Neurologic exam

Question 1

Deficits in cognitive function include?

Answer 1

intellect, memory, or higher brain function

Question 2

Deficits in consciousness may indicate?

Answer 2

lesions of the brainstem reticular activating system or bilateral cerevral damage

Question 3

Paralysis with loss of deep tendon reflexes indicates?

Answer 3

a lower motor neuron lesion at the reflex arc at the spinal cord, spinal root, plexus or peripheral nerve

Question 4

Unilateral lesion of the spinal cord?

Answer 4

Unilateral loss of touch and position sensation and contralateral loss of temp and pain

Question 5

A peripheral nerve lesion causes?

Answer 5

lower motor neuron paralysis accompanied by anesthesia in an appropriate distribution

Question 6

Cranial nerves emerge from?

Answer 6

the brain and pass through the foramina in the base of the skull

Question 7

Tools for a neuro exam

Answer 7

smelly thing, pen light, otoscope, cotton ball, sharp/dull object, test tube, tuning fork, tongue depressor

Question 8

How to test Olfactory

Answer 8

Check for patency of both nostrils, ask pt to close eyes and one nostril, inhale, what was it? do other side

Question 9

How to test optic

Answer 9

Visual acuity with pocket visual acuity chart, test temporal and nasal fields in both eyes

Question 10

How to test oculomotor

Answer 10

Function of superior rectus, medial rectus, inferior rectus, inferior oblique, levator palpebrae superioris and pupillary reaction

Question 11

How to test oculomotor

Answer 11

Function of superior rectus, medial rectus, inferior rectus, inferior oblique, levator palpebrae superioris and pupillary reaction

Question 12

How to test trochlear

Answer 12

Superior oblique, to midline and up

Question 13

How to test Abducens

Answer 13

Lateral rectus, horizontal plane

Question 14

Opthalmic branch of trigeminal

Answer 14

Cornea, cil;iary body, conjuctiva, nasal cavity and sinuses, skin of the eyebrows, forehead and nose

Question 15

Maxillary branch of trigeminal

Answer 15

nose, upper and lower eyelids, palate, maxillary gums

Question 16

Mandibular branch of trigeminal

Answer 16

Temporal regions, external ears, lower lip, lower face, mucosa of anterior two-thirds of the tongue, mandibular gums, teeth, motor of masseter, temporalis and pterygoids

Question 17

How to test trigeminal

Answer 17

sharp to dull on forehead, cheeks, and jaw; temperature sensation by tuning fork; light touch with cotton; cornea with cotton; clench jaw

Question 18

How to test facial

Answer 18

inspect face for asymmetry, note palpebral fissures, nasolabial, and corners of mouth; elevate his eyebrows, wrinkle forehead, frown, close eyes, show teeth, whistle, smile

Question 19

Cochlear nerve supplies

Answer 19

organ of corti, structure in cochlea of inner ear which produces nerve impulses in response to sound vibration, hearing

Question 20

Vestibularsensory nerve supplies

Answer 20

semicircular ducts, proprioception of head and balance

Question 21

Whisper’s test

Answer 21

position about 2 feet away on right or left side, cover far ear, whisper word, ask pt to repeat, increase tone if pt fails

Question 22

how to do Weber test

Answer 22

distinguish between neurosensory and conductive hearing loss; tuning fork in motion, place handle against midline of skull, ask pt if heard in both ears, if normal should appear to arise in midline

Question 23

How to interpret weber test

Answer 23

lateralization of sound: if pt reports hearing better in one ear, neurosensory hearing is intact bilaterally with conductive hearing loss, or conductive hearing is intact bilaterally with neurosensory hearing loss

Question 24

How to do Rinne test

Answer 24

Distinguish between sensorineural and conductive; set tuning fork in motion, press against mastoid and ask if pt can hear, tell when stop, quickly move to ear and ask if can hear again

Question 25

Interpreting rinne test

Answer 25

sensorineural hearing loss: tone is heard louder by air than bone, positive test means air conduction is better than bone

Question 26

How to test glossopharyngeal

Answer 26

sensory of posterior tongue, tonsils, taste; motor tested with vagus, gag reflex

Question 27

How to test vagus

Answer 27

sensory of pharync, larynx, esophagus and external ear, motor of soft palate, larynx, pharynx and speech, swallowing

Question 28

Testing glossopharyngeal and vagus

Answer 28

Pharynx: Say ah, gag reflex; larynx: ask pt to swallow water observe for coughing or reflux, evaluate voice

Question 29

How to test accessory nerve

Answer 29

raise shoulders against resistance, turn head to one side and bring chin back to midline against resistance

Question 30

How to test hypoglossal

Answer 30

ask pt to protrude tongue, also ask to push tongue on inside of cheek