Neurologic Exam & Radiologic/other studies

Question 1

Cranial Nerve: Olfactory (CN I)

Answer 1

smell

Projects from olfactory regions to the midbrain

Question 2

Cranial Nerve: Optic (CN II)

Answer 2

vision

Projects from the retina to the midbrain

Question 3

Cranial Nerve: Oculomotor (CN III)

Answer 3

adjusts/coordinates eye position during movement

Originates from the midbrain and projects to all extracellular muscles

Question 4

Cranial Nerve: Trochlear (CN IV) and Abducens (CN VI)

Answer 4

Trochlear - vertical eye movement
Originates from midbrain and projects to superior oblique muscles

Abducens - horizontal eye movement
Originates from the pons and projects to the lateral rectus muscle

Question 5

Cranial Nerve: Trigeminal (CN V)

Answer 5

sensory innervation to the face

Originates from the pons and innervates the upper, middle, and lower portions of the face

Question 6

Cranial Nerve: Facial (CN VII)

Answer 6

control facial movement and expression

Originates from lower pons and upper medulla

Question 7

Cranial Nerve: Vestibulocochlear (CN VIII)

Answer 7

auditory and vestibular functions

Projects from the auditory canal to the pontomedullary junction

Question 8

Cranial Nerve: Glossopharyngeal (CN IX)

Answer 8

General somatic sensory functions, including touch, pain, and temperature

Stems from medullar and projects to the pharynx, middle ear, and posterior tongue

Question 9

Cranial Nerve: Vagus (CN X)

Answer 9

Swallowing, gag reflex, digestion, heart rate, breathing

Originates in the medulla and provides parasympathetic innervation to the heart, lungs, and digestive tracts

Question 10

Cranial Nerve: Spinal Accessory (CN XI)

Answer 10

Neck and shoulder movement

Stems from spinal cord rather than the brain stem to the sternocleidomastoid muscle and trapezius

Question 11

Cranial Nerve: Hypoglossal (CN XII)

Answer 11

Lesions cause ipsilateral tongue weakness

Originates in the medullar and innervates the tongue muscles

Question 12

Examination of motor functions:
Akinesia -
Athetosis -
Chorea -
Ballismus -

Answer 12

Akinesia - lack of movement
Athetosis - slow writhing-like movement
Chorea - irregularly timed excessive jerky movement
Ballismus - extreme choreiform movement

Question 13

Skipping pg 89-91 examination of systems

Answer 13

too tired

Question 14

Neuroimaging: Computed Tomography (CT)

Answer 14

X-ray rotated around pt’s head, digitally reconstructed

Greatest absorption occurs for the densest (hyperdense), such as bone, freshly congealed blood, or other calcifications

Advantage: quick; ability to detect gross abnormalities (e.g., skull fractures, hemorrhage, and mass effect)

Disadvantage: less effective at detecting white matter changes (e.g., plaques in MS, microvascular ischemic changes) or refined differential diagnosis (e.g., tumor vs other mass)

Question 15

Neuroimaging: Magnetic Resonance Imaging (MRI)

Answer 15

MRI specific radiofrequency pulses generate an electromagnetic reaction of hydrogen protons in water molecules. When pulses are stopped, the protons return to original alignment, resulting in emission of electrical signals.

Therefore, T1 and T2 represent time constrains. T1 has greater anatomic detail but less tissue contrast. T2 have enhanced contrast and are more sensitive to detecting damaged versus intact tissue

Advantage: highly detailed images, no radiation (multiple use fine)

Disadvantage: slower, noisy, may produce claustrophobia in some individuals, unable to be performed with individuals with metal fragments

Question 16

Neuroimaging: Diffusion-weighted MRI

Answer 16

Variant of MRI, uses diffusion of water molecules to generate contrast in MR images.

DWI allows collection of information about molecular activity and cellular function (e.g., early detection of stroke before it can be detected on standard MRI)

Question 17

Neuroimaging: Diffusion Tensor Imaging (DTI)

Answer 17

Variant of MRI, examines white matter integrity and white matter tracts by detecting the directional movements of water molecules

Less organized, less myelinated ,or state of edema, injury, or inflammation can produce lower FA values

Question 18

Neuroimaging: Single-Photon Emission Computed Tomography (SPECT)

Answer 18

pg 94

Question 19

Neuroimaging: Positron Emission Tomography (PET)

Answer 19

pg 94

Question 20

Neuroimaging: Functional Magnetic Resonance Imaging (fMRI)

Answer 20

pg 94-95

Question 21

Neuroimaging: Electroencephalography (EEG)

Answer 21

pg 95

Question 22

Neuroimaging: Evoked Potentials (EPs)

Answer 22

pg 95-96

Question 23

Cerebral Arteriography

Answer 23

pg 96

Question 24

Computed Tomographic Angiography (CTA)

Answer 24

pg 96-97

Question 25

Lumbar Puncture

Answer 25

pg 97