A neurological examination is the assessment of sensory neuron and motor responses, especially reflexes, to determine whether the nervous system is impaired. This typically includes a physical examination and a review of the patient's medical history, but not deeper investigation such as neuroimaging.
These slides cover the points to be described in case of full neurological system examination. It was presented in a seminar of Medicine dept, Dhaka Medical College Hospital (MU VII) on 17 July, 2017. My guide was Associate professor Dr. Robed Amin Sir, MBBS, FCPS (Medicine)
For any comment- sani17k65@gmail.com
These slides cover the points to be described in case of full neurological system examination. It was presented in a seminar of Medicine dept, Dhaka Medical College Hospital (MU VII) on 17 July, 2017. My guide was Associate professor Dr. Robed Amin Sir, MBBS, FCPS (Medicine)
For any comment- sani17k65@gmail.com
This presentation gives detailed description of symptoms of catatonia with its etiologies and differential diagnoses. It should help to differentiate catatonia in neurological and psychiatric disorders.
A neurological examination is the assessment of sensory neuron and motor responses, especially reflexes, to determine whether the nervous system is impaired.
This presentation gives detailed description of symptoms of catatonia with its etiologies and differential diagnoses. It should help to differentiate catatonia in neurological and psychiatric disorders.
A neurological examination is the assessment of sensory neuron and motor responses, especially reflexes, to determine whether the nervous system is impaired.
A neurological examination is the assessment of sensory neuron and motor responses, especially reflexes, to determine whether the nervous system is impaired. This typically includes a physical examination and a review of the patient's medical history, but not deeper investigation such as neuroimaging.
THE NEUROLOGICAL SYSTEM -
The neurological system controls body functions and is
inter-related to other body systems i.e. a patient with diabetes
may suffer a stroke
Antepartum haemorrhage (APH) is defined as bleeding from or in to the genital tract, occurring from 24+0 weeks of pregnancy and prior to the birth of the baby. The most important causes of APH are placenta praevia and placental abruption, although these are not the most common.
Types 1 and 2 are classified as minor placental praevia as these typically result in minor antepartum haemorrhaging. Types 3 and 4 are referred to as major placental praevia due to the risk of heavy haemorrhaging in the case of a rupture due to the location of placental attachment.
Disorders of the placenta including: FGR, pre-eclampsia, placental abruption and abnormal (velamentous) cord insertion are associated with over 50% of stillbirths and are frequently cited as the primary cause of death [1–3]. Abnormal placental structure and function significantly increases the risk of stillbirth.
Placenta accreta, placenta increta, and placenta percreta. Abnormal placental implantation (accreta, incretak, and percreta) is described using a general clinical term, respectively, morbidly adherent placenta (MAP) [2] or “abnormal invasive placenta” (AIP).
A miscarriage, or spontaneous abortion, is an event that results in the loss of a fetus before 20 weeks of pregnancy. It typically happens during the first trimester, or first three months, of the pregnancy. Miscarriages can happen for a variety of medical reasons, many of which aren't within a person's control.
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Chromotherapy
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Color therapy (or chromotherapy) is an alternative remedy that uses color and light to treat physical or mental health by balancing the body's energy centers, also known as chakras. This concept dates back to ancient Egyptians who used sun-activated solarium rooms constructed with colored glass for therapeutic purposes.
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Behavioral therapy is an umbrella term for types of therapy that treat mental health disorders. This form of therapy seeks to identify and help change potentially self-destructive or unhealthy behaviors. It functions on the idea that all behaviors are learned and those unhealthy behaviors can be changed.
Behavior therapy
Behavior therapy or behavioral psychotherapy is a broad term referring to clinical psychotherapy that uses techniques derived from behaviorism and/or cognitive psychology.
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Light therapy
Description
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Cardioversion is a medical procedure by which an abnormally fast heart rate (tachycardia) or other cardiac arrhythmia is converted to a normal rhythm using electricity or drugs.
