Neuro Assessment Flashcards
The neurological system is responsible for…
- controlling and affecting the function of all body systems
- allows interactions with the external wound
- happens through transmission of chemical and electrical signals between brain and body
Basic functions of the brain
- cognition
- emotion
- memory
- sensation and perception
- homeostasis
The CNS is composed of….
- brain and spinal cord
- cerebral function
- cerebellar function
The PNS is composed of…
- nerves
- sensory function
- motor function
Cerebral is the
frontal lobe of the brain
Cerebral function is
- intellectual and behavior function
- LOC
- orientation
- mental status
- cognitive function
- communication
Cerebellar is the..
- bottom portion of the brain
- little brain
Cerebellar function
- coordinates skeletal and muscle movements
- regulates muscle tone
- largely responsible for proprioception or maintaining body posture
How many lobes in the brain
- 4 lobes plus cerebellum and brainstem
Nerves function
- carry out transmission of chemical and electrical signal between the brain and the rest of the body
- we can assess motor and sensory nerves
What part of the brain is responsible for intellectual and behavioral function?
Cerebral
What part of the brain is responsible for coordinating muscle movements?
Cerebellar
What is responsible for transmitting signals from the brain to the rest of the body?
Nerves
If you have a confused patient
- introduce yourself
- face patient
- allow time
- establish routine
- reorient
subjective: Health history symptoms
- headaches
- dizziness
- speech
- muscle control
- memory loss
- paresthesia
- senses
Subjective: Health history questions
- Do you have any history of nerve or brain problems?
- Any head trauma? Loss of consciousness, dizziness, etc
- Any memory problems or forgetfulness?
- Any weakness, numbness, or paralysis?
- Any history of alcohol or drug use?
Objective Data
- Cerebral function> mental status
- cranial nerve function
- motor and cerebellum function
- sensory system function
- reflex system
Assessing Level of Consciousness(LOC)
- assess behavior and arousal
- orientation
Expected findings: LOC
- well groomed/appropriate expression
- awake alert, and responsive
- patient is orientated to time, place, person, situation
- alert and orientated x4
Different arousal techniques
- verbal stimuli
- tactile stimuli(touch)
- painful stimuli(sternal rub)
Glasgow coma scale is a
- tool to document LOC
- 15: no imparment
- < 8: comatose
- <3: totally unresponsive
- lower number is more concerning
How many cranial nerves are there?
12 CN
CN I
- OLFACTORY
- occlude one nostril
- sniff and aromatic substances
CN II
- OPTIC
- ask client to identify smallest print readable(snellen chart)
- sensory nerve
CN III
- OCULOMOTOR
- Test EOMS by having client move eye through 6 cardinal field of gaze
- test pupil reaction to light and accommodation
- PERRLA
-CN IV
- TROCHLEAR
- Test EOMS by having client move eye through 6 cardinal field of gaze
- test pupil reaction to light and accommodation
- PERRLA
CN V
- TRIGEMINAL
- motor function> move jaw side to side, bite down
- sensory function> close eyes and identify when touch forehead
- corneal reflex> touch cornea with wisp of cotton or air
CN VI
- ABDUCENS
- Test EOMS by having client move eye through 6 cardinal field of gaze
- test pupil reaction to light and accommodation
- PERRLA
CN VII
- FACIAL NERVE
- test motor function with smile, frown, raise eyebrows, puff cheeks
CN VIII
- AUDITORY
- watch tick test
- romberg test
CN IX
- GLOSSOPHARYNGEAL
- observe talking, swallowing, cough
- motor: depress tongue and say ahh
- sensory: touch the pharynx with tongue blade to induce gag reflex
- Taste: test with sweet, salty, or sour
CN X
- VAGUS NERVE
- observe talking, swallowing, cough
- motor: depress tongue and say ahh
- sensory: touch the pharynx with tongue blade to induce gag reflex
- Taste: test with sweet, salty, or sour
CN XI
- SPINAL ACCESSORY
- place hands on shoulder, have client raise them with resistance
- place hand on head, turn side to side with resistence
CN XII
- HYPOGLOSSAL
- have client stick out tongue and move side to side
The cerebellum helps coordinate muscle movement of the skeleton, regulate muscle tone, and maintain posture T or F
TRUE
Assessing sensory function techniques
- superficial sensation> touch
- light touch> brush cotton on skin
- pain> toothpick on skin
- temperatures> hot/cold on skin
- Kinetic sensation> position sense> eyes closed finger up or down
Deep Tendon Reflexes include what reflexes
- bicep reflex
- tricep reflex
- brachioradalis reflex
- patellar reflex
- achilles reflex
Deep tendon reflex grading scale
0: no response
+ 1: diminished response
+2: NORMAL response
+3: response somewhat stronger than normal
+4: response is hyperactive
How do you test CN III, IV, VI
Test 6 cardinal fields of gaze and PERRLA
Which nerve is CN VII
Facial nerve
Newborn CN exam
- CN II> response to light, corneal light reflex
- CN III, IV, VI> eye movements
- CN VII> facial movements> asymmetry when crying
- CN VIII> response to sound
- CN IX + X> quality and strength of the cry
- CN X> Gag
- CN V, VII, IX, and XII> sucking and swallowing
Newborn reflexes
- blinking, sneezing, gagging, coughing
- babinski: toes fan out
- moro: startle reflex
- rooting: turn towards stimuli
- palmar and plantar grasp> finger/ toe curl around finger placed in the area
Pediatric Varaitions
- LOC> assess the interaction of infants and toddlers with their parents to assess alertness
- school-age> should be able to say name and place
- Balance> observe gait, balance, coordination
- older children> skip/ walk heel to toe for balance
Older adult variations
- memory issues can begin
- short term mem decreases
- decreased perception to temperature and pain
- taste and smell becomes dimished
- reflexes are slower, may lose achilles reflex
Death of a brain cell that occurs when there is a block is called
ischemic stroke
Death of a brain cell that occurs when there is a bleed is called
hemorrhagic stroke
Modifiable risk factors
- smoking
- hypertension
- birth control
- obseity
- deit
- high cholestral
non-modifiable risk factors
- age
- gender
- race
- family history
- prior stroke/tia
FAST acronym
F: Face drooping> uneven smile
A: arm weakness> one arm weak/ drift downward
S: speech difficulties
T: time to call 911
Other signs of stroke
- numbness
- confusion
- trouble seeing
- trouble walking
- severe headache
- balance issues
