Neurologic

Question 1

Beginning in childhood or adolescence, running in families, and three times more common in adult women then men refers to which type of headache?

Answer 1

Migraine

Question 2

Stress, lights, alcohol ingestion are common triggers for which type of headache?

Answer 2

Migraine

Question 3

Preceding aura of scotomata, unilateral location; pulsatile quality and pain that increases with activity is associated with?

Answer 3

Migraine

Question 4

MOST prevalent form of primary headaches?

Answer 4

Tension

Question 5

Presents as typically bilateral, non-throbbing, and mild-to-moderate in severity is often found with?

Answer 5

Tension headaches

Question 6

Headaches that are progressively frequent or severe over a 3 month period, sudden onset with a thunderclap or “worst headache of my life” and/or new onset after age 50 y/o are considered?

Answer 6

Red flags and need prompt investigation

Question 7

Major section of the neurological exam that assess complex, coordinated motor functions of the cerebellums and associated motor pathways is part of the _____ exam.

Answer 7

Coordination exam

Question 8

Major section of the neurological exam that assess sensory and motor functions of the cranial nerves and their associated central and peripheral structures is part of the _____ exam.

Answer 8

Cranial nerve exam

Question 9

Major section of the neurological exam that assess the cerebellum and descending pathways in the spinal cord through coordinated motor functions of walking and is a portion of the coordination exam is known as the ____ exam.

Answer 9

Gait exam

Question 10

Major section of the neurological exam that assess cognitive functions of the cerebrum is known as the _____.

Answer 10

Mental status exam

Question 11

Assessing muscle tone, strength, and presence of atrophy are part of the neurologic exam of the ____ systems.

Answer 11

Motor

Question 12

Vibration, position, pin prick, temperature, and light touch are used as part of the neurologic exam of the _____ system

Answer 12

Sensory system

Question 13

Clonus, Hoffman’s response, or Babinski are considered?

Answer 13

Reflexes

Question 14

Observing gait and Rhomberg is used in the neurologic exam to assess?

Answer 14

Coordination

Question 15

Optimal to assess the vibratory sense is the ____ hertx tuning fork?

Answer 15

126 Hertz

Question 16

Which system is stimulated by physiological and psychological stressors?

Answer 16

Sympathetic nervous system

Question 17

Which system conserves body resources, maintains digestion/elimination?

Answer 17

Parasympathetic nervous system

Question 18

Voluntary movement, fine motor skills, and eye movements occur here

Answer 18

Frontal lobe

Question 19

This lobe processes sensory data such as sound, taste, smell, sight, temperature, and pain

Answer 19

Parietal lobe

Question 20

This is the perception and interpretation center of the brain. It also controls balance and speech through Wernicke’s area

Answer 20

Temporal lobe

Question 21

This is the visual center of the brain

Answer 21

Occipital lobe

Question 22

This portion of the brain interprets sensory data for reflex control to maintain muscle tone, balance, and posture

Answer 22

Cerebellum

Question 23

This is regulates respiratory control, circulatory system, swallowing, coughing, and sneezing

Answer 23

Medulla

Question 24

This regulates respirations and reflexes

Answer 24

Pons

Question 25

How many cranial nerves are there?

Answer 25

12

Question 26

How many spinal nerves are there?

Answer 26

31

Question 27

Fever, headache, and neck stiffness are the triad for this diagnosis

Answer 27

Meningitis

Question 28

Which area of the brain is associated with strong emotions, anxiety and panic?

Answer 28

Amygdala

Question 29

What is the screening tool used for depression?

Answer 29

PHQ-9 questionaire

Question 30

Which areas of the brain are affected by SUDs?

