Response To Altered Perception

Question 1

➢is a medical imaging procedure
that uses x-rays and digital
computer technology to create
detailed pictures of the body
a non-invasive,
painless and uses a small
amount of radiation to produce
images; it has a high degree of
sensitivity for detecting lesions.

Answer 1

Computerized Tomography CT scan

Question 2

is a test that uses powerful
magnets, radio waves, and a
computer to make detailed
pictures of the inside of your
body

Answer 2

Magnetic resonance imaging MRI

Question 3

➢ is a type of nuclear medicine imaging.
➢ is a nuclear imaging technology that enables
visualization of metabolic processes in the body.

Answer 3

Positron Emission Tomography (PET)

Question 4

➢is an angiographic procedure that involves inserting a catheter
into a blood vessel in the groin or arm

Answer 4

Cerebral Angiography

Question 5

is the pressure required to move sufficient amounts of blood to the
brain (cerebral blood flow), which maintains life and prevents brain
ischemia.
➢defined as the difference between mean arterial pressure (MAP) and
ICP or central venous pressure, whichever is higher.

Answer 5

Cerebral perfusion pressure (CPP)

Question 6

Normal CPP

Answer 6

60-100 mmHG

Question 7

Normal MAP

Answer 7

70-100 mmHG

Question 8

Normal ICP

Answer 8

10-15 mmHG

Question 9

are the ones whose patient care
requires ICP monitoring as they have expertise in neurological
assessment and monitoring device management.

Answer 9

Neuroscience nurses

Question 10

➢is a pressure wave along the artery that offers
various information on cardiovascular
conditions.

Answer 10

Pulse wave form

Question 11

is a non-invasive, painless ultrasound
technique that uses high-frequency sound
waves to measure the rate and direction of
blood flow inside vessels.
➢The test examines and records the speed of
the blood flow in arteries known as the
Circle of Willis, which are located at the
base of the brain.

Answer 11

Transcranial doppler

Question 12

➢a valuable tool to assess brain
function
➢provides noninvasive, real-time
information about brain activity
➢Small flat metal discs called
electrodes are attached to your scalp
with wires
❖ Avoid eating or drinking anything containing caffeine for atleast 8 hrs. before the test

Answer 12

Continuous electroencephalogram
(EEG)

Question 13

is the most common scoring system used to describe the level of
consciousness in a person following a traumatic brain injury.

Answer 13

Glasgow coma scale GCS

Question 14

is a standardized
tool that is commonly used to assess patients suspected of experiencing
an acute cerebrovascular accident (i.e., stroke)

Answer 14

National Institutes of Health Stroke Scale (NIHSS)

Question 15

is commonly used to
assess a patient’s cognitive status when there is a concern of
cognitive impairment.
➢is sensitive and specific in detecting delirium and dementia

Answer 15

Mini-Mental Status Exam

Question 16

Ask the patient if they have noticed any
change in sense of smell

Answer 16

Olfactory nerve

Question 17

should be examined by various
modalities:
• Visual Acuity (VA) – Assess VA with a Snellen chart

Answer 17

Optic nerve

Question 18

(Assessment
of cranial nerves III, IV, and VI):
• Pupillary light reflex
• Pupillary accommodation
• Ocular movements

Answer 18

Oculomotor, Trochlear, and Abducens Nerves

Question 19

• Sensation requires both light touch and pin prick
assessment
• Motor function is checked by the muscles of
mastication

Answer 19

Trigeminal nerve

Question 20

• Initially assess for symmetry in the face at rest
• Ask the patient to perform the following
movements

Answer 20

Facial nerve

Question 21

Hearing can be assessed by whispering a number into each
ear separately, making a distracting noise with your fingers
in the contralateral ear, and asking the patient to repeat
-If any hearing loss suspected, perform Rinne’s and Weber’s
test

