Neuro SPBL

Question 1

order of exam

Answer 1

• metal status
• CNs
• motor
• sensory
• reflexes
• coordination
• gait and balance

Question 2

mental status

Answer 2

-yr, season date, day month
-where are we? (5)
-name 3 objects
-spell world backwards
-repeat the 3 objects
-point to 2 objects and have them name
. . . SP should tell us to move on

Question 3

CN 1

Answer 3

• pt closes eys

- hold 2 different odors under nose have them ID

Question 4

CN 2, 3, 4 and 6

Answer 4

done in eye exam

Question 5

CN 5

Answer 5

• motor: palpate temporal muscles while pt clenches teeth - both sides at once
• sensory: light touch face w/ pt eyes closed - both sides at same time; pt id where touched and if both at same time

Question 6

CN 7

Answer 6

• show teeth
• raise eyebrows
• puff out cheeks

Question 7

CN 8 and 9

Answer 7

8: done in ear exam
9: gag reflex (don’t do)

Question 8

CN 10

Answer 8

palatal elevation - have pt say ahh

Question 9

CN 11

Answer 9

• shoulder shrug against resistance

- turn head both ways against resistance

Question 10

CN 12

Answer 10

• stick out tongue

- deviation points toward side of defect

Question 11

motor tests

Answer 11

• tone: resist down pull on arm and release quickly
• tone: (leg) lift leg up and drop
• fine motor movement: finger tap rapidly then foot tap
• strength: in musculoskeletal exam

Question 12

sensory

Answer 12

• light touch hands and feet
• pinprick hands and feet
• vibration hands and feet
• proprioception finger and toes
• 2 point discrimination
• graphesthesia
• stereognosis
• tactile extinction

Question 13

reflexes

Answer 13

-biceps
-brachioradialis
-triceps
-patellar
-achilles
-babinski
(both sides)

Question 14

coordination

Answer 14

• finger to nose
• heel to shin
• rapid alternating movements
• precision finger tap

Question 15

gait and balance

Answer 15

• regular gait
• toe-walking
• heel walking
• tandem gait
• romberg

Question 16

general ROS (6)

Answer 16

• fever
• chills
• night sweats
• fatigue
• weakness
• weight change

Question 17

head ROS (4)

Answer 17

• headache
• dizziness
• syncope
• hx of trauma

Question 18

eye ROS (not all inclusive)

Answer 18

• visual acuity
• blurring
• diploplia
• pain
• redness
• tearing

Question 19

ear ROS

Answer 19

• hearing loss
• pain
• tinnitus
• discharge

Question 20

Neuro ROS (13)

Answer 20

• syncope
• fainting
• seizures
• weakness
• paralysis
• numbness
• tingling
• tremors
• involuntary movements
• ataxia
• dysphonia
• bowel or bladder dysfunction
• hx of stroke

Question 21

peripheral vascular ROS

Answer 21

• leg cramps
• leg edema
• varicose veins
• hx of:
• thrombophlebitis
• PE
• DVT