Neurological Assessment Slides 1-20

Question 1

Two regions of Nervous system

Answer 1

Central Nervous System (CNS)
Peripheral Nervous System (PNS)

Question 2

CNS - Brain

Answer 2

Control center of body
Covered and protected by scalp, skull, and meninges
Blood brain barrier
Cerebrum - right and left hemispheres, frontal, parietal, occipital & temporal lobes
Diencephalon - (thalamus and hypothalamus) body temp, sleep
Cerebellum - position sense, posture & equilibrium/balance
Brain Stem - (medulla oblongata, pons & midbrain) resp. & cardiac regulation, sneezing

Question 3

Lobes of the Cerebrum

Answer 3

Parietal – somatic sensory center
Frontal – higher intellect, speech production, personality, behavior, emotions, voluntary movement
Temporal – hearing, memory, speech perception and translation
Occipital – vision

Question 4

CNS – Spinal Cord

Answer 4

• Extends from medulla to the level of the first lumbar vertebra
• Cord protected by vertebra, meninges and cerebral spinal fluid
• Gray matter is on the inside and white matter on the outside
• Mediates deep tendon reflexes

Question 5

Spinal Roots

Answer 5

Cervical, thoracic, lumbar nerves
Posterior (sensory) roots
Anterior (motor) roots
Damage to posterior – loss of sensation
Damage to anterior – flaccid paralysis

Question 6

Peripheral Nervous System (PNS)

Answer 6

The PNS links CNS with the rest of the body

External environmental information received and transmitted via PNS
- Cold, wet, hot, pain

Question 7

Spinal Nerves

Answer 7

Cervical 8 pairs C1-C8
Thoracic 12 pairs T1-T12
Lumbar 5 pairs L1-L5
Sacral 5 pairs S1-S5
Coccygeal 1 pair Coccyx

Question 8

Reflex

Answer 8

Rapid involuntary predictable motor response to a stimulus. Reflex arc, is not dependent on the brain.

Somatic
-Skeletal muscle contraction

Autonomic
-Cardiac, smooth muscle and glands

Question 9

Three basic types of neurologic examination

Answer 9

Screening neurologic exam
Complete neurologic exam – neurologic concerns
Neurologic recheck exam

Question 10

Assessment

Answer 10

Neurologic Exam
Assess mental status first
Equipment

Question 11

Equipment

Answer 11

Eye charts, tuning fork, pen light, reflex hammer, key, buttons, coin, big safety pin

Question 12

Mental Status

Answer 12

• Level of consciousness (LOC)/orientated, intact recent and remote memory
• Cognitive abilities and mentation

Question 13

Level of consciousness (LOC)/orientated, intact recent and remote memory

Answer 13

Confusion/disorientation
Lethargy
Delirium
Coma
Glasgow Coma Scale – eye opening, verbal response, motor response

Question 14

Cognitive abilities and mentation

Answer 14

Mini Mental State Examination
Mental Status Exam

Question 15

The GlasgowComaScale (GCS) is a calculated scale that determines a patient’s level of consciousness. Medical professionals use it to evaluate patients with:

Answer 15

traumaticbrain injury
altered mental status

Question 16

The scale measures three categories:

Answer 16

Eye opening (E)
Motor response (M)
Verbal response (V)

Question 17

The GCS score is the sum of the score in each of the three categories, with a maximum score of 15 (normal) and a minimum score of 3 (deep unconsciousness), as follows:

Answer 17

GCS Score is equal to E + M + V

Question 18

What Is a Normal GCS Score?

Answer 18

A normal GCS score is equal to 15, which indicates a person is fully conscious.

Question 19

How Do You Interpret a GCS Score?

Answer 19

The GCS helps to define the severity of traumatic brain injury. In general:
Score 13-15: Mildhead injury
Score 9-12: Moderate head injury
Score of 8 or less: Severe head injury

Question 20

Mental Status

Answer 20

Physical appearance, dress, grooming, hygiene
-Appropriate for age, sex, culture, season, setting

Behavior and affect, facial expression
-Depressed, hostile, euphoric, fearful, flat/dull

Assess thought content/process

Question 21

Speech and Language

Answer 21

Quality
Rate
Volume

Fluency – Abnormal patterns
Aphonia/dysphonia – difficulty/discomfort in talking (laryngeal disease)
Cerebellar dysarthria – distorted speech sounds, may sound unintelligible, basic language intact

Question 22

difficulty/discomfort in talking (laryngeal disease)

Answer 22

Aphonia/dysphonia

Question 23

distorted speech sounds, may sound unintelligible, basic language intact

Answer 23

Cerebellar dysarthria

Question 24

isa language disorder that makes it hard for you to read, write, and say what you mean to say. Sometimes it makes it hard to understand what other people are saying, too. Aphasia is not a disease. It’s a symptom of damage to the parts of the brain that control language.

Answer 24

Aphasia

Question 25

3 kinds of Aphasia

Answer 25

Broca’s (expressive) – Understands, but cannot speak
Global – severe form, absent/reduced speech, absent/reduced understanding
Wernicke’s (receptive) – Ability to express self, but cannot understand others

Question 26

Thought Processes and Perception

Answer 26

Perceptions
-Illusions/delusions
-Hallucinations

Ability to make a decision/judgment

Insight