90 Questions
Which symptom can be indicative of depression?
Insomnia
What symptom may indicate a neurological issue?
Facial droop
Which condition may present with slurred speech?
Vertigo
What symptom could suggest a somatic disorder?
Tingling (paresthesia)
Which symptom could lead to consideration of a cardiovascular condition?
Numbness
What might be a potential diagnosis for a patient with speech disorders and memory loss?
Dementia
How can considering associated symptoms such as nausea, vomiting, and photophobia help in the diagnosis process?
They speed up the interview and suggest migraine headache.
What can be considered important risk factors when assessing a possible vascular cause for neurological symptoms?
Vascular diseases, hypertension, family history, and smoking.
Why is obtaining birth history and development information important in some neurological situations?
To provide valuable insights in assessing epilepsy and other conditions.
What could be a potential reason for neurological symptoms caused by medications?
Idiosyncratic reactions, dose-related issues, or chronic use.
How can a family history be crucial in understanding certain neurological disorders?
It can reveal single-gene defects or polygenic influences relevant to the disorder.
Why is it important to inquire about trauma when assessing neurological symptoms?
To determine if the onset was sudden or gradual.
Which type of tremor is typically unilateral, occurs at a frequency of about 5 per second, and is characterized by resting tremor, rigidity, and bradykinesia?
Parkinsonian tremor
Which type of tremor is high-frequency, bilateral, involves upper extremities with limb movement and posture, and subsides when the limb is relaxed?
Essential tremor
Absent at rest and worsening with movement, which type of tremor typically occurs with tasks that involve approaching a target and is often related to cerebellar disorders like multiple sclerosis?
Intention tremor
What type of tremor appears when a part of the body is actively maintaining a posture and includes examples like the fine rapid tremor seen in hyperthyroidism?
Postural tremor
What term is used to describe the feeling of fainting or about to faint without actually losing consciousness, often related to lightheadedness or weakness?
Presyncope
What should be determined regarding a patient who reports fainting episodes to guide management and potential hospital admission?
If they lost consciousness during the episode
What is the first step when a patient describes their symptoms as 'dizziness'?
Clarify exactly what the patient means by 'dizziness'
What is important to ask patients who present with neurological symptoms?
What they think might be wrong with them
When did the symptoms start for the patient?
The symptoms have a pattern over time
What should be done when a patient reports intermittent neurological symptoms?
Clarify the onset, duration and pattern of symptoms
What is important to consider when a patient presents with numbness as a symptom?
The patient may be describing a different symptom
What is an essential step when a patient presents with neurological symptoms?
Clarify or review the history with the patient and/or witness
What associated symptoms did the patient with a headache experience?
Nausea and photophobia
What was the patient's family history related to headaches?
Mother and sister have migraines
What neurological exam findings were present in the patient with a headache?
No papilledema, normal pupil reaction, extraocular movement, and facial sensation
What symptoms does the 72-year-old man present with?
Dizziness, vertigo, and falls
What would be an appropriate next step for the 72-year-old man's evaluation?
Refer to a neurologist for further evaluation
What is the patient's blood pressure and heart rate?
128/78 mmHg and 90 bpm
What aspect of gait does abductor contraction help to achieve?
Maintain balance
What can a lack of knee flexion during the stance phase of gait lead to?
Circumduction
What does a wide base in the gait suggest?
Cerebellar disease or foot problems
What can cause the pelvis to drop on the opposite side during walking?
Abductor weakness
What can inspection of the lumbar portion of the spine help assess?
Degree of lordosis
What should be assessed while inspecting the anterior and posterior surfaces of the hip?
Muscle atrophy
What is the purpose of looking for pitting when examining a patient?
To assess the severity of edema
During range of motion testing at the hip, why should the patient not be tested while standing?
It is difficult to assess the full range of motion while standing
How should the examiner assist the patient with movements of the hip during range of motion testing?
By positioning the patient near the edge of the table
When examining hip flexion, why might the hip flex further when the knee is also flexed?
Because knee flexion allows for hip relaxation
What is the purpose of stabilizing the pelvis during hip abduction testing?
To ensure accurate assessment of hip movement
Why does an examiner need to press down on the opposite anterior–superior iliac spine during hip abduction testing?
To stabilize the patient's body
How is muscle strength graded on a 0 to 5 scale during strength testing?
Using a scale from no muscular contraction to active movement against full resistance
How can hip flexion be tested during strength testing at L2, L3, and L4 nerve levels?
By asking the patient to perform a leg raise against resistance
Which movement is involved in testing the talocalcaneal joint strength?
Foot inversion and eversion
What does a grade of 3 indicate in muscle strength testing?
Active movement with gravity eliminated
How is the subtalar joint strength testing scale graded?
