MSK Exam I
Neuro Exam I
Neuro Exam II
Mixed Bag I
Mixed Bag II
100
In the upper extremities, which specific joint areas are assessed?
Spine, Shoulder, Elbow, Wrist, and Hand
100
What is the first component of the Neuro Exam?
Mental Status:
Level of Consciousness
Orientation (person, place and time)
Language (fluency, comprehension, repetition) Articulation (dysarthria)
100
What are small, rapid, involuntary contractions in skeletal muscles that are too weak to move a limb?
Facsciculations
100
What is normal reflex score?
2
Reflexes are graded on a 0-to-4 scale,
0 being "no response", 2 being "normal response", 3 being "hyperactive but considered normal".
A 4-plus response is hyperactive and may indicate disease.
There is often clonus associated with a reflex graded a 4.
100
What is the first step on any physical exam?
Observation/Inspection!
200
In the lower extremities, which specific joint areas are assessed?
Joints of Hips, Knees, Ankle and Foot.
200
What is best to imaging test to out intra-cranial hemorrhage?
Non-contrast CT of the head.
200
What unique aspect are we testing for in Neuro-Motor Exam?
Active and Passive Strength.
200
How do we test Graphesthesia?
Graphesthesia is writing numbers in the patient's hand and asking them to identify them.
200
How do we test Streognosis
Place objects (coins, pencils) in patient's hand with eyes closed and ask them to identify.
300
What condition does Tinel Sign and PhalenTest assess for?
Carpel Tunnel Syndrome
300
What are two neuro-cerebellar tests for upper extremities?
1. finger to nose
2. rapid alternating movements.
300
Which reflexes are assessed in the lower extremities?
1. Patellar tendon reflex
2. Achilles tendon reflex
3. Babinski reflex (Plantar response)
300
What would you observe in the affected eye with a Relative Afferent Pupillary Defect (Marcus-Gunn Pupil) during a swinging light test?
Affected eye won't constrict and appears dilated.
300
How Long can a TIA last for?
60 minutes
400
What unique function is assessed in the MSK exam that isn't in other PE.
Active and Passive Range of Motion
400
How do we test for CN XI?
Shrug against resistance and neck left and right against resistance.
400
What is the scale for testing neuro-motor strength?
Motor strength should be graded on a 0-to-5 scale:
0 no response
1 contraction of the muscle
2 active movement of the body part with elimination of gravity/
patient lying in bed moving their arm in the plane of the bed
3 active movement against gravity but not against resistance
4 active movement against gravity and some resistance
5 active movement against full resistance without obvious fatigue
400
Locate the stroke lesion:
Contralateral weakness and sensory loss in the lower limbs more marked than in upper limbs.
ACA most likely.
400
What is the inability to perform rapid alternating movements?
diadochokinesia
500
What does Varus & Valgus tests assess for?
Lateral and Medial Collateral Ligaments.
Knee flexed at 30 degrees, supported. Apply pressure, looking for laxity.
Bonus: what does McMurray Test assess for?
500
How is CN V tested?
Test both motor function and sensory function.
There are three divisions to the sensory function: the ophthalmic, maxillary, and mandibular divisions.
Test for sensation on both sides. Test temporalis and masseter muscles.
Corneal reflex is deferred in ICM.
500
How do we test for CN VII?
Facial movements:
Ask the patient to raise their eyebrows, wrinkle their forehead, close their eyes tightly, smile and puff up their cheeks.
Note symmetry of these movements.
500
Locate the stroke lesion:
Contralateral weakness and sensory loss more marked in the upper limbs and lower half of the face than in lower limbs
MCA most likely
500
What is the time frame for administering tPA?
Within 4.5 hours of symptoms or last normal interaction.