Section 1.5 Lecture

Question 2

What is the core rule the instructor emphasizes for the neurological exam?

Answer 2

Every maneuver answers the question, “What part of the nervous system am I testing right now?”

Question 3

Why does identifying the nervous system structure being tested help answer exam questions?

Answer 3

Because localizing the structure allows you to determine the diagnosis and clinical implication.

Question 4

During peripheral vision or finger-counting, what function is being tested?

Answer 4

Vision and peripheral vision.

Question 5

Which cranial nerve is tested during peripheral vision or finger-counting?

Answer 5

Cranial nerve II (optic nerve).

Question 6

Loss of peripheral vision suggests damage to what structure?

Answer 6

The optic pathway or optic chiasm.

Question 7

Is vision considered a sensory or motor function?

Answer 7

Sensory.

Question 8

During the pupillary light reflex, what is the afferent cranial nerve?

Answer 8

Cranial nerve II (optic).

Question 9

During the pupillary light reflex, what is the efferent cranial nerve?

Answer 9

Cranial nerve III (oculomotor).

Question 10

What brain structure is tested by the pupillary light reflex?

Answer 10

The midbrain.

Question 11

Why is the pupillary light reflex considered a brainstem test?

Answer 11

Because it specifically assesses midbrain function, not just the eye.

Question 12

What is being tested when a patient tracks a moving light with their eyes?

Answer 12

Extraocular muscle function and eye movement coordination.

Question 13

Which cranial nerves control eye movements?

Answer 13

Cranial nerves III, IV, and VI.

Question 14

What brainstem structure coordinates eye movement between nuclei?

Answer 14

The medial longitudinal fasciculus (MLF).

Question 15

If one eye does not move during tracking, what is the likely problem?

Answer 15

A motor cranial nerve problem.

Question 16

If the eyes do not move together, what condition is suggested?

Answer 16

Internuclear ophthalmoplegia.

Question 17

What is tested during the whisper hearing test?

Answer 17

Hearing.

Question 18

Which cranial nerve is tested during the whisper test?

Answer 18

Cranial nerve VIII (vestibulocochlear).

Question 19

Which structures are involved in hearing as tested in the neurological exam?

Answer 19

Inner ear and brainstem (medulla).

Question 20

What is being tested during shoulder shrugging and arm lifting against resistance?

Answer 20

Motor strength and shoulder movement.

Question 21

Which cranial nerve controls shoulder shrug and head movement?

Answer 21

Cranial nerve XI (spinal accessory).

Question 22

What part of the nervous system is assessed when testing strength against resistance?

Answer 22

Spinal cord motor pathways.

Question 23

What does an inability to move indicate in strength grading?

Answer 23

Severe motor deficit.

Question 24

What does movement against gravity indicate?

Answer 24

Partial motor strength.

Question 25

What does movement against resistance indicate?

Answer 25

Normal motor strength.

Question 26

What is tested by rapid alternating movements and finger-to-nose testing?

Answer 26

Cerebellar function.

Question 27

What cerebellar abilities are assessed by coordination testing?

Answer 27

Starting movement, stopping movement, and force calculation.

Question 28

What exam phrase is commonly used to describe rapid alternating movements?

Answer 28

They assess cerebellar function.

Question 29

What is being tested when an examiner pushes against the patient’s arms or legs?

Answer 29

Motor strength of upper and lower motor neurons.

Question 30

Why must right and left sides always be compared during motor testing?

Answer 30

Asymmetry indicates a neurological lesion.

Question 31

What reflex is tested by stroking the sole of the foot?

Answer 31

The Babinski reflex.

Question 32

What neural pathway is assessed by the Babinski reflex?

Answer 32

The corticospinal tract.

Question 33

A positive Babinski reflex in adults indicates damage to what?

Answer 33

Upper motor neurons.

Question 34

What pathway is tested by light touch using cotton?

Answer 34

The dorsal column pathway.

Question 35

What sensory modalities are carried by the dorsal column?

Answer 35

Fine touch, vibration, and proprioception.

Question 36

What pathway is tested using a sharp or painful stimulus?

Answer 36

The spinothalamic tract.

Question 37

What sensations are transmitted by the spinothalamic tract?

Answer 37

Pain and temperature.

Question 38

What does vibration testing with a tuning fork assess?

Answer 38

Dorsal column function.

Question 39

Why is vibration testing emphasized in diabetic patients?

Answer 39

Loss of vibration sensation increases injury and amputation risk.

Question 40

Loss of vibration sensation suggests damage to which pathway?

Answer 40

The dorsal column.

Question 41

What is tested by double simultaneous stimulation?

Answer 41

Sensory integration.

Question 42

Which brain region is tested during double simultaneous stimulation?

Answer 42

The parietal cortex.

Question 43

Missing one side during double simultaneous stimulation suggests what?

Answer 43

A cortical lesion.

Question 44

What do deep tendon reflexes assess?

Answer 44

Lower motor neurons and the spinal reflex arc.

Question 45

What does an absent reflex suggest?

Answer 45

A lower motor neuron lesion.

Question 46

What does hyperreflexia suggest?

Answer 46

An upper motor neuron lesion.

Question 47

What is tested during gait and balance examination?

Answer 47

Cerebellar and vestibular function.

Question 48

What activities are observed during gait testing?

Answer 48

Walking, heel-to-toe walking, turning, and balance tasks.

Question 49

Why are field sobriety tests related to the neurological exam?

Answer 49

Alcohol impairs cerebellar function and coordination.

Question 50

What does the orientation portion of the mini mental status exam assess?

Answer 50

Cerebral cortex function.

Question 51

What types of orientation are tested in the mental status exam?

Answer 51

Person, place, and time.

Question 52

What functions are tested by repetition and categorization tasks?

Answer 52

Language and working memory.

Question 53

What does failure in memory and language tasks suggest?

Answer 53

Cortical dysfunction.

Question 54

Why does failure on the mental status exam not suggest spinal or cerebellar damage?

Answer 54

Because these functions are mediated by the cerebral cortex.

Question 55

When answering an exam question, what three steps should you follow?

Answer 55

Identify the maneuver, determine the system tested, and localize the structure.

Question 56

A patient cannot perform rapid finger movements. What is the affected structure?

Answer 56

The cerebellum.

Question 57

What condition is suggested by impaired cerebellar coordination?

Answer 57

Ataxia.

Question 58

What is the most important takeaway from the neurological exam lecture?

Answer 58

The neurological exam is about localizing function, not memorizing steps.