Neurological Flashcards
What do you assess for when conducting a basic neurological exam?
mental status level of consciousness the cranial nerves reflexes motor function sensory function
What are the names and functions of the 12 cranial nerves?
I - olfactory - sense of smell
II - optic - vision and visual fields
III - oculomotor - Extraocular eye movement (EOM); movement of sphincter of pupil; movement of ciliary muscles of lens
IV - trochlear - EOM; specifically, moves eyeball downward and laterally
V - Trigeminal
-ophthalmic - Sensation of cornea, skin of face and nasal mucosa
- maxillary - Sensation of skin of face and anterior oral cavity (tongue and teeth)
- mandibular - Muscles of mastication; sensation of skin of face
VI - abducens - EOM; moves eyeball laterally
VII - facial - Facial expression; taste (anterior two-thirds of tongue)
VIII - Auditory - equilibrium and hearing
IX - Glossopharyngeal - Apply tastes on posterior tongue for identification. Ask the person to move tongue from side to side and up and down.
X - vagus - Sensation of pharynx and larynx; swallowing; vocal cord movement
XI - accessory - Head movement; shrugging of shoulders
XII - hypoglossal - Protrusion of tongue; moves tongue up and down and side to side
What do you assess when assessing mental status?
Language (aphasia = inability to speak/write/sign, disphasia = difficulties with speaking/writing/signing) (sensory aphasia = inability to comprehend, motor aphasia = inability to express)
Orientation - to place, time, person
Memory - immediate, short term, long term
Attention span/calculation
What are the three measures of the glasgow coma scale?
eye opening
motor response
verbal response
What are the levels of eye opening responses in the GCS?
Spontaneous (4)
To verbal command (3)
To pain (2)
No response (1)
What are the levels of motor responses in the GCS?
To verbal command (6) To localised pain (5) Flexes and withdraws (4) Abnormal flex (3) Abnormal extension (2) No response (1)
What are the levels of verbal responses in the GCS?
Oriented, converses (5) Disoriented, converses (4) Uses inappropriate words (3) Makes incomprehensible sounds (2) No responses (1)
What are the most common reflexes tested during a physical exam?
(a) the biceps reflex;
(b) the triceps reflex;
(c) the brachioradialis reflex;
(d) the patellar reflex;
(e) the Achilles reflex; and
(f) the plantar (Babinski) reflex.
What is a reflex?
an automatic response to a stimulus that cannot be learned or prevented (involuntary).
What is the Rhomberg test?
Testing to see if a patient can stand straight, legs together, arms by their sides, both with eyes open and eyes closed.
What reflexes are generally tested on infants
rooting: stroke the side of the face near mouth; infant opens mouth and turns to the side that is stroked
sucking: place nipple or finger 1 to 2 cm into mouth; infant sucks vigorously
tonic neck: place infant supine, turn head to one side; arm on side to which head is turned extends; on opposite side, arm curls up (fencer’s pose)
palmar grasp: place finger in infant’s palm and press; infant curls fingers around
stepping: hold infant as if weight bearing on a hard surface; infant steps along, one foot at a time
moro: if presented with a loud noise or unexpected movement, the infant spreads arms and legs, extends fingers, then flexes and brings hands together; may cry.
What is decorticate posturing?
the upper arms are close to the sides; the elbows, wrists and fingers are flexed; the legs are extended with internal rotation; and the feet are plantar flexed
What is decerebrate posturing?
the neck is extended, with the jaw clenched; the arms are pronated, extended and close to the sides; the legs are extended straight out; and the feet are plantar flexed. Often a sign of a fatal condition.
