Tina Jones Neurological Shadow Health Review Questions

To check the spinal levels L2, L3, and L4 in Tina, which reflexes deep in the tendon would need to be tested?

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Correct: The knee-jerk deep tendon reflex involves the sensory and motor nerve fibers linked with spinal sections L2, L3, and L4. Locating abnormal reflexes might help in pinpointing neurological issues in the spine.

– Achilles
– Biceps
– Knee (Correct Answer)
– Triceps

Imagine you were about to flush a Foley catheter of a patient who has a spinal cord injury at T4 in a urology clinic. When you moved the leg bag, the patient suddenly turned red and started sweating above the nipple line. What could be happening?

Correct: Autonomic dysreflexia is a sudden rise in blood pressure due to the sympathetic and parasympathetic nervous systems reacting to a painful stimulus below the spinal injury site. Other signs include slow heart rate, nervousness, blurred vision, headache, redness, and sweating. To resolve the condition, the painful stimulus (pulling the Foley catheter) must be relieved.

– Painful swallowing
– Feverish reaction
– Unexplained spinal reaction
– Autonomic dysreflexia (Correct Response)

Which of these is not a common sign of Parkinson’s disease?

Correct: Parkinson’s disease shows tremors at rest, slow movements, jerky rigidity, trouble balancing, shuffling gait, lack of facial expression, reduced arm swinging, and various psychological issues like sadness, fear, and sleep problems.

– Lack of facial expression
– Shuffling gait
– Jerky rigidity
– Tremors when intending to move (Correct Response)

Name at least three ways to check cerebellar function during a physical examination.

Student Response: 1. Walking heel to shin 2. Touching nose with finger 3. Checking walking and balance

Model Note: The cerebellum helps in smooth and precise coordination of voluntary movements. You can check cerebellar function by evaluating gait and instructing the patient to do finger-to-finger, finger-to-nose, heel-to-shin, fast alternating movements, and Romberg tests.

If Tina had a fever and sensitivity to light, you would need to check for meningitis. Explain how you would test for Kernig’s sign.

Student Response: Meningeal irritation is detected using the Kernig’s sign test. This involves bending the leg at the knee and hip when the patient is lying down, creating a right angle with the bent knee, then trying 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 detect meningeal irritation. To perform it, bend the leg at the knee and hip while the patient lies down, making a right angle with the bent knee. Then attempt to straighten the leg at the knee. Resistance and pain in the lower back indicate a positive Kernig’s sign, suggesting meningeal irritation.

Suppose you found decreased sensation in Tina’s left foot when assessing pain sensation. How would you proceed with your examination?

Student Response: It’s important to check both sides starting from Tina’s feet and moving up her legs because she’s at risk for diabetic neuropathy. Sensations to test include dull, sharp, and light touch, vibration, pinpointing, joint positioning, and temperature. It’s also crucial to assess the extent of her neuropathy, so superficial and deep tendon reflexes of the feet, ankles, and knees should be checked.

Model Note: Because Tina is at risk for diabetic neuropathy, it’s vital to test sensations on both sides, starting from her feet and moving up her legs. Sensation tests should cover sharp and dull touch, light touch, vibration, temperature, pinpointing, and joint positioning. Additionally, superficial and deep tendon reflexes of the feet, ankles, and knees should be evaluated to determine the extent of her neuropathy.

Shadow health Tina Jones Health History transcript

Tina Jones Neurological Shadow Health Review Questions