Answer 21

Vestibulocochlear Nerve CN VIII

Question 22

CN IX and CN X
nerves can be assessed together:
• Ask the patient to open the mouth wide and say ‘ah’, using
a tongue depressor to visual the palate and posterior
pharyngeal wall (assessing CN IX and X)

Answer 22

Glossopharyngeal and Vagus Nerves

Question 23

is a purely motor branch to the
trapezius and sternocleidomastoid muscles:

Answer 23

Accessory nerve

Question 24

can be assessed by asking the
patient to turn their head to each side, against the
examiners resistance

Answer 24

Sternocleidomastoid

Question 25

can be assessed by asking the patient to
shrug their shoulders, against the examiners resistance

Answer 25

Trapezius

Question 26

is a purely motor
branch to the muscles of the tongue:
✓ Ask the patient to open their mouth and
inspect the tongue for any wasting or
fasciculation
✓ Ask the patient to protrude the tongue
and move from side to side

Answer 26

Hypoglossal nerve

Question 27

Shoes and socks are removed. The foot is
elevated and supported with the examiner’s
hand or knee. The examiner gently but firmly
draws a pointed object such as the end of a
wooden cotton-tipped applicator up the lateral
portion of the bottom of the foot from the heel
forward and across the foot pad. A normal
response is plantar flexion of the toes. A
positive result is dorsiflexion of the big toe with
a fanning out or spreading of the other toes
and indicates upper motor neuron disease.

Answer 27

Babinski Reflex (plantar response)

Question 28

are often
psychologically traumatic or occur within a broader
context of psychological trauma, such as military
combat or recurrent interpersonal violence
e.g., motor vehicle accidents

Answer 28

Traumatic brain injury

Question 29

This type of stroke is caused by a blockage in an artery that supplies
blood to the brain. The blockage reduces the blood flow and oxygen to
the brain, leading to damage or death of brain cells

Answer 29

Acute ischemic stroke

Question 30

➢ is traumatic injury leading to damage of the spinal cord,
resulting in temporary or permanent change to neurological
function, including paralysis.

Answer 30

Traumatic spinal cord injury

Question 31

Meaning of BEFAST

Answer 31

B- balance
E- eyes
F- face
A- arms
S- Speech
T- Time

Question 32

Ask patient to place one hand over the next
and have them flip one hand back and forth
as fast as possible (alternatively you can ask
the patient to quickly tap their foot on the
floor as fast as possible) if abnormal, this is
called

Answer 32

Dysdiadochokinesia

Question 33

FINGER TO NOSE & FINGER TO
FINGER TEST
Ask patient to fully extend arm
then touch nose or ask them to
touch their nose then fully extend
to touch your finger. You increase
the difficulty of this test by adding
resistance to the patient’s
movements or move your finger to
different locations. Abnormality of
this is called

Answer 33

Dysmetria

Question 34

Have patient run their heel down
the contralateral shin (this is
equivalent the finger to nose test).
Abnormal exam occurs when they
are unable to keep their foot on
the shin.

Answer 34

Heel to shin

Question 35

To test tandem gait, the patient is
instructed to walk placing one foot
directly in front of the other, heelto-toe. Normal patients are able to
walk without swaying
❖If the patient has difficulty
performing tandem walking with
the eyes open, cerebellar disease
is indicated.

Answer 35

Gait Tandem

Question 36

➢ With the patient’s eyes closed,
the big toe is grasped from the
sides to avoid clues elicited by
pressure. The toe is bent
upwards or downwards and
the patient is asked to report
whether

Answer 36

PROPRIOCEPTION/POSITION

Question 37

the neurosurgeon will create
one or two small holes within
the skull, followed by an
incision in the dura if
necessary, in order to drain the
blood clot. Following surgery,
the incision area is closed up
using sutures.

Answer 37

Burr hole drainage

Question 38

➢ the neurosurgeon will
remove a section of bone to
create access, then remove
the blood clot. When the
procedure is complete, the
surgeon will replace the
section of bone and close up
the soft tissue using
sutures or staples.

Answer 38

Craniotomy