Cathlab procedures, it's contains what are the procedure doing in the cathla...jagan _jaggi
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Arterial blood gas test Diagnostic testjagan _jaggi
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Image result for obstetric instrumentswww.slideshare.net
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To strengthen your pelvic floor muscles, sit comfortably and squeeze the muscles 10-15 times in a row. Don't hold your breath or tighten your stomach, buttock or thigh muscles at the same time. When you get used to doing pelvic floor exercises, you can try holding each squeeze for a few seconds.
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The World Health Organization and UNICEF have recommended for a decade that mothers breastfeed for at least two years. But most US women who nurse stop before their baby is six months old – and many never start at all.
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
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Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
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Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
2. INTRODUCTION:
A neurological examination is the
assessment of sensory neuron and motor
responses, especially reflexes, to determine
whether the nervous system is impaired. This
typically includes a physical examination and a
review of the patient's medical history but not
deeper investigation such as neuroimaging. It
can be used both as a screening tool and as an
investigative tool.
3. Examples of Definitions
• Alert:
o awake, looks about
o responds in a meaningful manner to verbal instructions or
gestures
• Drowsy:
o oriented when awake but if left alone will sleep
• Confused:
o disoriented to time, place, or person
o memory difficulty is common
o has difficulty with commands
o exhibits alteration in perception of stimuli, may be agitated
4. • Stuporous:
o generally unresponsive except to vigorous stimulation
o may make attempt at verbalization to vigorous/repeated
stimuli
o Opens eyes to deep pain
• Comatose:
o unarousable and unresponsive
o some localization or movement may be acceptable within
the comatose category
depending on the coma definitions e.g. light coma to deep
coma
o Does not open eyes to deep pain
5. The difference between Coma and Sleep:
• sleeping persons respond to unaccustomed stimuli
• sleeping persons are capable of mental activity
(dreams)
• sleeping persons can be roused to normal
consciousness
• cerebral oxygen uptake does not decrease during
sleep as it often does in coma
6. Special States of Altered Levels of Consciousness
• Brain Death:
An irreversible loss of cortical and brain stem activity.
• Persistent Vegetative State:
A condition that follows severe cerebral injury in
which the altered state becomes
chronic or persistent.
• Locked-in Syndrome:
A state of muscle paralysis, involving voluntary
muscles, while there is preservation of full
consciousness and cognition.
7. Indications:
A neurological examination is indicated
whenever a physician suspects that a patient
may have a neurological disorder. Any new
symptom of any neurological order may be
an indication for performing a neurological
examination.
8. Organic Disease ?
Signs &/or symptoms that cannot be faked must
be examined closely.
Examples include, asymmetry in pupils, abnormal
retinal exams, nystagmus, muscle atrophy, and
muscle fasciculation.
9. Where are the Connections
Upper Motor Neurons (UMN) are defined as the
connections of motor nerves before they leave
the spinal cord
Lower Motor Neurons (LMN) are defined as after
the synapse (connection) into the peripheral
nerve cell bodies.
10. Objectives
Organize Exam into the 6 Subsets of Function
Concept of Screening Examination
Understand Afferent and Efferent Pathways for
Brainstem Reflexes
Differentiate Between Upper and Lower
Motor Neuron Findings
11. Six Subsets of the Neuro Exam
Here’s what you need to examine.
