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OSCE Neurological Assessment Flashcards

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Read the first 7 OSCE Neurological Assessment flashcards as text

  1. A patient demonstrates an intention tremor that worsens as the hand approaches a target during the finger-nose test. Which structure is most likely affected?

    Answer: Cerebellum

    Intention tremor that worsens near the target is a hallmark of cerebellar dysfunction, particularly affecting the ipsilateral hemisphere.

  2. When testing CN III, IV, and VI, you ask a patient to follow your finger in an 'H' pattern. A patient cannot abduct the left eye. Which nerve is most likely affected?

    Answer: Left CN VI

    CN VI (abducens) controls lateral rectus muscle; its palsy prevents ipsilateral eye abduction, causing medial deviation (esotropia).

  3. A patient scores 2 on the GCS eye-opening subscale. What does this indicate?

    Answer: Eyes open to pain only

    GCS eye-opening score of 2 indicates eyes open only to painful stimuli; 1 = none, 3 = to voice, 4 = spontaneous.

  4. In assessing gait during a neurological OSCE, which gait pattern is characterised by circumduction of the leg with a stiff, extended knee?

    Answer: Hemiplegic (spastic) gait

    Hemiplegic (spastic) gait involves circumduction of the affected stiff, extended leg due to increased tone from an upper motor neuron lesion.

  5. When assessing the gag reflex, the afferent limb is carried by which cranial nerve?

    Answer: CN IX

    The afferent limb of the gag reflex is CN IX (glossopharyngeal), while the efferent limb is CN X (vagus).

  6. A 65-year-old patient presents with sudden onset of the 'worst headache of their life.' Which neurological examination finding would most urgently suggest subarachnoid haemorrhage?

    Answer: Meningism (neck stiffness and positive Kernig's sign)

    Meningism — neck stiffness, Kernig's sign, and Brudzinski's sign — indicates meningeal irritation from blood, strongly suggesting subarachnoid haemorrhage.

  7. A patient with a T10 complete spinal cord injury would be expected to have preserved motor function in which muscle group?

    Answer: Hip flexors

    Hip flexors (iliopsoas, L1–L3) are above the T10 level; a T10 injury spares motor function above this level including hip flexion.

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