NEUROLOGICAL ASSESSMENT

Question 1

LOC- level of consciousness

ALOC- (abnormal findings)

Answer 1

awake; alert and oriented to person, place, time, situation (A&O x4)
ALOC- lethargic, confused, stuporous, comatose

Question 2

Speech

Abnormal findings

Answer 2

moderate tone, clear with moderate pace

Abnormal findings- slurred, garbled, grunts, moans, aphasic, no response

Question 3

Mood, feelings, and expressions

Abnormal findings

Answer 3

1) cooperative and friendly, feelings appropriate to situation
2) verbalizes positive feelings regarding others and the future
Abnormal- has suicidal thoughts

Question 4

Thought process

Answer 4

1) expresses full, free-flowing thoughts

2) expresses realistic perceptions

Question 5

Long term memory

Answer 5

recalls past events correctly

Question 6

Abstract reasoning

Answer 6

explains similarities and differences between objects or proverbs correctly

Question 7

judgements

Answer 7

gives answers to questions based on sound rationale

Question 8

sensory function

Answer 8

correctly identifies sharp and dull stimuli and light touch to distal and proximal parts of all extremities and trunk with eyes closed

Question 9

motor function

Abnormal findings

Answer 9

1) gag reflex intact
2) swallows without difficulty
3) moves extremities on command
Abnormal findings- unusual, involuntary movements, such as tremors

Question 10

Mini Mental Status Exam (MMSE)

Orientation to time and place

Answer 10

1) year, month, date, time

2) country, town, hospital

Question 11

(MMSE)

Registration

Answer 11

repeats 3 unrelated objects

Question 12

(MMSE)

Attention and Calculation

Answer 12

Serial 7s: Subtract 7 from 100, repeat x5

Question 13

(MMSE)

Recall

Answer 13

Recalls 3 objects learned from earlier after a 5min period

Question 14

(MMSE)

Language

Answer 14

1) name objects pointed to
2) repeat “no ifs, ands, or buts”
3) give 3-stage command: “place index finger of right hand on your nose then on your left ear”
4) ask pt to obey a written command on a piece of paper stating “close your eyes”
5) ask the pt to write a sentence

Question 15

(MMSE)

Copying

Answer 15

Ask pt to copy a pair of intersecting pentagons

Question 16

Glascow Coma Scale (GCS)

Eye opening response

Answer 16

Spontaneously- 4
To verbal stimuli- 3
To pain- 2
None- 1

Question 17

GCS

Best Verbal Response

Answer 17

Oriented/talks- 5
Confused/talks- 4
Inappropriate words- 3
Incomprehensible sounds- 2
None- 1

Question 18

GCS

Best Motor Response

Answer 18

Obeys commands- 6
Localizes pain- 5
Flexion/withdraws- 4
Flexes abnormally- 3
Extension to pain- 2
None- 1

Question 19

Special senses

Smell

Answer 19

Correctly identifies scent (alcohol wipes)

Question 20

Special senses

Vision

Answer 20

1) Reads print at 14in without difficulty
2) PERLA- pupils are equal, round, react to light and accommodate
3) size of pupils
4) identifies use of corrective lenses

Question 21

Special senses

Taste

Answer 21

Identifies correct taste

Question 22

Special senses

Hearing

Answer 22

1) able to hear whispered words from 1-2ft

2) identifies use of hearing aids