Neurological Assessment 3

Question 1

PERL or PERRLA

Answer 1

pupils, equal, round, reactive to light

Question 2

acute assessment

Answer 2

LOC (level of Consciousness); GCS (Glasgow Coma Scale); Pupillary Reaction; Extremity strength; Sensation; CN; EOM (extraocular movement), gag reflex and corneal reflex

Question 3

what is the window from onset to treatment in order to reverse symptoms

Answer 3

3 hours

Question 4

new onset could be

Answer 4

overdoes of medication such as aspirin causing tinnits

Question 5

0-4 year olds have higher risk for

Answer 5

brain injury

Question 6

elderly

Answer 6

possible slow bleed w/ falls, as we age greater the risk of strokes

Question 7

men often have

Answer 7

thromboylitic strokes

Question 8

there is a strong correlation between

Answer 8

a fib and stokes

Question 9

spinal cord injuries are higher in

Answer 9

young adults

Question 10

focused health history

Answer 10

Numbness; Seizures, tremors, fasciculations; Headaches; Dizziness, vertigo, syncope – blackout recently?; Changes in senses: smell, taste, vision, hearing (tinnitus); Changes in swallowing (dysphagia) or speech (dysphasia/dysarthria - difficulty announcing words); Mental status change; Family History - brain tumors, stokes, high bp and same risk for cardiovascular; Psychosocial—medications, alcohol, seat belts, head gear, lead exposure

Question 11

level of consciousness

Answer 11

Degree of wakefulness or arousability

Question 12

fully awake

Answer 12

highest LOC, respond to all sensory stimuli; may be fully awake, but still disoriented or forgetful

Question 13

alert

Answer 13

fully awake & oriented to person, place, time, environment; responds to verbal stimuli

Question 14

lethargic

Answer 14

drowsy or sleeps most of time; capable of spontaneous movements; gentle shaking/speaking needed; falls back to sleep easily

Question 15

obtunded

Answer 15

sleeps most of time and makes few spontaneous body movements; more vigorous stimulation to arouse; still makes verbal response

Question 16

stuporous

Answer 16

unconscious most of time, no spontaneous motor activity; requires strong, noxious stimuli; verbal response limited or absent

Question 17

comatose

Answer 17

cannot be aroused even by applying “painful” stimuli

Question 18

Glascow Coma Scale

Answer 18

Tests for basic neurological function (high score = 15, low = 3) ; Evaluates LOC; Three LOC parameters; Not always reliable(Pediatrics—uncooperative, afraid; Elderly—hearing, vision, memory loss; Paralyzed—altered motor function)

Question 19

Three LOC parameters

Answer 19

Eye opening, Best motor response, Best verbal response

Question 20

GCS- patients with scores of 3-8 are usually said to be

Answer 20

in a coma

Question 21

extension posturing

Answer 21

pons and upper function loss

Question 22

abnormal flexion

Answer 22

damage to midbrain

Question 23

awareness

Answer 23

ability to understand, think, feel emotions and sense of environment

Question 24

assessing orientation

Answer 24

Awareness; Oriented to time, place, person (x3) and environment (x 4); Mini-Mental State Examination (MMSE); Abstract Reasoning

Question 25

test for memory

Answer 25

immediate - repeat 10 numbers; remote - DOB, historical events; recent - breakfast