Neurology

Question 1

What are the 12 cranial nerves?

Answer 1

• Olfactory
• Optic
• Ophthalmic
• Trochlear
• Trigeminal
• Abducens
• Facial
• Vestibulocochlear
• Glossopharyngeal
• Vagus
• Accessory
• Hypoglossal

Question 2

Causes of clonus

Answer 2

• stroke
• multiple sclerosis
• cerebral palsy
• spinal cord damage

Question 3

Typical features of Parkinsonism

Answer 3

• bradykinesia
• rigidity
• tremor
• postural instability

Question 4

What does a confusion screen include?

Answer 4

CT head, vitamin B12 and folate levels, syphilis screen, glucose, TFTs, MSU

Question 5

What is the name of and how would you examine the 1st cranial nerve?

Answer 5

Olfactory nerve

• ask patient if they’ve had a change in smell
• offer to test using smelling salts

Question 6

What is the name of and how would you examine the 2nd cranial nerve?

Answer 6

Optic nerve

• test for visual acuity with Snellen chart
• state correct visual acuity for each eye
• test visual fields for both eyes
• accommodation for both eyes
• direct and consensual light reflex
• offer to perform:
• -fundoscopy
• -corneal reflex
• -colour vision with Ishihara plates

Question 7

What is the name of and how would you examine the 3rd, 4th and 6th cranial nerves?

Answer 7

Ophthalmic, trochlear and Abducens

• inspect for equal pupil size and ptosis
• test for full range of eye movement, asking about diplopia
• pause at extremities for nystagmus

Question 8

What is the name of and how would you examine the 5th cranial nerve?

Answer 8

Trigeminal

• state jaw jerk reflex
• test sensation over face bilaterally in all three areas
• test strength of masseter and temporals muscles (clench teeth, move jaw side to side, open jaw against resistance)

Question 9

What is the name of and how would you examine the 7th cranial nerve?

Answer 9

Facial

• inspect face, comment on any asymmetry
• ask about taste
• examine muscles of facial expression (raise eyebrows, scrunch up eyes, smile and puff out cheeks)

Question 10

What is the name of and how would you examine the 8th cranial nerve?

Answer 10

Vestibulocochlear

• test hearing using stimulus eg whispering in both ears
• offer to perform Rinne’s and Weber’s tests

Question 11

What is the name of and how would you examine the 9th and 10th cranial nerves?

Answer 11

Glossopharyngeal and Vagus

• examine for uvular deviation
• state gag reflex

Question 12

What is the name of and how would you examine the 11th cranial nerve?

Answer 12

Accessory

• ask to shrug shoulders against resistance
• deviate head left and right against resistance

Question 13

What is the name of and how would you examine the 12th cranial nerve?

Answer 13

Hypoglossal

• examine tongue for deviation, wasting and fasciculations
• test for tongue strength by pressing over cheek

Question 14

What are the important points to cover in a cerebellar exam?

Answer 14

DANISH:

• Dysdiadochokinesia
• Ataxia
• Nystagmus
• Intention tremor
• Slurred, staccato speech
• Hypotonia/heel-shin test