Neuro Exam Flashcards
The neuro exam is not a set checklist so ______ is critical
observation
Elements of the neuro exam 8
history
mental state
cranial nerves
motor exam
sensory exam
reflexes
coordination
gait
(Neuroanatomic structures evaluated in exam - mental state)
Attention
frontal and parietal lobe
Elements of the mental state
level of consciousness, attention, orientation, mood and affect, learning and memory
(Neuroanatomic structures evaluated in exam - mental state)
Arousal
reticular activating system, bilateral thalami, cerebral hemispheres
(Neuroanatomic structures evaluated in exam - mental state)
memory
temporal lobes
(Neuroanatomic structures evaluated in exam - mental state)
language
front lobes (typically left)
(Neuroanatomic structures evaluated in exam - mental state)
praxis
frontal and parietal
(Neuroanatomic structures evaluated in exam - mental state)
abstract reasoning
frontal
(Neuroanatomic structures evaluated in exam - mental state)
visuospatial processing
occipital and parietal
CN functions and strcuture
1, 2&3
1: smell - olfactory cortex
2 and 3: pupillary light reflex, midbrain nuclei
2: visual acuity and fields LGN, occipital cortex
CN functions and structure
3,4,6
eye movements,
brain stem, cerebellum
CN functions and structure
5
facial sensation, somatosensory cortex
CN functions and structure
7
facial movement, motor pathway from primary motor cortex
CN functions and structure
11
SCM, trap, primary motor cortex
CN functions and structure
8
hearing, inner ear, auditory cortex
vestibular
CN functions and structure
12
tongue movement, primary motor cortex
Function of peripheral nerves, nerve roots, and spinal cord
reflexes
Purpose of anterolateral system
pain and temperature
Purpose of dorsal column medial lemniscal
discriminative touch and vibration
Function of cerebellum and its sensory inputs
coordination
Alert meaning
interactions are normal unless
patient is awake and attentive to
normal levels of stimulation
Interactions are normal and
appropriate unless the patient has
some type of psychiatric disorder
Patient appears drowsy
and may fall asleep if not stimulated in
some way
pt may have difficulty
Lethargy
focusing attention on question at or task
Obtunded
what is required
the patient is difficult to
arouse from a sleeping state and is
frequently confused when awake
Repeated stimulation is required to maintain consciousness
The patient
responds only to strong, generally
noxious stimuli and returns to the
unconscious state when stimulation is
stopped.
when aroused …
Stupor
the patient is
unable to interact with the examiner
Coma
the patient cannot be aroused
by any type of stimulation. Reflex
motor responses may or may not be
elicited
What question’s are asked to determine a patient’s orientation?
Person: full name, age, born
Place: where are you
Time: today’s date, morning or night, time is it
Hypoglossal
Tongue movements
Accessory
Vagus
SCM and trapezius muscles
Movement of palate, sensation in throat, efferent limb of gag
reflex, parasympathetic functions of viscera
Glossopharyngeal
Movements of palate, sensation over palate, taste posterior
1/3 of tongue, afferent limb of gag reflex
Vestibulocochlear
Hearing, vestibular function
Facial
Abducens
Muscles of facial expression, taste anterior 2/3 of tongue,
efferent limb of corneal reflex
Lateral rectus
Trigeminal
Muscles of mastication, tensor tympani, facial sensation,
afferent limb of corneal reflex
Trochlear
Oculomotor
Superior oblique
Superior rectus, inferior rectus, medial rectus, inferior
oblique, levator palpebrae, efferent limb of the pupillary
reflex
Optic
Vision (acuity, fields, color), afferent limb of pupillary reflex
Olfactory
Olfaction (tested with non-noxious substances)
