Deck 3: The Neurological Examination and Evaluation: an Overview

Question 1

During the interview process,the patient demonstrates a range of symmetrical facial expressions,including the ability to blink symmetrically.These observations indicate integrity of which of the following cranial nerves?

A)Cranial nerve V-Trigeminal
B)Cranial nerve VII-Facial
C)Cranial nerves V-Trigeminal and VII-Facial
D)Cranial nerves V-Trigeminal,VII-Facial,and VI-Abducens

Answer 1

B

Question 2

What is the purpose of the screening neurological examination?

A)To "rule in" or "rule-out" the need for a more in-depth neurological examination in the absence of a known or suspected neurological lesion.
B)To "rule-in" an abnormality of the central nervous system
C)To "rule-out" an abnormality of the central nervous system
D)To "rule-in" or "rule-out" systems,eg,musculoskeletal system that may be contributing to an observed movement impairment

Answer 2

A

Question 3

During the screening sensory examination,a patient reports that the touch sensation on the back of the right hand does not feel the same as the touch in the same area on the left hand.Reflex testing of the right upper extremity demonstrated diminished response of the triceps with normal responses in the other muscles.Which of the following problems is the MOST likely source of these changes?

A)Impingement of the C7 spinal root as it exits the vertebral column
B)Damage to the radial nerve at the level of the elbow
C)Impingement of the C6 spinal root as it exits the vertebral column
D)Damage to the median nerve at the level of the elbow

Answer 3

A

Question 4

Which of the following elements of a neurological screening examination is NOT included in the acronym FOGS?

A)Family story of memory loss
B)Orientation of the patient
C)General information
D)Speech patterns and content

Question 5

A patient has difficulty performing the heel to shin test.A decrease in which of the following factors would have the LEAST effect on degrading the movement?

A)Endurance
B)Flexibility
C)Strength
D)Joint position sense

Question 6

During the interview,a family member makes the observation that the patient frequently reaches for furniture when walking through a room and walks down stairs one step at a time.The family has not noted any other problems.During the screening examination,all of the following screening tests are likely to demonstrate abnormal findings that contribute to this problem EXCEPT

A)Sitting down on an armless chair
B)Walking heel to toe in a straight line
C)Eliciting the Babinski reflex
D)Completing the heel to shin test

Question 7

A 10 year-old patient has hemiplegia as the result of perinatal brain damage.Which of the following dysfunctions is the MOST likely secondary impairment?

A)Lower extremity motor control impairment contralateral to the damage
B)Unilateral passive upper extremity joint motion limitations
C)Asymmetrical step lengths while walking at a self-selected gait speed
D)Sensory impairments greater in the upper extremity than the lower extremity

Question 8

During the initial interview of a patient,a slight tremor of the patient's hands is noted when the patient reaches to adjust the position of his clothing or scratch his head.Which of the following screening tests is MOST likely to demonstrate atypical findings?

A)Upper extremity rapid alternating movements
B)Biceps and triceps deep tendon reflexes
C)Bilateral hand grip strength
D)Upper extremity stereognosis

Question 9

A newly developed neurological function test requires the patient to select a rating of the amount of change that has occurred in the patient's quality of movement following a specific intervention.Which of the following characteristics are descriptive of this test?

A)Subjective,quantitative
B)Objective,quantitative
C)Subjective,qualitative
D)Objective,quantitative

Question 10

During the process of collecting information on a patient's history,the patient hesitates when responding to direct questions and family members fill in the responses.Which of the following questions is the MOST appropriate follow up to this observation?

A)What is the name of the President of the United States?
B)What day of the week is today?
C)Can you spell the word "WORLD" forward and backward?
D)Can you repeat this seven-digit number?

Question 11

A patient has a diagnosis of a unilateral cerebellar deficit.Which of the following responses in the involved upper extremity is MOST likely to occur when the patient is asked to hold the upper extremities in front of the body with the forearms supinated and the eyes closed?

A)The arm will rise.
B)The arm will drop.
C)Pronation will occur.
D)Internal rotation will occur.