Mental Status
Cranial Nerves
Motor
Sensory
Coordination
Reflexes
12. Concept of a Screening Exam
Screening each of the subsets allows one to check on
the entire neuroaxis (Cortex, Subcortical White Matter,
Basal Ganglia/Thalamus, Brainstem, Cerebellum,
Spinal Cord, Peripheral Nerves, NMJ, and Muscles)
Expand evaluation of a given subset to either
• Answer questions generated from the History
• Confirm or refute expected or unexpected findings on Exam
13. Neurological Examination
Mental Status Exam
“FOGS”
Family story of memory loss
Orientation
General Information
Spelling &/or numbers
Recognition of objects
14. 1. INTERVIEW
The patient/family interview will allow the nurse to:
• ƒgather data: both subjective and objective about the
patient's previous/present health state
• ƒprovide information to patient/family
• ƒclarify information
• ƒmake appropriate referrals
• ƒdevelop a good working relationship with both the patient
and the family
• ƒinitiate the development of a written plan of care which is
patient specific
15. Interview to identify presence of:
• headache
• difficulty with speech
• inability to read or write
• alteration in memory
• altered consciousness
• confusion or change in thinking
• disorientation
• decrease in sensation, tingling or pain
• motor weakness or decreased strength
• decreased sense of smell or taste
• change in vision or diplopia
• difficulty with swallowing
• decreased hearing
• altered gait or balance
• dizziness
• tremors, twitches or increased tone
16. Physical Examination Considerations
• Level of Consciousness
– Most important aspect of neurologic examination
– Level of consciousness first to deteriorate; changes often subtle,
therefore requiring careful monitoring.
• Consciousness:
– Composed of Two Components:
• Arousal (Alertness)
• Awareness (Content)
– Assessment: Orientation vs. Disorientation
» Person, Place & Time
» Varying sequence of questions is important !!
17. Assessing LOC
• Glasgow Coma Scale (GCS)
– Three Categories:
• Eye opening
• Best motor response
• Best verbal response
– Scoring
• Highest or best possible score 15
• A score of < 8 indicates coma
• Lowest or worst possible score 3
19. Pupillary Examination
• The pupillary examination can be quickly and easily
performed in the unconscious or minimally responsive
patient when a TBI is suspected, and can provide valuable
information about the degree of initial or progressing brain
injury. Several types of TBI’s may cause pupillary changes,
which indicate the need for rapid interventions to decrease
ICP caused by cerebral bleeding and/or edema. Nurses are
in a key position to detect early changes in a patient's
condition and administer or advocate for immediate
interventions.
20. Check pupil size in lighted room, and
reactivity to light in a darkened room.
23. Mental Status
Level of Alertness
• Subjective view of Examiner
• Definition of Consciousness
• Terminology for Depressed Level of Consciousness
• Concept of Coma
• Delerium
Degree of Orientation
• To what?
24. Mental Status
Concentration
• Serial 7’s or 3’s
• “WORLD” backwards
• Months of the Year Backwards
• Try to quantify degree of impairment
* A and O and Concentration need to be intact for other
aspects of the Mental Status Exam to have localizing
value!
26. Mental Status
Language
Aphasia vs Dysarthria
Receptive Language
• Command Following
Expressive Language
• Fluency
• Word Finding
Repetition
• Screens for Receptive, Expressive, and Conductive
Aphasias
28. Mental Status
Calculations, R-L confusion, finger agnosia,
agraphia
• Gerstmann’s Syndrome (Dominant Parietal Lobe)
Hemineglect
• Non-Dominant Parietal Lobe
Delusional Thinking, Abstract Reasoning, Mood,
Judgement, Fund of Knowledge, etc
• Important for Psychiatry
• Does not localize well to one region of the cortex
• Neurocognitive Testing required to get at more specific deficits
30. Olfactory Nerve
Distinguish Coffee from Cinnamon
Smelling Salts irritate nasal mucosa and test V2
Trigemminal Sense
Disorders of Smell result from closed head injuries
34. CN III Oculomotor: moves
eyes in all directions except
outward and down & in; opens
eyelid; constricts pupil
CN IV Trochlear:
moves eyes
down and in…..
