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Health Assessment > Week 13 NEURO > Flashcards

Week 13 NEURO Flashcards

1
Q

Infant CN 1

A

Olfactory

Difficult to test

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2
Q

how to test for visual acuity in infants? CN?

A

CN II
Optic

look for facial response & tracking

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3
Q

How to test for response to light in infants? CN?

A

CN II & III

Optic & Oculomotor

darken room
Optic blink reflex
pupillary response

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4
Q

How to test for EOM in infants? CN?

A

CN 3, 4, 6
Oculomotor, Trochlear, Abducens

how well infant tracks smiling face & if eyes move together

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5
Q

How to test for the motor system in infants? CN?

A

CN 5 Trigeminal

rooting reflex
suckling reflex & strength of suck

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6
Q

How to test the infant’s face? CN?

what does an abnormal response mean?

A

CN 7 Facial

Observe infant crying; symmetrical?

Asymmetry = congenital facial nerve palsy from birth trauma or developmental defects

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7
Q

How to test acoustics with infant? which CN?

A

CN 8 Vestibulocochlear

Blinking of both eyes in response to loud noise
Observe tracking in response to sound

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8
Q

How to test swallowing with infant? CN?

A

CN 9 & 10

Glossopharyngeal & Vagus

observe coordination with swallowing
Gag reflex

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9
Q

Dysphagia in an infant indicates injury to what cranial nerves?

A

Injury to CN 9, 10, 12

Glossopharyngeal, Vagus, Hypoglossal

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10
Q

How to test spinal accessory in infant? CN?

A

CN 11 Spinal Accessory

symmetry of shoulders

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11
Q

how to test hypoglossal in infant? CN?

A

CN 12 Hypoglossal

coordination of sucking, swallowing and tongue thrusting
Pinch nostrils; tongue midline?

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12
Q

Palmar Grasp reflex

Maneuver
Age
Meaning if it goes beyond? #2

A

fingers in infants hand

AGE:
Birth - 4 months

PERSISTENCE:
-beyond 6 months suggests pyramidal tract dysfx
-Persistance beyond 2 months= CNS damage, especially
if fingers over lap thumb

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13
Q

Plantar Grasp Reflex

Maneuver
AGE
persistence meaning?

A

Touch base of toes; toes should curl

AGE:
Birth - 8 months

PERSISTENCE:
-Pyramidal tract dysfx (corticospinal tract)

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14
Q

Rooting Reflex

Maneuver
AGE
absence?

A

Stroke perioral corners; mouth should open and infant turn head to suck

AGE
Birth - 4 months

ABSENCE:
generalized or CNS disease

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15
Q

Moro reflex

Maneuver
age
persistence
assymmetry

A

“startle reflex”

Abruptly lower supine infant 1 foot; arms abduct, hands open, legs flex

AGE
birth - 4 months

PERSISTENCE:
Neurologic disease (CP) esp if beyond 6 months

ASYMMETRY:
clavicle/humerus fracture
brachial plexus injury

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16
Q

Asymmetric tonic neck reflex

maneuver
age
persistence

A

turn head to one side, holding jaw over shoulder; opposite arm/leg will flex

AGE
Birth - 3 months

PERSISTENCE:
asymmetric CNS development
CP development

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17
Q

Galant Reflex

maneuver
age
absence
persistence

A

“Trunk Incurvation”

Prone infant & stroke 1 side of back 1cm from midline; spine should curve toward the stimulated side

AGE
Birth - 4 months

ABSENCE:
transverse SCI

PERSISTENCE:
delayed development

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18
Q

Landau reflex

maneuver
age
persistence

A

suspend infant prone; the head should lift & spine straighten

AGE
Birth - 6 months

PERSISTENCE:
delayed development

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19
Q

Parachute reflex

maneuver
age
DELAY

A

prone infant & lower head to surface; arms and legs extend

AGE:
8 months - lifetime

DELAY:
predict future delays in voluntary motor development

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20
Q

Positive support reflex

maneuver & what’s normal?
age
meaning if there’s no reflex?
Meaning if there is only fixed extension & adduction?

