Neurological Examination and Conditions Flashcards

A patient opens eyes to pain (2), gives confused speech (4), and localizes to pain (5). What is the total Glasgow Coma Scale score?

Answer: 11

GCS is the sum of the eye (2), verbal (4), and motor (5) components, totaling 11.

Homonymous hemianopia (loss of the same visual field in both eyes) results from a lesion where?

Answer: Optic tract or occipital cortex behind the chiasm

Lesions posterior to the optic chiasm affect the same visual field in both eyes, producing homonymous hemianopia.

A patient develops facial droop involving the forehead on one side with inability to close the eye. This localizes the lesion to:

Answer: Lower motor neuron facial nerve (Bell's palsy)

Forehead involvement indicates a peripheral (lower motor neuron) CN VII lesion, since the upper face has bilateral cortical innervation.

Which finding is characteristic of a cerebellar rather than a sensory ataxia?

Answer: Ataxia unchanged by eye closure

Cerebellar ataxia does not significantly worsen with eyes closed, unlike sensory ataxia which relies on visual compensation.

The Kernig sign, resistance and pain on extending the knee with the hip flexed, indicates:

Answer: Meningeal irritation

A positive Kernig sign reflects meningeal irritation, as seen in meningitis or subarachnoid hemorrhage.

A patient with a lesion of Broca's area would most likely have:

Answer: Non-fluent, effortful speech with intact comprehension

Broca's (expressive) aphasia causes halting, non-fluent speech while comprehension remains relatively preserved.

Which cranial nerve is tested by asking the patient to shrug the shoulders and turn the head against resistance?

Answer: CN XI (accessory)

The spinal accessory nerve (CN XI) innervates the trapezius and sternocleidomastoid, tested by shoulder shrug and head turn.