Visual Field Assessment and Neglect Test

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Questions and Answers

What is the primary purpose of the neurological examination described in the text?

  • To confuse patients with detailed questions
  • To localize the lesion (correct)
  • To waste time without any specific goal
  • To observe the examiner's magical thinking

What is highlighted as the key to performing an efficient neurological examination?

  • Observation of the patient (correct)
  • Extensive laboratory tests
  • Detailed questioning
  • Physical therapy sessions

Why does the text caution against performing an overly detailed neurological examination?

  • To prolong the consultation time
  • To impress the patient with medical knowledge
  • To avoid unnecessary expenses
  • To prevent unnecessary incidental findings (correct)

What aspect of a patient can help in localizing a lesion during a neurological examination?

<p>Their way of speaking and moving (C)</p> Signup and view all the answers

What is considered unnecessary when performing a neurological examination according to the text?

<p>Performing formalized testing (C)</p> Signup and view all the answers

What is an important aspect to consider when interpreting the results of a neurological examination?

<p>Relating observations to neuroanatomy (D)</p> Signup and view all the answers

What is the primary location of lesions that can cause apraxias?

<p>Frontal lobes (A)</p> Signup and view all the answers

Which type of apraxia is characterized by an inability to plan a series of complex tasks?

<p>Ideational apraxia (A)</p> Signup and view all the answers

How is memory typically assessed in a cognitive evaluation?

<p>Testing immediate recall and recent memory (B)</p> Signup and view all the answers

Which component of cognition can be tested by asking the patient to interpret a simple proverb?

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

What is the key aspect assessed when judging a patient's cognitive abilities by presenting an ambiguous situation?

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

Which abnormal thought content could indicate schizophrenia or delirium?

<p>Paranoid behavior (B)</p> Signup and view all the answers

What may be indicative of a basilar skull fracture when inspecting a patient's skull?

<p>&quot;Raccoon eyes&quot; (D)</p> Signup and view all the answers

"Bruits" heard over certain areas of the skull may suggest which condition?

<p>&quot;Arteriovenous malformations&quot; (A)</p> Signup and view all the answers

"Meningismus" may reflect inflammation of which structures when examining the spine?

<p>&quot;Meninges&quot; (A)</p> Signup and view all the answers

"Paratonic muscle rigidity" may cause limitations in which range-of-motion when assessing the spine?

<p>&quot;Both cervical and lumbar range-of-motion&quot; (C)</p> Signup and view all the answers

What structures are required for consciousness?

<p>Brain stem reticular activating system and one cerebral hemisphere (A)</p> Signup and view all the answers

Which of the following is a type of expressive aphasia?

<p>Broca's aphasia (B)</p> Signup and view all the answers

What is agnosia?

<p>Defect in recognizing a complex sensory stimulus (C)</p> Signup and view all the answers

Which area is involved in receptive aphasia?

<p>Temporal lobe (Wernicke's area) (D)</p> Signup and view all the answers

What is the hallmark of expressive aphasia?

<p>Significant difficulty producing language, but with preserved understanding (D)</p> Signup and view all the answers

In aphasia testing, what does repetition assess?

<p>Ability to repeat a spoken phrase (B)</p> Signup and view all the answers

Which of the following is an example of agnosia?

<p>&quot;Inability to recognize faces&quot; (C)</p> Signup and view all the answers

"Anosognosia" is associated with:

<p>&quot;Denial of illness&quot; (B)</p> Signup and view all the answers

"Apraxia" is a defect in:

<p>&quot;Performing a complex motor task&quot; (D)</p> Signup and view all the answers

Which lobe is primarily involved in recognizing faces?

<p>Temporal lobe (C)</p> Signup and view all the answers

What is the main reason why family members are often asked to provide historical details for patients with dementia?

<p>Because patients with dementia may have difficulty providing a cogent history. (C)</p> Signup and view all the answers

Why is summarizing the history important in making a tentative diagnosis?

<p>To help the physician fill in historical gaps that were missed. (A)</p> Signup and view all the answers

Which of the following is an example of a component of neurologic history besides past medical history?

<p>Occupation (D)</p> Signup and view all the answers

Why is obtaining a detailed medication history important in neurologic assessments?

<p>Many medications can affect the nervous system. (C)</p> Signup and view all the answers

What type of questions are typically included in the Neurologic Review of Systems component of the history?

<p>Questions about dysfunction affecting various parts of the nervous system. (C)</p> Signup and view all the answers

Which term refers to a patient's unawareness of their own disease?

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

'Entrapment of the median nerve across the carpal tunnel at the wrist' is associated with which occupational activity?

<p>Factory assembly line work (D)</p> Signup and view all the answers

'Cranial Nerves: Abnormalities in vision, hearing, smell, taste, speech or swallowing' is part of which component of neurologic history?

<p>'Cranial Nerves' (C)</p> Signup and view all the answers

'Difficulty maintaining balance' would be considered an abnormality in which component of neurologic examination?

<p>'Gait and Station' (D)</p> Signup and view all the answers

'Repetitive hand motion leading to carpal tunnel syndrome' is associated with which type of occupation?

<p>'Assembly line worker' (B)</p> Signup and view all the answers

Which eye movement fixates the image on the retina with respect to head and neck motion?

<p>Vestibulo-Ocular Reflex (C)</p> Signup and view all the answers

How is image motion sensed in the Visual Pursuit reflex?

<p>By the occipital cortex (B)</p> Signup and view all the answers

Which structure receives electrical impulses converted from angular acceleration?

<p>Vestibular Nuclei (A)</p> Signup and view all the answers

Which neural pathway is responsible for maintaining a stable visual field despite head motion?