A

hold infant around trunk until both feet touch surface; partial weight-bearing

AGE:
birth/2mos. - 6 months
:
NO REFLEX = flaccidity or hypotonia

-Fixed extension & Adduction (SCISSORING) = spasticity/neuro disease (CP)

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21
Q

Placing and Stepping reflex

maneuver
age
absence

A

hold upright w/ one foot touch surface; alternate stepping

AGE:
Birth - varies

ABSENCE = paralysis
*breech delivery may not have this

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22
Q

Define lethargy

A

drowsy, opens eyes when spoken to in LOUD VOICE

response to questions then falls asleep

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23
Q

Define Obtundation

A

opens uses with TACTILE STIMULUS

looks at you, responds slowly & CONFUSED

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24
Q

define stupor

A

arouses with PAINFUL stimuli

unresponsive when stimulus stops

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25
Q

Define & disease thought blocking

A

interruption in speech midsentence “lost the thought”

Schizophrenia

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26
Q

define & disease circumstantiality

A

speech with unnecessary detail, delay reaching the point

OCD

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27
Q

define & disease clanging

A

words based on sounds “wise eyes; rosey nosey”

Schizophrenia
Manic

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28
Q

define & disease confabulation

A

fabrication of facts; fill in teh gaps

Korsakoff syndrome from alcoholism

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29
Q

define & disease derailment

A

shifting topics that are loosely connected. Pt unaware there is no connection

schizophrenia
mania

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30
Q

echolalia

A

involuntary repetition of words

manic
schizophrenia

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31
Q

flight of ideas

A

the continuous flow of accelerated speech abrupt changes of topic
ideas not well connected

manic

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32
Q

incoherence

A

incomprehensible speech

schizophrenia

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33
Q

neologisms

A

invented words

schizophrenia
aphasia

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34
Q

perseveration in speech

A

persistent repetition of words or ideas

“unsolicited reiterations”

schizophrenia

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35
Q

What is dysarthria? indicate?

A

defective muscular control of speech
words are slurred or indistinct

CNS, PNS lesions
Parkinson
Cerebellar disease

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36
Q

Aphasia indicates?

A

disorder producing or understanding language

Lesions in dominant cerebral hemisphere, usually left

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37
Q

Dysphonia indicates?

which cranial nerve may be effected?

A

impaired volume, quality or pitch of voice

hoarse or only can whisper

laryngitis, tumors
unilateral vocal cord paralysis (CN 10 Vagus)

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38
Q

Aphonia indicates?

A

loss of voice

Larynx disease or nerve

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39
Q

Broca aphasia

A

Expressive aphasia

Comprehends language but nonfluent speech

Lesion of posterior inferior frontal lobe

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40
Q

Wernicke aphasia

A

Receptive aphasia

impaired comprehension; speech fluent but lacks meaning

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41
Q
  1. What are some of the most important questions to ask of the depressed patient?
A

Over the past 2 weeks, have you felt down, depressed, or hopeless?

Over the past 2 weeks, have you felt little interest or pleasure in doing things (anhedonia)?

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42
Q
  1. What are the five categories of the neurological exam?
A

**Mental status/speech/language
(alertness, appropriate speech, orientation)

  • *Cranial nerves
  • Visual acuity
  • pupillary light reflex
  • Eye Movements
  • Hearing
  • Facial Strength (smile, eye closure)
  • *Motor system
  • Assess strength
  • coordination (Rapid alternating movements)
  • Position sense (Romberg)
  • Gait
  • *Sensory system
  • light touch/pain/temperature/vibration/proprioception
  • *Reflexes
  • muscle stretch reflex
  • superficial stimulation reflex (anal, plantar, abdominal)
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43
Q

What could a headache indicate?

