CNS 2

Question 1

A difference of >0.4 mm in the diameter of one pupil compared to the other, is seen in
up to 38% of healthy individuals.

Answer 1

Anisocoria

Question 2

An involuntary jerking movement of the eyes with quick and slow components.

Answer 2

nystagmus

Question 3

drooping of the upper eyelid. Seen in 3rd nerve palsy, Horner syndrome and myasthenia gravis.

Answer 3

Ptosis

Question 4

are fine flickering irregular movements in small groups of muscle fibers

Answer 4

Fasciculations

Question 5

When a normal muscle with an intact nerve supply is relaxed voluntarily, it maintains a slight residual tension known as

Answer 5

muscle tone

Question 6

is velocity-dependent increased tone that worsens at the extremes of range.

Answer 6

Spasticity

Question 7

is increased resistance throughout the range of movement and in both directions; it is not rate-dependent.

Answer 7

Rigidity

Question 8

Impaired strength or weakness is called

Answer 8

paresis

Question 9

Absent strength is

Answer 9

paralysis, or plegia

Question 10

refers to weakness of one half of the body

Answer 10

Hemiparesis

Question 11

refers to paralysis of one half of the body.

Answer 11

hemiplegia

Question 12

means paralysis of the legs

Answer 12

Paraplegia

Question 13

means paralysis of all four limbs.

Answer 13

quadriplegia

Question 14

Scale for Grading Muscle Strength

Answer 14

0 —No muscular contraction detected
1 —A barely detectable flicker or trace of contraction
2 —Active movement of the body part with gravity eliminated
3 —Active movement against gravity
4 —Active movement against gravity and some resistance
5 — Active movement against full resistance without evident fatigue. This is normal muscle strength.

Question 15

Symmetric weakness of the proximal muscles suggests

Answer 15

myopathy

Question 16

symmetric weakness of distal muscles suggests

Answer 16

polyneuropathy

Question 17

In cerebellar disease, instead of alternating quickly, these movements are slow, irregular, and clumsy, an abnormality called____. It points to cerebellar disease.

Answer 17

dysdiadochokinesis

Question 18

Consistent deviation to one side which worsens with the eyes closed, referred
to as ___, suggests cerebellar or vestibular disease.

Answer 18

past pointing

Question 19

A uncoordinated gait with reeling and instability is

Answer 19

ataxic

Question 20

The patient stands fairly well with eyes open but loses balance when they are closed a positive of

Answer 20

Romberg sign

Question 21

Condition where the patient has difficulty standing with feet together whether the eyes are open
or closed.

Answer 21

cerebellar ataxia

Question 22

occurs when one forearm and palm turn inward and down and is both sensitive
and specific for a corticospinal tract lesion in the contralateral hemisphere.

Answer 22

Pronator drift

Question 23

a sensory level (when one or more sensory modalities are reduced below a dermatome on one or both sides) suggests

Answer 23

spinal cord lesion

Question 24

Symmetric distal sensory loss suggests a

Answer 24

diabetic polyneuropathy

Question 25

``` Dermatomes: ● both shoulders ● the inner and outer aspects of the forearms ● the thumbs and little fingers ● the fronts of both thighs ● the medial and lateral aspects of both legs ● the little toes ● the medial aspect of each buttock ```

Answer 25

● both shoulders (C4) ● the inner and outer aspects of the forearms (C6 and T1) ● the thumbs and little fingers (C6 and C8) ● the fronts of both thighs (L2) ● the medial and lateral aspects of both legs (L4 and L5) ● the little toes (S1) ● the medial aspect of each buttock (S3)

Question 26

___ refers to absence of pain sensation, ___ refers to decreased sensitivity to pain, and ___ refers to increased pain sensitivity.

Answer 26

- Analgesia - hypalgesia - hyperalgesia

Question 27

___ is absence of touch sensation, ___ is decreased sensitivity to touch, and ___ is increased sensitivity.

Answer 27

- Anesthesia - hypesthesia - hyperesthesia

Question 28

refers to the inability to recognize objects placed in the hand.

Answer 28

Astereognosis

Question 29

refers to the ability to identify an object by feeling it.

Answer 29

Stereognosis

Question 30

The inability to recognize numbers, or ____, indicates a lesion in the sensory cortex.

Answer 30

graphanesthesia

Question 31

is the band of skin innervated by the sensory root of a single spinal nerve.

Answer 31

Dermatome

Question 32

Scale for Grading Reflexes ``` 4 3 2 1 0 ```

Answer 32

4 - Very brisk, hyperactive, with clonus (rhythmic oscillations between flexion and extension) 3 - Brisker than average; possibly but not necessarily indicative of disease 2 - Average; normal 1 - Somewhat diminished; low normal 0 - Reflex absent

Question 33

a technique involving isometric contraction of other muscles for up to 10 seconds that may increase reflex activity.

Answer 33

Reinforcement

Question 34

Dorsiflexion of the big toe is a positive of ___, is occasionally accompanied by reflex flexion at hip and knee.

Answer 34

Babinski response

Question 35

Loss of the anal reflex suggests a lesion in the S2–3–4 reflex arc, seen in

Answer 35

cauda equina lesions