Neurological Exam 1. What six things are assessed in the neurological exam? 2.

What would you say to introduce the formal mental status portion of the neurologic exam? 3. Name the twelve things evaluated in the mental status examination? 4. How would you assess judgement? Give 2 examples of questions to assess this? 5. T or F: Judgement requires higher cerebral function 6. Orientation refers to the persons awareness of self in relation to ____, _____, & _____? 7. Disorientation occurs in association with _____ & _____? 8. Give 3 examples of questions to test orientation? 9. The ability to calculate depends on the integrity of the _____ _____ _____ & the patients _____? 10. How would you test this? What is the serial sevens test? 11. How would you test knowledge of current events? 12. The ability to name current events requires intact _____, intact ______, & the ability to think _____? 13. When is the first chance to assess level of consciousness? 14. If the patient doesnt respond what would you do? 15. Name two painful stimuli that you can use to check if someone is in a coma? 16. Object recognition is termed _____? 17. The failure to recognize a sensory stimulus despite normal primary sensation is called _____? 18. How would you test object recognition? 19. Normal vision, but failure to recognize object = ______? 20. Inability to recognize object by palpation in the absence of a sensory deficit = _____? A lesion in the ______ _______ ____ would cause this? 21. An patients inability to recognize his or her own body is called _______? 22. 5 factors that can affect a patients vocabulary are? 23. T or F: Patients should be asked to define several words in decreasing order of difficulty? 24. T or F: You should ask the patient if they have had any mood changes? 25. What is a patients affect? 26. The affect can be ________, _________, or _________? Describe the 3 affects to mention of the death of a loved one? 27. The ability to perform a motor activity is called ______? 28. The inability to perform a voluntary movement w/out deficits in motor strength, sensation or coordination is called ______? 29. The decreased ability to perform an activity is called _____? How could you test for this & how would the patient react to the test? What type of lesion would cause this? 30. ________ ________ is when a patient is unable to construct or draw simple designs? Where is the lesion that causes this? 31. Abstraction requires both _______ & __________? 32. Give 2 of statements you might ask the patient to interpret to test abstraction? 33. The glass will break if you throw a stone through it is an example of a __________ interpretation? 34. Concrete responses are common in patients with ________ or __________? 35. What is another type of patient that might answer with concrete responses? 36. What is another method of testing abstraction? 37. To test memory, have the patient recall ________ & ________ past? 38. How could you test recent memory? 39. How would you test remote memory? 40. What is another way to test for memory? 41. What is the name and function of CN I? 42. What are the clinical findings of a CN I lesion? 43. Describe how to test CN I? 44. The substance used for testing should be _________ & _________? Give some examples? 45. What is an example of an irritating substance? Why should irritating agents not be used? 46. Which is more important, unilateral or bilateral loss of smell? Why? 47. What is the name and function of CN II? 48. What are the clinical findings of a CN II lesion? 49. What is the name & function of CN III? 50. Lesion of CN III will result in ________, __________, _________, & _________?

51. 52. 53. 54. 55. 56. 57. 58. 59. 60. 61. 62.

What is the name & function of CN IV? Lesion of CN IV would cause ________? What is the name & function of CN V? A lesion of CN V would cause _________ & _________? Name the 3 divisions of CN V? CN V testing includes testing the _______ ______, ________ _______, & ________ _______? The corneal reflex depends on what 2 CNs? How do you perform the corneal reflex test? T or F: A prompt unilateral closure of the eyelid is a normal response to the corneal reflex test? The sensory limb of the corneal reflex is the _________ division of CN V The motor limb is conducted through CN _______? T or F: Touching the eyelashes or conjunctiva will give an inaccurate response w/ the corneal reflex test? 63. How would you test sensory function of CN V? 64. How would you test motor function of CN V? 65. Unilateral weakness causes the jaw to deviate toward _________? 66. What is the name & function of CN VI? 67. A lesion of CN VI would cause _______? 68. Remember LR__SO__AO__? 69. What is the name & function of CN VII? 70. A lesion of CN VII would cause __________, ____________, ____________, & ____________? 71. How would you test CN VII? 72. Describe the two types of CN VII lesion & their differences? 73. What is the common name for a CN VII lesion? 74. What is the name & function of CN VIII? 75. A lesion to CN VII could cause __________, ___________, _________, & __________? 76. What is the name & function of CN IX? 77. A lesion of CN IX would cause _______________, _______________, & _______________? 78. The gag reflex involves what 2 CNs? The sensory portion is CN _____? Motor portion is CN ____? 79. How would you elicit the gag reflex? 80. What is another test to look at function of this nerve? 81. What is the name & function of CN X? 82. A lesion of CN X would cause _______, _________, & _________? 83. How would you test CN X function? 84. What is the name & function of CN XI? 85. A lesion of CN XI would cause _________ & _____________? 86. Describe 2 ways to test CN XI? 87. The sternocleidomastoid m. rotates the head to the ______ side as the muscle itself? 88. What is the name & function of CN XII? 89. A lesion of CN XII would cause _________ ? 90. Fasciculations of the tongue are indicative of a ________________ lesion? 91. How would you test motor function of CN XII? 92. A lesion on the left side would cause deviation to the ______ side? 93. What is a chronic neurologic disease that causes progressive degeneration of motor neurons & causes LMN bulbar palsy of the tongue w/ fasciculations? 94. The motor system is evaluated for muscle ________, _________, & ________? 95. The motor examination starts with ________? 96. Inspection is used to detect _______ & ________? 97. How do you test muscle strength? 98. Describe the scale used to grade muscle strength? 99. Proximal muscle weakness is related to __________? Distal weakness related to __________? 100.The slight residual tension in a voluntarily relaxed muscle is called ________? 101.Tone is assessed by resistance to ________ movement? 102.Name 5 characteristics of UMN lesion? 103.Name 5 characteristics of LMN lesion? 104.T or F: The lower extremities are tested first in motor function exam?

