Neurological Assessment Flashcards
Dysphasia
impaired speech
DysphaGia
cant swallow
5 things tested for in neuro
- Mental Staus
- Cranial Nerves
- Motor and cerebellar
- sensory
- reflexes
Aphasia
impairment of producing or understanding language
What does GCS test for?
eyes open
Best verbal response
best motor response
Highest GCS Score
15 ( lower the score the worse their neuro function is)
PErRLA
pupils equal round and responsive to light and accommodation
Eye opening catergories
spontaneous
to sound
to pressure
none
Verbal response catergories
orientated
confused
words
sounds
none
Motor response catergories
obey commands
localising
normal flexion
abnormal flexion
extension
none
13-15 on GCS
Mild
9-12 on GCS
Moderate
3-8 on GCS
severe
GCS score < 8
comatose
GCS Score 3
unresponsive
Decorticate
arms brought to core/ chest
Decerebrate
extension of limbs
Mini mental state exam
ask patient to restate 3 words you told them earlier
Cranial nerve 1
Olfactory; tests for smell; sensory
Cranial Nerve 2
Optic; fundoycopic exam, visual acuity, confrontation test, snellen chart; sensory
Cranial Nerve 3,4 and 6
Oculomotor, trochlear, adbucens; eyelid elevation, cardinals fields of gaze, pupil reactions; tests motor
Cranial Nerve 5
Trigeminal: Motor- temporal and masseter muscle strength; Sensory- use sharp/dull test on forehead and cheeks and corneal reflex; motor and sensory
Cranial Nerve 7
Facial; observe for facial drooping or asymmetry; have patient- frown, raise eyebrows, wrinkle forehead, close both eyes to resistance, smile, puff out cheeks; mostly motor, some sensory
Cranial Nerve 8
Acoustic (vestibular); hearing and balance; romberg test, cover uncover test for nystagmus, weber and rinne test; sensory
Cranial Nerve 9 & 10
Glossopharyngeal and vagus; say “ah”; look for movement of soft palate and pharynx; inspect uvula; gag reflex; say “k,q,ch,b,d”; sensory and motor function
Cranial Nerve 11
spinal accessory; trapezius muscle, shrug and move shoulders against resistance; motor function
Cranial Nerve 12
hypoglossal; say “la la la”; protrude tongue and move side to side; motor
Cerebellar function
balance!!
Romberg test
stand with eyes closed; feet together and stand straight. Abnormal is they sway
Cerebellar Ataxia
wide-based, staggering, unsteady gait; cerebellar disease or intoxication
Parkinsonian Gait
shuffling gait, stooped posture with flexed hips and knees; parkinson disease
Spastic Hemiparesis
flexed arm held close to body while leg is dragged; stroke
Finger to nose test
tests coordination
Rapid alternating movements
flipping hands over; tests coordination
Heel to shin test
run heel down opposite shin; tests coordination
Vibration sense
use tuning fork and put on bony prominence and they should feel vibration index fingers & big toes bony prominence
Stereognosis
tests sensory; placing a common object in their hand
Graphesthesia
draw a number on hand and have them guess what it is
Deep Reflex Grade 0
absent- have someone double check
Deep Reflex Grade 1
present, but diminished
Deep Reflex Grade 2
normal
Deep Reflex Grade 3
mildly increased but not pathologic
Deep Reflex Grade 4
markedly hyperactive
Plantar Reflex
normal: feet curls up
abnormal; brudzinski; toes spread out
Nuchal Rigidity
stiff neck; patient resists bending head to chest
Kernigs sign
pain when attempting to extend a flexed knee, patient needs to be laying down
Brudzinki’s sign
flexion of kids when neck is flexed
Hypoactive Reflexes
Hypothyroidism, sedation, increased intracranial pressure, hypocalcemia, hypermagnesemia
Hyperactive Reflexes
Hyperthyroidism, hypercalcemia, hypomagnesemia