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    Neuro Ass

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    Imee Balbido Mallari
    The document outlines the components of a neurological exam, including mental status, cranial nerves, reflexes, motor skills, and sensory function. It describes how to assess each component, such as using the Glasgow Coma Scale to evaluate level of consciousness or testing light touch, vibration, and proprioception during the sensory exam. The exam concludes with assessing cerebellar function through gait, coordination, and balance tests and evaluating deep tendon reflexes.

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    Neuro Ass

    Uploaded by

    Imee Balbido Mallari
    242 views33 pages
    The document outlines the components of a neurological exam, including mental status, cranial nerves, reflexes, motor skills, and sensory function. It describes how to assess each component, such as using the Glasgow Coma Scale to evaluate level of consciousness or testing light touch, vibration, and proprioception during the sensory exam. The exam concludes with assessing cerebellar function through gait, coordination, and balance tests and evaluating deep tendon reflexes.

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    The document outlines the components of a neurological exam, including mental status, cranial nerves, reflexes, motor skills, and sensory function. It describes how to assess each component, such as using the Glasgow Coma Scale to evaluate level of consciousness or testing light touch, vibration, and proprioception during the sensory exam. The exam concludes with assessing cerebellar function through gait, coordination, and balance tests and evaluating deep tendon reflexes.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    242 views33 pages

    Neuro Ass

    Uploaded by

    Imee Balbido Mallari
    The document outlines the components of a neurological exam, including mental status, cranial nerves, reflexes, motor skills, and sensory function. It describes how to assess each component, such as using the Glasgow Coma Scale to evaluate level of consciousness or testing light touch, vibration, and proprioception during the sensory exam. The exam concludes with assessing cerebellar function through gait, coordination, and balance tests and evaluating deep tendon reflexes.

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    The Neurological System

    Neurological Exam 5 Components


    Mental status Cranial nerves Reflexes Motor- includes Cerebellar function Sensory

    Mental Status Examination

    Examination - ABCT
    Appearance Behavior Cognition Thought

    processes (thought content & perceptions)

    Mini Mental State Exam Glasgow Coma Scale

    Assessing LOC: Glasgow Coma Scale

    Eye opening

    Verbal responsiveness

    Motor responsiveness
    4

    Glasgow Coma Scale

    Physical Examination Levels of Consciousness Alert- awake or easily aroused Lethargic- not fully alert, drifts off when not stimulated Obtunded- sleeps most times, difficult to arouse (loud noise, vigorous shaking or pain) Stupor- need persistent loud noise or pain for arousal; responds to stimuli Coma- no response (Jarvis CH 2)
    6

    Cranial Nerves

    On old Olympus Towering Tops a

    Finn and German Viewed some hops.

    I Olfactory II Optic III Occulomotor IV Trochlear V Trigeminal VI Abducens

    VII - Facial VIII Auditory (V-C) IX - Glossopharyngeal X - Vagus XI Spinal Accessory XII - Hypoglossal
    7

    Neurological: Physical Examination


    Sensory System Function

    With eyes closed Interpret sensations Discriminate side to side Examine in detail if: Reduced sensation Numbness or pain Motor or reflex abnormal Skin changes

    Be specific: tell me where I

    Physical Examination Sensory Function Tests:

    Touch
    Light

    touch 1st then Pain & Temperature

    Vibration Proprioception: Position sense Stereognosis Graphesthesia 2-point discrimination


    9

    Sensory Function Tests: Sensory Exam: Light Touch

    10

    Sensory Function Tests: Sensory Exam: Vibration

    11

    Sensory Function Tests: Proprioception: Position sense

    12

    Sensory Function Tests: Stereognosis

    13

    Sensory Function Tests: Graphesthesia

    14

    Sensory Function Tests: Two-point discrimination

    15

    Sensory Function Tests: Dermatomes

    16

    Motor Examination
    Symmetry, size, and presence f involuntary movements Full ROM of joints Check strength against resistance

    Neuro patients: Assess hand grips and foot pushes if bedridden

    17

    Cerebellar Function
    1. Gait and posture Heel to toe in straight line Walking on toes and heels Hop on one foot Note width of gait

    18

    Cerebellar Function, cont 2. Coordination of hands and legs RAM nose to examiners finger heel to shin coordination
    19

    Cerebellar Function, cont RAM

    20

    Cerebellar Function, cont Nose to - Finger Test

    21

    Cerebellar Function, cont Heel to Shin

    22

    Cerebellar cont
    Romberg: Stand upright, place feet together, then close eyes loss of balance means + Romberg test
    3.

    Be prepared to protect client from falling!


    23

    4 types of Reflexes
    Abdominal Reflex

    Superficial (abdominal reflex, Cremasteric reflex) Visceral (pupillary response to light) PERRL Pathologic
    +

    Cremastic Reflex

    Babinski in adults

    DTRs (e.g. knee)


    24

    Reflexes-Cont: PERRL/PERRLA

    25

    Reflexes-Cont:
    Babinskis Reflex (Adult)

    26

    Reflexes-Cont: Reflex Arc Deep Tendon Reflex

    27

    Reflexes-Cont:
    Deep Tendon Reflexes
    Technique

    Position limb so muscle is slightly stretched Reflex hammer should strike tendon briskly to stretch tendon Get patient to relax

    28

    BRACHIORADIALIS

    BICEPS

    ACHILLES/PLANTAR TRICEPS

    PATELLAR DEEP TENDON REFLEXES


    29

    Grading of DTRs
    4+ 3+ 2+ 1+ 0

    very brisk brisker than average average, normal diminished, low normal no response

    30

    Assessment Guide: Neurological


    LOC: alert, comatose, lethargic, obtunded GCS Eye opening: spontaneously, to speech, to pain Verbal Response: oriented, confused, inappropriate, incomprehensible Motor Response: obeys, command, localizes pain, withdraws, flexion, extension

    31

    Assessment Guide : cont..

    Seizure
    Describe:

    tonic clonic, absence, status epilepticus Timing: once at 10 am; 2 pm and 2:45 pm

    32

    Altered mental status: yes, no Aphasia: present, none Intelllectual functioning: intact; short attention span, dementia, memory loss Itnerventions in use:

    Seizure

    precautions: side rails padded, oral airway at bedside Med List: Klonopin, Aricept, Neurontin, Dilantin, etc.

    33

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