Neuro Assessment Flashcards
Mentation Topics
- GCS assessment
- speech
- gait
- coordination
Speech Assessment
- does their speech have clarity, normal volume and content?
- can they express their thoughts? =stroke, parkinsons
GCS Assessment
- are they alert?
- orientated to TPP? (who am I, what time is it, where are we?)
- GCS 15 - move on command, open eyes on command, not confused)
- if less than 15 need to be concerned with pathology of why
Gait Assessment
- ask he pt to do a few steps (not runway)
- does it look normal? (rule out MSK complaint?)
- are they stable?
Ataxic (cerebellum) = stroke, alcohol - symmetrical must let mass? Any spacicity?
- assess tone and power in FAST assessment
Coordination Assessment
- finger to nose then move finger and repeat
- Head to chin
- rombergs test - stand still with eyes closed
- heel to toe walk
- Dysdiadochokinaesia - ‘clappy hands test’
- all test for cerebellum for coordination
Peripheral Assessment Topics
- sensation
- BE FAST assessment (+power)
- posterior stroke
Posterior Stroke
- use AVVV as way of remembering posterior stroke
A taxic
V isual field
V ertigo and vomiting
V usual disturbances - common symptoms include; loss of coordination
Sensation Assessment
- touch arms with pen and wool irregularly
- pt should feel the same
- pt should be able to distinguish between hard and soft
BE FAST (+Power)
Balance, headache, dizziness, gait
E yes, blurred vision, decreased field of view
F acial droop
A arms, weakness, Ky resistance, leg resistance (power?)
S speech, dysphagia
T time to go to hospital
- alternatively, the loss of muscle function could be due to nerve dmg, brain stem injury
- note power of legs/arms
Test for the Glossopharyngeal and Vagus Nerve
- any swallowing problems?
- ulvula midline
- palate rises when saying ‘ahhh’
Test for Accessory Nerve
- raise shoulders then again against resist an e
- turn face with little resistance
Test for Trigeminal Nerve
- clench jaw
- put pen on face, does it feel the same?
Olfactory Nerve Test
- any changes in smell?
Test for Hypoglossal Nerve
- stick out tongue, move side to side
- say ‘light, tight, dynamite’
Test for Vestibulochlear Nerve
- whisper test
Rombergs Test- stand with eyes closed, testing balance
Test for Facial Nerve
- raise eyebrows, smile and frown
- puff out cheeks
Occulomotor, Trochkear and Abducens Test
‘H’ Test - nystagmus? not indipendant? Ptosis?
Conveygance - putting pen towards face making pt go cross - eye
Optic Nerve Test
- Test near/distance vision (newspaper/sign)
- Test peripheral vision with their fingers
Occulomotor/Optic
- Test pupils as PEARL (swipe down)
- ask to to close then focus on pen
Which Cranial Nerve Tests are Grouped?
- glossopharyngeal/vagus
- optic/occulomotor
- occulomotor/trochlear/abducens
