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

1. The words spastic and rigid are describing the _____- of a muscle.

Fitness

Tone

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. 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.

6. 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.

7. Groin:

T8

T9

T10

T11

T12

8. 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

9. A brisk reflex is elicited.

0/4

14

2/4

3/4

4/4

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

0/4

1/4

2/4

3/4

4/4

11. 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.

12. 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

13. Cranial nerve 11 is essentialy a ____ nerve.

Sensory

Motor

14. 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.

15. 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.

16. When checking the gag reflex, does the palate go up or down?

Up

Down

17. 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.

18. A patient's muscle is flaccid:

0/5

1/5

2/5

3/5

19. The Rhine test tests for conductivity of both:

Air

Bone

Hair

Skin

Submit

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. Which of the following has the tendency to menifest itself in a dermatomal fashion?

Sensory

Motor

22. Umbilicus:

T7

T8

T9

T10

T11

23. 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

24. A comatose patient may have a grasp reflex. True or false?

True

False

25. 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.

26. 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

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.

28. When checking two point discrimination the further apart the two points that they can distinguish the ________ the problem

Less severe

Worse

29. 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.

30. 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.

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. 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

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

Cornea

Optic nerve

Retina

AKA disc.

Explanation

AKA disc.

37. 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

38. Patellar reflex - and Achilles reflex ___.

L3 & S1

L4 & S2

L4 & S1

L2 & S2

39. 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

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

CN-5

CN-7

CN-12

CN 9

41. The finger to nose test is usually done with the patient's eyes open or closed?

Open

Closed

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. 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

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

1/5

2/5

3/5

4/5

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 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

49. 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.

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

0/4

1/4

2/4

3/4

4/4

52. 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.

53. 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.

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

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

1. The words spastic and rigid are describing the _____- of a muscle.

2.

What first name or nickname would you like us to use?

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

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

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?

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

6. Why should each nostril be tested individually?

7. Groin:

8. 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?

9. A brisk reflex is elicited.

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

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

12. 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.

13. Cranial nerve 11 is essentialy a ____ nerve.

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

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

16. When checking the gag reflex, does the palate go up or down?

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

18. A patient's muscle is flaccid:

19. The Rhine test tests for conductivity of both:

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?

21. Which of the following has the tendency to menifest itself in a dermatomal fashion?

22. Umbilicus:

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

24. A comatose patient may have a grasp reflex. True or false?

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

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

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

28. When checking two point discrimination the further apart the two points that they can distinguish the ________ the problem

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

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

31. The nipple line is around:

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?

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.

34. Triceps reflex tests____ .

35. The sensory portion of the facial nerve innervates:

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

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

38. Patellar reflex ______- and Achilles reflex _________.

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

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

41. The finger to nose test is usually done with the patient's eyes open or closed?

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?

43. A normal reflex is elicited.

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

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

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

47. Xiphoid process:

48. 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?"

49. 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?

50. What do the following have in common?glabellar, roting, palmomental, grasp, snout and suck.

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

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

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

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

55. The reflex is elicited with subsequent clonus.

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

57. The pupillary light reflex tests the integrity of:

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

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

38. Patellar reflex - and Achilles reflex ___.

46. Biceps reflex tests and brachioradialis reflex tests ___ respectively.

50. What do the following have in common?

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