Week 1 Neurology History, Examination & Investigations

Question 1

What is Rinne’s and Weber’s tests

Answer 1

Used to test for cranial nerve VIII (whisper in one ear while blocking the other)

Question 2

What is the Mini-Mental State Examination (MMSE)?

Answer 2

Used to assess for dementia

Question 3

What are MMSE, MoCA, ACE-3 all examples of.

Answer 3

Cognitive function tests to assess for dementia

Question 4

When assessing tone what is lead pipe rigidity +/- cogwheeling a sign of?

Answer 4

Extrapyridimidal problem

Question 5

What nerve root does each reflex correspond to?

Biceps
Supinator
Triceps
Finger jerk

Knee
Ankle
Plantar responses

Answer 5

Biceps C5
Supinator C6
Triceps C7
Finger jerk C8

Knee L3/4
Ankle S1
Plantar responses S1

Hint: I do bi curls at 5, have a break for soup a 6, triceps at 7 then finally jerk off at 8

Question 6

What are the 6 stages of Medical Research Council (MRC) muscle power assessment?

Answer 6

0. No contraction
1. Flicker or trace of contraction
2. Active movement with gravity eliminated
3. Active movement against gravity
4. Active movement against gravity and resistance
5. Normal power

Question 7

What can you do reinforce an UL reflex?

Answer 7

Ask patient to clench their jaw

Question 8

What can you do to reinforce a lower limb reflex?

Answer 8

Ask patient to clasp their hands and pull their arms apart

Question 9

What does a postive Romberg’s Test
imply?

Answer 9

Sensory ataxia

Stand up, feet together and close eyes
+ve Romberg’s test = falling without correction = sensory ataxia = abnormal

Question 10

What would you do to test for proprioception?

Answer 10

Joint position sense
Finger-tip and toe
Ask patient to close eyes and move joint UP or DOWN
Start distally and work proximally

Question 11

What roots correspond to which leg power test?

Hip flexion
Hip extension
Knee flexion
Knee extension
Ankle dorsiflexion
Ankle plantar flexion

Answer 11

Hint: Work in order of front and down to up and back. Exception is ankle plantar flexion which comes last because it is the biggest movement.

Hip Flexion: L1/2
Knee Extension: L3/4
Ankle dorsi flexion: L4
Ankle plantar flexion: S1/S2
Knee flexion: L5/S1
Hip extension: L5/S1

Question 12

What roots correspond to which upper limb power test?

Shoulder abduction
Shoulder adduction
Elbow flexion
Elbow extension
Wrist flexion
Wrist extension
Finger abduction
Thumb adduction

Answer 12

Shoulder abduction C5
Shoulder adduction C6/7
Elbow flexion C5/6
Elbow extension C7
Wrist flexion C6/7
Wrist extension C6
Finger abduction T1
Thumb adduction T1