What are the red flags? #5

A

warrants careful evaluation for life-threatening causes EX meningitis, subarachnoid hemorrhage, or mass lesion
Red flags “ sudden onset,” onset after 50 years. Associated symptoms like fever & stiff neck. Papilledema & focal neurologic signs

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44
Q

What could dizziness indicate?

A

Dizziness: Positional Vertigo, or Meniere disease. Diplopia? (stroke) Related to medications?

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45
Q

7

What are some common or concerning symptoms that the FNP should assess for as part of the neurological history?

A 
Headache
Dizziness
Weakness
Numbness/Abnormal sensation
Syncope
Seizure
Tremors/involuntary movement
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46
Q

What could numbness/abnormal sensation indicate?

A

paresthesias or dysthesia (distorted sensation EX light touch causes burning sensation)

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47
Q

What could syncope indicate?

A

Syncope: Actually lose consciousness? (Vasovagal, hypotension, arrythmia) Or Seizure?

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48
Q

What information do you know about morbidity and mortality in relation to strokes?

A

Ischemia stroke is more common
More women die
More AA effected

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49
Q

What history and exam findings are consistent with TIAs/strokes?

A

TIA – resolves in 24 hours

Stroke risk – highest if you had TIA, >60 years, diabetes, focal symptoms, symptoms lasting more than 10 mins.

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50
Q

Findings for ACA stroke?

A

contralateral leg weakness

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51
Q

Findings for left MCA stroke?

A

aphasia

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52
Q

findings for Right MCA stroke?

A

neglect of opposite side of body

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53
Q

findings for middle MCA stroke?

A

contralateral hemiparesis & sensory deficits (no aphasia or neglect)

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54
Q

findings for PCA stroke?

A

contralateral visual field loss

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55
Q

findings for brainstem stroke?

A

dysphagia, dysarthria, tongue palate deviation, ataxia w/contralateral body

56
Q

findings for basilar artery stroke?

A

“locked in” syndrome = intact consciousness but quadriplegic/can’t speak

57
Q

Resting (static) Tremor

A

Prominent at rest; disappear with movement; Parkinson pill-rolling

58
Q

Postural Tremor

A

Appears when actively maintain posture. EX: rapid fine tremor of hyperthyroidism. OR essential tremor

59
Q

Intention Tremor:

what diseases do you find this with?

A

Absent at rest; appear w/movement and get worse when limb approaches target. EX cerebellum stroke or MS

60
Q

What are dizziness, vertigo, presyncope and syncope?

A

Presyncope: about to pass out or fall; Cause: orthostatic hypotension
Vertigo: spinning sensation w/ nystagmus & ataxia; Cause: peripheral vestibular dysfunction or brainstem lesion
Dizzy: includes presyncope, disequilibrium or vertigo

61
Q

What disease has….progressive & rapid development of lower weakness followed by upper

A

Guillain-Barre

62
Q

What disease has…chronic, gradual, progressive weakness

A

ALS or expanding tumors

63
Q

What disease has…Proximal limb weakness

A

Alcohol myopathy, glucocorticoids & inflammatory muscle

64
Q

What disease has..proximal weakness gets worse with effort (fatiguability)

A

Myasthenia Gravis:

65
Q

What disease has..Bilateral, distal weakness w/sensory loss

A

Diabetes

66
Q

How do you test for discriminative sensations

A

Absent stereognosis, graphesthesia & 2 point discrimination = posterior (dorsal) column disease

67
Q

Point Localization

A

Briefly touch point on patient’s skin and then ask to point to place touched

somatosensory test

68
Q

Graphesthesia

A

Identify numbers in patient’s palm

69
Q

Stereognosis

A

Identify an object by feeling it within 5 seconds

70
Q

Extinction:

How to test?
What does an abnormal result mean?

A

double simultaneous stimulation

sensory neglect = if only one side recognized (R parietal lobe or R basal ganglia lesions)

71
Q

What tests can be used to assess gait?

