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N211F > CNS II > Flashcards

CNS II Flashcards

12 cranial nerves assessment

1
Q

CN I assessment procedure

A

present props (coffee & soap) to one of the nostril & another one being occluded

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2
Q

CN I assessment abnormal result

A

inability to identify correct scent > loss of smell > inability to smell

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3
Q

CN I assessment normal result

A

correctly identify scent

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4
Q

CN II assessment 4 areas

A
  1. pupillary reaction
  2. vision acuity
  3. vision field
  4. optic fundi
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5
Q

CN II vision acuity assessment procedure

A

Snellen chart: 20 feet distance away
Newspaper: 35 cm away

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6
Q

CN II visual field assessment procedure

A

confrontation test in 4 visual qaurdrants

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7
Q

CN II optic fundi assessment procedure

A

use ophthalmoscope to assess retina & optic disc

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8
Q

CN II pupillary reaction assessment procedure

A

direct & concensual test
(react to direct light source on one side & another side also react by constriction)

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9
Q

CN II vision acuity assessment normal result

A

Snellen chart: test with one eye covered
Documentation: 20/20 vision (=able to see what an average person can see 20 feet away)

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10
Q

CN II optic fundi assessment normal result

A
  1. round red reflex is presented
  2. retina is pink
  3. optic disc: 1.5mm, round & oval shape, clear margin, creamy pink & paler physiologic cup
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11
Q

CN II vision acuity assessment abnormal result

A

Snellen chart: difficulty in reading, squinting eye
newspaper: closer > 35 cm/ farther (persbyopia, occur when aging)

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12
Q

CN II vision field assessment abnormal result

A

loss of vision field: retina damage/ detachment; parietal cortex lesion; optic nerve lesion

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13
Q

CN II & III assessment procedure & documentation

A

use penlight for direct & concensual response
Documention: PERRLA
pupil equal, round, react to light, accomodation

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14
Q

CN II & III assessment normal result

A
  1. bilateral illuminated pupils constrict simltaneously
  2. benign anisocoria: differ >0.5mm & reaction
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15
Q

CN II & III assessment abnormal result

A
  1. dilated pupils (6-7mm): oculootor paralysis
  2. Argyll Roberston pupils: neurosyphilis, alcoholism
  3. constrited/ fized pupils: narcotic abuse
  4. unilateral pupil unresponsive to loght/ no accomodation: CN III (oculomotor) damage
  5. Constricted pupils unresponsive to light/ accomodation: synpathetic nervous system lesion
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16
Q

CN II & III assessment abnormal result: signs of Argyll Roberston

A
  1. small pupils
  2. non-reactive to light
  3. do accomodate
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17
Q

CN III & IV & V assessment procedure

A

observe pt’s eyes movement by requiring pt to follow a moving target to detect nystagmus

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18
Q

CN III & IV & V assessment normal result

A
  1. PERRLA: pupil equal, round, reactive to light, accomodation
  2. smooth & coordinated movement in all directions
  3. eyelid cover 2mm of the iris
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19
Q

CN III & IV & V assessment 3 area

A
  1. margins of the eyelids
  2. extraoculor movement
  3. pupillary reaction
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20
Q

CN III & IV & V assessment 4 abnormal result

A
  1. abnormal pupillary reaction
  2. limited eye movement in the 4 area
  3. strabismus
  4. Nystagmus (rhythmic ocillation of the eyes)
21
Q

CN VI chewing function assessment procedure

A

ask pt to clentch and palpate temporal & messester muscle contraction

22
Q

CN VI sensation of 3
divisions (ophthalmic,
maxillary, mandibular) assessment procedure

A
  1. pt close eyes > use dull simulus (paper clip) to touch 3 divisions
  2. pt look up & away from examiner > use fine wisp cotton paper to approach pt’s cornea from out of his line of vision
23
Q

CN VI 3 areas of assessment

A
  1. cornea reflex
  2. motor: messester &　temporal
  3. sensation: pain, temperature & tactile sensation
24
Q

