5b Neuro Exam

Question 1

What is the correct order or neuro exam?

Answer 1

Observation
May be done by observing the patient at play
Orientation (if child > 5 years of age)
Head 
Shape/Size/Fontanels
Eyes/Ears/Mouth
Facial expression/Movement
Extremity strength/Reflexes
Coordination

Question 2

When to ask about orientation?

Answer 2

when child is over age of 5

Question 3

CN 1?

Answer 3

smells (olfactory)

Question 4

CN II?

Answer 4

Optic nerve - watch moving object

Question 5

CN III?

Answer 5

oculomotor - PERRLA

Question 6

CN IV?

Answer 6

trochlear motor function, watch moving object

Question 7

CN V

Answer 7

trigeminal, clenching teeth, jaw side to side, opening mouth against resistance

Question 8

CN VI

Answer 8

abducens, motor - abducts the eye, watch the eyes move laterally when moving an object

Question 9

Which cranial nerves involve watching a moving object?

Answer 9

CN II, CN IV, CN VI (optic, trochlear, abducens)

Question 10

CN VII

Answer 10

facial - smile, closing ees

Question 11

CN VIII

Answer 11

vestibulocochlear nerve - sensory, sound balance and movement

Question 12

CN IX

Answer 12

glossopharyngeal, gag and cough

Question 13

CN X

Answer 13

vagus - gag, cough, tste, voice, soft palate.

Question 14

CN XI

Answer 14

spinal accessory shug shoulders

Question 15

CN XII

Answer 15

hypoglossal - motor speech swallowing, sticking out tongue.

Question 16

What to consider when monitoring VS for increased ICP?

Answer 16

decreased HR and widened pule pressure is common, but changes from baseline are most important. Pediatric VS may be normal and lag behind clnical deterioration.

Question 17

What are the ratings of the pediatric glascow score? (it is a little different than adult - review)

Answer 17

Severe deficit <9
Moderate 9-12
Mild 12-15
less than 8 is at a significant risk of mortality