112 Questions
What is indicated by swaying or falling during the Romberg Test with eyes closed?
Proprioceptive dysfunction
Which test primarily assesses lower limb coordination?
Heel-to-Shin Test
What is being tested during the Finger-to-Nose Test?
Coordination and precision of movements
Which abnormal finding is indicated by an inability to recognize objects by touch?
Tactile discrimination impairment
What does the Two-point Discrimination test assess?
Fine touch discrimination
Which test evaluates the capacity to recognize writing on the skin purely by the sensation of touch?
Graphesthesia
What does an unsteady gait indicate during a Balance Test?
Cerebellar dysfunction
What is primarily tested during the Rapid Alternating Movements (RAM) test?
Cerebellar function
Which type of reflex involves the pupillary response to light?
Visceral
Which nerve tract is typically assessed by observing rapid flexion and extension of the foot at the ankles?
Pathologic
The abdominal reflexes are an example of which type of reflex?
Somatic
Which body areas are typically tested for assessing the cremasteric reflex?
Abdomen
Clonus, when assessed, indicates a disruption in which type of tracts?
Pathologic
Which reflex represents a dysfunction in the basal ganglia circuits?
Clonus
'Engaging in rhythmic oscillations at the ankles' can be associated with assessing:
Clonus
'Involuntary muscle movements' are commonly observed in which body area for assessment?
Limbs
What is a normal finding for the Point Location assessment?
After a point on the skin is touched, the person can accurately indicate where they were touched
What does a DTR score of 4 indicate?
Very brisk, hyperactive with clonus, indicative of disease
Which nerve tracts are tested during deep tendon reflexes?
Spinal cord segments and corresponding nerve tracts
What does the Extinction abnormal finding involve?
Failure to perceive touch on one side when both sides are touched simultaneously
What might an abnormality in the Superficial reflexes suggest?
Higher brain center dysfunction
Which body area is tested for the patellar reflex?
L2-L4
What is indicated by a DTR score of 0?
No response
During the Biceps reflex assessment, where is the thumb placed?
On the biceps tendon
Which reflex involves striking the triceps tendon just above the elbow?
Triceps reflex
What is the normal response during the Triceps reflex assessment?
Extension of forearm
In the Quadriceps reflex assessment, where should the tendon be struck?
Just below the patella
Which reflex involves holding the foot in dorsiflexion and striking the Achilles tendon directly?
Achilles reflex
What is the normal response during the Brachioradialis reflex assessment?
Supination of forearm
How should the lower legs be positioned during Quadriceps reflex assessment?
Dangling freely to flex knee
What is a normal finding during Abdominal Reflexes testing?
Contraction of abdominal muscles and towards movement of umbilicus
What is the definition of nystagmus?
Involuntary, rhythmic movements of the eyes
Which condition can vertigo indicate?
Inner ear problems
What is the purpose of a Snellen Eye Chart?
To measure visual acuity
Which test is used to evaluate balance and proprioception?
Romberg Test
What can cerumen accumulation in the ear cause?
Hearing impairment
Which type of lesion is often associated with clonus?
Upper motor neuron lesions
What does sinusitis refer to?
Inflammation of the paranasal sinuses
Which cranial nerve is primarily responsible for testing the gag reflex?
CN IX
Which cranial nerve is involved in assessing facial sensation and the muscles of mastication?
CN V
Which cranial nerve is crucial for lateral gaze movement?
CN VI
What is the abnormal finding related to the Corneal Reflex test?
Absence or asymmetry of blinking response
Which cranial nerve is linked to hearing and balance tests?
CN VIII
Which cranial nerve is responsible for controlling tongue movement?
CN XII
'Nystagmus' as an abnormal finding relates to dysfunction in which cranial nerve?
CN VIII
'Shoulder shrug and head turn against resistance' are used to evaluate the function of which cranial nerve?
CN XI
What can vertigo indicate?
Inner ear problems
What is the purpose of the Romberg Test?
Assess balance and proprioception
What is the function of a Snellen Eye Chart?
Measure visual acuity
What might indicate a cerumen-related issue?
Hearing impairment
What is clonus commonly associated with?
Upper motor neuron lesions
What does nystagmus indicate?
Vestibular dysfunction or neurological abnormalities
What does an abnormal Finger-to-Nose Test result indicate?
Proprioceptive feedback issues
During the Romberg Test, what does swaying or falling when eyes are closed suggest?
Proprioceptive feedback issues
What is primarily tested during the Heel-to-Shin Test?
Coordination and skilled movements
What is the normal finding in the Tactile discrimination test for Stereognosis?
Recognizing and identifying common objects by touch
If a person has difficulty discerning two distinct points on the skin applied simultaneously, what does it indicate?
Normal sensory function
What does an inability to stand without a wide base during the Balance Test suggest?
Proprioceptive feedback issues
In the Rapid Alternating Movements (RAM) test, what is primarily assessed?
Coordination of skilled movements
What is the abnormal finding associated with the Extinction test?
