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PA > Neurological > Flashcards

Neurological Flashcards

1
Q

Assess level of consciousness

A
  • Alert
  • Confused
  • Drowsy
  • Stupor
  • Coma
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2
Q

assess emotional responses

A
  • Affect: how does pt appear
  • Mood: how does pt fee
  • Speech and vocab
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3
Q

assess behaviors/thoughts

A
  • how pt acts
  • how pt thinks
  • what pt thinks about
  • report if pt is suicidal
  • be aware what affects some drugs can have on behavior
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4
Q

Mental status exam

A
  • Recent memory: repeat 3 words and recall in 3-5 min
  • remote memory: important past events
  • Orientation: person, place,and time
  • current events
  • judgement
  • abstraction
  • calculation ability
  • object recognition
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5
Q

Mini-Cog

A
  • give 3 words to remember
  • clock drawing test
  • recall the 3 words
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6
Q

Mini-Cog score

A
  • Recall 0: impaired
  • Recall 1-2 w/abnormal clock: impaired
  • Recall 1-2 w/normal clock: not impaired
  • Recall 3: not impaired
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7
Q

Cranial nerve mnemonic

A 
O - on
O - old
O - Olympus
T - towering
T - tops
A - A
F - Finn
A - and
G - German
V - viewed
S -  some
H - hops
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8
Q

cranial nerve mnemonic for function (S=sensory, M=motor, B=both)

A 
S - some
S - say
M - marry
M - money
B - but
M - my
B - brother
S - says
B - bad
B - businesses 
M - marry
M - money
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9
Q

CNI

A

olfactory

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10
Q

CNII

A

optic (visual acuity)

  • test snellen chart
  • visual fields
  • pupillary response
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11
Q

CNIII

A

oculomotor

  • observe for ptosis
  • test EOMI
  • test pupillary rxn to light
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12
Q

CNIV

A

trochlear

- test EOMI (inward and down)

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13
Q

CNV

A

trigeminal

  • test temporal and masseter muscle strength
  • ask pt to close eyes and tell you if they feel sharp or dull
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14
Q

CNVI

A

abducens

- test EOMI (lateral)

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15
Q

which cranial nerves are responsible for extraocular movements

A

3, 4, and 6

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16
Q

which cranial nerves are responsible for pupillary reflexes

A

2 and 3

17
Q

CNVII

A

facial

  • observe facial droop or asymmetry
  • ask pt to raise eyebrows and close eyes to resistance
18
Q

CNVII

A

Acoustic

  • hearing, balance, nystagmus
  • screen hearing
  • test lateralization (weber)
  • compare air/bone (rinne)
19
Q

CNIX and X

A

Glossopharyngeal and X - vagus:

  • gag, palatal movement, and phonation
  • listen to pts voice
  • ask pt to swallow, say “ah”
  • test gag reflex
20
Q

CN XI

A

Accessory

- shrug shoulder and turn head

21
Q

CNXII

A

Hypoglossal

- stick out tongue

22
Q

Peripheral nervous system

A
  • sensory function
  • motor function
  • reflexes
  • cerebellar function
23
Q

Sensory exams

A
  • microfilament - light touch
  • sharp vs dull pain
  • temperature (cold) sensation
  • vibration with tuning fork
24
Q

Motor exams

A
  • observe: involuntary mvmts, muscle symmetry, muscle atrophy
  • muscle strength (out of 5)
  • ROM
25
Q

Reflexes

A
  • deep tendon - depends on force of stimulus

- corresponds to spinal cord segment and peripheral nerves

26
Q

Biceps reflex

A

C5 and C6

27
Q

Triceps reflex

A

C6 and C7

28
Q

Brachioradialis

A

C5 and C6

29
Q

Knee

A

L2, L3, L4

30
Q

Ankle

A

S1 and S2

31
Q

Clonus

A

if reflexes seem hyperactive, test for clonus

  • Support the knee in a partly flexed position.
  • With the patient relaxed, quickly dorsiflex the foot.
  • Observe for rhythmic oscillations
32
Q

Coordination and Gait: rapid alternating movements

A
  • Ask the patient to strike one hand on the thigh, raise the hand, turn it over, and then strike it back down as fast as possible.
  • Ask the patient to tap the distal thumb with the tip of the index finger as fast as possible.
  • Ask the patient to tap your hand with the ball of each foot as fast as possible.
33
Q

Coordination and gait: point-to-point movements

A
  • Ask the patient to touch your index finger and his/her nose alternately several times. Move your finger about as the patient performs this task.
  • Hold your finger still so that the patient can touch it with one arm and finger outstretched. Ask the patient to move arm and return to your finger with eyes closed
34
Q

Coordination and gait: heel-to-shin test

A

Ask the patient to place one heel on the opposite knee and run it down he shin to the big toe. Repeat with the patient’s eyes closed

35
Q

Coordination and gait: Romberg

A
  • Be prepared to catch the patient if unstable.
  • Ask the patient to stand with feet together and eyes closed for 5-10 seconds without support.
  • Positive if the patient becomes unstable (vestibular or proprioceptive problem).
36
Q

Coordination and gait: pronator drift

A
  • Ask the patient to stand for 20-30 seconds with both arms straight forward, palms up, and eyes closed.
  • Instruct the patient to keep the arms still while you tap them briskly downward.
  • The patient will not be able to maintain extension and supination (and “drift into pronation”) with upper motor neuron disease
37
Q

Coordination and gait: gait

A 
Walk across the room, turn and come back.
Walk heel-to-toe in a straight line.
Walk on toes in a straight line.
Walk on heels in a straight line.
Rise from a sitting position.

PA (11 decks)

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