Neurology Exam

Question 1

Lesion in the brain

Answer 1

unilateral or bilateral UMN signs (tetra/hemi-paresis/paralysis), seizures, behavioural changes, CN deficits, decreased consciousness, cerebellar and vestibular signs, UMN bladder

Question 2

Lesion in C1-C5

Answer 2

upper signs in all 4 limbs, UMN bladder, hyper reflexia (lack of inhibition), paralysis/paresis

Question 3

Lesion in C6-T2

Answer 3

lower signs in forelimbs (hyporeflexia, atrophy), upper signs in hind limbs (intact/hyperactive reflexes, paresis/paralysis), UMN bladder

Question 4

Lesion in T3 - L3

Answer 4

normal forelimbs, upper signs in hind limbs (intact reflex, paresis/paralysis), UMN bladder

Question 5

Lesion in T4 - S3

Answer 5

normal forelimbs, lower signs in hind limbs (hypo/areflexia, paresis/paralysis), LMN bladder

Question 6

Overview of neuro exam

Answer 6

observe mental status, gait and posture
palpate muscular and skeletal system
evaluate postural reactions
evaluate cranial nerves
evaluate spinal nerves
evaluate sensation

Question 7

lack of responsiveness

Answer 7

depression

Question 8

depressed but can be aroused with pain

Answer 8

stupor

Question 9

severely depressed, cannot be aroused with stimuli

Answer 9

coma

Question 10

What is responsible for arousal of the cerebrum?

Answer 10

reticular activating system, deals with intelligence, lethargy, cranial nerves

Question 11

What deals with intelligence and goal directed behaviour

Answer 11

thalamocortex

Question 12

What is ataxia and what 3 aspects tie into coordination?

Answer 12

ataxia is incoordination or lack of awareness of limb position. 
conscious proprioception (crossing over of affected limb, scuffing of toes), cerebellum (broad based stance), vestibular

Question 13

What are some postural reactions?

Answer 13

hopping, placing, wheelbarrowing, extensor postural thrust, hemi walking

Question 14

pupillary light reflexes test which CNs?

Answer 14

optic and oculomotor

Question 15

Menace response tests which CNs?

Answer 15

optic and facial

Question 16

Oculocephalic reflex tests?

Answer 16

vestibulocochlear

Question 17

jaw tone indicates

Answer 17

trigeminal

Question 18

tongue tone indicates

Answer 18

hypoglossal

Question 19

a gag reflex tests

Answer 19

vagus and glossopharyngeal

Question 20

Hind limb nerve innervation + reflexes

Answer 20

flexor - sciatic and femoral
patellar - femoral
cranial tibial - sciatic

Question 21

forelimb nerve innervation + reflexes

Answer 21

flexor - musculocutaneous, median, ulnar

extensor carpi radialis - radial

Question 22

perineal reflex tests which nerve?

Answer 22

pudendal

Question 23

What is a crossed extensor reflex?

Answer 23

There are long spinal reflexes between limbs that are usually suppressed by UMNs. Damage to the UMNs releases this inhibition and flexion of one limb in response to a noxious stimulus is accompanied by extension of the contralateral limb.

Question 24

Describe an “upper motor neuron” bladder

Answer 24

small
reflex incomplete emptying
difficult to express

Question 25

Describe a “lower motor neuron” bladder

Answer 25

dilated, atonic, easily expressed

Question 26

What nerve does the panniculus reflex involve?

Answer 26

lateral thoracic nerve

Question 27

how can you test deep pain?

Answer 27

digit clamping