Neurology Examination

Question 1

What is involved in testing the cranial nerves as part of a neurological examination (7)

Answer 1

Visual fields
Pupillary reflexes
Fundoscopy
H test of eye movements
Facial nerve - facial expressions
Uvula
Tongue - fasciculations, wasting, deviation, movement

Question 2

Shoulder abduction nerve root

Answer 2

C5

Question 3

Elbow flexion nerve root

Answer 3

C5/C6

Question 4

Elbow extension nerve root

Answer 4

C7

Question 5

Wrist flexion and extension nerve root

Answer 5

C7

Question 6

Finger extension nerve root

Answer 6

C7

Question 7

Finger flexion nerve root

Answer 7

C8

Question 8

Finger and thumb abduction nerve root

Answer 8

T1

Question 9

Bicep jerk reflex nerve root

Answer 9

C5

Question 10

Supinator jerk reflex nerve root

Answer 10

C5/C6

Question 11

Tricep jerk reflex nerve root

Answer 11

C7

Question 12

Hip flexion nerve root

Answer 12

L1,2,3

Question 13

Hip extension nerve root

Answer 13

L5, S1

Question 14

Knee flexion nerve root

Answer 14

L5, S1

Question 15

Ankle dorsiflexion nerve root

Answer 15

L4, L5

Question 16

Ankle plantarflexion nerve root

Answer 16

S1, S2

Question 17

Knee reflex nerve root

Answer 17

L3/4

Question 18

Ankle reflex nerve root

Answer 18

S1, S2

Question 19

Aspects of upper limb examination as part of a neuro exam

Answer 19

Inspection
Pronator drift
Tone
Power
 - shoulder abduction
 - elbow flexion
 - elbow extension
 - wrist flexion and extension
 - finger extension
 - finger flexion
 - finger abduction
 - thumb abduction
Reflexes
 - biceps 
 - supinator
 - triceps
Co-ordination
Sensation

Question 20

Aspects of lower limb examination as part of a neuro exam

Answer 20

Inspection
Gait
Rombergs
Tone
Ankle clonus
Power 
 - hip flexion 
 - hip extension 
 - knee flexion
 - knee extension
 - ankle dorsiflexion
 - ankle plantarflexion
Reflexes
 - knee
 - ankle
Babinski
Co-ordination
Sensation

Question 21

MRC grades for muscle power

Answer 21

0 – no contraction
1 – flickers of contraction
2 – moves without gravity
3 – moves against gravity
4 – moves against resistance but weaker than expected
5 – normal power

Question 22

How do you write down/record reflex responses

Answer 22

\++++ clonus
\+++ brisk/increased
\++ normal/brisk
\+ normal/diminished
- absent
\+/- present only with reinforcement