Neuro skills

Question 1

Full order

Answer 1

Check for danger
Global overview
DRABCDE
Interventions (if necessary)
Medical model
FAST & pronator test
Smell
Eyes & vision
Facial
Hearing & balance
Mouth
Limbs
Mental test
Kernigs sign if necessary

Question 2

FAST test

Answer 2

Check for facial drooping/ weakness
Pronator test (hold hands palm up for 30 seconds with eyes closed)
Repeat phrase to check for slurring (Slow and steady wins the race)

Question 3

Smell test

Answer 3

Ask if any recent changes to smell

Question 4

Eyes (Cranial nerves 2,3,4,6)

Answer 4

Changes to vision (read something far)
Check visual field
PEARL
Pupils reaction to distance (look in distance)

Question 5

Eyes (Cranial nerves 3,4,6)

Answer 5

Follow H formation and close up
(checking for asymetrical movement, double vision or wobbling)

Question 6

Facial (cranial nerves 5,7,11)

Answer 6

Check sensation on forehead, cheekbone and jaw
Feel jaw muscle on clenching
Feel strength turning head and shrugging shoulders (checking for muscle wastage

Question 7

Hearing & Balance (cranial nerve 8)

Answer 7

Check if any recent changes to hearing
Hearing test (cover ears if necessary)
Romberg test (stand feet together with eyes closed for 30 seconds)

Question 8

Mouth (cranial nerves 9,10,12)

Answer 8

Check mouth for uvula deviation
Ask if any recent changes to voice
Ask if any problems swallowing
Poke out tongue, check if straight
Test strength of tongue against cheeks

Question 9

Limbs

Answer 9

Check for muscle wastage
Check for pushing/ pulling strength
Check shoulder strength
Check coordination finger to pen to nose and heel to shin
Check sensation of arms and legs

Question 10

Mental test

Answer 10

What is age?
what is approx time?
Remember address (42 west street)
Current year?
What is current address?
Recognize 2 people
Date of birth?
What years was WW1?
Current prime minister?
Count backwards from 20 to 1
Recall address given earlier

Question 11

Kernigs sign for meningitis

Answer 11

Bend knee to 90 degrees then slowly straigten
If pain in neck or head worsens it is a positive indication of meningitis

Question 12

Brudzinski sign for meningitis

Answer 12

Patient lies flat. Manually move head towards chest and if knees flex it is positive.

Question 13

Speech disorders

Answer 13

Disarthria - slurring
Disphonia - change in sound
Dysphasia - difficulty finding appropriate words