NR 304 Neuro Assessment Flash Cards

What 3 cranial nerves do we check when assessing extraocular muscles?

III, IV, and VI (3, 4, and 6 make the eyes do tricks)

(def)involuntary eye movement

nystagmus

What level of consciousness? arouses to stimulation/ responds with 1-2 words/ follows 1 step commands to stimulation

obtunded

What are localizing movements?

moving toward or removing a painful stimulus/moving away from a stimulus

How can the ulnar nerve be damaged?

- direct pressure- prolonged exposure to pressure- compression due to injury or swelling

What 5 things compose the mental status exam?

- general appearance and behavior - state of consciousness - mood and affect - thought content - intellectual capacity

What is the Romberg test and how is it performed?

- neurological test to detect poor balance and coordination- have patient stand still with heels together and to close their eyes. If the patient loses their balance, the test is positive

How do you perform a cerebellar test?

- observe for leaning to one side - test finger to nose, making sure patient fully extends arm **weakness occurs on the side with the deficit**

Which Cranial Nerve? moves tongues

CN XII (hypoglossal)

The cerebellum controls what 3 things?

1. Balance 2. Coordination 3. ability to perform skilled movements

What are the 3 components of the glasgow coma scale?

1. Eye opening 2. Motor Response 3. Verbal Response

How can the median nerve be injured? (3)

1. Trauma 2. entrapment (pressure here the nerve passes through a narrow structure) 3. Inflammation

What are 3 causes for injury to the radial nerve?

1. direct trauma (broken arm)2. prolonged pressure on the nerve (under arm pressure such as "crutch palsy")3. compression of the nerve due to swelling or injury to nearby structures

What are the 5 types of stimuli used to gauge a response (in order, from the first mechanism attempted to the last)?

1.Voice 2. Touch 3. Shaking 4. voice and shaking 5. noxious/painful stimuli

What does a Heel-to-toe test assess for?

Abnormalities in coordination, balance, and ability to perform skilled movements

How are EOM's tested?

BY assessing cardinal fields of vision for coordination and alignment

Which Cranial Nerve?Smell

CN I (Olfactory)

Which Cranial Nerve? Vision

CN II (Optic)

Which Cranial Nerve? moves eyes in all directions except outward and down&in/ constricts pupil/ opens eyelid

CN III (Oculomotor)

Which Cranial Nerve? moves eyes down and in

CN IV (Trochlear)

Which Cranial Nerve? moves the pharynx (swallow, speech & gag)

CN IX (glossopharyngeal)

Which Cranial Nerve? Has 3 branches- sensation to the face/cornea and the scalp/ opens jaw against resistance

CN V (Trigeminal)

Which Cranial Nerve? moves eyes outward

CN VI (abducens)

Which Cranial Nerve? moves the face/ taste

CN VII (Facial)

Which Cranial Nerve? Has 2 branches/ hearing and balance

CN VIII (Acoustic)

Which Cranial Nerve? Voice Quality

CN X (Vagus)

Which Cranial Nerve? turns head and elevates shoulders

CN XI (Spinal Accessory)

True/False: Mental status remains constant throughout life.

False- age related changes occur during growth and development.

True/False: A person who cannot be woken should be documented as unconscious on the medical chart.

False- this is a non-medical term, refer to proper medical terminology

How do we assess convergence of the eyes?

Move your finger towards the client's nose/eyes should converge (cross-eyed appearance)

When assessing orientation (state of consciousness), you should ask what type of questions to determine mental status?

Person, place & time *What is your name? What is your spouse's name? *Where are you? What is the state capitol? *What day is it? What year is it?

Language and speech are assessed together.What part of the brain controls this?

The left (dominant) side

Which side of the brain controls written and spoken language, reasoning, number skills, scientific knowledge and right hand control.

The left side

How do we assess the pupil's accommodation?

