neurological exam

Question 1

basic of medical history

Answer 1

chief complaint, history of present illness (HPI), past medical history, family history, social history, medications and allergies

Question 2

ROS

Answer 2

review of systems
-series of questions that evaluates patient from head to toe

Question 3

why is ROS important for audiology

Answer 3

others systems throughout the body have potential connections to HL or vestibular issues, so this allows for everything about the patient to be known

Question 4

cognition and hearing loss

Answer 4

untreated HL could lead to potential cognition deficits

Question 5

MMSE

Answer 5

mini-mental status exam
-tests for orientation, registration, attention/calculation, recall, language, etc.

Question 6

cranial nerve exam for CN1

Answer 6

olfactory nerve test by smelling something
-one nostril at a time with eyes closed

Question 7

cranial nerve exam for CN 2

Answer 7

optic nerve test by visual acuity and visual fields
-seeing and reporting what they are seeing

Question 8

cranial nerve exam for CN 3, 4, and 6

Answer 8

extraocular movements tests
-evaluating for nystagmus
-pupillary size, shape and reactivity

Question 9

specific tests for CN 3

Answer 9

consensual light reflex and eyelids

Question 10

consensual light reflex test

Answer 10

looking for the dilation of both pupils when it get’s shined into one eye at a time

Question 11

cranial nerve exam for CN 5

Answer 11

trigeminal nerve test by facial sensations
-using cotton wisp to see if they can feel it

Question 12

cranial nerve exam for CN 7

Answer 12

facial nerve test by facial expressions
-ask to make various facial shapes to see for symmetry and ability to do so
-taste

Question 13

cranial nerve exam for CN 8

Answer 13

vestibulocochlear nerve testing but doing a hearing test
-tuning fork tests
-vestibular assessment

Question 14

cranial nerve exam for CN 9 and CN 10

Answer 14

glossopharyngeal and vagus nerve testing by testing gag reflex

Question 15

cranial nerve exam for CN 11

Answer 15

spinal accessory nerve tested by testing strength of the trapezius and sternocleidomastoid muscle
-pushing against the muscles as the patient pushes upward

Question 16

cranial nerve exam for CN 12

Answer 16

hypoglossal nerves test by motor control of the tongue
-done by having patient stick out tongue and do different directions with it

Question 17

sensory system exam

Answer 17

primary sensory modalities (using a pinprick, light, touch, vibration, position, temp.) and cortical sensory modalities (object recognition, two point discrimination, etc.)

Question 18

motor system exam

Answer 18

observation, muscle tone and muscle strength
-strength scale 0-5 (0 no function, 5 normal range)

Question 19

deep tendon reflexes tested according to their ….

Answer 19

accommodating spinal cord position and muscle
-graded on a scale of 0-4 (0 is no reflex. 5 is over exaggerated reflex)

Question 20

romberg test

Answer 20

tests for proprioceptive and/or vestibular dysfunction as vision is omitted

Question 21

how to conduct the romberg test

Answer 21

stand with feet comfortably apart, arms any way, stand next to patient and ask them to close their eyes and have them stand still
-observe and watch for any swaying
-positive if patient sways or falls with eyes closed

Question 22

pronator drift testing

Answer 22

arms out, supinated, fingers together and closing the eyes
-watching for level of the arms adjusting

Question 23

finger to nose (dysmetria)

Answer 23

have them alternate between tapping their nose and tapping your finger
-looking for smoothness and the accuracy of movement

Question 24

heel to shin (hypermetria, hypometria)

Answer 24

have the patient run the heel along their shin up and down
-smooth movement from point A to point B

Question 25

RAM (rapid alternating movements)

Answer 25

looking at the smoothness and coordination of movements
-if testing hands, have them rapidly flip their hands over and back on their laps (palms facing up then facing down)
-if testing feet, can do a foot to hand tap

Question 26

gait

Answer 26

observing their walk
-look at their base, posture and stability, stride, balance, arm swing, tandem and turns
-ask patient to walk across the room and then around and walk back (heel to toe walking is tandem walking)

Question 27

blood pressure

Answer 27

can measure electronically or manually
-normal to prehypertension followed by stage 1 and stage 2 hypertension

Question 28

orthostatic hypotension

Answer 28

measurment of change in blood pressure and heart rate with change in positioning
-assess by measuring BP in a laid down position then a raised position
-video watched in class