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De Myer's The Neurologic Examination > Neurologic Examination > Flashcards

Neurologic Examination Flashcards

1
Q

Any detectable change produced by neural activation of an effector

A

Behavior

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2
Q

If restricted to one part of the examination, this is the most efficient method of physical diagnosis

A

Inspection

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3
Q

site of deposition of the Kayser-Fleischer ring

A

Descemet membrane

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4
Q

Kayser-Fleischer ring can be found in what other conditions aside from Wilson hepatolenticular degeneration?

A

Aceruloplasmimemia, Primary biliary cirrhosis, Hardikar syndrome, hypercupremia

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5
Q

A unilateral corneal arcus is diagnostic of what condition?

A

Carotid Artery Stenosis

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6
Q

Intercanthal distance of normal eyes in the newborn

A

1.9 cm

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7
Q

Condition when the medial orbital walls and consequently the eyes are set too far apart?

A

Orbital Hypertelorism

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8
Q

Facial hemangiomas in Sturge-Weber Syndrome occurs in what distribution of the trigeminal nerve?

A

V1 distribution

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9
Q

Pathologic bruits become audible over the carotids after how many % stenosis?

A

50%

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10
Q

Peripheral ocular motor nerves consists of

A

III, IV, VI and carotid sympathetic nerve

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11
Q

T/F: The mind projects afferent impulses to their usual site of origin in all sensory systems

A

True

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12
Q

The retinopretectal tract is for

A

pupilloconstriction to light

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13
Q

The retinohypothalamic tract is for

A

diurnal cycle of sleep and wakefulness

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14
Q

The retinogeniculate tract is for

A

vision

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15
Q

Cones mediate

A

central field of vision, visual acuity, color vision

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16
Q

Rods mediate

A

peripheral field of vision, night vision and motion detection

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17
Q

Extent of the total field of peripheral vision

A

180 degrees wide

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18
Q

A central scotoma that blends with the blind spot is called

A 
centrocecal scotoma
(paracentral-near the point of central vision but detached from it)
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19
Q

Eye to eye distance during the confrontation testing

A

50cm

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20
Q

Characteristics of cortical blindness

A

1) complete blindness with no light perception and no response to a menacing gesture
2) loss of smooth pursuit
3) No optokinetic nystagmus
4) Normal pupillary reactions, fundoscopic examination and no nystagmus
5) Denial of blindness

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21
Q

T/F: Visible pulsations occur in nearly 90% of normal patients when both eyes are examined.

A

True

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22
Q

Swollen disc, normal vision

A

papilledema

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23
Q

Swollen disc, blurred vision

A

papillitis

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24
Q

Normal disc, blurred vision

A

Acute retrobulbar neuritis

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25
Q

Muscle with the strongest depressant action when the eye is adducted

A

Superior Oblique

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26
Q

Muscle with the strongest depressant action when the eye is abducted

A

Inferior Rectus

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27
Q

The only EOM that originates anteriorly?

A

Inferior oblique

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28
Q

Upward deviation of an eye only during occlusion of central vision?

A

Hyperphoria

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29
Q

A patient with right lateral rectus palsy would tend to keep the head turned to the ________.

A

right

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30
Q

T/F: When the patient complains of diplopia, the false image projects in the opposite direction as the direction of the eye deviation

A

True

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31
Q

Mediates the smooth pursuit system

A

Retino-geniculo-occipito-parieto-frontal-tegmental pathways

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32
Q

Alexander’s Law

A

Looking in the direction of the fast phase of a jerk nystagmus increases its amplitude

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33
Q

If the patient can move the jaw to the right but not to the left, the ___________ muscle is paralysed.

A

Right lateral pterygoid muscle

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34
Q

Which chewing muscle can you most readily palpate to check for atrophy?

A

Masseter

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35
Q

Many axial muscles that ordinarily contract symmetrically have __________ UMN innervation.

A

bilateral

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36
Q

The freest unilateral facial movement normally is

A

lip retraction

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37
Q

CN IX exclusively supplies this muscle?

A

Stylopharyngeus

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38
Q

In a normal patient, he/she should swallow a glass of tap water at a rate exceeding ___ ml/s.

A

10 ml/s

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39
Q

If the palate fails to elevate when the patient says Ah but does not elevate during the gag reflex, there is a lesion of the ____.

A

UMN

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40
Q

The most reliable sign of CN XII lesion?

A

hemiatrophy

41
Q

In activating muscles for voluntary contractions, the cerebrum communicates with the cerebellum via the corticopontocerebellar pathway, which ends mainly in the ________ lobe of the cerebellum.

A

Posterior

42
Q

T/F: The Geniculate ganglion is the only ganglion of CN VII.

A

True

43
Q

T/F: The muscles are strongest when acting from their shortest position.

A

True

44
Q

Muscles required in arm abduction

A

supraspinatus, deltoid, scapular muscles

45
Q

Muscles that hold the scapula in place against the chest wall

A

serratus anterior and trapezius

46
Q

T/F: If some abdominal muscles are weak, the umbilicus will migrate away from the pull of the intact muscles during strong abdominal contraction.

A

True

47
Q

T/F: No normal person show percussion myotonia because it indicates a primary disease of the muscle.

A

True

48
Q

T/F: Hung-up reflexes are mostly seen in patients with hypothyroidism.

A

True

49
Q

T/F: Using the counterpressure method of reinforcement to elicit muscle stretch reflex, the patient contract weakly the muscle being tested.

A

True

50
Q

T/F: Fibrillations begin about three weeks after denervation and continue for as long as the denervated muscle fiber remains alive, until the final stage of denervation atrophy when the muscle fibres die.

A

True

51
Q

T/F: The resistance in the catch-and-yield sequence of spasticity is simply a muscle stretch reflex which then fades out as the muscle spindles readjust.

