Neurological Assessment

Question 1

What is important about completing a neuro assessment?

Answer 1

Comparing both sides of the body.

Question 2

What do you need to do throughout a neuro assessment?

Answer 2

Make sure the patient is comfortable, ensure the patient, and use appropriate language.

Question 3

What are the 3 upper body neuro assessments?

Answer 3

Index finger to nose test, Pronate and supinate hands on knees, and fingers to thumb.

Question 4

What are the steps of preforming the index finger to nose test?

Answer 4

1. Explain all 3 upper body tests. 2. Ask patient for consent and if they would wish to sit or stand. 3. Show the patient what to do (bring index finger to nose from side and then back x 3) 4. Instruct to do with eyes closed. 5. Repeat on the other side. 6. Report findings against expected findings to lecturer.

Question 5

What are the steps of preforming the pronate and supination of hands test?

Answer 5

1. ask patient to sit down for this test. 2. Show patient what to do with your hands and ask them to copy keeping up with your speed. 3. Change the speed and see if they can keep up. 4. Report findings against expected findings to lecturer.

Question 6

What does pronate mean?

Answer 6

Turn or hold (a hand, foot, or limb) so that the palm or sole is facing downwards or inwards.

Question 7

What does supinate mean?

Answer 7

Turn or hold (a hand, foot, or limb) so that the palm or sole is facing upwards or outwards

Question 8

What are the steps for completing the fingers to thumb test?

Answer 8

1. Have patient sitting or standing. 2. demonstrate assessment touching each finger to thumb ON ONE HAND. 3. Get them to do this on one hand. 4. Get them to repeat using the other. 5. Report findings against expected findings to lecturer.

Question 9

What are the 3 lower body neuro assessments?

Answer 9

Heel down shin, heel to toe walk, romberg test, and one foot balance.

Question 10

What are the steps for the heel to shin test?

Answer 10

1. Explain procedures for all 4 tests. 2. Gain consent and ask client to either sit or lay down. 3. While sitting show them what to do (running the heel of one leg down the shin of the other leg from top to bottom. 4. Ask them to do this on each leg. 5. Report findings against expected findings to lecturer.

Question 11

What are the steps for the heel to toe walk test?

Answer 11

1. Get patient to stand. 2. explain to the patient that you want them to walk a certain distance step by step heel to toe. 3. If confused demonstrate. 4. Ensure patient does this with eyes open. 5. Report findings against expected findings to lecturer.

Question 12

What are the steps for romberg test?

Answer 12

1. Get the patient to stand up with their feet together, arms extended at side or front. 2. Get the patient to close their eyes. 3. Count for 10 seconds then get the patient to open their eyes and return to normal. 4. Report findings against expected findings to lecturer.

Question 13

What are the steps for the one foot balance test?

Answer 13

1. Ask the patient to stand as normal and lift one leg with eyes open. 2. Demonstrate then observe.

Question 14

What is a positive romberg test?

Answer 14

Swaying when eyes are closed

Question 15

What is a negative romberg test?

Answer 15

Minimal or absent swaying

Question 16

What are the 2 upper body reflex tests?

Answer 16

Biceps reflex and triceps reflex

Question 17

How do you preform the biceps reflex test?

Answer 17

1. Explain procedure and ask for consent. 2. Get the patient to sit comfortably and ensure distraction maybe get someone to talk to them. 3. Get patient to flex bicep and locate tendon. 4. Place thumb over the tendon while supporting forearm 5. Ask patient to relax arm and either talk to person or count something. 6. Hit thumb with tendon hammer and feel for a tendon reaction. 7. Repeat on other arm. 8. Report findings against expected findings to lecturer.

Question 18

How do you preform the triceps reflex test?

Answer 18

1. Explain procedure and ask for consent. 2. Get the patient to sit comfortably and ensure distraction maybe get someone to talk to them. 3. Hold patients arm with your non dominant arm and get patient to flex tricep to locate tendon 4. Ask patient to relax arm and either talk to person or count something. 6. Hit the tendon with the tendon hammer and look for a reaction of the patients arm. 7. Repeat on other arm. 8. Report findings against expected findings to lecturer.

