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N211F > CNS II > Flashcards

CNS II Flashcards

12 cranial nerves assessment (49 cards)

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1
Q

CN I assessment procedure

A

present props (coffee & soap) to one of the nostril & another one being occluded

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2
Q

CN I assessment abnormal result

A

inability to identify correct scent > loss of smell > inability to smell

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3
Q

CN I assessment normal result

A

correctly identify scent

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4
Q

CN II assessment 4 areas

A
  1. pupillary reaction
  2. vision acuity
  3. vision field
  4. optic fundi
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5
Q

CN II vision acuity assessment procedure

A

Snellen chart: 20 feet distance away
Newspaper: 35 cm away

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6
Q

CN II visual field assessment procedure

A

confrontation test in 4 visual qaurdrants

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7
Q

CN II optic fundi assessment procedure

A

use ophthalmoscope to assess retina & optic disc

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8
Q

CN II pupillary reaction assessment procedure

A

direct & concensual test
(react to direct light source on one side & another side also react by constriction)

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9
Q

CN II vision acuity assessment normal result

A

Snellen chart: test with one eye covered
Documentation: 20/20 vision (=able to see what an average person can see 20 feet away)

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10
Q

CN II optic fundi assessment normal result

A
  1. round red reflex is presented
  2. retina is pink
  3. optic disc: 1.5mm, round & oval shape, clear margin, creamy pink & paler physiologic cup
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11
Q

CN II vision acuity assessment abnormal result

A

Snellen chart: difficulty in reading, squinting eye
newspaper: closer > 35 cm/ farther (persbyopia, occur when aging)

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12
Q

CN II vision field assessment abnormal result

A

loss of vision field: retina damage/ detachment; parietal cortex lesion; optic nerve lesion

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13
Q

CN II & III assessment procedure & documentation

A

use penlight for direct & concensual response
Documention: PERRLA
pupil equal, round, react to light, accomodation

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14
Q

CN II & III assessment normal result

A
  1. bilateral illuminated pupils constrict simltaneously
  2. benign anisocoria: differ >0.5mm & reaction
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15
Q

CN II & III assessment abnormal result

A
  1. dilated pupils (6-7mm): oculootor paralysis
  2. Argyll Roberston pupils: neurosyphilis, alcoholism
  3. constrited/ fized pupils: narcotic abuse
  4. unilateral pupil unresponsive to loght/ no accomodation: CN III (oculomotor) damage
  5. Constricted pupils unresponsive to light/ accomodation: synpathetic nervous system lesion
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16
Q

CN II & III assessment abnormal result: signs of Argyll Roberston

A
  1. small pupils
  2. non-reactive to light
  3. do accomodate
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17
Q

CN III & IV & V assessment procedure

A

observe pt’s eyes movement by requiring pt to follow a moving target to detect nystagmus

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18
Q

CN III & IV & V assessment normal result

A
  1. PERRLA: pupil equal, round, reactive to light, accomodation
  2. smooth & coordinated movement in all directions
  3. eyelid cover 2mm of the iris
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19
Q

CN III & IV & V assessment 3 area

A
  1. margins of the eyelids
  2. extraoculor movement
  3. pupillary reaction
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20
Q

CN III & IV & V assessment 4 abnormal result

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A
  1. abnormal pupillary reaction
  2. limited eye movement in the 4 area
  3. strabismus
  4. Nystagmus (rhythmic ocillation of the eyes)
21
Q

CN VI chewing function assessment procedure

Study These Flashcards
A

ask pt to clentch and palpate temporal & messester muscle contraction

22
Q

CN VI sensation of 3
divisions (ophthalmic,
maxillary, mandibular) assessment procedure

Study These Flashcards
A
  1. pt close eyes > use dull simulus (paper clip) to touch 3 divisions
  2. pt look up & away from examiner > use fine wisp cotton paper to approach pt’s cornea from out of his line of vision
23
Q