The normal pupil constricts when focused on a near object and dilates when focused on a far object

How do you assess the motor function of this nerve?: Ulnar nerve

abduction of fingers (spread fingers apart)

(def)a disorder in processing language

aphasia

(def)a disorder in programming speech (saying the wrong word)

apraxia of speech

Eye opening is what component of consciousness?

arousal

(def) Loss of the ability to coordinate muscular movement.

ataxia

If a person if fully conscious, we document this how?

awake, alert, and oriented x 4

(def) aware of self and the environment with the ability to focus and interact

awareness

What part of the brain is tested when assessing coordination, smooth movement, and position sense?

cerebellum

Mental status determine ________functioning.

cerebral

What level of consciousness? sleep-like state with eyes closed/ does not respond appropriately to bodily or environmental stimuli/ no verbal sounds

comatose

What level of consciousness? disoriented to time, place, person, or situation/ short attention span/poor memory/ easily bewildered confused

confused

Moving towards a painful stimulus is an action triggered in what part of the brain?

cortex

What are purposeful movements?

direct, specific movements (scratching nose, etc)

What is sixth nerve palsy? How do you assess for it?

double vision- cover one eye, should correct if positive. Offer a patch over the "good" eye

When is mental status assessed?

during history

(def) a disorder in the mechanics of speech

dyarthria

(def) a lack of coordination of movement, typified by the undershoot or overshoot of intended position with the hand, arm, leg, or eye

dysmetria

What are non-purposeful movements?

flexion, abnormal extension, fisted hands, flexed wrists, etc.

How do you assess the motor function of this nerve?: Radial Nerve

have client move wrist back and forth

How do you assess the motor function of this nerve?: Median nerve

have client perform thumb opposition with remaining 4 fingers

How do you assess the motor function of this nerve?: peroneal nerve

have the client dorsiflex foot (up)

How do you assess the motor function of this nerve?: Femoral nerve

have the client perform a straight leg raise

How do you assess the motor function of this nerve?: Tibial nerve

have the client plantar flex foot (down)

Moving away from a painful stimulus is an action triggered in what part of the brain?

hypothalamus

What level of consciousness? oriented with slow, sluggish speech and mental processes/responds appropriately

lethargic

Carpal tunnel syndrome is linked to what nerve?

median nerve

A glasgow coma scale score of 13 indicates what?

mild brain injury

A glasgow coma scale score of 9-12 indicates what?

moderate brain injury

How do we assess the pupil's reaction to light?

penlight is moved from the side to in front of the client's eye, pupil should constrict

Injury to the knee, leg, or fibula could damage what nerve?

peroneal nerve

The tibial and peroneal nerves are branches of what larger nerve?

sciatic nerve

A glasgow coma scale score <8 indicates what?

severe brain injury

How do you assess the sensory function of this nerve?: Femoral Nerve

stroke the anterior thigh

How do you assess the sensory function of this nerve?: tibial nerve

stroke the sole of the foot

How do you assess the sensory function of this nerve?: peroneal nerve

stroke the web space between the 1st and 2nd toe

What level of consciousness? lies quietly with minimal movement/responds only to vigorous and repeated stimulation/ opens eyes and responds to pain appropriately/ makes incomprehensible sounds

stuporous

Which side of the brain controls insight, 3-d forms, art and music awareness, imagination, and left hand control?

the right side

What assessment is done if the pain sensation test results show an area(s) non-reactive to pain?

the temperature sensation test (test temperature sensation by using hot and cold vials against the skin)

How do you assess the sensory function of this nerve?: median nerve

touch or stroke the tip of the second finger

How do you assess the sensory function of this nerve?: Ulnar nerve

touch or stroke tip of the 5th finger

How do you assess the sensory function of this nerve?: radial nerve

touch the space between the thumb and 2nd finger

True/False: When assessing the patient, you should look for symmetry, therefore you always compare left to right.

true

Prolonged pressure to the base of the palm of the hand may injure what nerve?

ulnar nerve

What nerve is commonly injured at the elbow due to elbow fracture or dislocation?

ulnar nerve

Describe how to do a sensory assessment?

use a wisp of cotton and lightly touch one specific spot, and then the same spot on the other side of the body. Patient says yes when cotton if felt.

What is a pain assessment?

using the blunt and sharp points of a reflex hammer, have the client say sharp or dull as you touch anatomical areas at random