CN VI assessment normal result

A

bilateral contraction of temporal & messester

25
Q

CN VI assessment abnormal result

A
  1. unilateral/ bilateral sides muscle weakness
  2. pain when clentching
  3. decrease contraction on one/ both sides
  4. asymmetrical strength in moving jaw
26
Q

CN VIII assessment procedure

A
  1. Weber, Rinne & Whisper test
  2. ask pt to close their eyes & stand for 20s & inspect their stability
27
Q

CN VIII assessment normal result

A
  1. Weber: Vibration should be heard by both sides of the ears
  2. Rinnie: Air Conduction > Bone conduction
  3. Whisper: hear whispered words clearly from 1-2 feet away
28
Q

CN VIII assessment abnormal result

A
  1. Air conduction is not as twice longer than bone conduction
  2. Vibratory sounds is lateralized in good ears
29
Q

CN IX& X assessment proedure

A
  1. ask patient to say ‘ahh’
  2. bilateral & symmetrical arise of soft palete & uvula, without hoarse
  3. take a sip of water to see ability to swallow
  4. use tongue depressor to lightly touch posterior part of the tongue to see gag reflex
30
Q

CN IX& X assessment 3 areas

A
  1. motor function of pharyn larynx, soft palete
  2. gag reflex
  3. ability to swallow
31
Q

CN IX & X assessment normal result

A
  1. soft palete & uvula arise bilaterally & symmetrically while phonation
  2. Swallow without difficulties & without hoarseness
  3. gag reflex present
32
Q

CN IX & X assessment 3 abnormal result

A
  1. hoarseness present
  2. absent of gag reflex
  3. soft palete do not arise bilaterally
33
Q

CN XI assessment procedure

A
  1. inspect symmetry of scapula & neck & shoulder muscle
  2. apply counterforce when ask pt to turn their head to left/ right > test sternocleidomastoid strength against force
  3. apply countreforce when ask pt to shrug their shoulders > test trapezius
34
Q

CN XI assessment normal result

A
  1. strong contraction of sternocleimastoid oppposite the side where the face turn to
  2. symmetrical & strong contraction of trapezius
35
Q

CN XI assessment abnormal result

A
  1. muscle weakness
  2. muscle atrophy/ fasciculaton
  3. asymmetrical muscle contraction
36
Q

CN XII assessment procedure

A
  1. ask pt to stick out his tongue & move from side to side
  2. ask pt to say ‘light’ & ‘tight’, notice their pronunciation
37
Q

CN XII assessment normal result

A

smooth & symmetric tongue movement
bilateral strength

38
Q

CN XII assessment abnormal result

A
  1. tongue atrophy/ fasciculation
  2. tongue deviation
39
Q

Motor & cerebellum system: how to test condition & movement of muscle

A

observe gait
weight should be evenly distribued
stand on toes & heels

40
Q

Motor & cerebellum system: Romberg test

A

To test balance
ask patient to stand up & oserve any unsteadiness & imblanace
ask patient to close eyes for 20s, observe imbalance & swaying

41
Q

Motor & cerebellum system: 5 tests for coordination

A
  1. tandem walking: walk on straight heels & toes
  2. tandem stand: stand on one foot, do a shallow knee bend/ hop
  3. rapid hand alternation movement
  4. finger to nose
  5. heel slide test
42
Q

What is the sequence of sensation test?

A

light touch> pain> temperature
from dital to proximal each limb

43
Q

what instrument is use for vibration sensation test?

A

tunning fork
from distal to proximal each limb

44
Q

2 tests for testing tacile discrimmination

A
  1. test position sense
  2. stereognosis: recognize objects by touching
45
Q

point localization test

A

breifly touch patient> ask to identify which point is being touched

46
Q

What is graphesthesia?

A

use intrument to write number on patient’s hand, a kthem to identify the numbers written

47
Q

two point discrimmination test

A

patient cloed eye> identify number of points being touched with EKG calibers> when patient no longer separate 2 point: measure the distance of the two points

48
Q

How to test extinction

A

simultaneously touch the same area of the both side of the body, ask patient to identify the area touched

49
Q

Kernig’s signs & Brudzinski’s sign & testing neck’s mobility is for?

A

meningeal irritation/ inflammation

N211F (14 decks)

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