Module 6- Neurological Assessment Flashcards
nerves carry fibres that can be separated into two parts. what are the two parts?
somatic and automatic
- somatic- innervate skeletal (voluntary) muscle
- automatic- innervate smooth (involuntary) muscle, cardiac muscle, and glands
what are the developmental considerations for infants?
- neurological system is not completely developed at birth
- motor activity in newborns is under control of spinal chord and medulla
- process of myelinization follows cephalocaudal order and proximal to distal order (head, neck, trunk and extremities)
- born with primitive reflexes
what are the developmental considerations for older adults?
- aging process causes a general atrophy with steady loss of neurons in brain and spinal chord
- causes a decrease in weight and volume with thinning of cerebral cortex, reduced subcortical brain structures, expansion of the ventricles
- neuron loss leads to many people 65+ with loss of muscle bulk, loss of muscle tone in face, decreased muscle strength etc.
- decreased muscle strength and impaired fine coordination
- slowed reaction time
- dizziness and loss of balance
list subjective data for neuro
- Headache
- Head injury
- Dizziness or vertigo
- Seizures
- Tremors
- Weakness
- Incoordination
- Numbness or tingling sensation
- Difficulty swallowing
- Difficulty speaking
- Significant past history
- Environmental and occupational hazards
what is additional history that you’d wanna know for infants and children?
- Maternal health
- Neonatal period (full term, premature? Any birth trauma?
- Reflexes
- Weakness and balance
- Seizures
- Physical development
- Environmental hazards
- Cognitive development
- Family history
what is additional history that you’d wanna know for older adults?
- Risk for falls
- Cognitive function
- Tremor
- Vision
what is normal for infants with their development?
- very alert, eyes open demonstrates strong, urgent sucking
- baby smiles responsively and recognizes the parents face
what is normal for preschool and school age children with their development?
- assess child’s general behaviour during play activities, reaction to parent, and cooperation with parent and with you
- note gait when walking and running
what is normal for older adults with their development?
- decrease in muscle bulk in hand- normal
- slower gait
what is the correct sequence for the abbreviated neurological examination?
- Level of consciousness
- Motor function
- Pupillary response
- Vital signs
describe LOC
- earliest and most sensitive index of change in neurological status
- note ease of arousal and state of awareness and orientation
describe motor function
-check voluntary movement of each extremity by giving specific commands
describe pupillary response
- note size, shape, symmetry of both pupils
- shine light into each pupil and note direct and consensual light reflex
- both should constrict
what is the glascow coma scale used for?
for patients with head trauma
- widely used scoring system for patients with altered level of consciousness in ICU
- GCS used to assess functional state of brain as a whole, not of any particular site in the brain
what are the 3 divided areas on the glascow coma scale?
- eye opening, verbal response, motor response
- each area is rated separately and patients best response is scored numerically
- 3 numbers are added; total score reflects brains functional level
what is the score of someone who is fully alert, normal patient?
15
what score reflects coma?
less than 7
what is flaccid quadriplegia?
a. Complete loss of muscle tone and paralysis in all four extremities
b. Indicating completely non functional brain stem
what is Opisthodomos
a. Prolonged arching of back with head and heels bent backward
b. Indicates meningeal irritation
what part in body regulates sensory function?
parietal lobe and spinal chord
what regulates movement?
frontal lobe (basal ganglia)
what regulates vital signs?
hypothalamus
what regulates motor coordination and equilibrium
cerebellum
what about nerve impulse and conduction?
grey matter of brain
