PRELIMS: Intro to Neurologic Examination

Question 1

How to conduct Mental Status Examination

Answer 1

Assess word articulation, speech content, and overall mental status.
Check for alertness and orientation to time, place, and person.
Observe facial expression, eye movements, blinking, and posture.

Question 2

Cranial Nerve I Testing

Answer 2

Test sense of smell using extracts like vanilla or lemon.
Ask the patient to identify the scent with eyes closed.

Question 3

Cranial Nerves II, III, IV, VI Testing

Answer 3

Test visual fields and pupillary light reflex (CN II).
Observe eye movements and alignment of palpebral fissures (CNs III, IV, VI).

Question 4

Cranial Nerve VII Testing

Answer 4

Check facial strength: Ask the patient to smile and close their eyes tightly.
Observe for symmetry in facial movements.

Question 4

FOUR TYPES OF OPERATIONS IN A NEUROLOGIC EXAMINATION

Answer 4

Inspection
Questions
Request or Command
Maneuvers

Question 4

Sensory System Testing

Answer 4

Assess light touch, pain/temperature, or proprioception, especially at the toes.
If a spinal lesion is suspected, test each dermatome and perianal sensation.

Question 5

Motor System: Strength Testing

Answer 5

Test shoulder abduction, elbow extension, wrist extension, finger abduction, hip flexion, knee flexion, and ankle dorsiflexion.
Observe the patient’s gait and coordination during casual walking, heel-toe walk, and tandem walk.

Question 5

Fatigability Testing

Answer 5

Have the patient perform repetitive eye movements.
Measure the width of the palpebral fissure at rest and after 1 minute of upward gaze to assess for fatigue in cranial nerve muscles.

Question 6

Difficulty in articulating the individual sounds or the units (phonemes) of speech, the f’s, r’s, g’s, vowels, consonants, labials (CN VII), gutturals (CN X), and linguals (CN XII).

Answer 6

DYSARTHRIA

Question 6

It is level of alertness, appropriateness of responses, orientation to date and place

Answer 6

Mental Status

Question 7

Difficulty in producing voice sounds (phonating).

Answer 7

DYSPHONIA

Question 8

DYSARTHRIA what CN are affected?

Answer 8

(CN VII), (CN X), and CN XII).

Question 8

Difficulty with the melody and rhythm of speech, the accent of syllables, the inflections, intonations, and pitch of the voice.

Answer 8

DYSPROSODY

Question 9

Difficulty in expressing or understanding words as the symbols of communication.

Answer 9

DYSPHASIA

Question 10

Test higher level sensory functions, if the history or mental status examination suggests a cerebral lesion you will test for?

Answer 10

test for graphagnosia, finger agnosia, poor twopoint discrimination, right or left disorientation, topagnosia, and tactile, auditory, and visual inattention to bilateral simultaneous stimuli.