Podcast
Questions and Answers
Which nerve is responsible for wrist flexion?
Which nerve is responsible for wrist flexion?
- Radial nerve
- Musculocutaneous nerve
- Median nerve (correct)
- Ulnar nerve
What is the motor function of the radial nerve?
What is the motor function of the radial nerve?
- Arm abduction and elbow flexion
- Elbow flexion and forearm sensation
- Finger flexion and wrist flexion
- Wrist extension and finger extension (correct)
Which nerve provides sensation to the palmar cutaneous branch?
Which nerve provides sensation to the palmar cutaneous branch?
- Musculocutaneous nerve
- Radial nerve
- Ulnar nerve
- Median nerve (correct)
Which nerve is responsible for the sensation in the anterior thigh and medial leg?
Which nerve is responsible for the sensation in the anterior thigh and medial leg?
Which muscle is NOT responsible for hip flexion and knee extension?
Which muscle is NOT responsible for hip flexion and knee extension?
Which nerve is responsible for the sensation in the posterolateral leg and lateral foot?
Which nerve is responsible for the sensation in the posterolateral leg and lateral foot?
Which nerve is responsible for the motor function of knee adduction?
Which nerve is responsible for the motor function of knee adduction?
Which muscle is responsible for dorsiflexion of the foot?
Which muscle is responsible for dorsiflexion of the foot?
Which nerve is responsible for the sensation in the anterior and lateral thigh down to the knee?
Which nerve is responsible for the sensation in the anterior and lateral thigh down to the knee?
What is the primary function of the CN V Trigeminal nerve?
What is the primary function of the CN V Trigeminal nerve?
What is the function of the CN III Oculomotor nerve?
What is the function of the CN III Oculomotor nerve?
What is the primary purpose of the Mental Status examination?
What is the primary purpose of the Mental Status examination?
What is the function of the CN VIII Vestibular cochlear nerve?
What is the function of the CN VIII Vestibular cochlear nerve?
What is the primary purpose of the Modified Glasgow Coma Scale?
What is the primary purpose of the Modified Glasgow Coma Scale?
What is the function of the CN IX Glossopharyngeal nerve?
What is the function of the CN IX Glossopharyngeal nerve?
What is the primary purpose of taking a good history during a neurological assessment?
What is the primary purpose of taking a good history during a neurological assessment?
What is the function of the CN X Vagus nerve?
What is the function of the CN X Vagus nerve?
What is the primary purpose of the elements of the Mental Status examination?
What is the primary purpose of the elements of the Mental Status examination?
What is the primary function evaluated by the Romberg Test?
What is the primary function evaluated by the Romberg Test?
What is characterized by a lack of voluntary coordination of muscle movements and a wide, uncoordinated gait?
What is characterized by a lack of voluntary coordination of muscle movements and a wide, uncoordinated gait?
What is the term for an involuntary shaking movement with an associated rhythm?
What is the term for an involuntary shaking movement with an associated rhythm?
What is Benign Paroxysmal Positional Vertigo (BPPV) an example of?
What is Benign Paroxysmal Positional Vertigo (BPPV) an example of?
What is the term for a loss of proprioception characterized by a stomping, heel-striking gait?
What is the term for a loss of proprioception characterized by a stomping, heel-striking gait?
What does the Tandem Walk exam evaluate?
What does the Tandem Walk exam evaluate?
What is the primary characteristic of upper motor neuron lesions in terms of muscle tone?
What is the primary characteristic of upper motor neuron lesions in terms of muscle tone?
A patient exhibits fasciculations and profound muscle atrophy. Which type of motor neuron lesion is most likely present?
A patient exhibits fasciculations and profound muscle atrophy. Which type of motor neuron lesion is most likely present?
What is the term for the ability to identify objects by feel?
What is the term for the ability to identify objects by feel?
A reflex arc with a single synapse between afferent and efferent neurons is classified as a?
A reflex arc with a single synapse between afferent and efferent neurons is classified as a?
What is the primary goal of the finger to nose to finger test?
What is the primary goal of the finger to nose to finger test?
Which of the following is NOT a component of gait evaluation?
Which of the following is NOT a component of gait evaluation?
A patient exhibits pins and needles, decreased sensation, and anesthetic skin. What aspect of sensory function is likely involved?
A patient exhibits pins and needles, decreased sensation, and anesthetic skin. What aspect of sensory function is likely involved?
What is the term for the ability to identify two or more places being touched simultaneously?
What is the term for the ability to identify two or more places being touched simultaneously?
What element(s) contribute to taking a good history?
What element(s) contribute to taking a good history?
What tests are used to assess cognitive status?
What tests are used to assess cognitive status?
What does the Glasgow Coma Scale (GCS) measure in human physiology?
What does the Glasgow Coma Scale (GCS) measure in human physiology?
What are evaluated in assessing motor function?
What are evaluated in assessing motor function?
In what motor lesions does hypotonia manifest?
In what motor lesions does hypotonia manifest?
Strength is graded 0-5. Which score indicates full strength?
Strength is graded 0-5. Which score indicates full strength?
