3 Neurological assessment b

Question 1

ASSESSING CONSCIOUSNESS AND COGNITION

Answer 1

Mental status:
Orientation
Intellectual function
Thought content
Level of consciousness

Question 2

Mental status:

Answer 2

observe patients appearance and behaviour, noting dress,
grooming and personal hygiene. Posture, gestures, movements, facial
expressions and motor activity provide important information.

Question 3

Orientation

Answer 3

to time, place and person.

Question 4

Intellectual function

Answer 4

the capacity to interpret well-known proverb tests or to

count backwards from 100.

Question 5

Thought content

Answer 5

are thoughts spontaneous, natural, clear, relevant and

coherent?

Question 6

Level of consciousness

Answer 6

level of wakefulness and ability to respond to the
environment. The level of consciousness is the most sensitive indicator of
neurological function.

Question 7

LEVEL OF CONSCIOUSNESS

Answer 7

glasgow coma scale

Avpu( alert, voice,pain , unresponsive)

Question 8

MOTOR ASSESSMENT

Answer 8

Assessment of muscle size, tone and strength, coordination and balance.
Test muscle strength against a resistance, using a 0 ‐ 5 scale, with 0 = no
movement and 5 = strong muscle strength. Muscle strength should be equal
bilaterally.

Question 9

Abnormal muscle tone findings can include

Answer 9

Limited range of motion
 Pain on motion
 Decreased resistance (flaccidity) or increased resistance (rigidity), or spasticity

Question 10

Involuntary Movements:

Answer 10

Tics, tremors, and fasciculation (involuntary contraction of a muscle) are all
examples of abnormal involuntary movements

Question 11

GERONTOLOGICAL CONSIDERATIONS

Answer 11

Important to distinguish normal ageing changes from
abnormal changes
 Determine previous mental status for comparison.
Assess mental status carefully to distinguish delirium
from dementia

Question 12

Normal GERONTOLOGICAL changes may include

Answer 12

Losses in strength and agility; changes in gait,
posture and balance; slowed reaction times and
decreased reflexes; visual and hearing alterations;
deceased sense of taste and smell; dulling of tactile
sensations; changes in the perception of pain; and
decreased thermoregulatory

Question 13

DIAGNOSTIC EVALUATION

Answer 13

Computed tomography(CT)
 Positron emission tomography (PET)
 Single photon emission computed tomography (SPECT)
 Magnetic resonance imaging (MRI)
 Cerebral angiography
 Myelography
 Non-invasive carotid flow studies
 Transcranial doppler
 Electroencephalography (EEG)
 Electromyography (EMG)
 Nerve conduction studies, evoked potential studies
 Lumbar puncture, and analysis of cerebrospinal fluid

Question 14

Assessment of pupils

Answer 14

Unilateral dilated- nerve compression 
Bilateral dilated - midbrain injury
Irregular- orbital trauma
Conjugat gaze deviation- frontal lobe lesion
Small/ pinpoint- opiate administration