NCS Neuro Screen & Differential Diagnosis

Question 1

what are the components of the neurological screen

Answer 1

observation and mental status
reflex testing
sensation
motor
coordination
CN screen
balance

Question 2

what should you assess during your mental status assessment

Answer 2

alertness, orientation, memory screen, behavior, language, attention, affect

Question 3

what does the pronator drift test assess
a. sensation
b. motor
c. coordination

Answer 3

b. motor - look to see if there is weakness

Question 4

what is considered a positive pronator drift test

Answer 4

elbow flexion, pronation, or reduced shoulder flexion

Question 5

you are doing a neuro screen on your patient who has a glioblastoma. on sensation testing, they demonstrate a + extinction test. this means there is a deficit of what brain area
a. dorsolateral prefrontal cortex
b. posterior parietal cortex
c. mediotemporal lobe

Answer 5

b. posterior parietal cortex

Question 6

you are performing coordination testing as part of your neuro screen. your patient demonstrates deficits while performing RAMS of the forearm. how would you document these deficits
a. hypermetria
b. hypometria
c. dysdiadochokinesia
d. dysmetria

Answer 6

c. dysdiadochokinesia

Question 7

true or false: a positive Romberg exam indicates a sensory deficit affecting balance

Answer 7

true

Question 8

true or false: a positive Romberg exam indicates a sensory deficit affecting balance due to impaired vestibular sense

Answer 8

false - could be vestibular, motor, BG, cerebellum

Question 9

for cranial nerve testing, how do you screen but not test CN 1

Answer 9

ask about changes in smell

Question 10

for cranial nerve testing, how do you screen but not test CN 2

Answer 10

ask about changes in vision

Question 11

for cranial nerve testing, how do you screen but not test CN 7

Answer 11

ask about changes in taste

Question 12

how do you test CN 2

Answer 12

test visual fields, pupil light reflex, peripheral vision

Question 13

what CNs are you testing with oculomotility

Answer 13

3,4,6

Question 14

how do you test the motor portion of CN 7

Answer 14

facial expressions

Question 15

how do you test the motor portion of CN 5

Answer 15

muscles of mastication

Question 16

how do you test the sensory portion of CN 5

Answer 16

facial sensation

Question 17

how do you test CN 8

Answer 17

hearing finger rub

Question 18

how do you test CN 9 and 10

Answer 18

palate/uvula elevation vs deviation

Question 19

how do you test CN 11

Answer 19

shoulder shrug and head turn

Question 20

how do you test CN 12

Answer 20

stick tongue out in midline

Question 21

you are testing your patients cranial nerves and note that their tongue sticks out and to the R
you then know they have a palsy of what CN
a. L CN 9
b. R CN 9
c. L CN 12
d. R CN 12

Answer 21

d. R CN 12

Question 22

true or false: the following are NON emergent red flags
bowel/bladder dysfunction, neuro signs inconsistent with dx, bulbar or CN changes, change in cognition

Answer 22

true

Question 23

your patient comes in for strengthening and does not have a diagnosis. you find a pattern of proximal over distal weakness. this presentation is consistent with lesion of
a. brainstem
b. neuromuscular junction
c. polyneuropathy
d. myopathy

Answer 23

d. myopathy

Question 24

your patient comes in for strengthening and does not have a diagnosis. you find a pattern of weakness of some overused BLE. this presentation is consistent with lesion of
a. brainstem
b. neuromuscular junction
c. polyneuropathy
d. myopathy

Answer 24

b. neuromuscular junction

Question 25

perceptual sensory disorders such as stereognosis, extinction, and graphesthesia is associated with injury to what brain area
a. frontal cortex
b. mediotemporal cortex
c. posterior parietal cortex
d. cerebellum

Answer 25

c. posterior parietal cortex