neurological exam Flashcards
basic of medical history
chief complaint, history of present illness (HPI), past medical history, family history, social history, medications and allergies
ROS
review of systems
-series of questions that evaluates patient from head to toe
why is ROS important for audiology
others systems throughout the body have potential connections to HL or vestibular issues, so this allows for everything about the patient to be known
cognition and hearing loss
untreated HL could lead to potential cognition deficits
MMSE
mini-mental status exam
-tests for orientation, registration, attention/calculation, recall, language, etc.
cranial nerve exam for CN1
olfactory nerve test by smelling something
-one nostril at a time with eyes closed
cranial nerve exam for CN 2
optic nerve test by visual acuity and visual fields
-seeing and reporting what they are seeing
cranial nerve exam for CN 3, 4, and 6
extraocular movements tests
-evaluating for nystagmus
-pupillary size, shape and reactivity
specific tests for CN 3
consensual light reflex and eyelids
consensual light reflex test
looking for the dilation of both pupils when it get’s shined into one eye at a time
cranial nerve exam for CN 5
trigeminal nerve test by facial sensations
-using cotton wisp to see if they can feel it
cranial nerve exam for CN 7
facial nerve test by facial expressions
-ask to make various facial shapes to see for symmetry and ability to do so
-taste
cranial nerve exam for CN 8
vestibulocochlear nerve testing but doing a hearing test
-tuning fork tests
-vestibular assessment
cranial nerve exam for CN 9 and CN 10
glossopharyngeal and vagus nerve testing by testing gag reflex
cranial nerve exam for CN 11
spinal accessory nerve tested by testing strength of the trapezius and sternocleidomastoid muscle
-pushing against the muscles as the patient pushes upward
cranial nerve exam for CN 12
hypoglossal nerves test by motor control of the tongue
-done by having patient stick out tongue and do different directions with it
sensory system exam
primary sensory modalities (using a pinprick, light, touch, vibration, position, temp.) and cortical sensory modalities (object recognition, two point discrimination, etc.)
motor system exam
observation, muscle tone and muscle strength
-strength scale 0-5 (0 no function, 5 normal range)
deep tendon reflexes tested according to their ….
accommodating spinal cord position and muscle
-graded on a scale of 0-4 (0 is no reflex. 5 is over exaggerated reflex)
romberg test
tests for proprioceptive and/or vestibular dysfunction as vision is omitted
how to conduct the romberg test
stand with feet comfortably apart, arms any way, stand next to patient and ask them to close their eyes and have them stand still
-observe and watch for any swaying
-positive if patient sways or falls with eyes closed
pronator drift testing
arms out, supinated, fingers together and closing the eyes
-watching for level of the arms adjusting
finger to nose (dysmetria)
have them alternate between tapping their nose and tapping your finger
-looking for smoothness and the accuracy of movement
heel to shin (hypermetria, hypometria)
have the patient run the heel along their shin up and down
-smooth movement from point A to point B
RAM (rapid alternating movements)
looking at the smoothness and coordination of movements
-if testing hands, have them rapidly flip their hands over and back on their laps (palms facing up then facing down)
-if testing feet, can do a foot to hand tap
gait
observing their walk
-look at their base, posture and stability, stride, balance, arm swing, tandem and turns
-ask patient to walk across the room and then around and walk back (heel to toe walking is tandem walking)
blood pressure
can measure electronically or manually
-normal to prehypertension followed by stage 1 and stage 2 hypertension
orthostatic hypotension
measurment of change in blood pressure and heart rate with change in positioning
-assess by measuring BP in a laid down position then a raised position
-video watched in class