On a scale from 0 to 5 depending on muscle strength
During ankle strength testing, what indicates normal muscle strength?
$5(7 + 3)$
What structure in the knee is formed by the convex curves of the medial and lateral condyles of the femur as they articulate with the concave condyles of the tibia?
Condylar tibiofemoral joints
Which tendon continues below the knee joint and inserts distally on the tibial tuberosity?
Patellar tendon
What is the function of the patella in the knee?
It slides on the groove of the anterior aspect of the distal femur during flexion and extension of the knee.
What are the three articular surfaces in the knee?
Condylar tibiofemoral joints, patellofemoral joint, and tibial tuberosity
What structure in the knee rests on the anterior articulating surface of the femur midway between the epicondyles?
Patella
What are the two surfaces on which the patella slides during flexion and extension of the knee?
Anterior aspect of the distal femur and trochlear groove
Which assessment is used to evaluate foot dorsiflexion and plantar flexion?
Heel and toe walk
What is the documentation for the strength of the right elbow in the provided sample?
Strength 4/5
Which joint is described as having limited flexion due to pain and swelling in the provided sample?
Right knee
What is the purpose of the Skills Lab mentioned in the provided text?
To practice inspection, palpation, range of motion, and strength testing
Which of the following is NOT mentioned as a finding in the sample documentation for the upper extremities?
Decreased sensation
Which of the following is NOT mentioned as a finding in the sample documentation for the lower extremities?
Decreased strength
During range of motion testing for the hip, what is the purpose of stabilizing the pelvis?
To prevent rotation of the thigh
What does pitting indicate when observed during a physical examination?
Edema
Why should the patient not be tested while standing during hip range of motion testing?
Risk of falling
What is the primary concern when an examiner must assist a patient with hip movements during a physical examination?
Avoiding joint hyperextension
When performing hip abduction testing, what does reaching the limit of abduction indicate?
Normal range of motion
What should be considered regarding the hamstrings during hip flexion testing?
Hamstring relaxation allows for greater flexion
Which of the following is NOT a part of the inspection of the lower extremities?
Examining lung capacity
What is the clinical significance of finding genu varum in a patient?
It suggests the patient has bowlegs
On inspection, which of the following is NOT a common finding in the lower extremities?
Nail polish
Which of the following is NOT a part of the technique for inspection of the lower extremities?
Check for muscle strength
Which of the following is NOT a common deformity observed during the inspection of the lower extremities?
High arches
What is the clinical significance of finding calluses and corns during the inspection of the lower extremities?
They suggest the patient has a foot deformity
What is the function of the patellar tendon in the knee?
It connects the patella to the tibial tuberosity.
Which of the following structures is NOT found on the anterior surface of the knee?
Medial condyle of the femur
Which joint is formed by the convex curves of the medial and lateral condyles of the femur as they articulate with the concave condyles of the tibia?
Tibiofemoral joint
What is the purpose of the trochlear groove in the knee?
It provides a sliding surface for the patella during flexion and extension.
Which of the following is NOT a part of the ankle/foot palpation?
Medial epicondyle of the femur
Which of the following is NOT a common cause of knee pain?
Patellar tendonitis
Which muscle action is involved in ankle/foot plantar flexion?
Flexors
What is the primary purpose of stabilizing the pelvis during hip abduction testing?
To isolate the movement of the hip joint
What type of motion is described by 'swinging the lower leg medially for external rotation at the hip'?
External rotation
Which position is preferred when testing ankle/foot dorsiflexion passively?
Supine
Which movement is involved in testing the talocalcaneal joint strength?
Inversion and eversion
What is the purpose of the patella in the knee?
To protect the articulating surfaces of the femur and tibia
What is the recommended position for the patient during knee palpation?
Sitting on the edge of the examining table with knees in flexion
What are the main structures located on the anterior surface of the hip?
The iliac crest, iliac tubercle, anterior superior iliac spine, and greater trochanter
What is the purpose of assessing the temperature of the feet and legs with the backs of the fingers?
To compare one side with the other for any temperature differences
What is the primary objective of palpation during a physical examination?
To identify any abnormalities, such as heat, tenderness, swelling, crepitus, abnormal muscle tone, or masses
What structures are located on the posterior surface of the hip?
The posterior superior iliac spine, greater trochanter, ischial tuberosity, and sacroiliac joint
What should be the examiner's first step when palpating the hip and knee joints?
Inspect the joint for any visible abnormalities
Test your knowledge on how to assess and recommend testing or treatment for patients with common neurological symptoms like headache, dizziness, weakness, numbness, fainting, seizures, and tremors. Learn about clarifying patient complaints and understanding difficult-to-describe symptoms.
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