Approach to the Neurologic Exam

Question 1

what is defective articulation?

Answer 1

dysarthria

Question 2

what is dysarthria usually caused by?

Answer 2

defect in motor control of speech apparatus

Question 3

what is a disorder in producing or understanding language?

Answer 3

aphasia

Question 4

what is aphasia usually caused by?

Answer 4

lesions in the dominant hemisphere

Question 5

what is the major difference between delirium and dementia?

Answer 5

delirium is reversible while dementia is not

Question 6

ptosis can be caused by a lesion on what cranial nerve?

Answer 6

CN III

Question 7

if a patient has a lesion on CN III what direction will their eye present as?

Answer 7

down and out

Question 8

what is the medical term for the presentation of the eye direction of down and out?

Answer 8

opthalmoplegia

Question 9

a patient with a cranial nerve IV lesion will present with what?

Answer 9

eye position that drifts medially and upwards

Question 10

what is the most common isolated CN palsy?

Answer 10

CN VI palsy

Question 11

a CN VI palsy is seen most often in patients with what?

Answer 11

subarachnoid hemorrhage, late syphilis, and trauma

Question 12

a patient with a cranial nerve V lesion will have jaw deviation where?

Answer 12

toward the weak side

Question 13

what reflex is lost if a patient has a CN V lesion?

Answer 13

corneal reflex

Question 14

what is trigeminal neuralgia?

Answer 14

recurrent brief episodes of unilateral shock-like pain along one or more distributions of the trigeminal nerve

Question 15

what is trigeminal neuralgia cuased by?

Answer 15

aberrant vein or artery compression on the nerve

Question 16

if you have a lesion of the CN VII, what will result?

Answer 16

paralysis of the muscles of facial expression (Bell’s palsy)

Question 17

what type of facial paralysis is bell’s palsy?

Answer 17

peripheral facial paralysis

Question 18

what type of facial palsy is a supranuclear facial palsy?

Answer 18

central

Question 19

how can you tell if a lesion of CN VII is central or peripheral in nature?

Answer 19

peripheral lesions of CN VII will cause paralysis of both the upper and lower quadrant of one side of the face while a central lesion will only causes paralysis of one lower quadrant

Question 20

lesions of CN VIII-vestibular result in what?

Answer 20

disequilibrium and nystagmus

Question 21

lesions of CN VIII- cochlear result in what?

Answer 21

hearing loss or tinnitus

Question 22

what are the two phases of nystagmus?

Answer 22

1. slow drift away from an object 2. saccade (quick reaction back)

Question 23

what is a nystagmus named for?

Answer 23

the saccade phase

Question 24

which cranial nerves are responsible for the gag reflex?

Answer 24

IX and X (in IX out X)

Question 25

if there is a lesion of cranial nerve XI and there is paralysis of the SCM, what will result?

Answer 25

difficulty turning the head to the opposite side

Question 26

if there is a lesion of cranial nerve XI and there is weakness of the trapezius muscle what will result?

Answer 26

unilateral shoulder droop

Question 27

testing for pain is testing what tract?

Answer 27

the spinothalamic tract

Question 28

testing for temperature is testing what tract?

Answer 28

the spinothalamic tract

Question 29

testing for vibration is testing what?

Answer 29

the posterior columns

Question 30

testing proprioception is testing what?

Answer 30

the posterior columns

Question 31

what is stereognosis?

Answer 31

the ability to identify shapes of objects

Question 32

what is graphesthesia?

Answer 32

ability to identify numbers written on the palm

Question 33

what does the rhomberg test for?

Answer 33

vision, vestibular, proprioception

Question 34

what are the signs of cerebellar ataxia?

Answer 34

staggering, unsteady, feet wide apart

Question 35

what are the signs of sensory ataxia?

Answer 35

unsteady, feet wide apart, feet thrown forward and slapped down first on the heels then forefoot, patients watch the ground when walking