Neurologic Examination - 2 Lectures : Bns Exam 2 (Msq Drill 278)

2. A patient has ful motion of their arm and the examiner cannot break. The patient can resist the examiner fully.

0/5

1/5

2/5

3/5

5/5

3. Cerebellar function can also be assessed by observing a patient's gait. True or false?

True

False

So tremor, gair and smoothness give an idea of cerebellar function.

Explanation

So tremor, gair and smoothness give an idea of cerebellar function.

4. Closing the patient's left eye and then using your right hand, you ask the patient to notify you if they can see your fingers that you are wiggling in their peripheral vision. What are you testing?

Visual acuity

Visual fields

5. Why should each nostril be tested individually?

Because they have one central innervation

Because each has its own innervation

A patient can have an olfactory tract impingement that could be missed if the nostrils are not tested individually.

Explanation

A patient can have an olfactory tract impingement that could be missed if the nostrils are not tested individually.

6. When checking muscle strength it is important to check only the distal portions as these have the greatest effect against gravity. True or false?

True

False

Both proximal and distal portions of the muscle must be checked.

Explanation

Both proximal and distal portions of the muscle must be checked.

7. Groin:

T8

T9

T10

T11

T12

8. No reflex is elicited. What is the grading?

0/4

1/4

2/4

3/4

4/4

9. A brisk reflex is elicited.

0/4

14

2/4

3/4

4/4

10. The heel of the patient's leg is stroked with a continous lateral stroke applied by the examiner. The examiner continues to stroke the ball of the foot of the patient. The patient's toes flair in response to this test. How would you interprete this finding?

Negative babinski

Positive babinski

12. Muscle fasciculations are always pathological. Tue or false?

True

False

Sleep deprivation and coffee can cause fasciculations. But, they are also seen in patients with Lou Gehrigs and AMS.

Explanation

Sleep deprivation and coffee can cause fasciculations. But, they are also seen in patients with Lou Gehrigs and AMS.

13. You perform a pronator drift test on a patient with a left sided cortical stroke. On what side would you expect the arm to pronate and drift.

Left hand drift

Right hand drift

14. When testing cranial nerve 1, it is important to use a noxious substance in order to elicit the maximum response. True or false?

True

False

Do not use a noxious substance that can irritate their nasal lining.

Explanation

Do not use a noxious substance that can irritate their nasal lining.

15. Why is it important to check the olfactory nerve in patient's with parkinson's disease?

They never lose their sense of smell unless the disease has worsened.

They have no sense of smell

They have a tendency to lose their sense of smell.

16. The Rhine test tests for conductivity of both:

Air

Bone

Hair

Skin

Submit

18. A patient's muscle is flaccid:

0/5

1/5

2/5

3/5

19. A patient with a fine tremor may have a lesion in their:

Cortex

Cerebellum.

Hippocampus

Thalamus

Internal capsule

Parkinsonian patient mey exhibit a high amplitude tremor.

Explanation

Parkinsonian patient mey exhibit a high amplitude tremor.

20. You tap on the patient's forehead. You stop tapping but notice that the patient's eyes keep blinking. How would you interprete this test?

Negative frontal test

Positive glabellar

Negative frontal test

Negative glabellar

It is a normal finding in infants though.

Explanation

It is a normal finding in infants though.

21. You observe a patient laughing uncontrolably and at times crying for no reason. You document this as inapprpriateness of:

Demeanor

Emotion

Patients with Parkinson's disease have a form of emotional incontinence known as pseudobulbar palsy

Explanation

Patients with Parkinson's disease have a form of emotional incontinence known as pseudobulbar palsy

23. Umbilicus:

T7

T8

T9

T10

T11

25. How would you assess a patient's function?

By observing their behavior and activities

By establishing whether their thinking is abstract or concrete

By checking to see if they are alert and oriented

By checking their intermediate memory

26. The gag reflex should be elicited by irritating the middle portion of the uvula only. True or false?

True

False

Each side should be checked separately. The motion of the uvula should be symmetrical.

Explanation

Each side should be checked separately. The motion of the uvula should be symmetrical.

27. When a patient is brain dead can a relfex still be elicited?

Yes

No

lower motor neuron, there is no cortical input in a simple motor reflex.

Explanation

lower motor neuron, there is no cortical input in a simple motor reflex.

29. Is the visual fields by confrontation test a very specific diagnostic test that usually will pick up minute visual deficincies?

Yes

No

It is a gross exam. Visual field testing may be needed for more accurate diagnosis although a stroke such as an occipital lobe stroke can be picked up by visual field testing.

Explanation

It is a gross exam. Visual field testing may be needed for more accurate diagnosis although a stroke such as an occipital lobe stroke can be picked up by visual field testing.

30. When checking a patient with a lesioned right cranial nerve 12, the tongue will be observed deviated to the:

Right

Left

The tongue will deviate to the weak side.

