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Neurological Examination/60 Questions and answers
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Neurological Examination/60 Questions and answers
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Neurological Examination/60 Questionsand answers
6 components of a Neurological examination - -1. mental status
2. Cranial Nerves
3.Moto exam
4. reflexes
5. sensory exam
6. coordination and gait
-In every neurological examination you ned to - -assess (speech)
inspect (facial movements and symmetry)
observe (swallowing and breathing)
-If during the history it is suggested of CN injury - -examine all 10 CN
-If during the history it is suggested of spinal injury - -test all sensory
function
-If during the history it is suggested of cerebral injury - -test memory,
aphasia, apraxia, agnosia
-11 points to assess in the mental status examination - -1. Level of
alertness,attention and cooperation
2. Orientation for time, place, and person
3. Speech and language
4. Memory for immediate, recent, and remote events
5. Calculations and right/left orientation, finger agnosia, and agraphia
6. Apraxia
7. Constructions and neglect
8. Logic and abstractions
9. Sequencing tasks and frontal release signs
10. Delusions and Hallucinations
11. Mood
-Level of alertness,attention and cooperation - -MMSE (mini-mental status
exam Normal 26-30, < 9 sever deficit)
Alert: vigile
Leathery: latargico
Obtundation: ottudimento (gentle shake)
Stupor: stuporoso (painful stimuli will arouse)
Coma: coma
-Types of Speech and language to assess - -spontaneous
, comprehension
naming
repetition
reading
writing
-apraxia - -inability to complete simple motor tasks
-Hemineglect - -lack of attention to one side of body and world. Not due to a
primary sensory or motor disturbance
-ideomotor apraxia - -unable to pretend to do simple tasks (example
brushing hair)
-preservation - -repeating a pattern of behavior (seen often in dementia)
-hallucination - -False sensory perceptions that are not in response to an
external stimulus
-delusion - -A false belief or opinion of one's self
-CN I - -Olfactory
Noxious stimulus are sensed by CN V
-CN II - -optic
color (specifically red) and acuity
pupil reactivity (direct and consensual) light and accommodation
sympathetic dilates (Cocaine)
Para sympathetic contracts (heroin)
-CN III, IV, VI - -eye movement
draw H at extremities look for nystagmus
-CN V - -facial sensation and masseter-temperal muscle (chewing)
press on specific point and sensation close mouth contract mandible
-CN VII - -facial (taste, tears, facial expression)
motor
central lesion: paralysis lower part on contralateral side
peripheral lesion: paralysis and hyposthenia ipsilateral hemifacial
Hare's eye (lagopthalmos) (dropping a bit
-CN VIII - -Vestibulo-Ocular
test:
*soft whisper
*Weber
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