Failure to perceive touch on one side when both sides are touched simultaneously
Which nerve tract is being tested during Superficial reflexes?
Higher brain centers and spinal cord
What does a DTR score of 1 indicate?
Diminished, low normal, or occurs with reinforcement
Where is the common site tested for the Achilles reflex?
S1-S2
What is being tested during the Point Location assessment?
Ability to accurately indicate where on the skin was touched
What does a DTR score of 2 indicate?
Average, normal
Which body area is commonly tested for the brachioradialis reflex?
C6-C7
What is indicated by a diminished response during the Patellar reflex assessment?
'Diminished, low normal, or occurs with reinforcement'
What is a normal finding during the Cremasteric Reflex assessment in males?
Elevation of the testicle on the side stroked
Which term best describes a sensation of lightheadedness, faintness, or unsteadiness without the sensation of movement?
Dizziness
What is an abnormal finding during the Plantar Reflex assessment?
Extension of the big toe with fanning of other toes
What is a common characteristic of Tension Headaches?
Tightness or pressure across the forehead or head
Which neurological condition is mainly recognized by intense, debilitating headaches along with other symptoms like nausea and sensitivity to light and sound?
Migraine
In the context of headaches, what does Cluster headache refer to?
Pain on one side of the head
What does an abnormal response during the Plantar Reflex assessment indicate?
'Extension of the big toe' with fanning of other toes, representing CNS lesions
Which type of dizziness is characterized by a sensation of spinning or movement?
'Vertigo'
What is the term for age-related loss of near vision due to decreased lens flexibility in the eye?
Presbyopia
Which condition is characterized by unequal pupil sizes and can indicate underlying neurological or ophthalmological issues?
Anisocoria
What does Glasgow Coma Testing evaluate in a patient following a neurological event?
Consciousness level
Which type of hearing loss is caused by damage to the inner ear or auditory nerve?
Sensorineural Hearing Loss
A combination of conductive and sensorineural hearing loss results in which type of hearing loss?
Mixed Hearing Loss
What does central hearing loss result from?
Brain damage
Which type of hearing loss is often caused by problems in the outer or middle ear?
Conductive Hearing Loss
In a balance assessment, what does standing with feet together and eyes closed primarily evaluate?
Balance maintenance without visual input
What nerve tract is primarily responsible for autonomic reflexes?
Visceral nerve tract
Which body area is primarily tested during the assessment of dyskinesia?
Limbs or body
What type of tracts are disrupted when clonus is observed?
Motor tracts
During which reflex assessment can rapid flexion and extension at the ankles elicit rhythmic oscillations?
Clonus reflex
What is the primary responsibility of the basal ganglia circuits?
Regulation of voluntary motor movements
Which cranial nerve is involved in assessing the pupillary response to light?
Optic nerve
What area of the body is primarily tested during the abdominal reflexes assessment?
Pelvis and lower abdomen
What does a disruption in the trigeminal nerve circuit typically relate to?
Dysfunction in sensory input to the face
What does an abnormal Finger-to-Nose Test result suggest?
Proprioceptive feedback dysfunction
During the Two-point Discrimination test, what does an abnormal finding indicate?
Inability to discern two distinct points
What does swaying or falling during the Romberg Test with eyes closed indicate?
Proprioceptive or vestibular dysfunction
What is primarily tested during the Heel-to-Shin Test?
Lower limb coordination
During the Graphesthesia test, what is indicated by difficulty in recognizing writing on the skin purely by touch?
Proprioceptive dysfunction
What does an inability to recognize objects by touch suggest during the Stereognosis test?
Proprioceptive feedback impairment
During the Rapid Alternating Movements (RAM) test, what is primarily assessed?
Cerebellar function
What is suggested by loss of balance or requiring a wide base to stand during the Balance Test?
Proprioceptive feedback issues
During the Biceps reflex assessment, what is the normal response when striking the biceps tendon?
Contraction of biceps muscle and flexion of forearm
Which area is targeted when assessing the Quadriceps reflex?
Directly below the patella
What is the expected outcome during the Achilles reflex assessment?
Foot plantar flexes against your hand
When performing the Brachioradialis reflex assessment, where should you strike the forearm?
About 2 to 3 cm above radial styloid process
During the Triceps reflex assessment, what should be done to elicit a normal response?
Strike triceps tendon directly above the elbow
Where should you support a person’s forearm during the Triceps reflex assessment?
On yours
'Knee jerk' reflex is associated with which neurological levels during assessment?
L2 to L4
What cranial nerve is primarily responsible for the sense of smell?
CN I
Which cranial nerve is associated with pupillary response and extraocular eye movements?
CN III
Which cranial nerve is related to hearing and balance tests?
CN VIII
Which cranial nerve is responsible for facial movements and taste in the anterior 2/3 of the tongue?
CN VII
Involuntary rhythmic shaking or oscillation of the eyes is an abnormal finding related to which cranial nerve?
CN VIII
Which cranial nerve is associated with facial sensation and muscles of mastication?
