Tina Jones Neurological Shadow Health Review Questions
To check Tina’s spinal levels L2, L3, and L4, which deep tendon reflexes should be examined?
Correct: The patellar deep tendon reflex checks the sensory and motor nerve fibers linked to spinal segments L2, L3, and L4. Detecting abnormal reflexes can help identify spinal cord issues.
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– Achilles
– Biceps
– Patellar (Correct Answer)
– Triceps
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Imagine you’re about to flush a Foley catheter for a patient with a T4 spinal cord injury in a urology clinic. When moving the leg bag, the patient suddenly turns red and starts sweating above the nipple line.
What could be the issue?
Correct: Autonomic dysreflexia is a sudden blood pressure increase caused by the nervous system’s response to a painful stimulus below the spinal cord injury site. Other symptoms include slow heartbeat, anxiety, blurred vision, headache, flushing, and sweating. To resolve it, the painful stimulus (in this case, the Foley catheter) should be addressed.
– Odynophagia
– Febrile reaction
– Idiopathic spinal reaction
– Autonomic dysreflexia (Correct Answer)
Which of these is not a common symptom of Parkinson’s disease?
Correct: Parkinson’s disease typically shows symptoms like resting tremors, slow movements, rigidity, balance problems, shuffling gait, reduced facial expressions, and various psychological issues like depression and anxiety.
– Reduced facial expression
– Shuffling gait
– Rigidity with a jerky feel
– Intention tremors (Correct Answer)
Name at least three methods to evaluate cerebellar function during a physical examination.
Student Response: 1. Heel-to-shin test 2. Finger-to-nose test 3. Gait and balance assessment
Model Note:
The cerebellum coordinates voluntary movements smoothly. Cerebellar function can be assessed through various tests, including examining gait, instructing the patient to perform tasks like finger-to-finger, finger-to-nose, heel-to-shin, rapid alternating movements, and Romberg tests.
If Tina had a fever and photophobia, you would need to check for meningitis. Explain how you would perform the Kernig’s sign test.
Student Response:
Meningeal irritation can be detected using the Kernig’s sign test. To perform it, flex the patient’s leg at the knee and hip when they are lying down, creating a right angle with the bent knee. Then try to straighten the leg at the knee. If this causes pain and resistance in the lower back, it indicates a positive Kernig’s sign, suggesting meningeal irritation.
Model Note:
The Kernig’s sign test is used to identify meningeal irritation. It involves flexing the patient’s leg at the knee and hip while they are lying down, creating a right angle with the bent knee. Attempt to straighten the leg at the knee. Pain and resistance in the lower back constitute a positive Kernig’s sign, indicating meningeal irritation.
Suppose you noticed reduced sensation in Tina’s left foot when assessing pain sensation. How would you continue with the examination?
Student Response:
It’s essential to assess sensation bilaterally, starting from Tina‘s feet and moving up her legs because she’s at risk for diabetic neuropathy. Sensation testing should include various aspects like dullness, sharpness, soft touch, vibration, point location, joint positioning, and temperature. To determine the extent of her neuropathy, you should also check superficial and deep tendon reflexes in her feet, ankles, and knees.
Model Note:
Due to Tina’s risk of diabetic neuropathy, it’s crucial to assess sensation bilaterally, beginning with her feet and moving up her legs. Sensation evaluation should cover aspects like sharp and dull touch, light touch, vibration, temperature, point location, and joint positioning. Additionally, assess superficial and deep tendon reflexes in her feet, ankles, and knees to gauge the extent of neuropathy.
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