CN VI 3 areas of assessment

Study These Flashcards
A
  1. cornea reflex
  2. motor: messester &　temporal
  3. sensation: pain, temperature & tactile sensation
24
Q

CN VI assessment normal result

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A

bilateral contraction of temporal & messester

25
CN VI assessment abnormal result
1. unilateral/ bilateral sides muscle weakness 2. pain when clentching 3. decrease contraction on one/ both sides 4. asymmetrical strength in moving jaw
26
CN VIII assessment procedure
1. Weber, Rinne & Whisper test 2. ask pt to close their eyes & stand for 20s & inspect their stability
27
CN VIII assessment normal result
1. Weber: Vibration should be heard by both sides of the ears 2. Rinnie: Air Conduction > Bone conduction 3. Whisper: hear whispered words clearly from 1-2 feet away
28
CN VIII assessment abnormal result
1. Air conduction is not as twice longer than bone conduction 2. Vibratory sounds is lateralized in good ears
29
CN IX& X assessment proedure
1. ask patient to say 'ahh' 2. bilateral & symmetrical arise of soft palete & uvula, without hoarse 3. take a sip of water to see ability to swallow 4. use tongue depressor to lightly touch posterior part of the tongue to see gag reflex
30
CN IX& X assessment 3 areas
1. motor function of pharyn larynx, soft palete 2. gag reflex 3. ability to swallow
31
CN IX & X assessment normal result
1. soft palete & uvula arise bilaterally & symmetrically while phonation 2. Swallow without difficulties & without hoarseness 3. gag reflex present
32
CN IX & X assessment 3 abnormal result
1. hoarseness present 2. absent of gag reflex 3. soft palete do not arise bilaterally
33
CN XI assessment procedure
1. inspect symmetry of scapula & neck & shoulder muscle 2. apply counterforce when ask pt to turn their head to left/ right > test sternocleidomastoid strength against force 3. apply countreforce when ask pt to shrug their shoulders > test trapezius
34
CN XI assessment normal result
1. strong contraction of sternocleimastoid oppposite the side where the face turn to 2. symmetrical & strong contraction of trapezius
35
CN XI assessment abnormal result
1. muscle weakness 2. muscle atrophy/ fasciculaton 3. asymmetrical muscle contraction
36
CN XII assessment procedure
1. ask pt to stick out his tongue & move from side to side 2. ask pt to say 'light' & 'tight', notice their pronunciation
37
CN XII assessment normal result
smooth & symmetric tongue movement bilateral strength
38
CN XII assessment abnormal result
1. tongue atrophy/ fasciculation 2. tongue deviation
39
Motor & cerebellum system: how to test condition & movement of muscle
observe gait weight should be evenly distribued stand on toes & heels
40
Motor & cerebellum system: Romberg test
To test balance ask patient to stand up & oserve any unsteadiness & imblanace ask patient to close eyes for 20s, observe imbalance & swaying
41
Motor & cerebellum system: 5 tests for coordination
1. tandem walking: walk on straight heels & toes 2. tandem stand: stand on one foot, do a shallow knee bend/ hop 3. rapid hand alternation movement 4. finger to nose 5. heel slide test
42
What is the sequence of sensation test?
light touch> pain> temperature from dital to proximal each limb
43
what instrument is use for vibration sensation test?
tunning fork from distal to proximal each limb
44
2 tests for testing tacile discrimmination
1. test position sense 2. stereognosis: recognize objects by touching
45
point localization test
breifly touch patient> ask to identify which point is being touched
46
What is graphesthesia?
use intrument to write number on patient's hand, a kthem to identify the numbers written
47
two point discrimmination test
patient cloed eye> identify number of points being touched with EKG calibers> when patient no longer separate 2 point: measure the distance of the two points
48
How to test extinction
simultaneously touch the same area of the both side of the body, ask patient to identify the area touched
49
Kernig’s signs & Brudzinski’s sign & testing neck's mobility is for?
meningeal irritation/ inflammation

N211F (14 decks)

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