35. CN VI Abducens: moves eyes outward
EOM’s:
(extraoccular movement)
assessment of eye
movement in all
directions ( III, IV VI)
41. Vestibulocochlear Nerve
Hearing and Balance
• Patients will complain of tinnitis, hearing loss, and/or vertigo
Weber and Renee Test
• Differentiates Conductive vs Sensorineural hearing loss
Afferent input to the Oculocephalic Reflex
• Doll’s Eye Maneuver
• Cold Calorics
• Not “COWS”
“Hearing grossly intact AU”
49. Strength
Medical Research Council Scale
5/5 = Full Strength
4/5 = Weakness with Resistance
3/5 = Can Overcome Gravity Only
2/5 = Can Move Limb without Gravity
1/5 = Can Activate Muscle without Moving
Limb
0/5 = Cannot Activate Muscle
55. Drift Assessment
Drift Assessment: test for motor weakness
Arm: hold arms out with palms up; eyes closed
• Pronator drift: hands pronate (roll over);
• Motor drift: arm “drifts” downward
• Cerebellar drift: arm “drifts” back
toward head or out to side
Leg: no need to close eyes
motor: leg “drifts”toward bed
56. Movement Assessment
Movements are purposeful or non-purposeful purposeful: picking at
tubings or bed linens, scratching nose
localizing: moving toward or removing a painful stimulus; must cross the midline; occurs in
the cortex
withdrawal: pulling away from pain; occurs in the hypothalamus
non-purposeful: do not cross the midline
abnormal flexion: (decorticate)
rigidly flexed arms and wrists; fisted
hands; occurs in upper brainstem
abnormal extension: (decerebrate)
rigidly, rotated inward extended arms
with flexed wrists and fisted
hands; occurs in midbrain or pons.
Decorticate
Decerebrate
59. Pain and Temperature
• Pinprick (One pin per patient!)
• Sensation of Cold
• Look for Sensory Nerve or
Dermatomal Distribution
Vibration Sensation
• C-128 Hz Tuning Fork (check great toe)
Joint Position Sensation
• Check great toe
• Romberg Sign
60. Higher Cortical Sensory Function
Graphesthesia
Stereognosis
Two-Point Discrimination
Double Simultaneous Extinction
Gerstmann’s Syndrome (acalculia, right-left
confusion, finger agnosia, agraphia)
• Usually seen in Dominant Parietal Lobe lesions
61. Hemisphere Dysfunction
Dysmetria on Finger-Nose-Finger Testing*
Irregularly-Irregular Tapping Rhythm*
Dysdiadochokinesis*
Impaired Check*
Hypotonia*
Impaired Heel-Knee-Shin*
Falls to Side of Lesion*
Nystagmus (Variable Directions)
* All Deficits are Ipsilateral to the side of the lesion
67. Abmornal Reflexes
Abnormal Reflexes:
Babinski: initial inflection of great toe in response
stroking of sole; upgoing toe is abnormal
Grasp: involuntary grasp in response to stimulation
of palm; abnormal in an adult
Doll’s eyes: impairment of eye movement to opposite
side when head is turned = damage to brainstem; no
movement = loss of
brainstem
68. Neuro Aessessment Quiz
• 1. Peripheral Nervous System (PNS)
is made up of the following except::
a) Cranial nerves (12)
b) Ventricles
c) Axons and Neurons
d) Spinal nerves (31)
e) Cerrebellar nerves
• 2. The Autonomic Nervous System
contains both the Sympathetic
Division of nerves and the
Parasympathetic Division of nerves.
True or False________________.
• 3. Intracranial Hemorrhage can occur
in the following places except:
a) Epidural space
b) Subdural space
c) Subarachnoid space
d) Ethmoid space
• .4. A Coup Contracoup injury is defined
as: When the head strikes a fixed object,
the coup injury occurs at the site of impact
and the contrecoup injury occurs at the
opposite side. True or
False____________________
• 5. The Facial nerve controls:
a) Movement of the chin, tongue and parotid
glands.
b) Movement of the tongue, soft palete and
eyebrows.
c) Movement of the chin and cheeks
muscles.
d) Movement of all the facial expression
muscles.
