Neuro Assessment

Question 1

Mentation Topics

Answer 1

• GCS assessment
• speech
• gait
• coordination

Question 2

Speech Assessment

Answer 2

• does their speech have clarity, normal volume and content?
• can they express their thoughts? =stroke, parkinsons

Question 3

GCS Assessment

Answer 3

• 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

Question 4

Gait Assessment

Answer 4

• 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

Question 5

Coordination Assessment

Answer 5

• 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

Question 6

Peripheral Assessment Topics

Answer 6

• sensation
• BE FAST assessment (+power)
• posterior stroke

Question 7

Posterior Stroke

Answer 7

• 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

Question 8

Sensation Assessment

Answer 8

• touch arms with pen and wool irregularly
• pt should feel the same
• pt should be able to distinguish between hard and soft

Question 9

BE FAST (+Power)

Answer 9

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

Question 10

Test for the Glossopharyngeal and Vagus Nerve

Answer 10

• any swallowing problems?
• ulvula midline
• palate rises when saying ‘ahhh’

Question 11

Test for Accessory Nerve

Answer 11

• raise shoulders then again against resist an e
• turn face with little resistance

Question 12

Test for Trigeminal Nerve

Answer 12

• clench jaw
• put pen on face, does it feel the same?

Question 13

Olfactory Nerve Test

Answer 13

• any changes in smell?

Question 14

Test for Hypoglossal Nerve

Answer 14

• stick out tongue, move side to side
• say ‘light, tight, dynamite’

Question 15

Test for Vestibulochlear Nerve

Answer 15

• whisper test
  Rombergs Test- stand with eyes closed, testing balance

Question 16

Test for Facial Nerve

Answer 16

• raise eyebrows, smile and frown
• puff out cheeks

Question 17

Occulomotor, Trochkear and Abducens Test

Answer 17

‘H’ Test - nystagmus? not indipendant? Ptosis?
Conveygance - putting pen towards face making pt go cross - eye

Question 18

Optic Nerve Test

Answer 18

• Test near/distance vision (newspaper/sign)
• Test peripheral vision with their fingers

Question 19

Occulomotor/Optic

Answer 19

• Test pupils as PEARL (swipe down)
• ask to to close then focus on pen

Question 20

Which Cranial Nerve Tests are Grouped?

Answer 20

• glossopharyngeal/vagus
• optic/occulomotor
• occulomotor/trochlear/abducens