Clinical Assessment of Neurological Disorders

Question 1

What are the functions of the frontal lobe?

Answer 1

Intellectual function, praxis, inhibition, bladder continence, saccadic eye movement, motor function, expression of language.

Question 2

What symptoms may occur in frontal lobe dementia?

Answer 2

Disinhibited behavior, sweet tooth, reduced smell, bladder dysfunction, gait apraxia, progressive motor dysphasia.

Question 3

Where are primary motor neurons located?

Answer 3

Layer 4 of the motor cortex (Brodmann area 4).

Question 4

Where do most motor fibers cross in the brain?

Answer 4

At the medullary pyramids.

Question 5

What tract do most crossing motor fibers enter after decussation?

Answer 5

Lateral corticospinal tract.

Question 6

A lesion in the right motor cortex causes weakness on which side?

Answer 6

Left (contralateral) upper motor neuron weakness.

Question 7

A spinal cord lesion on the right side affects which side of the body?

Answer 7

Right side below the lesion (ipsilateral UMN signs).

Question 8

What are signs of a left MCA territory stroke?

Answer 8

Right UMN facial weakness, expressive dysphasia, right arm > leg weakness.

Question 9

What is the visual deficit in a left occipital lobe stroke?

Answer 9

Right homonymous hemianopia.

Question 10

What functions are attributed to the parietal lobe?

Answer 10

Sensory integration and receptive language.

Question 11

What occurs with a dominant parietal lobe lesion?

Answer 11

Dyslexia, acalculia, poor left-right discrimination, finger agnosia.

Question 12

What symptoms occur with temporal lobe seizures?

Answer 12

Déjà vu, jamais vu, hallucinations, panic, fear, tonic-clonic seizures.

Question 13

What type of sensation does the spinothalamic tract carry?

Answer 13

Pain and temperature.

Question 14

Where do spinothalamic fibers cross?

Answer 14

At the level of the spinal cord entry.

Question 15

What sensations do posterior column pathways carry?

Answer 15

Joint position, deep pressure, and vibration.

Question 16

Where do posterior column fibers cross?

Answer 16

In the medulla.

Question 17

What cranial nerves originate in the midbrain?

Answer 17

3, 4

Question 18

Which cranial nerves originate in the pons?

Answer 18

5, 6, 7, 8

Question 19

Which cranial nerves originate in the medulla?

Answer 19

9, 10, 11, 12

Question 20

What is Weber syndrome?

Answer 20

Ipsilateral CN III palsy and contralateral hemiparesis.

Question 21

What is Wallenberg syndrome?

Answer 21

Lateral medullary infarct with ipsilateral ataxia, Horner’s, vertigo, and contralateral sensory loss.

Question 22

What are the three functional regions of the cerebellum?

Answer 22

Vermis (balance), paravermis (tone), cerebellar hemispheres (fine coordination).

Question 23

What are the features of cerebellar dysfunction (VANISH’D)?

Answer 23

Vertigo, ataxia, nystagmus, intention tremor, slurred speech, hypotonia, dysmetria.

Question 24

Do cerebellar lesions cause ipsilateral or contralateral signs?

Answer 24

Ipsilateral.

Question 25

What functions are associated with thalamic regions?

Answer 25

Movement, sensation, mood, vision, and hearing.

Question 26

What can result from a ventroposterior thalamic infarct?

Answer 26

Severe sensory loss and pain syndromes.

Question 27

What are the components of a neurological exam?

Answer 27

Cognition, cranial nerves, motor, sensory, coordination, gait, Romberg's.

Question 28

What are three tools used for cognitive assessment?

Answer 28

MMSE, ACE-R, MOCA.

Question 29

What signs occur with a complete CN III lesion?

Answer 29

Eye down and out, dilated pupil, partial ptosis.

Question 30

What is Horner’s syndrome?

Answer 30

Ptosis, miosis, anhidrosis—loss of sympathetic supply.

Question 31

What distinguishes UMN vs LMN facial weakness?

Answer 31

UMN: lower face only (contralateral); LMN: full face (ipsilateral).

Question 32

What are the key signs of upper motor neuron lesion (UMNL)?

Answer 32

Spasticity, hyperreflexia, Babinski sign.

Question 33

What are signs of lower motor neuron lesion (LMNL)?

Answer 33

Flaccidity, atrophy, fasciculations, reduced reflexes.

Question 34

How is muscle power graded?

Answer 34

From 0 (no movement) to 5 (normal power).

Question 35

What does an extensor plantar response indicate?

Answer 35

UMN lesion (Babinski sign).

Question 36

What is clonus?

Answer 36

Repetitive, rhythmic muscle contractions after stretch—sign of UMN lesion.

Question 37

What sensations are tested for spinothalamic tract function?

Answer 37

Pain and temperature.

Question 38

What sensations are tested for posterior column function?

Answer 38

Vibration and joint position.

Question 39

What type of sensory loss occurs in Brown-Séquard syndrome?

Answer 39

Ipsilateral posterior column and motor loss; contralateral spinothalamic loss.

Question 40

What is syringomyelia?

Answer 40

Central cord lesion causing dissociative sensory loss and possibly UMN signs.

Question 41

What is anterior spinal artery syndrome?

Answer 41

Bilateral motor and spinothalamic loss, with spared posterior columns.

Question 42

What is a spastic gait?

Answer 42

Stiff, scissoring pattern, often due to bilateral UMNL.

Question 43

What is a Parkinsonian gait?

Answer 43

Shuffled, slow steps, festinant in advanced cases.

Question 44

What is a cerebellar gait?

Answer 44

Broad-based, unsteady.