105.Name the different parts of testing motor function & nerve involved if applicable? 106.Increased resistance (muscle rigidity or spasticity) means ____________ tone? 107.Decreased resistance (limpness or flaccidity) means _______________ tone? 108.Ratchety jerkiness to the motion during palpation of proximal muscle during passive movement is called _________ & is cause by ___________ disease? 109.The 2 main types of reflexes tested are ___________ & _____________? 110.Tapping the tendon of a muscle produces the _________ reflex? 111.Describe the grading scale for reflexes? 112.Hyperactive reflexes are characteristic of _________ __________ disease? What else? 113.Diminished reflexes are characteristic of _______ _______ ________ disorders & ________? 114.Decreased relaxation after DTR in patients w/ hypothyroidism is termed the ___________ reflex? 115.What technique is useful in testing patients with diminished reflexes? Describe it? 116.Having the patient lock fingers and try to pull apart while testing lower extremity reflexes is called _____________ maneuver? 117.The five DTRs that are usually tested are ________, _______, ________, _______, & __________? 118.Know the method for testing each reflex? 119.The 2 most commonly tested superficial reflexes are the __________ & _________? 120.When eliciting the abdominal reflex, does the umbilicus deviate toward or away from the stimulus? 121.When eliciting the cremasteric reflex, elevation of the which testicle is elevated? 122.Babinski reflex causes _______ of the big toe & _________ of the toes? 123.T or F: When testing for sign of Babinski use a sharp pin to stroke the bottom of the fooot? 124.Dorsiflexion of big toe is also a sign of pyramidal tract disease. This is called _________ sign? 125.W/ pyramidal tract disease pressure on shin causes dorsiflexion of big toe. This is ________ sign? 126.Adduction & flexion of the thumb & flexion of fingers when the distal phalanx of middle finger is flexed & released is called _________ sign? 127.Sensory testing involves testing what 5 things? 128.Lightly touching skin w/ gauze tests __________? 129.A spinal cord level below which there is a marked decrease in sensation is called a ________ level? 130.Touching the patient with a safety pin & asking whether dull or sharp tests _________? 131.Placing a tuning fork on a bony prominence tests ______________? 132.Moving the distal phalanx & asking the patient if its moved up or down tests _________? 133.Touching a patient in two places and asking them where you touched them tests _______ ? 134.Extinguishing the sensation on the contralateral side of the lesion is called _________? 135.Checking the distance at which 2 pins can be felt on the skin tests _________? 136.Two-point discrimination for the fingertips is _______? Tonge = _____? Toes = _______? Palms = _______? Back = ________? 137.A lesion in the ________ lobe impairs 2-point discrimination? 138.Having a patient identify an object placed in hand is called _______? It is the integrative function of the _________ & _________ lobes? 139.The ability to identify a number written in the hand is called _________? 140.T or F: The number should be written facing the patient? 141.The ability to point to an area where one is touched is called ____________? 142.Name 5 tests to check cerebellar function? 143.Patients with cerebellar disease overshoot their target during the finger-to-nose test. This is called _____? 144.In the heel-to-knee test, a patient with cerebellar disease will do what? 145.The ability to perform rapid alternating movements is called ____________? 146.An abnormality in performing rapid alternating movements is called __________? 147.Describe a positive Rombergs test? 148.___________ is when one of a patients arms drifts downward with flexion of the fingers during the Romberg test? 149.Walking with one foot in front of the other is called a ___________ gait? 150.Dragging or circumducting a weak or spastic leg along with flexed elbow across abdomen is called ___________? 151.A patient with ___________ disease shuffles with short, hurried steps?

152.A patient with __________ __________ walks with a wide based gait (feet far apart & staggers from side to side? 153.A patient with ___________ has a characteristic slapping gait resulting from weakness of dorsiflexors of ankle? 154.A patient with ____________ has a high stepping gait & they slap feet down firmly?