A

Walk across the room
Walk heel-to-toe/Tandem walking
Walk on toes, then on heels

72
Q

What does the inability to walk on heels mean?

A

corticospinal damage

73
Q

What do you see with spastic hemiparesis? what does it mean?

A

Unilateral weakness w/ spasticity of affected muscles & increased tendon reflexes

-Affected arm flexed & immobile; Drag toe/circle leg while walking

Corticospinal tract lesions: Cerebral Palsy/Stroke

74
Q

What do you see with steppage gait? what does it mean?

A

drag feet or lift them high with a SLAP onto floor; can’t walk on heels

-Foot drop; 2nd peripheral nervous system disease

75
Q

What do you see with scissors gait? What does it mean?

A

Stiff, slow, thighs cross forward on each other

Spinal cord disease w/ spasticity

76
Q

What are tests of coordination?

A

rapid alternating movements
Point-to-Point movements
Gait & stance

77
Q

What do the point-to-point movements test?
What are the Point to Point tests?
What is abnormal and its meaning?

A

COORDINATION TEST
Finger To Nose
Abnormal: clumsy, unsteady, inappropriate speed/force = cerebellar disease
Abnormal: unable to touch providers finger with eyes closed means a loss of position sense = sensory ataxia

Heel-to-Shin
Abnormal: overshoots knee (dysmetria) & oscillates side to side (intention tremor) = cerebellar disease

78
Q

What do the rapid alternating movements test for? what does abnormal look like?

A

Strike hand on thigh
In cerebellar disease instead of alternating quickly, these movements are slow, irregular, and clumsy = dysdiadochokinesis

Alternating fingers

          - imprecise, irregular rhythm = cerebellar disease
      - slow, low amplitude = UMN & basal ganglia
79
Q

What does imprecise, irregular rhythm with rapid alternating fingers mean?

A

cerebellar disease

80
Q

While rapidly alternating fingers…the pt is slow and has low amplitude…what does this mean?

A

UMN weakness

Basal ganglia disease

81
Q

What is the Biceps Reflex reponse?

Where on spine?

A

Biceps (C5,C6) [Flexion elbow & muscle contract]

82
Q

What is the brachioradialis reflex???

Where?

A

Brachioradialis reflex (C5, C6) [hand on rest on lap, flexion at elbow & supination of forearm]

83
Q

What do you see with the Triceps Reflex?

Where in spinal cord?

A

Triceps (C6, C7) [extension elbow]

84
Q

What do you see with the Patellar reflex?

Where?

A

Patellar reflex (L2-4) flex knee…tap below knee…quadriceps contract & knee extends

85
Q

What is the Achilles Reflex?

Where?

A

Achilles Reflex (S1) dorsiflex foot…plantar flexion at ankle

86
Q

What is the plantar response in adults?
What is normal?
What is abnormal?

A

Plantar Response…normal = plantar flexion; abnormal = dorsiflexion big toe; Babinski

87
Q

What is the anocutaneous reflex?
Where on spine?
What is abnormal and what does it mean?

A

Anocutaneous Reflex (S3-4)…normal = external anal sphincter contraction; abnormal = cauda equina lesion

88
Q

What could cause a slowed relaxation phase of reflex?

A

Hypothyroidism

89
Q

What do hyperreactive reflexes mean?

A

CNS lesions involving corticospinal tract usually with weakness, spasticity or Babinski

90
Q

What do hyporeactive reflexes mean?

A

PNS lesions associated with weakness, atrophy & fasciculations

91
Q

How does the FNP assess for clonus? What does clonus indicate?

A

Knee in flexed position…sharply dorsiflex foot & maintain in dorsiflexion…rhythmic oscillations = clonus

92
Q

What does a sustained clonus mean?

A

CNS disease of corticospinal tract

93
Q

5

How would the FNP assess for diabetic neuropathy?