Weakness is present in both lower motor and upper motor lesions
Weakness is present in both lower motor and upper motor lesions
Fasciculations are present in upper motor lesions
Fasciculations are present in upper motor lesions
Upper motor lesions present with increased/spastic muscle tone and increased muscle stretch reflexes
Upper motor lesions present with increased/spastic muscle tone and increased muscle stretch reflexes
Atrophy and reduced muscle stretch reflexes are profound in lower motor lesions
Atrophy and reduced muscle stretch reflexes are profound in lower motor lesions
What modalities should be evaluated when performing a neurologic assessment on the upper extremities?
What modalities should be evaluated when performing a neurologic assessment on the upper extremities?
Which part of the CNS does light touch discrimination run through?
Which part of the CNS does light touch discrimination run through?
What type of sensation is conveyed through the lateral spinothalamic tract?
What type of sensation is conveyed through the lateral spinothalamic tract?
Which type of information is conveyed through the lateral spinothalamic tract?
Which type of information is conveyed through the lateral spinothalamic tract?
Which part of the spinal cord is responsible for conveying vibration sense?
Which part of the spinal cord is responsible for conveying vibration sense?
Through which aspects of the spinal column does proprioceptive information travel?
Through which aspects of the spinal column does proprioceptive information travel?
What is graphesthesia?
What is graphesthesia?
What is a polysynaptic reflex?
What is a polysynaptic reflex?
How is the corneal reflex tested?
How is the corneal reflex tested?
How is the pupillary reflex tested?
How is the pupillary reflex tested?
What is the difference between autonomic reflexes and superficial reflexes?
What is the difference between autonomic reflexes and superficial reflexes?
Which of the following are examples of deep tendon reflexes?
Which of the following are examples of deep tendon reflexes?
Deep tendon reflexes are monosynaptic reflexes
Deep tendon reflexes are monosynaptic reflexes
What would a normal reflex response be graded as?
What would a normal reflex response be graded as?
What would a hyperreactive reflex with clonus be graded as?
What would a hyperreactive reflex with clonus be graded as?
Which are examples of lower extremity deep tendon reflexes?
Which are examples of lower extremity deep tendon reflexes?
Which is an example of a lower extremity superficial reflex?
Which is an example of a lower extremity superficial reflex?
Superficial reflexes are polysynaptic & are the result of
direct stimulation of a body part.
Superficial reflexes are polysynaptic & are the result of direct stimulation of a body part.
What is indicated by a positive Babinski sign in adults?
What is indicated by a positive Babinski sign in adults?
The plantar reflex is also known as
The plantar reflex is also known as
Which nerve roots are involved in the patellar reflex?
Which nerve roots are involved in the patellar reflex?
Which nerve roots are involved in the Achilles and plantar reflex?
Which nerve roots are involved in the Achilles and plantar reflex?
What nerve roots are involved in the biceps reflex?
What nerve roots are involved in the biceps reflex?
What nerve roots are involved in the triceps reflex?
What nerve roots are involved in the triceps reflex?
What nerve roots are involved in the brachioradialis reflex?
What nerve roots are involved in the brachioradialis reflex?
What is ankle clonus?
What is ankle clonus?
What does simultaneous toe tapping evaluate?
What does simultaneous toe tapping evaluate?
What does the heel to shin maneuver evaluate?
What does the heel to shin maneuver evaluate?
What is ataxia?
What is ataxia?
What does rapid alternating hand movements evaluate?
What does rapid alternating hand movements evaluate?
What are the two elements of gait?
What are the two elements of gait?
What are aspects of balance in a neuro assessment?
What are aspects of balance in a neuro assessment?
How is the Romberg test performed?
How is the Romberg test performed?
What does an antalgic gait indicate?
What does an antalgic gait indicate?
What is a characteristic of a spastic gait?
What is a characteristic of a spastic gait?
What is a characteristic of a steppage gait?
What is a characteristic of a steppage gait?
What is a Parkinsonian gait characterized by?
What is a Parkinsonian gait characterized by?
What type of gait is present in cerebellar ataxia?
What type of gait is present in cerebellar ataxia?
What is characteristic of an ataxic gait?
What is characteristic of an ataxic gait?
Symptoms worsen when eyes are closed in which type of ataxia?
Symptoms worsen when eyes are closed in which type of ataxia?
Which type of ataxia may be the result of spinal cord pathology?
Which type of ataxia may be the result of spinal cord pathology?
Sensory ataxia is seen in which disease processes?
Sensory ataxia is seen in which disease processes?
What is vertigo?
What is vertigo?
Vertigo is caused by asymmetry of the vestibular system
Vertigo is caused by asymmetry of the vestibular system
Which of the following are causes of vertigo?
Which of the following are causes of vertigo?
Vertigo can have cardiac etiologies
Vertigo can have cardiac etiologies
What are the 4 sources of tremors?
What are the 4 sources of tremors?
What do reflex oscillations result from?
What do reflex oscillations result from?
What causes natural central oscillations in the nervous system?
