Neurological Assessment Upper Limb Instructions
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Questions and Answers

What is a key component of the neurological examination for Parkinson's disease?

  • Assessment of cerebellar dysfunction
  • Evaluation of cranial nerve damage
  • Testing for diabetic neuropathy
  • Exploration of medication history (correct)

Which neurological condition involves assessing for signs of postural instability?

  • Parkinson's disease (correct)
  • Peripheral neuropathy
  • Multiple Sclerosis (MS)
  • Amyloid neuropathy

What is a common feature in the history-taking for multiple sclerosis (MS)?

  • Assessment of diabetic neuropathy
  • Exploration of muscle weakness
  • Testing for tremors
  • Falls risk assessment (correct)

Which sign is specifically assessed in the clinical examination for multiple sclerosis (MS)?

<p>Reflex loss (B)</p> Signup and view all the answers

What is a key focus of the physical exam for peripheral neuropathy?

<p>Assessments of diabetic neuropathy (A)</p> Signup and view all the answers

In the context of Parkinson's disease, what additional sign besides tremors and rigidity is important in establishing a diagnosis?

<p>Postural instability (C)</p> Signup and view all the answers

What is a key point to remember when assessing pupils?

<p>To assess with symmetry and look at both direct and consensual response to light (A)</p> Signup and view all the answers

What is a common abnormality seen in eye movements indicative of myasthenia gravis?

<p>Complex ophthalmoplegia (A)</p> Signup and view all the answers

Which nerve is predominantly involved in finger-to-nose ataxia testing for cerebellar function?

<p>Cranial nerve 12 (D)</p> Signup and view all the answers

What can pronator drift indicate when assessing tongue movements?

<p>Contralateral lesion side in a stroke (B)</p> Signup and view all the answers

Why is the brief neuro exam used when history taking fails to identify red flags for serious neuro pathology?

<p>To confirm the patient's symptoms are not due to any occult pathology. (B)</p> Signup and view all the answers

Why is it important to keep the patient's head still during extraocular movement assessment?

<p>To ensure accurate assessment of specific interocular muscles (D)</p> Signup and view all the answers

What visual field defect may be identified when testing each quadrant individually?

<p>Visual neglect (A)</p> Signup and view all the answers

What is a limitation of using the brief neuro exam according to Dr. David Nicholl?

<p>It may not be tailored to specific diseases like peripheral neuropathy. (B)</p> Signup and view all the answers

What does Dr. Ghaniah Hassan-Smith emphasize about the brief neuro exam in relation to history taking?

<p>It doesn't need to be complicated to provide valuable information. (A)</p> Signup and view all the answers

Why does Dr. David Nicholl suggest using the brief neuro exam after excluding pathology?

<p>To rapidly assess the patient's neurological function comprehensively. (C)</p> Signup and view all the answers

Why is testing gait considered critically important by Dr. Ghaniah Hassan-Smith?

<p>It can reveal subtle motor dysfunction not evident in other exam components. (C)</p> Signup and view all the answers

What does Dr. Ghaniah Hassan-Smith imply about a healthy gait?

<p>It indicates normal motor function in the patient. (C)</p> Signup and view all the answers

What is the most sensitive test for early peripheral nerve dysfunction?

<p>128 Hz tuning fork test for vibration sense (B)</p> Signup and view all the answers

When assessing power in the lower limbs, what action should the patient perform to test for clonus?

<p>Bend the leg up (D)</p> Signup and view all the answers

What does it suggest if, during assessment, a patient's ankle 'flies off the couch' when their leg is flexed at the hip?

<p>Pyramidal tract or motor neurone problem (A)</p> Signup and view all the answers

What is the main instruction given to the patient to assess power in the upper limbs?

<p>'Put your arms up like this, push me away' (C)</p> Signup and view all the answers

If a history is more suggestive of an upper motor neuron problem, what should be done during sensory testing?

<p>Mapping out the sensory level (C)</p> Signup and view all the answers

To ensure a true reflection of power with elbow extension, what angle should be left at the elbow during assessment?

<p>'Big enough angle' (A)</p> Signup and view all the answers

Which positioning is generally recommended to allow a patient to relax during tone assessment?

<p>'Lying supine' (D)</p> Signup and view all the answers

During reflex assessment, what action should be taken to ensure the patient is as relaxed as possible?

<p>'Put hand under knee to take weight' (D)</p> Signup and view all the answers

What is suggested by an ankle flying off the couch when testing lower limb tone?

<p>'Pyramidal tract or motor neurone problem' (D)</p> Signup and view all the answers

Which action should be performed to assess for clonus in the lower limbs?

<p>'Bend your leg up' (B)</p> Signup and view all the answers

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