Neurologic Examination - 2 Lectures : Bns Exam 2 (Msq Drill 278)
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- 1.
How would you assess a patient's function?
- A.
By observing their behavior and activities
- B.
By establishing whether their thinking is abstract or concrete
- C.
By checking to see if they are alert and oriented
- D.
By checking their intermediate memory
Correct Answer
A. By observing their behavior and activities -
- 2.
You observe a patient laughing uncontrolably and at times crying for no reason. You document this as inapprpriateness of:
- A.
Demeanor
- B.
Emotion
Correct Answer
B. EmotionExplanation
Patients with Parkinson's disease have a form of emotional incontinence known as pseudobulbar palsyRate this question:
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- 3.
When testing cranial nerve 1, it is important to use a noxious substance in order to elicit the maximum response. True or false?
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
Do not use a noxious substance that can irritate their nasal lining.Rate this question:
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- 4.
Why should each nostril be tested individually?
- A.
Because they have one central innervation
- B.
Because each has its own innervation
Correct Answer
B. Because each has its own innervationExplanation
A patient can have an olfactory tract impingement that could be missed if the nostrils are not tested individually.Rate this question:
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- 5.
Why is it important to check the olfactory nerve in patient's with parkinson's disease?
- A.
They never lose their sense of smell unless the disease has worsened.
- B.
They have no sense of smell
- C.
They have a tendency to lose their sense of smell.
Correct Answer
C. They have a tendency to lose their sense of smell. -
- 6.
When doing a funduscopic exam, it is important to examine the head of the ________ .
- A.
Cornea
- B.
Optic nerve
- C.
Retina
Correct Answer
B. Optic nerveExplanation
AKA disc.Rate this question:
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- 7.
The pupillary light reflex tests the integrity of:
- A.
The motor portion of CN 2
- B.
The afferent portion of CN 2
- C.
Motor portion of CN 3
- D.
Afferent portion of CN 3
Correct Answer
B. The afferent portion of CN 2 -
- 8.
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?
- A.
Visual acuity
- B.
Visual fields
Correct Answer
B. Visual fields -
- 9.
Is the visual fields by confrontation test a very specific diagnostic test that usually will pick up minute visual deficincies?
- A.
Yes
- B.
No
Correct Answer
B. NoExplanation
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.Rate this question:
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- 10.
Testing the sensation of pain to the skin on the upper face is testing done for which of the following?
- A.
V-2
- B.
V-3
- C.
V-1
- D.
CN-7
Correct Answer
C. V-1 -
- 11.
The corneal friction rub should elicit a response in which eye(s)?
- A.
Ipsilateral
- B.
Contralateral
- C.
Bilateral
Correct Answer
C. BilateralExplanation
A direct and a contralateral response.Rate this question:
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- 12.
In order to expedite the neurologic exam, all the divisions of the trigeminal nerve should be checked at the same time. True or false?
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
Each division should be checked individually.Rate this question:
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- 13.
The sensory portion of the facial nerve innervates:
- A.
Post 1/3 of the tongue
- B.
Ant 2/3rds of the tongue
- C.
Post 2/3 of the tongue
- D.
Ant 1/3 of the tongue
Correct Answer
B. Ant 2/3rds of the tongue -
- 14.
When checking for the sense of taste on the tongue, one must remember to:
- A.
Check the front and back of the tongue
- B.
Check each side of the tongue on its own.
Correct Answer
B. Check each side of the tongue on its own. -
- 15.
A left hemispheric stroke will manifest itself on the face as:
- A.
Paralysis of the whole right side of the face
- B.
Paralysis of the upper portion of the right side of the face
- C.
Paralysis of the contralateral lower quadrant of the face.
Correct Answer
C. Paralysis of the contralateral lower quadrant of the face.Explanation
The lower face is innervated contralaterally by the upper motor neuron. The upper face has bilateral cortical input.Rate this question:
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- 16.
A pontine stroke will manifest itself on a patient's face as:
- A.
Paralysis to the top part of the face
- B.
Paralysis to the whole side
- C.
Paralysis to the bottom part of the face
Correct Answer
B. Paralysis to the whole side -
- 17.
You place a vibrating fork on a patient's head and ask them where they are feeling the vibration. You are perfomring a ______ test.
- A.
Rhinne
- B.
Kernig's
- C.
Weber's
Correct Answer
C. Weber's -
- 18.
The Rhine test tests for conductivity of both:
- A.
Air
- B.
Bone
- C.
Hair
- D.
Skin
Correct Answer(s)
A. Air
B. Bone -
- 19.
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?
- A.
Right
- B.
Left
Correct Answer
B. LeftExplanation
Conductive hearing lateralizes away from the affected side.Rate this question:
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- 20.
What nerve is responsible for taste to the posterior 2/3 of the tongue?
- A.
CN-5
- B.
CN-7
- C.
CN-12
- D.
CN 9
Correct Answer
D. CN 9 -
- 21.
The gag reflex should be elicited by irritating the middle portion of the uvula only. True or false?
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
Each side should be checked separately. The motion of the uvula should be symmetrical.Rate this question:
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- 22.
When checking the gag reflex, does the palate go up or down?
- A.
Up
- B.
Down
Correct Answer
A. Up -
- 23.
Cranial nerve 11 is essentialy a ____ nerve.
- A.
Sensory
- B.
Motor
Correct Answer
B. Motor -
- 24.
