Chapter 23: Neuro Flashcards
Cranial nerve I test
Olfactory nerve,
test smelling
Cranial nerve II test
Optic nerve:
Test visual acuity and visual fields via the confrontation test, examine ocular fundus
Cranial nerve III, IV, VI test
Oculomotor, Trochlear, Abducens nerves;
check pupil size, extraocular movements via cardinal signs, Checking for nystagmus
Cranial nerve V motor test
Motor function: Trigeminal nerve; muscles of mastication by palpating the temporal and masseter muscles as person clenches teeth, muscles should feel equal and strong
Sensory:
Cranial nerve VII test
Facial nerve;
mobility and facial symmetry, smile, frown, close eyes tightly, lift eyebrows, show teeth, puff cheeks (air should exit from both sides equally)
Cranial nerve VIII test
Acoustic (Vestibulocochlear); test hearing acuity through normal conversation and whisper test, tuning fork, Balance (Romberg)
Cranial nerve IX and X test
Glossopharyngeal and Vagus nerve;
Motor function: depress the tongue and note pharyngeal movement as they say “ahhh”
Note gag reflex
Cranial nerve XI test
Spinal accessory:
examine sternomastoid and trapezius for equal size and check the strength
Cerebellar function
Have person move face laterally against your hand on their chin
Put hands on their shoulder and have them push up against
Cranial nerve XII test
Hypoglossal; have them move their tongue and have them say “light, tight, dynamite” making sure the l,t and d are said clearly
Cerebellar function: Coordination of movements
Cranial nerve V sensory test
Sensory: With persons eyes closed, test light touch sensation by touching cotton wisp to forehead, cheeks and chin and have person say “now” when they feel the cotton (tests ophthalmic, maxillary, mandibular)
Cerebellar function
Coordination of movements
Rapid alternating movements “RAM”
Tests cerebellar function
Have person pat knees with both hands, lift up, turn hands over and then pat knees with back of hand and have patient do it faster in a coordinated rhythmic pace
Finger to Finger test
Tests cerebellar function
Have patient touch thumb to each finger
Finger to nose test
Tests cerebellar function
Have patient close eyes and reach out and then touch tip of nose with each index finger separately
Heel to shin test
Tests cerebellar function
Tests lower extremities; supine position place heel on opposite knee (normally person move their knee in a straight line down the shin)
Balance test
Observe gait, have person walk 10-20 ft in a straight lint and turn around and walk back
Romberg Test
Ask person to stand up with feet together and arms at sides and then close eyes and balance for 20 seconds
What is a positive Romberg test?
If the person falls
What is a negative Romberg test?
If the person doesn’t fall
Spinothalamic tract test for pain
Pain: tested by person’s ability to feel a pinprick, break stick in half and then have patient if they feel the sharp or dull side when you lightly apply point to their skin
Spinothalamic tract test for light touch
Light touch: Apply wisp of cotton (stretched out cotton ball) to the skin and brush it over the skin randomly on arms, forearms, hands, chest, thighs and legs and have them say “now” when they feel it
Posterior dorsal column test for vibration
using low pitch tuning fork you test the ability to feel vibrations on bony surfaces like on the surfaces of the fingers and great toe
Posterior dorsal column test for position (Kinesthesia)
Move a finger or toe and with the patients eyes closed ask them which direction it moved
Posterior Dorsal Column for two point discrimination
Apply the two points of an opened paper clip lightly to the skin in a close distance and see if they can feel both