• 6. Which nerve controls movement on the
neck and shoulders?
a) Abducens
b) Accoustic
c) Spinal Assesory
d) Occulomotor
69. • 7. A serious injury to the cervical spine
and spinal cord most likely will result in
the following condition:
a) Hemiplegia
b) Quadraplegia
c) Paraplegia
d) Contralateral paralysis
• 8. Any suspected head, neck or spine
injured victim should immediately be
given spinal immobilization precautions,
except:
a) When the victim complains of pain only
upon turning his head to one side.
b) When the victim refuses to allow spinal
immobilization even after listening
carefully to multiple attempts to explain
the dangers and risk involved.
c) When the victim is intoxicated on alcohol
and cannot speak clearly.
d) When the victim was never unconscious
and denies any pain.
• 9. When assessing a patient with altered LOC,
you feel his state of awareness/arousal is best
described as “Obtunded”, this means:
a) Very drowsy, when not stimulated, but can
follow simple commands when stimulated (i.e.
shaking or shouting); verbal responses include
one or two words, but will drift back to sleep
without stimulation.
b) A state of drowsiness; client needs increased
external stimuli to be awakened but, remains
easily arousable; verbal, mental & motor
responses are slow or sluggish.
c) Awakens only to vigorous and continuous
noxious (painful) stimulation; minimal
spontaneous movement; motor responses to
pain are appropriate but, verbal responses are
minimal and incomprehensible (i.e. moaning).
d) Vigorous external stimulation fails to produce
any verbal response; both arousal and
awareness are lacking; no spontaneous
movements but, motor responses to noxious
stimuli maybe be purposeful
70. • 10. The Glasgow Coma scale tests for
three kinds of responses, they are:
a) Eye Opening
b) Motor Response
c) Verbal Response
d) Auditory Response
• 11. The best and worst possible score on
the GCS is:
a) 15 and 0
b) 13 and 3
c) 15 and 3
d) 18 and 5
• 12. When assessing pupillary response,
you are looking for the following
conditions except:
a) Coordinated eye movement and bilateral
blinking.
b) Reactivity to and accommodation to light.
c) Symmetry of pupils and accommodation
to light.
d) Abnormal pupil shape.
• 13. A constricted “pin point” pupil indicates:
(best answer)
a) Brain Stem herniation
b) Cardiac Arrest
c) Cerebral Infarction of the parietal lobe
d) Cerebral Infarction of the occipital lobe
e) A wide variety of conditions, some being
extremely life threatening.
• 14. What Cranial nerve(s) controls the
movement of the eyes down and in?
a) CN VI Abducens
b) CN III Oculomotor
c) CN IV Trochlear
d) CN II Optic
• 15. The Motor strength scale goes from 0/5 to
5/5, 0 being no strength at all and 5 being
normal strength. A person with a motor strength
of 4/5 would be:
a) overcomes gravity; offers no resistance
b) strong against resistance
c) weak against resistance
d) no muscle movement
71. • 16. Match the following postures with its
definition:
• Decerebrate_____________
• Decorticate______________
a) Abnormal flexion: rigidly flexed arms and
wrists; fisted hands; occurs in upper
brainstem
b) Abnormal extension: rigidly, rotated
inward, extended arms with flexed wrists
and fisted hands; occurs in midbrain or
pons.
• 17. The Babinski reflex is the initial
inflection (extension) of great toe in
response stroking of the sole of the foot,
select the correct answer:
a) An upgoing great toe is abnormal.
b) An upgoing great toe is normal.
c) An upgoing great toe is abnornal in
adults.
d) An upgoing great toe is normal in infants.
• Answers
• 1 e
• 2 True
• 3 d
• 4 True
• 5 d
• 6 c
• 7 b
• 8 b
• 9 a
• 10 d
• 11 c
• 12 a
• 13 e
• 14 c
• 15 c
• 16 Decer = b. Decor = a
• 17 c&d