Answer 30

Basal ganglia, extended amygdala, and the prefrontal cortex

Question 31

Which spinal nerve(s) is this DTR assessing? Achilles

Answer 31

S1, S2

Question 32

Which spinal nerve(s) is this DTR assessing? Biceps

Answer 32

C5, C6

Question 33

Which spinal nerve(s) is this DTR assessing? Brachioradial

Answer 33

C5, C6

Question 34

Which spinal nerve(s) is this DTR assessing? Patellar

Answer 34

L2-L4

Question 35

Which spinal nerve(s) is this DTR assessing? Triceps

Answer 35

C6-C8

Question 36

Olfactory

Answer 36

CNI

Question 37

CNI is assessed by...

Answer 37

Inhaling a scent into one nares and a different scent in the other nares. The patient should be able to smell both and differentiate between the two

Question 38

Optic

Answer 38

CNII

Question 39

CNII is assessed by....

Answer 39

Visual acuity screening tool

Question 40

Oculomotor, Trochlear, and Abducens

Answer 40

CNII, CNIV, and CNVI

Question 41

How are CNIII, CNIV, and CNVI assessed?

Answer 41

EOM (H exam)

Question 42

Trigeminal

Answer 42

CNV

Question 43

How is CNV assessed?

Answer 43

CNV has 3 divisions and assessed with sharp, dull, and light touch on the forehead, cheeks and the the chin/jawline bilaterally

Question 44

Facial

Answer 44

CNVII

Question 45

How is CNVII assessed?

Answer 45

The facial nerve is assessed with the various facial expressions of: squeeze your eyes shut, raise your eyebrows, wrinkle your forehead, show me your teeth, puff your cheeks, purse your lips

Question 46

Acoustic

Answer 46

CNVIII

Question 47

How is CNVIII assessed?

Answer 47

This is the hearing exams such as the whisper test or the Weber/Rinne exams. This is also where vestibular function is assessed due to the CNVIII innervation of the cochlea which is assessed with the Romberg test.

Question 48

Glossopharyngeal and Vagus

Answer 48

CNIX and CNX

Question 49

How are CNIX and CNX assessed?

Answer 49

They are assessed simultaneously with the gag reflex and the swallowing reflex. CNIX can also be assessed by taste as it is used for sour and bitter taste, however this is not readily available in practice.

Question 50

Spinal accessory

Answer 50

CNXI

Question 51

How is CNXI assessed?

Answer 51

This innervates the trapezius and sternocleidomastoid muscles so it is assessed by placing a hand on each shoulder and asking the patient to shrug against your resistance and then placing a hand on the cheek and asking the patient to turn laterally against your resistance

Question 52

Hypoglossal

Answer 52

CNXII

Question 53

How is CNXII assessed?

Answer 53

This nerve innervates the tongue so it is assessed by asking the patient to move their tongue in/out, side-to-side and up/down as well as listening for speech

Question 54

OOOTTAFAGVSH

Answer 54

Olfactory Optic Oculomotor Trochlear Trigeminal Abducens Facial Acoustic Glossopharyngeal Vagus Spinal Hypoglossal

Question 55

Key Findings/Physical Exam: Unilateral facial weakness and drooping; eyelid weakness; facial pain; pain around the ear; abnormal taste; reduced hearing; hx of recent infection

Answer 55

Bells Palsy

Question 56

Key Findings/Physical Exam: Difficulty eating, drinking, and swallowing; poor nutrition; difficulty with speech, language, and coordination; scoliosis, hip dysplasia, non-specific back pain, increased muscle tone/dystonia and spasticity, muscle fatigue, headaches, nonspecific abdominal pain, dental pain, dysmenorrhea; sleep disturbances; depression, anxiety, antisocial behaviors, learning disabilities, ADHD; vision/hearing impairments; vomitting, regurgitation and reflux; constipation; epilepsy; hx of preterm birth, low birth weight

Answer 56

Cerebral palsy

Question 57

Key Findings/Physical Exam: Jerking movements of one or more extremities; nystagmus; abrupt movement of head to one side or the other; moans or cries; fearful or sad emotions; humming or buzzing noises; intense or unpleasant smells or tastes; tingling in one area or side of the body; flashing lights in a portion of the visual fields

