The Nervous System 2

Question 1

How to assess for diabetic neuropathy?

Answer 1

Pin-prick sensation, ankle reflexes, vibration perception, plantar light though sensation (monofilament test)

Question 2

Test for position sense - having the patient stand with feet together and eyes open and then closed for 30 to 60 seconds without support

Answer 2

Romberg test - positive if patient loses balance when eyes are closed

Question 3

How is muscle strength graded?

Answer 3

0-5
0 - no muscular contraction detected
1 - a barely detectable flicker or trace of contraction
2 - Active movement of the body part with gravity eliminiated
3 - Active movement against gravity
4 - Active movement against gravity and some resistance
5 - Active movement against full resistance without evident fatigue (normal muscle strength)

Question 4

What are a few important questions to ask yourself when doing a review of the nervous system?

Answer 4

• Is mental status intact?
• Are right and left sided findings the same or symmetric?
• If findings are asymmetric, do the lesions lie on peripheral or central nervous systems?

Question 5

What type of patient remains unarousable with eyes closed, with no evident response to inner need or external stimuli?

Answer 5

Comatose

Question 6

What type of patient arouses from sleep only after painful stimuli, and has slow and absent verbal responses and upon cessation of stimuli, they lapse back into an unresponsive state?

Answer 6

Stupor

Question 7

What is a patient who appears drowsy but opens their eyes and looks at you, responds to questions, and then falls back asleep?

Answer 7

Lethargic

Question 8

What type of patient open their eyes and looks at you, but responds slowly and somewhat confused with decreased alertness and interest in the environment?

Answer 8

Obtunded

Question 9

FAST Stroke Warning Signs

Answer 9

F- Face Drooping
A- Arm Weakness
S- Speech Difficulty
T- Time to call 9-1-1
Also:
–sudden numbness or weakness of an extremity or face
–sudden confusion or trouble understanding
–sudden trouble seeing in one or both eyes
–sudden trouble walking, dizziness, loss of balance or coordination
–sudden severe headache with no known cause

Question 10

You are assessing a patient experiencing contralateral visual field loss. You suspect the patient is experience an occlusion of:

Answer 10

Posterior cerebral artery (PCA) - posterior circulation

Question 11

This type of tremor appears with movement and often gets worse as the target gets close- absent at rest.

Answer 11

Intention Tremors

Causes: cerebellar disorders such as MS