CN V
Study Notes
Cranial Nerve Functions
- Cranial Nerve I (Olfactory): responsible for smell, performs Smell Test
- Cranial Nerve II (Optic): responsible for visual acuity and fields, performs Visual Acuity and Fields Test
- Cranial Nerve III (Oculomotor): responsible for pupillary response and eye movements (EOMs)
- Cranial Nerve IV (Trochlear): responsible for eye movements (EOMs), especially downward gaze
- Cranial Nerve V (Trigeminal): responsible for facial sensation and muscles of mastication
- Cranial Nerve VI (Abducens): responsible for lateral gaze
- Cranial Nerve VII (Facial): responsible for facial movements and taste (anterior 2/3 of tongue)
- Cranial Nerve VIII (Vestibulocochlear): responsible for hearing and balance tests
- Cranial Nerve IX (Glossopharyngeal): responsible for gag reflex and taste (posterior 1/3 of tongue)
- Cranial Nerve X (Vagus): responsible for gag reflex, voice quality, and visceral reflexes
- Cranial Nerve XI (Spinal Accessory): responsible for shoulder shrug and head turn against resistance
- Cranial Nerve XII (Hypoglossal): responsible for tongue movement
Eye Assessment
- Nystagmus: involves Cranial Nerve VIII (vestibulocochlear nerve) and related nerves (III, IV, and VI); abnormal finding: involuntary rhythmic shaking or oscillation of the eyes
- Corneal Reflex: involves Cranial Nerve V (trigeminal nerve) and Cranial Nerve VII (facial nerve); abnormal finding: absence or asymmetry of blinking response
Cerebellar Function Tests
- Balance Test: abnormal findings include loss of balance, unsteady gait, inability to walk straight, or requiring a wide base to stand
- Romberg Test: abnormal findings include swaying or falling when eyes are closed, indicating proprioceptive or vestibular dysfunction
- Rapid Alternating Movements (RAM): tests cerebellar function, specifically the ability to perform rapid, alternating movements smoothly
- Finger-to-Nose Test: tests coordination and precision of movements, pointing to cerebellar function or proprioceptive feedback
- Heel-to-Shin Test: tests lower limb coordination and the ability to perform smooth, accurate movements
Tactile Discrimination and Reflexes
- Stereognosis: ability to recognize and identify common objects by touch and manipulation without visual input; abnormal finding: inability to recognize objects by touch
- Graphesthesia: ability to recognize writing on the skin purely by sensation of touch; abnormal finding: difficulty in recognizing writing on the skin
- Two-point Discrimination: ability to discern two distinct points when simultaneously applied to the skin at close proximity; abnormal finding: inability to distinguish two nearby points
- Extinction: failure to perceive touch on one side when both sides are touched simultaneously
- Point Location: ability to accurately indicate where a point on the skin was touched after the stimulus is removed; abnormal finding: difficulty in identifying the exact point touched
Reflexes
- Deep Tendon Reflexes (DTRs): tests the integrity of spinal cord segments and corresponding nerve tracts, using a 4-point scale
- Superficial Reflexes: tests the function of higher brain centers and the spinal cord
- Visceral Reflexes: tests the autonomic nervous system and involves smooth muscle responses rather than skeletal muscle
- Pathologic (Abnormal) Reflexes:
- Clonus: indicates disruption of motor tracts, typically within the central nervous system
- Dyskinesia: represents a dysfunction in the basal ganglia circuits, affecting voluntary motor movements and procedural learning### Biceps Reflex (C5-C6)
- Supports person's forearm on yours
- Places thumb on biceps tendon and strikes a blow
- Normal response: contraction of biceps muscle and flexion of forearm
Triceps Reflex (C7-C8)
- Tells person to let arm "just go dead"
- Strikes triceps tendon directly just above the elbow
- Normal response: extension of forearm
Brachioradialis Reflex (C5-C6)
- Holds person's thumbs to suspend forearms in relaxation
- Strikes forearm directly, 2-3 cm above radial styloid process
- Normal response: flexion and supination of forearm
Quadriceps Reflex (L2-L4, "Knee Jerk")
- Lets lower legs dangle freely to flex knee and stretch tendons
- Strikes tendon directly just below patella
- Normal response: extension of lower leg
Achilles Reflex (L5-S2, "Ankle Jerk")
- Positions person with knee flexed
- Holds foot in dorsiflexion and strikes Achilles tendon directly
- Normal response: foot plantar flexes against your hand
Superficial Reflexes - Abdominal Reflexes
- Tests four quadrants: upper and lower on each side
- Normal finding: abdominal muscles contract, and umbilicus moves towards the stimulus when the skin of the abdomen is lightly stroked
- Abnormal finding: absence of contraction of the abdominal muscles and movement of the umbilicus in response to stroking the skin
Test your knowledge on tactile tests used in sensory examination. Learn about recognizing abnormal and normal findings in tests like recognition threshold, extinction, and point location.
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