Explanation

The tongue will deviate to the weak side.

31. The nipple line is around:

T3

T4

T5

T6

32. In order to expedite the neurologic exam, all the divisions of the trigeminal nerve should be checked at the same time. True or false?

True

False

Each division should be checked individually.

Explanation

Each division should be checked individually.

33. You place a vibrating fork on a patient's head and ask them where they are feeling the vibration. You are perfomring a ______ test.

Rhinne

Kernig's

Weber's

34. Triceps reflex tests____ .

C5

C6

C7

C8

35. When doing a funduscopic exam, it is important to examine the head of the ________ .

Cornea

Optic nerve

Retina

AKA disc.

Explanation

AKA disc.

36. The sensory portion of the facial nerve innervates:

Post 1/3 of the tongue

Ant 2/3rds of the tongue

Post 2/3 of the tongue

Ant 1/3 of the tongue

37. Testing the sensation of pain to the skin on the upper face is testing done for which of the following?

V-2

V-3

V-1

CN-7

38. A pontine stroke will manifest itself on a patient's face as:

Paralysis to the top part of the face

Paralysis to the whole side

Paralysis to the bottom part of the face

39. What nerve is responsible for taste to the posterior 2/3 of the tongue?

CN-5

CN-7

CN-12

CN 9

40. Patellar reflex ______- and Achilles reflex _________.

L3 & S1

L4 & S2

L4 & S1

L2 & S2

42. You are testing a patient's muscles and you notice that they can elicit a contraction but cannot move the extremity. How would you grade them?

0/5

1/5

2/5

3/5

4/5

43. A normal reflex is elicited.

1/4

2/4

3/4

4/4

44. A patient can move their muscle but cannot resist gravity:

1/5

2/5

3/5

4/5

45. Which of the following can you use to assess diabetic neuropathy in a diabetic patient?

Weber's test

Vibrating tuning fork to hands and feet

Babinski

46. Biceps reflex tests ________ and brachioradialis reflex tests ___________ respectively.

C2 & C3

C5 & C6

C4 & C5

C6 & C7

47. Xiphoid process:

T3

T4

T5

T6

T7

48. When perfomring the Weber's test, if a patient has a lesioned nerve on the right, on which side will they hear feel the vibrating fork?

Right

Left

Conductive hearing lateralizes away from the affected side.

Explanation

Conductive hearing lateralizes away from the affected side.

49. When observing the motion, an intact cerebellum will manifest itself in smooth movements. What is the term used to describe a patient that has a lesion that breaks up the movement into component "unsmooth parts?"

Decrepitation of movement

Decomposition of movement

Delineation of movement

50. What do the following have in common?

glabellar, roting, palmomental, grasp, snout and suck.

Lower motor neuron damage signs

Frontal release signs

Cortical release signs

Parietal release signs

Seen in infants and patients with parkisons as well.

Explanation

Seen in infants and patients with parkisons as well.

51. A left hemispheric stroke will manifest itself on the face as:

Paralysis of the whole right side of the face

Paralysis of the upper portion of the right side of the face

Paralysis of the contralateral lower quadrant of the face.

The lower face is innervated contralaterally by the upper motor neuron. The upper face has bilateral cortical input.

Explanation

The lower face is innervated contralaterally by the upper motor neuron. The upper face has bilateral cortical input.

52. What test is done to check for cerebellar function. This test would pick up ataxia in one of the extremities if it is lesioned.

Slow alternating test

Rapid alternating test

Heel to shin test

You watch both sides as the patient is performing the RAM's. The lesioned side will be ataxic. Remember not to confuse ataxia with asteristix.

Explanation

You watch both sides as the patient is performing the RAM's. The lesioned side will be ataxic. Remember not to confuse ataxia with asteristix.

53. The reflex is elicited and it is less than normal.

0/4

1/4

2/4

3/4

4/4

54. The corneal friction rub should elicit a response in which eye(s)?

Ipsilateral

Contralateral

Bilateral

A direct and a contralateral response.

Explanation

A direct and a contralateral response.

55. The reflex is elicited with subsequent clonus.

0/4

1/4

2/4

3/4

4/4

56. When checking for the sense of taste on the tongue, one must remember to:

Check the front and back of the tongue

Check each side of the tongue on its own.

57. The pupillary light reflex tests the integrity of:

The motor portion of CN 2

The afferent portion of CN 2

Motor portion of CN 3

Afferent portion of CN 3

58. A patient is able to bend their arm against gravity. How would you grade them?

0/5

1/5

2/5

3/5

4/5

59. Which of the following have small unmyelinated fibers? Check all that apply.

Pain

Temperature

Vibration

Proprioception

Vibration and proprioception have large myelinated fibers. This is why we use a pin prick for testing pain sensation.

Explanation

Vibration and proprioception have large myelinated fibers. This is why we use a pin prick for testing pain sensation.

Submit