Neurologic exam

Question 1

What are the 7 main components of the neurologic exam?

Answer 1

• Mental status/language
• CNs
• Motor
• Sensory
• Cerebellar
• Reflexes
• Gait
  (GRS MCs)

Question 2

by looking at level of consciousness you’re looking at the ______ which is testing what 3 parts of your brain?

Answer 2

• Reticular Activating System (RAS)

- medulla, thalamus, cortex

Question 3

A patient who’s unarousable and is unaware of themselves and their environment is _____

Answer 3

• in a coma

Question 4

A coma involves all or a combination of ______(3)

Answer 4

• cortex
• thalamus
• RAS

Question 5

Content of thought is looking at what 2 lobes?

Answer 5

• frontal

- temporal (anterior)

Question 6

How do you test their content of thought/cognitive status?

Answer 6

• MMSE

Question 7

Results of the MMSE vary with____

Answer 7

education and age

- this is why you always ask how far they’ve gone in school!!!!<–test question

Question 8

Strength grade 0

Answer 8

no movement of isolated muscle

Question 9

Strength grade 1

Answer 9

flicker of movement

Question 10

Strength grade 2

Answer 10

able to move perpendicular to gravity only

Question 11

Strength grade 3

Answer 11

able to move against gravity (if someone can raise their elbow they automatically have a grade 3, if they can walk–their psoas needs to be able to pull against gravity–they automatically have a 3)

Question 12

Strength grade 4

Answer 12

able to move against gravity and resistance

Question 13

Strength grade 5

Answer 13

full strength

Question 14

Strength grades 1-4 indicate _____

Answer 14

paresis (weakness)

Question 15

Strength grade 0 indicates

Answer 15

plegia

Question 16

Increased muscle tone can be due to (2)

Answer 16

• spasticity (increased tone in only one muscle or the other–flexor or extensor–resulting in stiff movement)
• rigidity

Question 17

For how long should a patient be able to sense vibration at the distal extremities?

Answer 17

• 20-(patient’s age in decades)

Question 18

What 2 things are you looking for on the cerebellar exam?

Answer 18

• appendicular ataxia (finger to nose or heel to shin testing)
• axial ataxia (gait testing)
  NOTE: ataxia is basically a tremor of the trunk muscles

Question 19

Deep tendon reflexes test the state of _____

Answer 19

the spinal cord

Question 20

Reflex grade 0

Answer 20

no reflex

Question 21

Reflex grade 1

Answer 21

hypoactive reflex (not a big deal)

Question 22

Reflex grade 2

Answer 22

normoactive reflex

Question 23

Reflex grade 3

Answer 23

hyperactive reflex (upper motor neuron problem)

Question 24

Reflex grade 4

Answer 24

clonus (reflex continues without further stimulation)