Neuro-7 Questions Flashcards
What is all involved in the Neurological assessment?
Level of Consciousness (LOC), physical status, chief complaint, cognitive function, appearance
and behavior, speech
What all is included in the health history ?
ADL abilities, changes in sensation, neurological “red flags”, cranial nerves, sensory/motor function.
What does LOC indicate?
Person, place, time, situation
How many times should you assess for alert and oriented?
4x or x4
What does “alert” mean?
Fully awake, responding to all stimuli, following verbal commands.
What is “lethargic” mean?
Drowsy or asleep a lot, can be woken with gentle shake or name, spontaneous movements, forgetful, delayed responses to verbal command.
What is “obtunded” mean?
Extreme drowsiness, minimally responsive, barely follows commands, vigorous stimulation to awake, difficulty, staying awake.
What is stuporous or Semi-comatose?
unconscious most of the time, no spontaneous movements, awakens briefly only with repeated vigorous stimulation, responds in groans or moans, responds to painful stimuli with purposeful movements.
What is comatose mean?
no response to verbal or painful stimuli, cannot be awakened, some reflexes
may be present, decorticate position (abnormal flexion) or decerebrate position (abnormal extension).
For the Glasgow coma scale, what rating is a mild brain injury?
13-15
For the Glasgow coma scale, which rating is a moderate brain injury?
9 to 12
For the Glasgow coma scale, which rating is a severe brain injury?
8 or less
What should you check for speech?
Pace, volume, fluidity, spontaneity, ability to articulate (coherent)
For ineffective speech, what should assess for further for?
Aphasia
What is Aphasia?
Person loses the ability to understand or express speech.
What motor or expressive Aphasia for (Broca’s)?
Impaired fluency and difficult finding words.
What is Sensory or Receptive Aphasia (Wernicke’s)?
Inability to understand written words or
speech and the use of made-up words
What is Global aphasia?
lacks both expressive and receptive language
When repeating a series of numbers what memory is that?
Immediate recall
When stating 3 unrelated objects or “what did you have for breakfast?” what memory is that ?
Recent Memory
When stating “What is your birthday?” what memory is that?
Remote (Past) Memory
For memory what should you assess for or check for?
knowledge, abstract thinking, association, judgement
What cranial nerve is CN I?
olfactory-smell
What cranial nerve is CN II?
Optic - visual acuity
What cranial nerve is CN III?
Oculomotor - Pupil constriction and PERRLA
What cranial nerve is CN IV (4)?
Trochlear- eye movements: down and inward
What cranial nerve is CN V (5)?
Trigeminal - light touch and pain on face and neck
What cranial nerve is CN VI (6)?
Abducens =eye movement lateral
What cranial nerve is CN VII (7)?
Facial - sense of taste, facial symmetry, expression
What cranial nerve is CN VIII (8)?
Auditory -hearing
What cranial nerve is CN IX (9)?
(glossopharyngeal) – movement of pharynx, swallowing, gag reflex, taste
What is cranial nerve CN X (10)?
(vagus) – swallowing and speaking
What is cranial nerve CN XI (11)?
(accessory) – movement of shoulder muscles
What is cranial nerve CN XII (12)?
(hypoglossal) – position, strength, and movement of tongue
What abnormal pupil findings are unequal pupil size (CNS disease)?
Anisocoria
What abnormal pupil findings are dilated and fixed pupils (brain damage, drug induced, ‘blown pupils’?
Mydriasis
What abnormal pupil findings have no reaction to light; small and irregular bilaterally (CNS
syphilis, brain tumor, meningitis, chronic alcoholism)?
Argyll Robertson Pupil
What abnormal pupil findings are one pupil large, fixed, dilated?
Temporal lobe herniation
What abnormal pupil findings are constricted, fixed pupils, bilaterally (often drug induced)?
Miosis
What is it called when different nerve pathways relay sensations; area of skin that is supplied mainly from one spinal cord segment through a particular spinal nerve?
Dermatomes
When it comes to sensory function what should you testy for and include?
pain, temperature, light touch, vibration, position, two-point discrimination.
When it comes to motor function what two things do you look for ?
Coordination and Balance
What are the movements for the motor function test ?
Touch each finger to nose, stand on one foot, pat knees
What is the Romberg’s Test ?
It tests Balance -stands feet together, arms at side, eyes open and then closed,
watch for side to side swaying (slight swaying is normal)
What two reflexes do you assess for reflexes?
Deep tendon reflexes and cutaneous reflexes
What are the three common reflexes assessed ?
bicep, patellar, and plantar (Babinski)
What kind of scale do you grade reflexes ?
0-4
0: no response,
1: sluggish,
2: active/normal,
3: slightly brisk,
4:brisk and hyperactive with intermittent or transient clonus
What parts of the brain is effected by decerebrate posture?
Damage to the upper Brain stem.
What part of the brain is effected by the decorticate posture?
Damage to one or both corticospinal
What is the posture of Decerebrate ?
Arms are adducted and extended, wrists pronated, and fingers flexed. legs extended and feet plantar flexion.
What is the posture of Decorticate?
Arms are adducted and elbows are flexed, with the wrists and fingers on the chest.
