Week Four

Question 1

What is anosomnia?

Answer 1

Loss of smell (effects on olfactory nerve)

Question 2

What is ptosis?

Answer 2

Drooping of the eyelid is called ptosis. Ptosis may result from damage to the nerve that controls the muscles of the eyelid, problems with the muscle strength (as in myasthenia gravis), or from swelling of the lid.

Question 3

What is strabismus?

Answer 3

Also known as hypertropia and crossed eyes — is misalignment of the eyes, causing one eye to deviate inward (esotropia) toward the nose, or outward (exotropia), while the other eye remains focused.

Question 4

What is atrophy?

Answer 4

(of body tissue or an organ) waste away, especially as a result of the degeneration of cells, or become vestigial during evolution.

Question 5

What is hypertrophy?

Answer 5

the enlargement of an organ or tissue from the increase in size of its cells

Question 6

What is paresis?

Answer 6

a condition of muscular weakness caused by nerve damage or disease; partial paralysis.

Question 7

What is plegia?

Answer 7

paralysis

Question 8

What is flaccidity?

Answer 8

A type of paralysis in which a muscle becomes soft and yields to passive stretching, which results from loss of all or practically all peripheral motor nerves that innervated the muscle

Question 9

What is hypoalgesia?

Answer 9

is diminished pain in response to stimulation that typically produces pain.

Question 10

What is hyperalgesia?

Answer 10

a symptom that causes unusually severe pain in situations where feeling pain is normal, but the pain is much more severe than it should be.

Question 11

What is hypoaesthesia?

Answer 11

an abnormal sensory response in which sensation is reduced in one or more body parts in response to a stimulus such as touch, vibration or cold temperature. Partial numbness occurs where and when an individual would expect to feel touch, vibration or change in temperature.

Question 12

What is hyperaesthesia?

Answer 12

a neurological condition that causes a person extreme sensitivity to touch, pain, pressure, and thermal sensations

Question 13

What is a screening neurological examination?

Answer 13

Healthy patient with no significant history of a neurological issue

Question 14

What is a complete neurological examination?

Answer 14

If the patient has answered “yes” to questions and shows signs of neurological issues

Question 15

What is a neurological recheck examination?

Answer 15

If the client is having/showing deficits or a difference in their status… looking for either a positive change or a negative change

Question 16

Testing the Cranial Nerves:
Olfactory Nerve (I)

Answer 16

1) Client closes their eyes and has to smell the scents put under their nose (cinnamon or vanilla)

2) Client occludes each nare individually by plugging each nostril individually and breathing in and out to check the patency

Question 17

Testing the Cranial Nerves:
Optic Nerves (II)

Answer 17

Snellen Chart

Question 18

Testing the Cranial Nerves:
Occulomotor (III), Trochlear (IV) and Abducens Nerves (VI)

Answer 18

1) Ask patient to open eyes and close them and assess for uniform opening and symmetry (any drooping?) this is known as palpebral fissure

2) Testing the 4 visual quadrants by getting the patient to follow your pen without moving their head but moving their eyes while you move the pen to the 4 visual quadrants. Watch to see how their eyes move.

3) Assess patients pupillary reaction and size

Question 19

Testing the Cranial Nerves:
Trigeminal Nerve (V) motor or sensory

Answer 19

1) Get patient to grit their teeth and close their mouth and then as the nurse attempt to pull their chin/jaw open (it should remain closed)

2) Place fingers on jaw bones and ask patient to open and close mouth – you might feel crepitus while they do this

Question 20

Testing the Cranial Nerves:
Facial Nerve (VII) motor and sensory

Answer 20

1) Sensory: Test sensation in 3 Zones with a cotton swab and get patient to close their eyes
- Forehead
- Midzone (both cheeks)
- Chin

2) Motor: Get patient to raise eyebrows and look for symmetry in forehead creases, smile and look for symmetry, or puff cheeks out to assess for even muscle tone on either side of facde

Question 21

Testing the Cranial Nerves:
Acoustic Nerve (VIII)

Answer 21

1) Whisper test

2) Tuning Fork –>
Conduct the Rinne Test
- Air conduction: place the tuning fork prongs perpendicular on the ear
-Bone Conduction: Place the base of the tuning fork perpendicular above the ear on the bone to see if they can feel the vibrations

Webers test:
- Place the base of the tuning fork on the top of the patients head and ask if they can hear the sound equally bilaterally in both ears

