OSCE Neurological Assessment 3

Question 1

When testing the corneal reflex, the afferent limb is carried by which nerve?

Accepted Answer

CN V1 (ophthalmic branch of trigeminal)

Answer

The afferent limb of the corneal reflex travels via CN V1 (ophthalmic division of trigeminal), while the efferent blink response is mediated by CN VII.

Question 2

A 65-year-old has right-sided facial droop affecting both upper and lower face, right arm weakness, and right leg weakness. Where is the lesion?

Accepted Answer

Left internal capsule

Answer

Left internal capsule lesion causes contralateral (right-sided) hemiplegia including lower face, arm, and leg due to interruption of corticospinal and corticobulbar fibers.

Question 3

Which maneuver is used to assess for meningeal irritation by passively flexing the hip and knee then extending the knee?

Accepted Answer

Kernig's sign

Answer

Kernig's sign is positive when extension of the knee from a flexed hip position produces pain or resistance, indicating meningeal irritation.

Question 4

A patient with a suspected stroke has sudden loss of the right visual field in both eyes. The lesion most likely involves:

Accepted Answer

Left optic tract or left occipital cortex

Answer

Right homonymous hemianopia (loss of the right visual field in both eyes) results from a lesion in the left optic tract, left lateral geniculate body, or left occipital cortex.

Question 5

When performing the finger-nose-finger test, a patient's finger overshoots the target and the error worsens as the finger approaches. This is best described as:

Accepted Answer

Intention tremor with dysmetria

Answer

Dysmetria (overshoot/undershoot) and intention tremor that worsens on approach to the target are hallmarks of cerebellar dysfunction assessed by the finger-nose-finger test.

OSCE Practice Test

OSCE Practice Test

OSCE Neurological Assessment 3