A

Vibration sense if first sensation lost in peripheral neuropathy.
Loss of position sense (can’t sense big toe proprioception)
Pin-prick sensation
Ankle reflex (diminished)
Plantar light touch

94
Q

What is reinforcement and how can it be used to assess reflexes?

A

Used if a reflex seems diminished or absent

Involves isometric contraction of other muscles for 10 seconds that increases reflex activity.

If reinforcement is used, grade reflex response to 1

95
Q

What is the Romberg test? What does an abnormal finding indicate?

A

Tests POSITION SENSE
Stand w/ feet together & eyes open then with eyes closed

  • Loss of balance with eyes closed = + positive Romberg = Sensory Ataxia
  • Loss of balance with eyes closed & open = Cerebellar Ataxia
96
Q

How is muscle strength graded?

A

• Muscle strength graded on a 0 to 5 scale:
o 5 – Active movement against full resistance without evident fatigue
 Normal muscle strength
o 4 – Active movement against gravity and some resistance
o 3 – Active movement against gravity
o 2 – Active movement of the body part with gravity eliminated (planar motion)
o 1 – A barely detectable flicker or trace of contraction
o 0 – No muscular contraction detected

97
Q

What are meningeal signs?

A

Nuchal rigidity

Brudzinski sign

Kernig Sign

Jolt accentuation of the Headache

98
Q

Nuchal rigidity

A

neck stiffness w/ resistance to flexion

99
Q

Brudzinski Sign

A

+meningitis

flex neck & watch hips and knees in reaction…

+sign = flexion of hips & knees

100
Q

Kernig Sign –

A

Meningitis

Flex patient’s leg at hip & knee then slowly extend the leg and straighten knee…

+ sign= pain & increased resistance to knee extension

101
Q

Jolt accentuation of the Heachache (JAH) –

A

patient nods “no”…

+sign = headache worsened

102
Q

Analgesic rebound

PROCESS
LOCATION
QUALITY/SEVERITY
ONSET
DURATION
COURSE
ASSOCIATED S/S
AGGRAVATORS
A

PROCESS: withdrawal medication

LOCATION: previous headache pattern

QUALITY/SEVERITY: Varies

ONSET/DURATION/COURSE/ASSOCIATED S/S : Varies

AGGRAVATE: Fever, carbon monoxide, caffeine withdrawal,

103
Q

Errors of Refraction (farsightedness & astigmatism NOT nearsight)

PROCESS
LOCATION
QUALITY/SEVERITY
ONSET
DURATION
COURSE
ASSOCIATED S/S #3
AGGRAVATORS
RELIEF
A

PROCESS: sustained contraction EOM
LOCATION: around & over eyes, radiates to occipital
QUALITY: steady, ache,dull
ONSET: gradual
DURATION/COURSE: varies
ASSOCIATED SYMPTOMS: eye fatigue, “sandy,” red conjunctiva
AGGRAVATORS: prolonged eye use, close work
RELIEF: rest

104
Q

Acute Glaucoma

PROCESS
LOCATION
QUALITY/SEVERITY
ONSET
DURATION
COURSE
ASSOCIATED S/S
AGGRAVATORS
A

PROCESS: sudden increase intraocular pressure

LOCATION: pain in/around one eye

QUALITY/SEVERITY: steady & severe, ache

ONSET: Rapid

DURATION/COURSE: Varies

ASSOCIATED S/S: blurry vision, N/V, halos around lights, red eye

AGGRAVATE: mydriatic drops

RELIEF: none
105
Q

Sinusitis Headache

PROCESS
LOCATION
QUALITY/SEVERITY
ONSET
DURATION
COURSE
ASSOCIATED S/S #4
AGGRAVATORS #3
RELIEF
A

PROCESS: inflammation paranasal sinuses

LOCATION: frontal sinuses above eyes or over maxillary sinus

QUALITY/SEVERITY: ache/throb, possibly migraine

ONSET: varies
DURATION: daily several hours, persists until tx
COURSE: daily repetitive pattern