Question 22

Testing the Cranial Nerves:
Glossopharyngeal Nerve (IX) and Vagus Nerve (X)

Answer 22

1) Ask patient if they have a sensitive gag reflex

2) Then take a tongue depressor and get the patient to open their mouth, place the tongue depressor on their tongue and get them to say “Ahhhh”
Assess for:
- The uvula moving upwards
- The tonsils moving to the side

Question 23

Testing the Cranial Nerves:
Spinal Accessory Nerves (XI)

Answer 23

1) Place hand on patient cheek and get them to try to move their head against the resistance of your hand towards midline

Question 24

Testing the Cranial Nerves:
Hypoglossal Nerve (XII)

Answer 24

1) Get patient to stick tongue out to assess

2) Then with the tongue back in their mouth, get the patient to state these three words to assess their speech
–> “Light, tight, dynamite”

Question 25

What do you assess the muscles for?

Answer 25

• Size (are the muscles symmetrical bilaterally)
• Strength
• Tone

Question 26

How do you test a patients muscle tone?

Answer 26

test patients ability to go limp and then do passive ROM (there should always be some resistance)

Question 27

What is nystagmus?

Answer 27

Abnormal pupil movement

Question 28

What is the Romberg Test?

Answer 28

Ask the patient to stand up with feet together and arms at the sides. Once they are in a stable position, ask the patient to close the eyes and to hold the position. Wait approximately 20 seconds

Question 29

What is the Romberg test assessing?

Answer 29

the patients balance in regard to their cerebellar function

Question 30

How do you assess the patients Gait?

Answer 30

• Get the patient to walk 3-6 meters (ensure to walk behind the patient) then get them to turn and walk back

Question 31

What do coordinated and skilled movements assess?

Answer 31

cerebellar function

Question 32

What are 4 different ways to assess coordination and skilled movements?

Answer 32

1) Rapid alternating movements (palms on knees and flip hands over really fast- dorsal and palm)

2) Finger-to-finger test

3) Finger-to-nose test

4) Heel-to-shin test

Question 33

Assessing the Sensory System:
Spinothalamic Tract

Answer 33

1) Pain - use a sterile cue tip and rotate between the cue tip and the sharp end of it and ask patient if they feel “sharp” or “dull” sensations when touched on both upper and lower extremities bilaterally

2) Temperature - only used when unable to decipher the pain

3) Light Touch - touch a cotton swab/wisp on upper and lower extremities bilaterally and ask if they feel it

Question 34

Assessing the Sensory System:
Posterior Column Tract

Answer 34

1) Vibration (use a fine tune fork and place it on the second finger joint and ask if they feel the vibrations)

2) Position/Kinesthesia (passively manipulate fingers and big toe and ask patient “is it pointing up or down?”

3) Tactile discrimination (fine touch)

Question 35

Assessing the Sensory System:
Posterior Column Tract

How do you assess tactile discrimination?

Answer 35

1) Stereognosis (Place a familiar object in hand with pts eyes closed - ask patient if they recognize what object they are holding)

2) Graphesthesia (pt holds palm out with eyes closed and nurse traces a # or a letter on it and asks patient what they drew on their palm)

3) Two-point discrimination (pt’s eyes closed, use both finger tips and have finger tips start at different points on the limb and then bring the finger tips closer together while touching the limb and ask the patient how many fingers they feel. Do this on both upper and lower extremities bilaterally)

4) Extinction

5) Point Location

Question 36

What is dizziness?

Answer 36

feeling light headed, foggy, or spinning

Question 37

What is vertigo?

Answer 37

Feeling rotational spinning

Question 38

What is the difference from subjective vertigo and objective vertigo?

Answer 38

Subjective Vertigo: The patient is spinning

Objective Vertigo: The room is spinning

Question 39

What is some subjective data that the examiner will ask a patient in a neurological assessment?

Answer 39

• Headache
• Head Injury
• Seizures
• Difficulty swallowing
• Tremors
• Weakness (generalized or local)
• Dizziness/vertigo
• incoordination
• numbness/tingling sensation
• Difficulty speaking
• Significant past history (CVA?)
• Environmental/Occupational considerations (toxins in the workplace?)

Question 40

What is some additional subjective data that the examiner should ask when assessing an older adult?

Answer 40

• Risk for falls
• Tremor
• Vision
• Cognitive function

Question 41

What is paresthesia?

Answer 41

a burning or prickling sensation that is usually felt in the hands, arms, legs,