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Questions and Answers
Which test involves the patient lying supine, flexing the thigh at the hip with the leg extended at the knee, and observing for lumbar pain radiating down the leg?
Which test involves the patient lying supine, flexing the thigh at the hip with the leg extended at the knee, and observing for lumbar pain radiating down the leg?
- Sciatic stretch test
- Brudzinski sign
- Kernig sign
- Straight leg raise test (correct)
What is typically signified by hematomas below the eyes (raccoon eyes) and behind the ears (battle sign)?
What is typically signified by hematomas below the eyes (raccoon eyes) and behind the ears (battle sign)?
- Meningismus
- Basilar skull fracture (correct)
- Scoliosis
- Subarachnoid hemorrhage
In a patient with severe neck pain that worsens with neck flexion, what condition may be indicated?
In a patient with severe neck pain that worsens with neck flexion, what condition may be indicated?
- Osteoarthritis
- Scoliosis
- Paratonic muscle rigidity
- Meningitis (correct)
What is the purpose of palpating the skull during an examination?
What is the purpose of palpating the skull during an examination?
What does the Kernig sign assess in a patient when performed during an examination?
What does the Kernig sign assess in a patient when performed during an examination?
What does the Brudzinski sign involve during a clinical examination when a patient flexes their neck?
What does the Brudzinski sign involve during a clinical examination when a patient flexes their neck?
What is the purpose of a neurological examination?
What is the purpose of a neurological examination?
Why does a clinician conduct a neurological examination?
Why does a clinician conduct a neurological examination?
What role does observation play in the neurological examination?
What role does observation play in the neurological examination?
Which part of the neurological examination assesses mental status?
Which part of the neurological examination assesses mental status?
What does the level of alertness refer to in a mental status examination?
What does the level of alertness refer to in a mental status examination?
Why is the mental status examination described as a key part of the initial neurological assessment?
Why is the mental status examination described as a key part of the initial neurological assessment?
What is the purpose of the mental status examination?
What is the purpose of the mental status examination?
Which area of the brain is affected by damage that produces abnormalities in cognition?
Which area of the brain is affected by damage that produces abnormalities in cognition?
What is aphasia?
What is aphasia?
Which type of aphasia is characterized by slow, halting speech and struggles to find the right word?
Which type of aphasia is characterized by slow, halting speech and struggles to find the right word?
What does mood refer to in the context of a mental status examination?
What does mood refer to in the context of a mental status examination?
Which of the following is an example of focal cortical deficit?
Which of the following is an example of focal cortical deficit?
What is the purpose of tests for aphasia?
What is the purpose of tests for aphasia?
Which area of the brain could be affected by a stroke resulting in hemiagnosia?
Which area of the brain could be affected by a stroke resulting in hemiagnosia?
What is a key feature of receptive aphasia?
What is a key feature of receptive aphasia?
What does apraxia refer to?
What does apraxia refer to?
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Study Notes
Neurological Examination
- The examination assesses sensory neuron and motor responses, including reflexes, to localize lesions and determine nervous system impairment.
Mental Status Examination
- The purpose is to obtain evidence of symptoms and signs of mental disorders, including danger to self or others.
- Components:
- Alertness: level of verbal or motor response to a specific stimulus.
- Cognition:
- Orientation: time and place awareness.
- Memory: recalling three objects.
- Intellect: simple calculations or fact recall.
- Abstraction: interpreting a proverb or comparing apples and oranges.
- Judgment: responding to an ambiguous situation.
- Mood and Affect:
- How the patient feels.
- How the patient comes across to others.
- Thought Content:
- Abnormal thought content includes hallucinations, paranoid behavior, and loss of reality.
- Associated with delirium and schizophrenia.
Focal Cortical Functioning
- Aphasia: defect in language processing, including speaking, reading, and writing.
- Apraxia: defect in performing complex motor tasks, such as dressing.
- Agnosia: difficulty interpreting sensory data from the environment or one's own body.
- Subtypes of agnosia:
- Inattention/hemiagnosia: deficit in attention to and awareness of the contralateral side of the body or environment.
- Astereognosis: difficulty perceiving objects through tactile stimulation.
Skull, Spine, and Meninges
- The central nervous system (CNS) consists of the brain and spinal cord, protected by the skull, spine, and meninges.
- Lesions affecting these structures are commonly associated with neurological signs and symptoms.
- Examination steps:
- Palpate the skull to detect trauma or surgery.
- Inspect for hematomas, particularly below the eyes and behind the ears.
- Inspect the spine for scoliosis.
- Check tenderness and range of motion in the cervical and lumbar regions.
- Examine for severe neck pain made profoundly worse with neck flexion (meningismus).
- Tests for injuries to the skull, spine, and meninges:
- Straight leg raise test (sciatic stretch test).
- Brudzinski sign: spontaneous flexion of the legs at the hips and knees following neck flexion.
- Kernig sign: resistance to knee extension when the hips are flexed, indicating meningeal inflammation.
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