ASSOCIATED S/S: local tender, congestion, discharge, fever

AGGRAVATOR: cough, sneeze, jarring head

RELIEF: Nasal decongestants, antibiotics

106
Q

Meningitis

PROCESS
LOCATION
QUALITY/SEVERITY
ONSET
DURATION
COURSE
ASSOCIATED S/S
A

PROCESS: viral/bacterial infection

LOCATION: generalized

QUALITY/SEVERITY: severe steady throbbing

ONSET: rapid, sudden

DURATION: varies

COURSE: viral <1wk; bacterial persistent until tx

ASSOCIATED S/S: fever, stiff neck, photophobia, mental status change

107
Q

Subarachnoid Hemorrhage

PROCESS
LOCATION
QUALITY/SEVERITY
ONSET
DURATION/COURSE
ASSOCIATED S/S
AGGRAVATORS
A

PROCESS: bleeding ruptured aneurysm
LOCATION: generalized
QUALITY/SEVERITY: very severe “worst of my life” thunder clap
ONSET: Sudden
DURATION/COURSE: varies
ASSOCIATED S/S: N/V, unconscious, neck pain,
AGGRAVATORS: Increased ICP, cerebral edema, rebleeding

108
Q

Brain Tumor

QUALITY/SEVERITY
DURATION
COURSE
ASSOCIATED S/S #6
AGGRAVATORS #3
A

QUALITY/SEVERITY: ache, steady, dull, worse on awakening and better after several hours
DURATION: brief, depends on location and rate of growth
COURSE: intermittent but progresses intensity over days
ASSOCIATED S/S: seizures, hemiparesis, field cuts, personality change, N/V, vision & gait change
AGGRAVATORS: cough, sneeze, sudden movements

109
Q

Giant Cell (temporal) Arteritis

PROCESS
LOCATION
QUALITY/SEVERITY
ONSET
DURATION
COURSE
ASSOCIATED S/S
AGGRAVATORS
RELIEF
A

PROCESS: transmural lymphocytic vasculitis involving multinucleated giant cells that disrupt internal elastic lamina of large caliber arteries

LOCATION: near involved artery, usually temporal

QUALITY/SEVERITY: Severe throb, generalized, persistent,

ONSET: gradual or rapid
DURATION: varies
COURSE: recurrent/persistent over weeks- months

ASSOCIATED S/S: tender, fever, weight loss, new headache, jaw, visual loss, rheumatica

AGGRAVATE: movement neck or shoulders

RELIEF: steroids

110
Q

How would the FNP assess sensory function in the infant? What would abnormal findings indicate?

A

Can only test for pain by flicking infant’s palm or sole.

Observe for withdrawal, or change in facial expression.

Paralysis = If infant cries but there is no withdrawal

111
Q

What exam findings would be present in the newborn that has been exposed to maternal substance abuse or the infant experiencing neonatal abstinence syndrome?

A

Irritable, jittery, tremors, hypertonicity & HYPERreflexes.

Poor feeding, seizures, autonomic signs

112
Q

What are the 6 components of the mental health examination?

A

Appearance & Behavior – LOC, Dress, Mannerisms

Speech & language – fluency, articulation, rate/volume

Mood – describe level & fluctuations r/t life events

Thoughts & Perceptions – Thought process (how they think/ logic, coherence, relevance, organization) Thought content (what they think about/ insight, judgment,
hallucinations)

Cognitive function – orientation, attention, memory, new learning ability

Insight & Judgement

113
Q

What are the classifications of personality disorders? What are their characteristic behavior patterns?

A

Odd or Eccentric Disorders
(Paranoid/schizoid/schizotypal)

Dramatic, Emotional or Erratic
(Antisocial, borderline, histrionic, narcissistic)

Anxious or Fearful
(Avoidant, dependent, OCD)

114
Q

What is dysdiadochokinesis? What disease is it found in?