When checking a patient with a lesioned right cranial nerve 12, the tongue will be observed deviated to the:
- A.
Right
- B.
Left
Correct Answer
A. RightExplanation
The tongue will deviate to the weak side.Rate this question:
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- 25.
Muscle fasciculations are always pathological. Tue or false?
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
Sleep deprivation and coffee can cause fasciculations. But, they are also seen in patients with Lou Gehrigs and AMS.Rate this question:
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- 26.
The words spastic and rigid are describing the _____- of a muscle.
- A.
Fitness
- B.
Tone
Correct Answer
B. Tone -
- 27.
When checking muscle strength it is important to check only the distal portions as these have the greatest effect against gravity. True or false?
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
Both proximal and distal portions of the muscle must be checked.Rate this question:
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- 28.
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?
- A.
0/5
- B.
1/5
- C.
2/5
- D.
3/5
- E.
4/5
Correct Answer
B. 1/5 -
- 29.
A patient is able to bend their arm against gravity. How would you grade them?
- A.
0/5
- B.
1/5
- C.
2/5
- D.
3/5
- E.
4/5
Correct Answer
D. 3/5 -
- 30.
A patient's muscle is flaccid:
- A.
0/5
- B.
1/5
- C.
2/5
- D.
3/5
Correct Answer
A. 0/5 -
- 31.
A patient has ful motion of their arm and the examiner cannot break. The patient can resist the examiner fully.
- A.
0/5
- B.
1/5
- C.
2/5
- D.
3/5
- E.
5/5
Correct Answer
E. 5/5 -
- 32.
A patient can move their muscle but cannot resist gravity:
- A.
1/5
- B.
2/5
- C.
3/5
- D.
4/5
Correct Answer
B. 2/5 -
- 33.
Which of the following have small unmyelinated fibers? Check all that apply.
- A.
Pain
- B.
Temperature
- C.
Vibration
- D.
Proprioception
Correct Answer(s)
A. Pain
B. TemperatureExplanation
Vibration and proprioception have large myelinated fibers. This is why we use a pin prick for testing pain sensation.Rate this question:
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- 34.
When checking two point discrimination the further apart the two points that they can distinguish the ________ the problem
- A.
Less severe
- B.
Worse
Correct Answer
B. Worse -
- 35.
Which of the following can you use to assess diabetic neuropathy in a diabetic patient?
- A.
Weber's test
- B.
Vibrating tuning fork to hands and feet
- C.
Babinski
Correct Answer
B. Vibrating tuning fork to hands and feet -
- 36.
Which of the following has the tendency to menifest itself in a dermatomal fashion?
- A.
Sensory
- B.
Motor
Correct Answer
A. Sensory -
- 37.
The nipple line is around:
- A.
T3
- B.
T4
- C.
T5
- D.
T6
Correct Answer
B. T4 -
- 38.
Xiphoid process:
- A.
T3
- B.
T4
- C.
T5
- D.
T6
- E.
T7
Correct Answer
E. T7 -
- 39.
Umbilicus:
- A.
T7
- B.
T8
- C.
T9
- D.
T10
- E.
T11
Correct Answer
D. T10 -
- 40.
Groin:
- A.
T8
- B.
T9
- C.
T10
- D.
T11
- E.
T12
Correct Answer
E. T12 -
- 41.
A patient with a fine tremor may have a lesion in their:
- A.
Cortex
- B.
Cerebellum.
- C.
Hippocampus
- D.
Thalamus
- E.
Internal capsule
Correct Answer
B. Cerebellum.Explanation
Parkinsonian patient mey exhibit a high amplitude tremor.Rate this question:
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- 42.
The finger to nose test is usually done with the patient's eyes open or closed?
- A.
Open
- B.
Closed
Correct Answer
B. Closed -
- 43.
What test is done to check for cerebellar function. This test would pick up ataxia in one of the extremities if it is lesioned.
- A.
Slow alternating test
- B.
Rapid alternating test
- C.
Heel to shin test
Correct Answer
B. Rapid alternating testExplanation
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.Rate this question:
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- 44.
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?"
- A.
Decrepitation of movement
- B.
Decomposition of movement
- C.
Delineation of movement
Correct Answer
B. Decomposition of movement -
- 45.
Cerebellar function can also be assessed by observing a patient's gait. True or false?
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
So tremor, gair and smoothness give an idea of cerebellar function.Rate this question:
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- 46.
Biceps reflex tests ________ and brachioradialis reflex tests ___________ respectively.
- A.
C2 & C3
- B.
C5 & C6
- C.
C4 & C5
- D.
C6 & C7
Correct Answer
B. C5 & C6 -
- 47.
Triceps reflex tests____ .
- A.
C5
- B.
C6
- C.
C7
- D.
C8
Correct Answer
C. C7 -
- 48.
Patellar reflex ______- and Achilles reflex _________.
- A.
L3 & S1
- B.
L4 & S2
- C.
L4 & S1
- D.
L2 & S2
Correct Answer
C. L4 & S1 -
- 49.
No reflex is elicited. What is the grading?
- A.
0/4
- B.
1/4
- C.
2/4
- D.
3/4
- E.
4/4
Correct Answer
A. 0/4 -
- 50.
The reflex is elicited with subsequent clonus.
- A.
0/4
- B.
1/4
- C.
2/4
- D.
3/4
- E.
4/4
Correct Answer
E. 4/4 -
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