Answer 57

Epilepsy

Question 58

Key Findings/Physical Exam: Trauma hx; N/V, headache, AMS, seizures; weakness or paralysis, facial droop, monocular or binocular blindness, blurred vision, dysarthria, vertigo, ataxia, aphasia

Answer 58

Hemorrhagic stroke

Question 59

Key Findings/Physical Exam: Sudden onset of severe headache; "thunderclap" headache; nuchal rigidity, photophobia or eye pain; N/V; syncope

Answer 59

Subarachnoid hemorrhage

Question 60

Key Findings/Physical Exam: Persistent headaches that wake patient from sleep; seizures; visual changes; appetite loss; N/V; changes in behavior or personality; children may experience irritability, lethargy, cranial nerve palsies, and weight loss; confusion; papilledema; aphasia; nystagmus; ataxia; CT/MRI positive findings

Answer 60

Intracranial tumor

Question 61

Key Findings/Physical Exam: Sudden severe headache with no known cause; abrupt onset of hemiparesis or monoparesis; visual field changes; facial droop; ataxia; nystagmus; aphasia (expressive or receptive); sudden numbness or weakness of face, arm, or leg; abrupt decrease in LOC

Answer 61

Ischemic stroke

Question 62

Key Findings/Physical Exam: Fever; chills; headache; neck stiffness; N/V; lethargy; sleepiness; photophobia; confusion; irritability; delirium; seizures; coma; AMS; nuchal rigidity; increased BP with bradycardia; positive Brudzinski's and Kernig's signs; petechial and purpura rash

Answer 62

Meninigitis

Question 63

Key Findings/Physical Exam: Paresthesia; muscle cramping d/t spaticity; bowel/bladder dysfunction; constipation; dysarthria, nystagmus, intention tremor; Lhermitte's sign (electric shock sensation); Trigeminal neuralgia; fatigue; heat intolerance; decreased attention span, concentration, memory loss; depression; BPD; dementia; localized weakness; hyper-reactive reflexes; increased muscle tone/stiffness; optic neuritis

Answer 63

MS

Question 64

Key Findings/Physical Exam: Drooping eyelids; double vision; difficulty swallowing or speaking; fatigue or weakness; difficulty walking; facial weakness when puffing out cheeks; hypophonia; respiratory compromise; skeletal muscle weakness

Answer 64

MG

Question 65

Key Findings/Physical Exam: Genetic pattern of inheritance; confusion, depression, cognitive dysfunction, dementia, psychosis; rest tremors, slowness of movement, freezing or inability to continue movements, rigidity, postural instability; pill-rolling movement with fingers, head tremors, numbness, tingling, muscle soreness, difficulty swallowing, drooling, stooped posture, shuffled gait, slow slurred speech

Answer 65

Parkinsons Disease

Question 66

Key Findings/Physical Exam: Numbness, tingling, shooting, burning, electric shock sensations; all sensation is painful; occurs in hands and feet; night pain in one or both feet; reduced touch sensation; reduced sensation in feet with monofilament examination; diminished post tibial and dorsalis pedis pulses; distal muscle weakness, cannot stand on toes or heels; skin ulcerations

Answer 66

Peripheral neuropathy

Question 67

Key Findings/Physical Exam: Unilateral burning, stabbing, electric shock, excruciating facial pain in chin or cheek; pain episodes may occur several times/day to several times/month; increased pain with chewing, swallowing, talking, brushing teeth, cold exposure; intermittent pain-free periods; inflammation of maxillofacial region, ENT; hx of recent dental work, MS

Answer 67

Trigeminal neuralgia

Question 68

Test: clinician flexes the patient's neck forward and the patient bends the hips/knees in response to the neck flexion

Answer 68

Positive Brudzinski's test

Question 69

Toe walking helps assess which spinal nerve?

Answer 69

S1