A

In cerebellar disease instead of alternating quickly, these movements are

slow, irregular, and clumsy

115
Q

While rapid alternating fingers you find the movements irregular and imprecise…What does this mean?

A

cerebellar disease

116
Q

What are the characteristics of an ectopic pregnancy?

A

abdominal pain
adnexal mass/tenderness
uterine bleeding

117
Q

What is paget’s disease of the nipple?

A
  • scaly, eczema lesion on nipple that weeps/crusts/erodes.
  • Suspect Pagets for persistent dermatitis of nipple.

sign of breast cancer

118
Q

What is cranial nerve II? How do you test for it? infant?

A

Optic

Tests for visual acuity & optic fields
“tell me when you see the finger”

INFANT:
look for facial response and tracking

119
Q

What is CN III? How do you test for it? infant?

A

Oculomotor

pupillary constriction, eyelid opening, EOM

TESTS:
Ptosis
Convergence test (follow finger to bridge of nose)
Nystagmus (focus on distant object)
6 Cardinal fields

INFANT:
“blink reflex”
pupillary response w/ light
Tracks smiling face & if eyes move together

120
Q

What is CN IV? How do you test for it?

A

Trochlear

Downward inward rotation of the eye
Cardinal fields

121
Q

What is CN V? How do you test for it? Infant?

A

Trigeminal

Motor (jaw clenching & lateral jaw movement)
Sensory (Facial) *pain sensation?

INFANT:
Rooting reflex
sucking reflex

122
Q

What is CN VI? How do you test for it?

A

Abducens

Lateral deviation of eye
Cardinal fields

123
Q

What is CN VII? How do you test for it? Infant?

A

Facial

Motor (facial expressions) *puff cheeks, forehead, neck muscles
Sensory (taste ant tongue)

INFANT
symmetry of crying

124
Q

What is CN VIII? how do you test for it? Infant?

A

Vestibulocochlear

Hearing & balance

whisper test

INFANT:
Blinking in response to loud sound

125
Q

What is CN IX? how do you test for it? Infant?

A

Glossopharyngeal

  • “aah”
  • Gag reflex

INFANT:
coordination swallowing

126
Q

What is CN X? how do you test for it? Infant?

A

Vagus

Motor (palate)
Sensory (pharynx & larynx)

INFANT:
coordination swallowing

127
Q

What is CN XI? how do you test for it?
What abnormalities are you looking for?
Infant?

A

Spinal accessory nerve

Sternocleidomastoid and trapezius

  • *Shrug shoulders against hands
  • Turn head against chin
  • tun chin into hand

LOOKING FOR:
fasciculations = small irregular twitching or atrophy

INFANT:
symmetry of shoulders

128
Q

What is CN XII? how do you test for it? Infant?

A

Hypoglossal nerve

*Stick out tongue and move side to side

INFANT:
Pinch. nostrils to open mouth and observe tongue midline

129
Q

If the palate fails to rise…what CN lesion is this?

A

CN X Vagus

130
Q

If you see a patient’s should droop and the scapula is displaced downward and laterally…what does this mean? Which CN might be effected?

A

CN XI Spinal Accessory

Trapezius muscle paralysis

131
Q

The patient’s tongue is protruding and toward the side of the CN ____ lesion

A

CN XII Hypoglossal

132
Q

The whispered voice tests CN ___

A

CN VIII Vestibulocochlear

133
Q

A peripheral injury to CN ___ , as seen in Bell’s Palsy, affects both the upper and lower face

A

CN VII Facial

134
Q

You notice flattening of the nasiolabial fold and drooping of the lower eyelid that suggests facial weakness. There is a problem with CN ___

A

CN VII Facial

135
Q

What 3 senses do you test for CN V (trigeminal)

A

light touch, pain, temperature

136
Q

Your patient is having difficulty clenching their jaw, what CN dysfunction is this?

A

CN V trigeminal

137
Q

Which cranial nerve palsy would you see ptosis?

A

CN III Oculomotor

Health Assessment (3 decks)

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