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NU 673 COMPREHENSIVE ASSESSMENT MIDTERM EXAM 2025-2026 200+ QUESTIONS AND ANSWERS GRADED A+ This consists of aggregations of neuro- nal cell bodies. It rims the surfaces of the cerebral hemispheres, forming the cerebral cortex A. Gray matter B. White matter A. Gray matter
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This consists of aggregations of neuro- nal cell bodies. It rims the surfaces of the cerebral hemispheres, forming the cerebral cortex
A. Gray matter
B. White matter
A. Gray matter
Bickley, Lynn S. Bates' Guide to Physical Examination and History Taking, 12th Edition. Wolters Kluwer Health, 20160620. VitalBook file.
This consists of neuronal axons that are coated with myelin. The myelin sheaths, which create the white color, allow nerve impulses to travel more rapidly.
A. Gray matter
B. White matter
B. White matter
Bickley, Lynn S. Bates' Guide to Physical Examination and History Taking, 12th Edition. Wolters Kluwer Health, 20160620. VitalBook file.
Consciousness relies on the interaction between intact cerebral hemispheres and a structure in the diencephalon and upper brainstem
A. Reticular activating system
B. Cerebellum
A. Reticular activating system
their functions during times of stress and arousal, and the para- sympathetic nervous system, which conserves energy and resources during times of rest and relaxation."5 (Bickley)
Bickley, Lynn S. Bates' Guide to Physical Examination and History Taking, 12th Edition. Wolters Kluwer Health, 20160620. VitalBook file.
Determine the pairs of peripheral nerves
A. Cervical
B. Thoracic
C. Lumbar
D. Sacral
E. Coccygeal
A. Cervical- 8
B. Thoracic- 12
C. Lumbar- 5
D. Sacral- 5
E. Coccygeal- 1
plexuses outside the cord, from which peripheral nerves emerge. Most peripheral nerves contain both sensory (afferent) and motor (efferent) fibers. (Bickley)
Bickley, Lynn S. Bates' Guide to Physical Examination and History Taking, 12th Edition. Wolters Kluwer Health, 20160620. VitalBook file.
Determine the Cranial Nerve:
Oflactory: sense of smell
A. I
B. Ii
C. III
D. IV
E. V
F. Vi
G. VII
H. VIIi
I. IX
J. X
K. Xi
L. XII
XII Hypoglossal motor tongue
C. Cerebellar system
A. Corticospinal (pyramidal) tract
● The basal ganglia system. This exceedingly complex system includes motor pathways between the cerebral cortex, basal ganglia, brainstem, and spinal cord. It helps to maintain muscle tone and to control body movements, espe- cially gross automatic movements such as walking.
● The cerebellar system. The cerebellum receives both sensory and motor input and coordinates motor activity, maintains equilibrium, and helps to control posture. (Bickley)
Bickley, Lynn S. Bates' Guide to Physical Examination and History Taking, 12th Edition. Wolters Kluwer Health, 20160620. VitalBook file.
When upper motor neuron systems are damaged above their crossover in the medulla, motor impairment develops on and becomes (STA)
A. Ipsilateral
B. Contralateral
C. Exaggerated reflex
D. Lack of reflex
B. Contralateral & C. Exaggerated reflex
Bickley, Lynn S. Bates' Guide to Physical Examination and History Taking, 12th Edition. Wolters Kluwer Health, 20160620. VitalBook file.
Determine the location of the spinal nerve
A. Ankle
B. Knee
C. Brachioradialis
D. Bicep
E. Tricep reflex
Identify the presentation
Bickley, Lynn S. Bates' Guide to Physical Examination and History Taking, 12th Edition. Wolters Kluwer Health, 20160620. VitalBook file.
identification
A. Abrupt onset of motor and sensory deficits occurs in
B. Progressive subacute onset of lower extremity weakness
C. Chronic, more gradual, onset of lower extremity weakness occurs in
D. Focal or asymmetric weakness has both central (ischemic, thrombotic, or mass lesions) and peripheral
E. Proximal limb weakness, when sym- metric with intact sensation
F. proximal typically asymmetric weakness that gets worse with effort (fatigability), often with associated bulbar symptoms such as diplopia, ptosis, dysarthria, and dysphagia
G. Bilateral predominantly distal weak- ness, often with sensory loss
A. TIA or Stoke
B. Guillan-Barre
c. metastatic spinal cord tumors. (Bickley)
D. M,yopathies
E. occurs in myopathies from alcohol, drugs like glucocorticoids, and inflammatory muscle disorders like polymyositis and dermatomyositis
F. Myasthenia Gravis
G. Polyneuropathy
Identification
A. Burning pain occurs in painful sensory neuropathies from conditions like
B. A pattern of stocking, then glove, sensory loss occurs in
C. multiple patchy areas of sensory loss in diffe ent limbs suggest
D. The most com- mon cause of syncope, look for the prodrome of nausea, diaphoresis, and pallor triggered by a fearful or unpleasant event, then vagally medi- ated hypotension, often with slow onset and offset. In syncope from arrhythmias, onset and offset are often sudden, reflecting loss and recovery of cerebral perfusion. (Bickley)
Bickley, Lynn S. Bates' Guide to Physical Examination and History Taking, 12th Edition. Wolters Kluwer Health, 20160620. VitalBook file.