<p>MLF to CNs III, IV, and VI (C)</p> Signup and view all the answers

Which reflex redirects the line of sight?

<p>Visual Saccade (C)</p> Signup and view all the answers

What is the role of the lateral gaze center in ocular movements?

<p>Relaying information about image motion (A)</p> Signup and view all the answers

What is the significance of abnormal findings in a neurological examination?

<p>They are crucial for diagnosing neurological conditions (B)</p> Signup and view all the answers

What is the purpose of including short cases in a handout about neurological examinations?

<p>To demonstrate how to efficiently conduct a neurological examination (B)</p> Signup and view all the answers

When should lower cranial nerves (IX-XII) be tested during a neurological examination?

<p>Only if dysphagia and dysarthria are present (C)</p> Signup and view all the answers

Which part of the neurological exam is a test of proprioception?

<p>Touching nose with eyes closed (A)</p> Signup and view all the answers

In a neurologic diagnosis, what does an anatomic diagnosis aim to do?

<p>Locate the lesion within a specific area of the nervous system (A)</p> Signup and view all the answers

Why are confirmatory laboratory data and imaging techniques considered secondary in neurologic diagnosis?

<p>The history and physical exam are more important (D)</p> Signup and view all the answers

What is the purpose of focusing sensory testing on a patient's symptoms?

<p>To ensure accurate diagnosis based on specific complaints (D)</p> Signup and view all the answers

Why is gait considered one of the most important parts of a neurological exam?

<p>'It evaluates overall coordination and motor function (C)</p> Signup and view all the answers

What technique is used to assess the visual field in each quadrant of the eye?

<p>Bilateral simultaneous stimuli (C)</p> Signup and view all the answers

What is considered the only purely objective part of the neurological exam?

<p>Reflexes (D)</p> Signup and view all the answers

How is visual neglect often related to brain lesions?

<p>Parietal lobe lesions (C)</p> Signup and view all the answers

Which cranial nerve is responsible for pupillary constriction in response to light?

<p>CN III (Oculomotor nerve) (A)</p> Signup and view all the answers

What is the term for a dilated pupil that does not respond to direct or consensual light?

<p>Hutchinson pupil (A)</p> Signup and view all the answers

Which part of the brain is responsible for shifting pupils from far to near gaze?

<p>Optic pretectum (A)</p> Signup and view all the answers

Which of the following can be visualized during a funduscopic examination?

<p>Cornea and lens (D)</p> Signup and view all the answers

What results from an impaired light response and slow constriction to near vision?

<p>Adie's tonic pupil (B)</p> Signup and view all the answers

Which area coordinates voluntary and reflex eye movements?

<p>Frontal eye fields (A)</p> Signup and view all the answers

'Convergence' is a normal dysconjugate eye movement associated with which type of response?

<p>'Far to near' response (D)</p> Signup and view all the answers

What does a positive straight leg-raising test indicate?

<p>Herniated lumbar disks (C)</p> Signup and view all the answers

What maneuver stretches the sciatic nerve during the straight leg-raising test?

<p>Thigh flexion at the hip and leg extension at the knee (A)</p> Signup and view all the answers

Which sign is indicative of meningeal inflammation and involves spontaneous leg flexion following neck flexion?

<p>Brudzinski sign (A)</p> Signup and view all the answers

How are cranial nerves III through XII evaluated?

<p>By examining the brain stem (A)</p> Signup and view all the answers

Which nerve is tested by occluding one nostril and presenting a non-volatile stimulus to the other nostril?

<p>Olfactory nerve (C)</p> Signup and view all the answers

What is the most common cause of loss of smell?

<p>Inflammation of the nasal mucosa (A)</p> Signup and view all the answers

How are visual fields typically evaluated during an eye exam?

<p>Using the Snellen chart (D)</p> Signup and view all the answers

What does visual acuity evaluate?

<p>Refractile components of the eye (D)</p> Signup and view all the answers

What is an important distinction to make regarding neck stiffness due to meningeal inflammation?

<p>It is primarily limited to flexion only (B)</p> Signup and view all the answers

During the straight leg-raising test, what increases the amount of stretch on the sciatic nerve?

<p>Dorsiflexion of the foot while thigh is flexed and lower leg extended (C)</p> Signup and view all the answers

What type of lesions are typically due to expanding mass lesions, such as a tumor or abscess?

<p>Slowly progressive lesions (B)</p> Signup and view all the answers

Which type of lesions are typically due to vascular accidents, such as stroke?

<p>Lesions of sudden onset (B)</p> Signup and view all the answers

What do symptoms that have a waxing and waning course with exacerbations and remissions suggest in terms of etiology?

<p>Demyelinating etiology (A)</p> Signup and view all the answers

Which component of neurologic diagnosis is the most important according to the text?

<p>Neurologic history (C)</p> Signup and view all the answers

What plays a major role in various neurologic disorders such as carpal tunnel syndrome and peripheral neuropathy?

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

What should a good rule of thumb be when listening to the patient initially for important information according to the text?

<p>&gt;5 minutes without interruption (A)</p> Signup and view all the answers

What do chronic and progressive symptoms suggest in terms of etiology?

<p>Degenerative disorder (B)</p> Signup and view all the answers

What type of illnesses may have normal or non-focal findings on neurologic examination and often require relying heavily on neurologic history for diagnosis?

<p>&quot;Most types of dementia&quot; (D)</p> Signup and view all the answers

"Abnormalities on laboratory studies may be incidental to the patient’s primary problem or may simply represent" what according to the text?

<p>&quot;Coincidental process irrelevant to the patient’s concerns&quot; (B)</p> Signup and view all the answers

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