What causes natural central oscillations in the nervous system?
What causes pathologic central oscillations?
What causes pathologic central oscillations?
What is peripheral neuropathy?
What is peripheral neuropathy?
Peripheral neuropathy may be sensory, motor, or autonomic
Peripheral neuropathy may be sensory, motor, or autonomic
Peripheral neuropathy may be caused by traumatic injuries, infection, metabolic problems (diabetes), alcohol exposure, and environmental toxins
Peripheral neuropathy may be caused by traumatic injuries, infection, metabolic problems (diabetes), alcohol exposure, and environmental toxins
What are x-ray films useful for?
What are x-ray films useful for?
CT has poor tissue differentiating capabilities
CT has poor tissue differentiating capabilities
X-ray exposure is less in CT
X-ray exposure is less in CT
MRI images are less detailed than CT
MRI images are less detailed than CT
What are the signs of a Parkinsonian gait?
What are the signs of a Parkinsonian gait?
Deep tendon reflexes are also which type of reflexes?
Deep tendon reflexes are also which type of reflexes?
The corneal and gag reflexes are examples of what type of reflex?
The corneal and gag reflexes are examples of what type of reflex?
The pupillary light reflex is an example of what type of reflex?
The pupillary light reflex is an example of what type of reflex?
What are the 3 components of the Glasgow Coma Scale (GCS)?
What are the 3 components of the Glasgow Coma Scale (GCS)?
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Study Notes
Neurological Assessment
- A good history should include:
- Chief complaint
- Onset and precipitating event
- Associated symptoms
- Aggravating and relieving factors
- Past medical and surgical history (including anesthetic history)
- Occupational, family, and social history
Mental Status Examination
- Elements of a Mental Status examination:
- Memory
- Orientation (person, place, time)
- Intelligence
- Affect
- Insight and Judgment
- General health
Modified Glasgow Coma Scale
- Elements of the Modified Glasgow Coma Scale:
- Eye opening
- Verbal response
- Motor response
Cranial Nerves
- The 12 cranial nerves and their functions:
- CN I (Olfactory): Olfaction/smell
- CN II (Optic): Vision (fields and acuity)
- CN III (Oculomotor): Eye movement (superior rectus, medial rectus, inferior rectus, and inferior oblique) and pupil reflex
- CN IV (Trochlear): Eye movement (superior oblique)
- CN V (Trigeminal): Motor - Face sensation and chewing; Sensory - V1 (ophthalmic), V2 (maxillary), and V3 (mandibular)
- CN VI (Abducens): Eye movement (lateral rectus)
- CN VII (Facial): Motor - Face movement (most facial muscles), salivary glands; Sensory - Taste from anterior 2/3 of tongue, hard and soft palate
- CN VIII (Vestibular/Cochlear): Hearing and balance
- CN IX (Glossopharyngeal): Motor - Swallowing, phonation; Sensory - Taste from back 1/3 of tongue, sensory component of gag reflex
- CN X (Vagus): Motor - Movement, sensation, parasympathetic functions
- CN XI (Spinal Accessory): Neck movement (SCM and upper traps)
- CN XII (Hypoglossal): Tongue movement
Motor Function
- Elements of motor function:
- Trophic state (size, shape, symmetry)
- Tone (hypertonic, hypotonic)
- Strength on a 0-5 scale
Nerves of the Brachial Plexus
- Sensory and motor functions of the nerves of the brachial plexus:
- Axillary (C5): Superior lateral cutaneous nerve - inferior region of deltoid; Arm abduction - deltoid
- Musculocutaneous (C5, C6): Lateral cutaneous branch of forearm - lateral half of anterior forearm, tiny lateral portion of posterior forearm; Elbow flexion - biceps and brachioradialis
- Radial (C7): Posterior aspect of arm and forearm, posterolateral aspect of hand; Elbow, wrist, and finger extension - triceps, extensor digitorum
- Median (C8): Palmar cutaneous branch - lateral part of hand and digital cutaneous branch - lateral 3.5 fingers on palmar surface of hand; Wrist flexion - flexor carpi ulnaris, and finger flexion - flexor digitorum superficialis, profundus
- Ulnar (C8, T1): Anterior and posterior surfaces of medial 1.5 fingers (pinky and half of ring) and palm; Finger abduction - interossei muscles
Nerves of the Lumbar Plexus
- Sensory and motor functions of the nerves of the lumbar plexus:
- Femoral: Anterior thigh and medial leg; Hip flexion and knee extension
- Lateral femoral cutaneous: Anterior and lateral thigh down to knee; None
- Obturator: Medial thigh; Knee adduction
- Sciatic: None directly but sensory info through terminal branches; Inversion/eversion of foot, dorsiflexion/plantarflexion, flexion/extension of toes, knee flexion, hip adduction
- Tibial (branch of sciatic): Posterolateral leg, lateral foot, sole of foot; Posterior compartment of leg, intrinsic foot muscles
- Peroneal/Common fibular (branch of sciatic): Anteriorolateral leg, dorsum of foot; Dorsiflexion - anterior tibialis
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