Bates- Neuro Physical Exam Questions and Answers 100% Verified
_________________ is often the first sensation to be lost in a peripheral neuropathy and increases the likelihood of peripheral neuropathy 16-fold - Vibration sense "Worst headache of my life" is a common presentation for - Subarachnoid Hemorrhage 2 positions for biceps reflex, 2 positions for triceps reflex - sitting, lying down sitting, supine A "gag reflex" involves what 3 actions - elevation of the tongue and soft palate, constriction of the pharynx A fingers initial overshoot and compensation to finally reach the target is called - dysmetria A muscle is strongest when __________ and weakest when __________ - shortest, longest Abdominal Reflex - lightly stroke each side of the abdomen and umbilicus the umbilicus should deviate TOWARDS the stimulus Analgesia Hypalgesia Hyperalgesia - Absence of pain decreased sensitivity to pain increased sensitivity Bell's Palsy - CN VII injuryBoth the Romberg Test and the Pronator Drift Test test for - Stance Dull headache increased by coughing and sneezing, especially in the same location, occurs in - mass lesions from tumors or abscess epilepsy is defined as - 2 or more seizures that are not provoked by other illnesses or circumstances Fasciculations with atrophy &muscle weakness suggests - disease of peripheral motor unit graphesthesia - do a number on their palm, inability suggests lesion in sensory cortex How do you eliminate gravity when testing muscle strength? - Move the muscle in a horizontal plane How do you test CN VII? - Ask pt to raise eyebrows, frown, close both eyes tightly, show upper and lower teeth, smile, puff out both cheeks How do you test CN XI? - Inspect atrophy or fasciculations on the trapezius Ask pt to shrug their shoulders against your hands Ask pt to turn their head against your hands How do you test Cranial Nerve VIII? - Whispered Voice Test, and if there is a problem determine if its conductive or sensorineural from weber and rinne test How do you test for a lesion of CN X? - Ask the pt to say ah and watch the movement of the soft palate and pharynx How do you test for clonus - support knee in partial flexiondorsiflex and plantar flex the foot a few times, encourage pt to relax, then sharply dorsiflex the foot and maintain it,,, look for rhythmic ossilations between dorsiflexion and plantar flexion How do you test for muscle strength in the wrist? - Test extension by asking the patient to make a fist and resist your hand pulling it down weakness: peripheral nerve disease, radial nerve damage How do you test for proprioception in the feet? - Pull the big toe away and with pts eyes closed ask them to move the toe either up or down How do you test for the biceps tendon reflex? - Place your thumb over the tendon, patients arm should be partially flexed at the elbow with palm down strike with your reflex hammer so that the blow is aimed directly through How do you test the function of CN I? - 1. occlude each nostrils and test for patency 2. ask the pt to close their eyes 3. bring a smell to each of their nostrils and ask them to identify it How do you test the function of CN II and III? - 1. inspect pupils for size difference (aniscoria >0.04mm) 2. test pupillary light rxns (direct/consenual) 3. Near response (accommodation) How do you test the function of CN II? - 1. Test Visual Acuity 2. Fundoscopic- optic disc enlargement, pallor, and bulging 3. Confrontation TestHow do you test the function of CN III, IV, and VI? - 1. Test EOMs (if pt has diplopia, what direction makes it worse?) 2. Check for convergence How do you test the motor function of CN V? - Ask the pt to clench the teeth and note the strength of muscle contraction in masseter and pterygoid Ask pt to move jaw side to side How do you test the sensory function of CN V? - Test the forehead, cheeks, and jaw for pain sensation, sharp vs. dull on 3 places on face Abnormality found: temperature sensation How to test for light touch - with a fine wisp of cotton, touch the skin lightly ask the patient to respond when touch is felt How to test for pain sensory - use a sharp safety pin or cotton swab and alternate, asking ifits sharp or dull How to test with vibration - use a tuning fork over a distal IP joint on a finger, then big toe ask what the patient feels if vibration impared, move proximally If there is binocular diplopia, what could that be a sign of? - CN III, IV, VI neuropathy If things are impaired in the sensory test at a distal point, what would you do? - move proximally If you are having trouble getting a reflex out of the triceps tendon, you can ask the patient to - let the arm go limp as it were hung up to dryIn true motor weakness, the cause may involve (3) - nerve, NMJ, or muscle Loss of proprioception can be cauesd by - tabes dorsalis, multiple sclerosis, b12 deficiency Migraines are often preceeded by - aura or prodome
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