Neurological Assessment Flashcards
Body Control & Coordination
- Brain & spinal cord
Brainstem Components
- Pons
- Medulla
- Connects to spinal cord
Cerebral Cortex Components
- Frontal lobe
- Parietal lobe
- Temporal lobes
- Occipital lobe
Wernicke’s Area
- Temporal Lobe
- Processing speech
Broca’s area
- Frontal Lobe
- Language production
Peripheral NS Components
- Cranial nerves
- Spinal nerves
- Peripheral nerves
Cranial Nerves
- 12 pairs enter & exit brain
- No cerebellum association
- Relay brain information to body
- Cerebral cortex 1 & 2
- Brainstem 3-12
Olfactory Nerve 1
- Sensory
Optic Nerve 2
- Sensory
Oculomotor Nerve 3
- Motor
Trochlear Nerve 4
- Motor
Trigeminal Nerve 5
- Motor & sensory
Abducens Nerve 6
- Motor
Facial Nerve 7
- Motor & sensory
Auditory/Vestibulocochlear Nerve 8
- Sensory
Glossopharyngeal Nerve 9
- Motor & sensory
Vagus Nerve 10
- Motor & sensory
Spinal Accessory Nerve 11
- Motor
Hypoglossal Nerve 12
- Motor
Spinal Nerve Breakdown
- 8 cervical
- 12 thoracic
- 5 lumbar
- 5 sacral
- 1 coccygeal
Autonomic NS
- Maintains involuntary functions
- Cardiac/smooth muscle
Sympathetic Division
- Fight/flight
- Adrenaline
- Periods of physiological & psychologic stress
Parasympathetic Division
- Rest & digest
- Acetylcholine
- Conserve body resources
Reflexes
- Involuntary responses
Neurological Concerns
- Facial droop
- Head injury
- Loss of consciousness
- Dizziness
- Limb weakness
- Speech difficulty
Glasgow Coma Scale (GCS)
- Assessing extent of consciousness impairment
- Numerical scale (3-15)
- 8 or lower = profound impairment
GCS Components
- Eye opening
- Verbal response
- Motor response
Levels of Eye Opening
- Spontaneous
- Normal voice
- Loud voice
- Tactile
Noxious Stimulation
- Apply nailbed pressure to elicit pain response
- Start periphery and move centrally
- Warn before applying pressure
Verbal Response
- Person
- Place
- Time
- All 3 to be considered oriented document A&O x3
Motor Response
- Simple command & produce action
- Understanding directions
Pupillary Assessment
- Cranial nerves 2 & 3
Pupil Size, Shape, Equality
- Measure in mm
- Both should be same size
Direct Light Reflex
- Brisk constriction
- Immediate response to light source
Consensual Light Reflex
- Constrict when light source aimed at opposite pupil
Accommodation Assessment
- 12 inches from face
- Bring towards nose
- Equal constriction
- Converge (inward) together
Facial Nerve Assessment
- Facial expression/movement
Glossopharyngeal & Vagus Nerves Assessment
- Swallow/taste test
Expressive Aphasia
- Broca’s area
- Frontal lobe
- Understands language
- Can’t form words
Receptive Aphasia
- Wernicke’s area
- Temporal lobe
- Speech is fine
- Language comprehension impaired
Pronator Drift Assessment
- Sit up & close eyes
- Hold arms pronated position at shoulder height
- Hold for 20 seconds
- Arm weakness (arm will drift)
Romberg Assessment
- Cerebellar testing
- Stand with feet together & eyes closed
- Stand next to them (avoid fall)
Coordination & Skilled Movement
- Rapid altering movements
Babinski Reflex
- Lateral aspect of foot sole
- Run firm object up foot sole
- Flexion of all toes
- Toes fan with positive reflex
Muscles of Strength Assessment
- Biceps
- Triceps
- Deltoid
- Hamstrings
- Quadriceps
Bowel Movement Importance
- Organs can be affected
- Brain inflammation
- Constipation increases intracranial pressure
Signs of Increased Intracranial Pressure
- Difficulty with speech/movement
- Vomiting
- Change in alertness
- Blurred vision/headache
- Behavioural changes
Widening Pulse Pressure
- Difference between diastolic & systolic
- Cause changes to blood brain barrier
- Dementia development
Cushing’s Triad
- Elevation of intracranial pressure
- Caused by widening pulse pressure, irregular respirations & bradycardia
