Final exam neuro assessment

Question 1

Subjective

Answer 1

• headaches, head injuries, dizziness, seizures, tremors
• problems with swallowing, speaking, balance, coordination, falls
• Hx of strokes, spinal cord injury, meningitis, exposure to environmental toxins
• Family history of conditions like Stroke, MS, Fibromyalgia, Parkinson’s Disease

Question 2

Cranial nerves

Answer 2

• Inspect face (note drooping, asymmetry, redness, swelling, ptosis)
• CN I- Check sense of smell using extracts
• CN II- Check visual acuity with hand-held Snellen
• CN III, IV, VI- PERRLA, Extraocular movements (all 6 diagnostic positions)
• CN V, and TMJ- Test facial sensation with cotton ball.Test mastication muscles (note muscle strength, pain, limited movement- TMJ)
• CN VII-Facial muscle tone and movement ( raise eyebrows, close eyes tightly, smile, frown, puff out cheeks) Note symmetry, strong/smooth movement
Check taste
• CN VIII- Hearing acuity- do Whisper test
• CN IX, X, XII- Swallowing, pharynx movements, gag reflex, speech, tongue movement
• CN XI and Cervical Spine- Test Sternomastoid and Trapezius muscles against resistance. Test cervical spinal movement