Question 19

What are the 3 lower body reflex tests?

Answer 19

The quadriceps refelx, achilles reflex, and planter reflex.

Question 20

How do you preform the quadriceps reflex test?

Answer 20

1. Explain procedure and ask for consent. 2. Have patient sitting on side of bed ensure legs are dangling. 3. Get patient to flex leg and locate desired tendon. 4. Ask patient to talk to friend or to count something (aka provide distraction). 5. Hit tendon with tendon hammer and watch for reaction in leg. 6. Repeat on other leg. 7. Report findings against expected findings to lecturer.

Question 21

How do you preform the achilles reflex test?

Answer 21

1. Explain procedure and ask for consent. 2. Have patient lying down on bed with shoes and socks removed with legs crossed. 4. Ask patient to talk to friend or to count something (aka provide distraction). 5. Hold foot in dorsiflexion. 6. Hit achilles with tendon hammer and observe a reaction. 7. Repeat on other foot. 8. Report findings against expected findings to lecturer.

Question 22

How do you preform the planter reflex test?

Answer 22

1. Explain procedure and ask for consent. 2. Have patient lying down on bed with shoes and socks removed. 3. Ask patient to talk to friend or to count something (aka provide distraction). 4. With the end of the tendon hammer stroke the patients foot laterally curving at the ball of the foot aka making a J shape. 5. Repeat on other foot. 6. Report findings against expected findings to lecturer.

Question 23

Define dorsiflexion.

Answer 23

Dorsiflexion occurs in your ankle when you draw your toes back toward your shins. You contract the shinbones and flex the ankle joint when you dorsiflex your foot.

Question 24

What is your achilles?

Answer 24

The Achilles tendon is a strong fibrous cord that connects the muscles in the back of your calf to your heel bone.

Question 25

What is involved in sensation testing?

Answer 25

Completing a stimuli test on forearms.

Question 26

What are the steps of completing a sensation test?

Answer 26

1. Explain procedure and gaining consent. 2. Showing the patient what each stimuli will feel like using their forearm. 3. Asking the patient to close their eyes and to say which stimuli they feel. 4. Alternate between hard and soft stimuli on forearms at least 6 times on each forearm before completing assessment. 5. Ensure you have done both arms and then compare sides. 6. Report findings against expected findings to lecturer.

Question 27

What are the steps of completing a vibration test?

Answer 27

1. Explain procedure and gain consent. 2. Show the patient what the vibration will feel like. 3. Press against each interphalangeal joint in intervals, ask the patient to tell you when the vibration stops on each one of these joints. 4. Compare both hands. 5. Report findings against expected findings to lecturer.

Question 28

What instrument do you use for a vibration test?

Answer 28

A tuning fork

Question 29

What sort of results would we expect from the upper body neuro testing?

Answer 29

That the patient can follow instructions, have equality on sides of body, keep up to speed with nurse aka rapid alternating movement especially when pronating and supinating.

Question 30

What sort of results would we expect from the lower body neuro testing?

Answer 30

Patient can follow instructions, have equality on sides of body, and show a negative romberg test result.

Question 31

When we are completing the reflex testing what is the scale for our results?

Answer 31

0 - No reflex
1+ - diminished/no reflex
2+ - average/normal 
3+ - brisker than average 
4+ - very brisk/hyperactive

Question 32

During the plantar reflex what would be an expected result?

Answer 32

The toes would curl down

Question 33

What is an unusual result of the plantar reflex test?

Answer 33

The toes curl upwards.

Question 34

What is an important factor for completing a reflex test?

Answer 34

Ensuring the patient is comfortable and distracted

Question 35

If you do not gain a reaction during a reflex test what may you say?

Answer 35

This could be due to a lack of distraction or of knowing what would happen aka preforming test on a fellow student.

Question 36

What is involved in a neurological assessment?

Answer 36

Coordination tests (upper body and lower body), Reflex testing (upper body and lower body), Sensation testing, and vibration testing.