A

True

52
Q

T/F: Clasp-knife spasticity indicates a lesion of the pyramidal tract whereas lead-pipe rigidity indicates a lesion of the extrapyramidal tracts.

A

True

53
Q

T/F: The sciatic nerve divides into two large branches just proximal to the knee; the branch to the toe flexors is the tibial nerve and the branch to the extensors is the peroneal nerve.

A

True

54
Q

First spinal reflex to return after spinal shock

A

Anal reflex

55
Q

Minimum rate of conduction of myelinated nerve fibers

A

3m/s

56
Q

Most sensitive area for temperature discrimination

A

forehead

57
Q

T/F: Pain of neurogenic origin arises from some form of heightened sensitivity from a lesion that affects the peripheral or central nervous system, apart from stimulation of local pain endings

A

True

58
Q

T/F: The crossed, straight leg-raising sign is nearly pathognomonic of a herniated disc.

A

True

59
Q

T/F: When testing proprioception, using digit 4 presents the greatest challenge to and therefore the best test of position sense.

A

True

60
Q

What is the minimum number of trials that the patient must get right to make chance unlikely in testing proprioception?

A

5

61
Q

T/F: The gag reflex is often absent in healthy adults and studies in stroke patients have not shown a consistent relation between an absent gag reflex and swallowing problems

A

True

62
Q

T/F: A consistent difference of more than 10-20 mmHg between the two arms suggest proximal occlusive disease, usually of one of the subclavian arteries

A

True

63
Q

This is the keystone cerebral lobe

A

Parietal lobe

64
Q

This cerebral lobe attaches the four lobes to the hemispheric hilus

A

Limbic lobe

65
Q

Regarded as the axis of symmetry of the brachial plexus

A

C7

66
Q

T/F: C1 does not have a sensory branch

A

True

67
Q

T/F: The reticular formation extends through the tegmentum from the rostral end of the spinal cord into the caudal end of the diencephalon

A

True

68
Q

T/F: The retinal image is reversed not only laterally but also vertically.

A

True

69
Q

T/F: Hemianopia is detected by using one stimulus whereas visual inattention is detected by using simultaneous stimuli.

A

True

70
Q

T/F: Because of the absence of visible pulsations in some normal persons, the presence of pulsation is more important tan its absence.

A

True

71
Q

The drusen or hyaloid bodies pressing up from beneath the nerve fiber layer may cause this condition?

A

pseudopapilledema

72
Q

Optic nerve hypoplasia associated with underdevelopment of septal region, hypothalamus and pituitary gland

A

septooptic dysplasia

73
Q

It is the only ocular muscle that originates anteriorly.

A

Inferior oblique muscle

74
Q

Two major actions of the lateral pterygoid muscles

A

Lateral movement and opening of the jaw

75
Q

T/F: Interruption of sensory afferents from the muscle will not cause paralysis.

A

True

76
Q

The patient has areflexia, hypotonia, loss of sensation but no atrophy, weakness or EMG abnormalities noted. Where is the lesion?

A

Dorsal root

77
Q

Usual time required for the denervation signs such as fibrillations to appear

A

3 weeks

78
Q

2 cranial nerves that supply sensory fibers to the olfactory epithelium

A

I, V

79
Q

Cortical representation of gustatory sensation

A 
Insular cortex (island of reil)
Adjacent parietal operculum (area 43 of brodmann)
80
Q

T/F: To present the most uniform sound, hold the tuning fork prongs perpendicular, not parallel to the patient’s ears.

A

True

81
Q

T/F: Vertigo means a specific sense of dysequilibrium as though the person or the world were spinning around or undergoing a swerving or tilting movement.

A

True

82
Q

T/F: Positional nystagmus provides an objective sign of organic disease of the labyrinthine system

A

True

83
Q

Tullio phenomenon accompanied by tinnitus, hearing loss and ear pressure sensitivity is attributed to what condition?

A

Perilymphatic fistula and superior canal dehiscence

84
Q

T/F: The cerebellum has no clinically evident role in the conscious appreciation of sensation despite massive sensory connections.

A

True

85
Q

Largest lobe of the cerebellum

A

Posterior lobe

86
Q

It is the most sensitive clinical test for gait ataxia

A

tandem walking

87
Q

T/F: Nerve fibers conducting faster than 3m/s are myelinated.

A

True

88
Q

It is the most sensitive area for temperature discrimination.

A

Forehead

89
Q

It is the part of the dorsal horn that relays pain and temperature.

A

Substantia gelatinosa of Rolando

90
Q

It is the largest branch of the median nerve.

A

Anterior interosseous nerve

91
Q

T/F: In testing position sense, where chance has a 50% success rate, the smallest number of trials the patient must get right to make chance unlikely is five trials.

A

True

92
Q

It means the inability to perform a voluntary act even though the motor system, sensory system and mental status are relatively intact.

A

Apraxia

93
Q

T/F: Apraxic patients are often unaware of their deficits and may do an act automatically that they cannot do on command.

A

True

94
Q

It is submerged area between the transverse temporal gyri and the posterior end of the Sylvian fissure.

A

Planum Temporale

95
Q

It is a false sensory perception based on natural stimulation of a sensory receptor.

A

Illusion

96
Q

It is a false sensory perception not based on natural stimulation of a sensory receptor.

A

Hallucination

97
Q

It is a false belief that reason cannot dispel.

A

Delusion

98
Q

It means the inability to locate, identify and orient one’s body parts.

A

Autotopagnosia

99
Q

A sign where an unconscious patient show a variety of mutterings, shivers, myoclonias, patterned movements of choreiform or aimless picking at the bedclothes.

A

Carphologia

De Myer's The Neurologic Examination (1 decks)

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