Neurological Exam

Question 1

What are some basic components of a medical case history?

Answer 1

Chief complaint
History of illness
Past medical and surgical history
Family history
Social history
Medications
Allergies
Review of systems

Question 2

What is the most important aspect of a neurologic exam?

Answer 2

History of present illnesses

Question 3

What does ROS mean?

Answer 3

Review of systems

Question 4

Why is the ROS important for audiology?

Answer 4

Need to know how the whole body affects the ear

Question 5

Can we review the mental status of a patient?

Answer 5

We can administer a screening (such as cognivue) to refer

Question 6

What is the MMSE?

Answer 6

Mini-mental status exam

Question 7

What does the MMSE do?

Answer 7

Helps us examine the mental status of a patient

Question 8

How do you measure orthostatic/postural blood pressure?

Answer 8

Measure BP and heart rate with change in positioning

Question 9

How can you tell if someone has orthostatic hypertension?

Answer 9

If the BP drops when they stand up

Question 10

How can someone assess CN I?

Answer 10

Smelling pungent substance one nostril at a time

Question 11

How can someone assess CN II?

Answer 11

Visual acuity chart, visual fields test, and fundoscopic exam

Question 12

How can someone assess CN III, IV, and VI?

Answer 12

Evaluate for nystagmus, consensual eye reflex, extraocular movement test, opening and closing eyelids

Question 13

How can someone assess CN V?

Answer 13

Touching with cotton wisp and cold tuning fork
Corneal reflex
Jaw movement
(sensory and motor)

Question 14

How can someone assess CN VII?

Answer 14

Ask patient to smile, grimace, and raise eyebrows
Taste anterior 2/3 of tongue
(motor and sensory)

Question 15

How can someone assess CN VIII?

Answer 15

Test hearing
Tuning fork test (weber and rinne)
Otoscopic exam
Caloric

Question 16

How can someone assess CN IX and X?

Answer 16

Test gag reflex
Inspection of palate, uvula, and pharynx
Assess voice quality
(sensory and motor)

Question 17

How can someone assess CN XI?

Answer 17

Shrug shoulders
Turn head against pressure
(motor)

Question 18

How can someone assess CN XII?

Answer 18

Tongue out and to both sides
(motor)

Question 19

What is a motor systems exam?

Answer 19

Seeing if the patient has normal muscle tone and movement

Question 20

What does a motor systems exam include?

Answer 20

Observation (inspect muscles)
Muscle tone (passive flexion and extension)
Muscle strength
Abnormal movements

Question 21

What are the two components of a sensory system exam?

Answer 21

Primary sensory modalities
Cortical sensory modalities

Question 22

What do primary sensory modalities include?

Answer 22

Test each sensory dermatome
Sharp vs dull
Light touch
Position
Temperature

Question 23

What are the cortical sensory modalities?

Answer 23

Two point discrimination
Stereognosis (object recognition)
Graphesthesia (trace symbols on skin)

Question 24

What scale are reflexes graded on?

Answer 24

0-4 (0 being no contraction and 4 being repetitive muscle shortening)
2 is normal

Question 25

What does a positive romberg test indicate?

Answer 25

Proprioceptive and vestibular dysfunction

Question 26

What does pronator drift indicate?

Answer 26

UMN lesion

Question 27

What does a positive finger to nose test indicate?

Answer 27

Dysmetria

Question 28

What does a positive RAM indicate?

Answer 28

Dysdiadochokinesia