnel syndrome? A. Drop wrist test B. Crossover test C. Lachmen test D. Tinel's sign and Phalen's test ```

83. D

In testing the knee, a positive anterior drawer sign indicates A. A tear in the ACL (anterior cruciate ligament) B. Effusion of the knee C. A tear in the PCL (posterior cruciate ligament) D. Ligamentous laxity and partial tear of the lateral collateral ligament E. Ligamentous laxity and a partial tear of the medial collateral ligament

84. A

``` The test for extension of the hips involves what muscle group? A. Iliopsoas B. Gluteus minimus C. Gluteus maximus D. Hip adductors ```

85. C

``` In doing the physical range of motion maneuvers, what phrase would you tell your patient to cause cervical extension? A. Turn your head to the left B. Touch your chin to your chest C. Look up at the ceiling D. Tilt your head to the left ```

86. C

``` Bilateral swelling and tenderness of the fingers for several weeks duration is often associated with? A. Bursitis B. Rheumatoid arthritis C. Epicondylitis D. Osteoarthritis ```

87. B

``` Normal flexion of the elbow goes from 0 degrees to? A. 90 degrees B. 1 00 degrees C. 110 degrees D. 120 degrees E. 160 degrees ```

88. E

``` The ankle deep tendon reflex is primarily associated with? A. S1 B. L4 C. L3 D. T12 ```

89. A

``` Flaccidity is commonly associated with? A. Guillain-Barre syndrome B. Parkinsonism C. Dementia D. Hypothyroidism ```

90. A

``` In Bell's palsy, the eye? A. Does not close B. Eyeball rolls down C. Eyeball moves medially D. Closes E. Eyeball moves laterally ```

91. A

``` You are testing for normal shoulder flexion using passive ROM. You expect . A. 170-180 degrees B. 190-200 degrees C. 250-260 degrees D. 90-100 degrees ```

92. A

``` You are testing for normal cervical spine flexion using passive ROM. you expect A. 70 degrees B. 60 degrees C. 90 degrees D. 80 degrees ```

93. B

``` You are testing for normal lumbar-thoracic spine flexion using passive ROM. You expect A. 35-40 degrees B. 60-65 degrees C. 45-50 degrees D. 70-75 degrees ```

94. C

``` Range of motion (ROM) is measured by a A. Goniometer B. Jointmeter C. Flexometer D. Rom-meter ```

95. A

``` You are testing for lumbar-thoracic spine flexion using passive ROM. Which of the following shows restricted movement? A. 50 degrees B. 45 degrees C. 30 degrees D. 47 degrees ```

96. C

``` When abducting the arm of patients with rotator cuff disorders, there will be pain at which degree of abduction? A. 60-120 degrees B. 150-160 degrees C. 160-180 degrees D. 20-40 degrees ```

97. A