00:01
So we just covered a lot of
material on the Neurologic Exam.
00:05
Let me just highlight
a few key points here.
00:08
So we went through all of the cranial
nerves and we were highlighting
the motor function and the sensory
function of a variety of these nerves,
acknowledging that there are
many functions of these nerves,
which we can't readily
assess on the physical exam.
00:21
In terms of coordination,
we talked about distinguishing
between limb ataxia,
and gait ataxia.
00:27
Not to mention distinguishing
gait ataxia from sensory ataxia,
ataxia that's caused
by cerebellar problems
versus that caused by sensory problems
from the peripheral nervous system.
00:41
We also talked how
to assess for tremor,
whether there's resting
tremor or action tremor.
00:46
We reviewed tests of higher
cortical functioning,
starting with just
cortical sensation,
and then talking about mental
status, for example,
dementia and delirium.
00:57
And lastly,
we looked at some of those tests
we've used historically
in meningitis,
acknowledging that they're
not particularly useful
when making a bedside diagnosis.
01:07
Which of the following assesses the
function of the accessory nerve?
A. Sticking out the tongue.
01:13
B. Asking the patient to bite down
while palpating the masseter muscles.
01:16
C. Assessing for midline uvula.
01:19
Or D. Asking the patient to
shrug his or her shoulders.
01:26
So sticking out the tongue is a test of
the twelfth cranial nerve, the Hypoglossal.
01:31
Asking a patient to bite down while
palpating the masseter muscles
would help us to identify a problem with
the fifth cranial nerve, the Trigeminal.
01:40
Assessing for a midline uvula is
a feature of the Glossopharyngeal
with some contributions
from the vagal nerve.
01:48
So the answer is D.
Asking patients to shrug their shoulders
is a test of the eleventh
or accessory cranial nerve.
02:01
Which of the following would not be
used to assess cerebellar function?
A. The Romberg
B. Dysdiadochokinesia
C. Finger-nose-finger
or D. the Heel-shin test.
02:16
So the Romberg is actually really
used to look for a sensory ataxia.
02:22
When a patient closes their
eyes if they were relying
upon visual input to help
maintain their balance
due to a loss of
proprioceptive input,
you would see that person
start to lose their balance.
02:33
Cerebellar functioning is
more about coordination
and that's what Dysdiadochokinesia,
the Finger-nose-finger
and the Heel-shin tests are
designed to investigate.
02:43
So the answer is letter A.