A. Diabetes
B. Polyneuropathies
C. Monotneuritis multiplex
D. Vasovagal
A. the patient hear external noise or voices throughout the episode, feel light- headed or weak, but fail to actually lose consciousness
B. Patient actually experience complete loss of consciousness, a more serious symptom representing
A. Near synocpe
B. True syncope
Bickley, Lynn S. Bates' Guide to Physical Examination and History Taking, 12th Edition. Wolters Kluwer Health, 20160620. VitalBook file.
Middle cerebral, Left middle cerebral, right middle cerebral
A. Causes visual field cuts and contralateral hemiparesis and sensory deficits
B. Produces aphasia
C. neglect or inattention to the opposite side of the body.
A. middle cerebral
B. left middle cerebral
C. right middle cerebral
A. This is the most common type of diabetic neuropathy. It is slowly progressive, often asymptomatic, and a risk factor for ulcerations, arthropathy, and amputation. Symptomatic patients report burning electrical pain in the lower extremities, usually at night.
B. which initially causes unilateral thigh pain and proximal lower extremity weakness.
Distal symmetric sensorimotor polyneuropathy
B. Autonomic dysfunction, mononeuropathies, polyrediculopathies
A. an acute confusional state marked by sudden onset, fluctuating course, inattention, and at times changing levels of consciousness.
B. is characterized by declines in memory and cogni- tive ability that interfere with activities of daily living. (Bickley)
C. is more common in individuals with significant medical conditions, including several neurologic disorders—dementia, epilepsy, multiple sclerosis, and Parkinson disease—and is also underdiagnosed.
A. Delirium- Confusional Assessment Method (CAM) algorithm, displayed below, is recom- mended for screening at-risk patients. The CAM instrument can quickly and accurately detect delirium at the bedside
B. Dementia- The most common types are Alzheimer disease (affecting 5 million Americans over age 65 years), vascular dementia, Lewy body dementia, and frontotemporal dementia.
C. Depression- Have you been feeling down, depressed, or hopeless (depressed mood)?" and, "Have you felt little inter- est or pleasure in doing things (anhedonia)?" (Bickley)
Bickley, Lynn S. Bates' Guide to Physical Examination and History Taking, 12th Edition. Wolters Kluwer Health, 20160620. VitalBook file.
Bickley, Lynn S. Bates' Guide to Physical Examination and History Taking, 12th Edition. Wolters Kluwer Health, 20160620. VitalBook file.
A. is seen in local problems with glasses or contact lenses, cataracts, astigmatism, or pto- sis
B. Occurs in CN III, IV, and VI neuropathy (40% of patients), and eye muscle disorders from myas- thenia gravis, trauma, thyroid ophthal- mopathy, and internuclear ophthalmoplegia
C. an involuntary jerking movement of the eyes with quick and slow components.
D. is seen in 3rd nerve palsy (CN III), Horner syndrome (ptosis, miosis, forehead anhidrosis), or myasthenia gravis
E. is absent in both eyes in CN V lesions and on the side of weakness in lesions of CN VII. Absent blinking and sensorineural hearing loss occur in acoustic neuroma.
A. Mononocular diplopia
B. Binocular diplopia
C. Nystagmus- Nystagmus is seen in cerebellar dis- ease, especially with gait ataxia and dysarthria (increases with retinal fixa- tion), and vestibular disorders (decreases with retinal fixation); and in internuclear ophthalmoplegia.
D. Ptosis
E. Blinking
A. affects both the upper and lower face; a central lesion affects mainly the lower face. Loss of taste, hyperacusis, and increased or decreased tearing also occur
B. air and bone conduction
C. lateraliza- tion
D. is both sen- sitive (>90%) and specific (>80%) when assessing presence or absence of hearing loss
E. Vertigo with hearing loss and nystag- mus typifies
A. Bells Palsy
B. Rinne test
C. Weber
D. Whispered voice test
E. Ménière disease.
A. The palate fails to rise with a bilateral lesion of
B. Unilateral absence of this reflex sug- gests a lesion of CN IX, and perhaps CN X.
C. fine flickering irregular movements in small groups of muscle fibers
D. What CN: Observe the contraction of the opposite sternocleido- mastoid (SCM) muscle and note the force of the movement against your hand
A. is velocity-dependent increased tone that worsens at the extremes of range
B. Marked floppiness indicates muscle...
C. Is increased resis- tance throughout the range of move- ment and in both directions; it is not rate-dependent.
D. Impaired strength or weakness is called
E. Absent strength is
A. Spasticity- pasticity, seen in central corticospinal tract diseases, is rate- dependent, increasing with rapid movement.
B. Hypotonia/ flaccidity
C. Rigidity
D. Paresis
E. Palegia
Bickley, Lynn S. Bates' Guide to Physical Examination and History Taking, 12th Edition. Wolters Kluwer Health, 20160620. VitalBook file.
Identify the muscle strength:
A. Active movement against gravity
A. 3
Bickley, Lynn S. Bates' Guide to Physical Examination and History Taking, 12th Edition. Wolters Kluwer Health, 20160620. VitalBook file.
A. Symmetric weakness of the proximal muscles suggests
B. symmet- ric weakness of distal muscles sug- gests
A. Myopathy
B. Polymyopathy
■ The sensory system, for position sense