NEUROLOGICAL ASSESSMENT Flashcards
LOC- level of consciousness
ALOC- (abnormal findings)
awake; alert and oriented to person, place, time, situation (A&O x4)
ALOC- lethargic, confused, stuporous, comatose
Speech
Abnormal findings
moderate tone, clear with moderate pace
Abnormal findings- slurred, garbled, grunts, moans, aphasic, no response
Mood, feelings, and expressions
Abnormal findings
1) cooperative and friendly, feelings appropriate to situation
2) verbalizes positive feelings regarding others and the future
Abnormal- has suicidal thoughts
Thought process
1) expresses full, free-flowing thoughts
2) expresses realistic perceptions
Long term memory
recalls past events correctly
Abstract reasoning
explains similarities and differences between objects or proverbs correctly
judgements
gives answers to questions based on sound rationale
sensory function
correctly identifies sharp and dull stimuli and light touch to distal and proximal parts of all extremities and trunk with eyes closed
motor function
Abnormal findings
1) gag reflex intact
2) swallows without difficulty
3) moves extremities on command
Abnormal findings- unusual, involuntary movements, such as tremors
Mini Mental Status Exam (MMSE)
Orientation to time and place
1) year, month, date, time
2) country, town, hospital
(MMSE)
Registration
repeats 3 unrelated objects
(MMSE)
Attention and Calculation
Serial 7s: Subtract 7 from 100, repeat x5
(MMSE)
Recall
Recalls 3 objects learned from earlier after a 5min period
(MMSE)
Language
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
(MMSE)
Copying
Ask pt to copy a pair of intersecting pentagons
Glascow Coma Scale (GCS)
Eye opening response
Spontaneously- 4
To verbal stimuli- 3
To pain- 2
None- 1
GCS
Best Verbal Response
Oriented/talks- 5 Confused/talks- 4 Inappropriate words- 3 Incomprehensible sounds- 2 None- 1
GCS
Best Motor Response
Obeys commands- 6 Localizes pain- 5 Flexion/withdraws- 4 Flexes abnormally- 3 Extension to pain- 2 None- 1
Special senses
Smell
Correctly identifies scent (alcohol wipes)
Special senses
Vision
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
Special senses
Taste
Identifies correct taste
Special senses
Hearing
1) able to hear whispered words from 1-2ft
2) identifies use of hearing aids
