330 Neuro Assessment

Question 1

Cranial nerve 1 is intact

Answer 1

patient reports no change in smell

-Just ask if change in smell

Question 2

Cranial nerve 2 is intact

Answer 2

visual acuity intact as evidenced by the Snellen and near vision screening

-Snellen test: pt 20 feet from chart cover 1 eye and read lowest line possible
-Near vision test: give pt card hold 14 inches from eyes, see if they move it farther or closer as they read

Question 3

Cranial nerve 3, 4, & 6 is intact

Answer 3

PERRLA & EOM’s intact
-EOM: have pt follow 6 cardinal directions

Question 4

Cranial nerve 5 is intact

Answer 4

temporal and masseter muscles strong bilaterally equal, Sensation of forehead, cheeks, and chin intact equal bilaterally

-Have pt clench teeth, touch forehead, cheeks, chin laterally with qtip

Question 5

Cranial nerve 7 is intact

Answer 5

Facial muscles symmetrical bilaterally and patient reports no change in taste
-Have pt close eyes tightly, lift eyebrows, puff cheeks, frown, smile, show teeth
-Ask if change in taste

Question 6

Cranial nerve 8 is intact

Answer 6

gross hearing intact
-Stand behind pt and whisper “peanut” as they cover one ear, repeat with other ear “Flower”

Question 7

Cranial nerve 9 & 10 is intact

Answer 7

patient uvula rises and falls with phonation, and patient reports no difficulty in swallowing

Question 8

Cranial nerve 11 is intact

Answer 8

trapezius and sternocleidomastoid muscles are strong equal bilaterally
-Have put shrug shoulders up while w/ your hands on their shoulders
-Hand on cheek and have pt push same direction as your hand

Question 9

Cranial nerve 12 is intact

Answer 9

tongue midline, no tremors, speech clear and distinctive.
-Stick tongue out , move side to side
-Assess speech

Question 10

Subjective data that would lead to a neuro assessment?

Answer 10

Garbled speech, gait (instability), decreased sensation, seizures, tremors, headache, loss of balance, weakness, change in mood or demeanor

Question 11

What tools do you need for neuro assessmet?

Answer 11

1. Pen light
2. Percussion hammer
3. Q tip

Question 12

What are the every patient every time things you have to do before a neuro assessment?

Answer 12

LOC
Orientation
Pain
Explain/Permission

Question 13

How would you test sensory response?

Answer 13

Break a q tip in half show the patient what the sharp and dull feels like with their eyes open
Then have them close their eyes and guess if it is sharp or dull end

Question 14

How woulds you test cerebellar function?

Answer 14

Tandem walk: head to toe walk as you are beside them

Romberg: stand with feet together and eyes closed for 30 seconds, assess any sway, expected is NEG romberg

Question 15

How do you assess deep tendon reflexes?

Answer 15

Patellar: hit knee reflex with percussion hammer and grade

Plantar reflex: drag hand up the bottom of foot to see if toes have a normal negative babinski response where toes flex down

Question 16

How would you assess muscle strength and symmetry?

Answer 16

Upper extremities: Have pt push and pull their elbows as you give resistance

Lower extremities: Have pt push and pull their calfs as you give resistance

Pronator drift: raise hands and close eyes for 30 seconds to see if one hand drifts