USAHS NEURO CORRECT COMPREHENSIVE
QUESTIONS AND ANSWERS SURE A+
palsy finding - ✔✔Eye "down and out," ptosis, fixed dilated pupil.
✔✔CN VI palsy finding - ✔✔Medial deviation of eye; cannot abduct.
✔✔CN IV palsy finding - ✔✔Difficulty looking down/in (trouble reading stairs); vertical
diplopia.
✔✔CN V motor test - ✔✔Clench jaw; palpate masseter & temporalis for symmetry.
✔✔CN VII upper motor neuron lesion - ✔✔Lower face weak contralaterally; forehead
spared.
✔✔CN VII lower motor neuron lesion - ✔✔Entire ipsilateral face paralyzed.
✔✔CN VIII screening - ✔✔Rub fingers or tuning fork next to each ear; Weber + Rinne
tests.
✔✔Right optic nerve lesion - ✔✔Right monocular blindness.
✔✔Optic chiasm lesion - ✔✔Bitemporal hemianopia (loss of temporal fields).
✔✔Optic tract lesion - ✔✔Contralateral homonymous hemianopia.
✔✔Meyer's loop (temporal) lesion - ✔✔Contralateral superior quadrantanopia ("pie in
the sky").
✔✔Parietal radiation lesion - ✔✔Contralateral inferior quadrantanopia ("pie on the
floor").
, ✔✔Upper calcarine bank lesion - ✔✔Lower visual field defect.
✔✔Lower calcarine bank lesion - ✔✔Upper visual field defect.
✔✔UMN facial lesion - ✔✔Contralateral lower face weakness only (forehead spared).
✔✔LMN facial lesion - ✔✔Ipsilateral full-face paralysis.
✔✔Bell's palsy - ✔✔LMN lesion of CN VII causing sudden ipsilateral facial paralysis.
✔✔Brainstem lesion hallmark - ✔✔"Crossed" deficits — ipsilateral CN deficits with
contralateral body weakness or sensory loss.
✔✔Brainstem lesion symptoms - ✔✔Vertigo, diplopia, dysphagia, dysarthria, respiratory
changes, ataxia.
✔✔Semicircular canals function - ✔✔Detect angular (rotational) acceleration.
✔✔Utricle function - ✔✔Detects horizontal linear acceleration + head tilt.
✔✔Saccule function - ✔✔Detects vertical linear acceleration.
✔✔Apraxia - ✔✔Difficulty planning/executing purposeful movements despite intact
motor ability.
✔✔Dystonia - ✔✔Sustained muscle contractions causing abnormal postures.
✔✔Chorea - ✔✔Involuntary, irregular, dance-like movements; basal ganglia pathology.
✔✔Hemiballismus - ✔✔Violent flinging movements; lesion in subthalamic nucleus.
✔✔Dysphagia - ✔✔Difficulty swallowing; CN IX, X, XII involvement common.
✔✔Dysarthria - ✔✔Difficulty articulating speech due to motor impairment; not a
language disorder.
✔✔Proprioception screening - ✔✔Move limb and ask patient to identify up/down or
mirror with other limb.
✔✔Light touch screening - ✔✔Tell patient "Say yes when you feel this"; test
dermatomes.
✔✔Pain/temperature screening - ✔✔Use sharp/dull tool; alternating warm/cool stimuli.
QUESTIONS AND ANSWERS SURE A+
palsy finding - ✔✔Eye "down and out," ptosis, fixed dilated pupil.
✔✔CN VI palsy finding - ✔✔Medial deviation of eye; cannot abduct.
✔✔CN IV palsy finding - ✔✔Difficulty looking down/in (trouble reading stairs); vertical
diplopia.
✔✔CN V motor test - ✔✔Clench jaw; palpate masseter & temporalis for symmetry.
✔✔CN VII upper motor neuron lesion - ✔✔Lower face weak contralaterally; forehead
spared.
✔✔CN VII lower motor neuron lesion - ✔✔Entire ipsilateral face paralyzed.
✔✔CN VIII screening - ✔✔Rub fingers or tuning fork next to each ear; Weber + Rinne
tests.
✔✔Right optic nerve lesion - ✔✔Right monocular blindness.
✔✔Optic chiasm lesion - ✔✔Bitemporal hemianopia (loss of temporal fields).
✔✔Optic tract lesion - ✔✔Contralateral homonymous hemianopia.
✔✔Meyer's loop (temporal) lesion - ✔✔Contralateral superior quadrantanopia ("pie in
the sky").
✔✔Parietal radiation lesion - ✔✔Contralateral inferior quadrantanopia ("pie on the
floor").
, ✔✔Upper calcarine bank lesion - ✔✔Lower visual field defect.
✔✔Lower calcarine bank lesion - ✔✔Upper visual field defect.
✔✔UMN facial lesion - ✔✔Contralateral lower face weakness only (forehead spared).
✔✔LMN facial lesion - ✔✔Ipsilateral full-face paralysis.
✔✔Bell's palsy - ✔✔LMN lesion of CN VII causing sudden ipsilateral facial paralysis.
✔✔Brainstem lesion hallmark - ✔✔"Crossed" deficits — ipsilateral CN deficits with
contralateral body weakness or sensory loss.
✔✔Brainstem lesion symptoms - ✔✔Vertigo, diplopia, dysphagia, dysarthria, respiratory
changes, ataxia.
✔✔Semicircular canals function - ✔✔Detect angular (rotational) acceleration.
✔✔Utricle function - ✔✔Detects horizontal linear acceleration + head tilt.
✔✔Saccule function - ✔✔Detects vertical linear acceleration.
✔✔Apraxia - ✔✔Difficulty planning/executing purposeful movements despite intact
motor ability.
✔✔Dystonia - ✔✔Sustained muscle contractions causing abnormal postures.
✔✔Chorea - ✔✔Involuntary, irregular, dance-like movements; basal ganglia pathology.
✔✔Hemiballismus - ✔✔Violent flinging movements; lesion in subthalamic nucleus.
✔✔Dysphagia - ✔✔Difficulty swallowing; CN IX, X, XII involvement common.
✔✔Dysarthria - ✔✔Difficulty articulating speech due to motor impairment; not a
language disorder.
✔✔Proprioception screening - ✔✔Move limb and ask patient to identify up/down or
mirror with other limb.
✔✔Light touch screening - ✔✔Tell patient "Say yes when you feel this"; test
dermatomes.
✔✔Pain/temperature screening - ✔✔Use sharp/dull tool; alternating warm/cool stimuli.
