Neurology 1.3 Flashcards

(56 cards)

1
Q

What is the significance of a careful history during a neurological exam?

A

hx can be used to get most of the necessary information in localizing a lesion which gives rise to a neurologic complaint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

In a neurological exam, how is mental status evaluated?

A

alert, oriented to person, place, time ( patient gives a cogent medical history)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

In a neurological exam, how is speech evaluated?

A

fluent, normal syntax, comprehension, repetition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

In a neurological exam, how are cranial nerves evaluated?

A

visual fields, extra ocular movements, fundoscopic exam, facial symmetry and facial sensation, and hearing is normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

In a neurological exam, how are motor nerves evaluated?

A

mass, tone and strength of muscles (compare bilaterally)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

In a neurological exam, how are sensory nerves evaluated?

A

light touch, pin prick and double simultaneous stimulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

In a neurological exam, how is gait evaluated?

A

stepping, toe-heel walking, turning; be observant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

In a neurological exam, how is cerebellar function evaluated?

A

finger nose finger, heal shin, no involuntary movements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

In a neurological exam, how are reflexes evaluated?

A

upper and lower extremities, toes planter bilaterally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

In a neurological exam, how is cerebrovascular function evaluated?

A

carotid, orbital or cranial bruits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

In a neurological exam, how is musculoskeletal function evaluated?

A

range of motion axial and appendicular structures, normal Osteopathic exam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which neurological exam requires the most patient cooperation?

A

sensory nerve function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the goal directed behavior of executive functioning in testing mental status?

A

complex set of activities (involves, volition, planning, purpose, action, and effective performance). Activities of daily living affected.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is praxis?

A

(idiomotor apraxia; can’t do a simple task when asked, but can do it involuntarily); tested during mental status exam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is Gerstmann Syndrome and how is it tested?

A

left posterior hemispheric lesion;

1) R-L confusion (touch left shoulder, etc.)
2) Finger agnosia (inability to recognize fingers, pinky? Index/)
3) Agraphia (inability to write; couldn’t write name)
4) Acalculia (inability to calculate 2=+1=, 4+2=?)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which domains are affected in Gerstmann Syndrome?

A

1) visuospatial (r-l confusion, fingers)
2) praxis (can’t write name)
3) calculation (dyscalculia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which domains are unaffected in Gerstmann Syndrome?

A

1) level of consciousnes
2) memory
3) mood
4) thought content

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the Montreal Cognitive Assessment test?

A

MoCA; test short term memory, visual spatia, repetition of words, executive functioning, attention, concentration, working memory, orientation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is CN I?

A

olfactory nerve; important test in early CNS degenerative disorder assesment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is CN II?

A

optic nerve; visual fields and acuity, also tested with fundoscopic exam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is inspected in a fundoscopic exam?

A

1) disc margins
2) venous pulsations
3) retinal vessels
4) retina
5) macula

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is anisocoria?

A

asymmetric pupils; pupillary defect in CN III

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is CN III?

A

oculomotor; anisocoria, Horner’s syndrome

24
Q

Which nerves are being tested with eye movements?

A

CN III, IV, VI; ptosis, EOM, nystagmus

25
What is Internuclear Opthalmoplegia?
INO; produced by lesion of medial longitudinal fasciculus which connects CN VI with CN III
26
How is Internuclear Opthalmoplegia tested?
impaired adduction on affected side with nystagmus in the other abducting eye
27
What is CN IV?
trochlear nerve
28
What is CN V?
trigeminal nerve; facial sensation and mastication muscles
29
What is CN VI?
abducens nerve
30
What is CN VII?
facial nerve; controls facial muscles; lesion is usually peripheral; Bell's Palsy
31
What is Bell's Palsy?
peripheral weakness or paralysis of one side of the face causing facial droop; CN VII
32
What is CN VIII?
vestibulocochlear nerve; hearing, balance
33
Which nerves test palatal movement?
CN IX, X; "say ahh", gag reflex
34
Which nerves test dysarthria?
CN VII, IX, X, XII; articulation errors and voice quality
35
Which nerves test head rotation and shoulder elevation?
CN XI (sternocleidomastoid and trapezius)
36
What is CN IX?
glossopharyngeal nerve
37
What is CN X?
vagus nerve
38
What is CN XI?
spinal accessory nerve; head rotation and shoulder elevation
39
What is CN XII?
hypoglossal nerve; tongue weakness
40
What is monoparesis?
weakness of a single limb
41
What is hemiparesis?
weakness of one side of the body
42
What is paraparesis?
weakness of both lower extremities
43
What is quadraparesis?
weakness of all four limbs
44
What is plegia?
complete or nearly complete paralysis of the involved limbs
45
What is diplegia?
applied mainly to bilateral facial paralysis
46
What is spasticity?
clasp knife (give and catch) requires additional force; part of muscle tone
47
What is rigidity?
increased resistance throughout range of motion; part of muscle tone
48
What is rapid alternating movements?
hands on thighs and rapidly supinate; pronate hands for 10 seconds
49
What is dysdiadochokinesis?
inability to perform rapid alternating movements slow or irregular; movement disorder
50
What is point to point movements?
index finger from axaminer's to nose and back and forth
51
What is dysmetria?
inability to perform point to point movements
52
What is heel down shin?
side down from know to top of foot
53
What is the Rhomberg test?
patient stands still, feet together, then ask patient to close eyes and extend arms; positive if significant and immediate loss of balance (be prepared to make a catch)
54
What is the cerebrovascular evaluation?
auscultate for carotid, orbital and cranial bruits
55
What is a false positive of a cerebrovascular test?
anemia hypermetabolic state pressing too hard with stethoscope
56
What is a false negative of a cerebrovascular test?
total occlusion