Neurological Assessment

Question 1

What is a neurological assessment?

Answer 1

A thorough neurologic assessment will include assessing mental status, cranial nerves, motor and sensory function, pupillary response, reflexes, the cerebellum, and vital signs. However, unless you work in a neuro unit, you won’t typically need to perform a sensory and cerebellar assessment.

Question 2

What are the three main parts of the brain?

Answer 2

• Cerebrum
• Cerebellum
• Brain stem

Question 3

What is the cerebrum responsible for?

Answer 3

Initiation of movement, coordination of movement, temperature, touch, vision, hearing, judgment, reasoning, problem solving, emotions, and learning.

Question 4

What is the cerebellum responsible for?

Answer 4

Busy planning, adjusting and executing movements of the body, the limbs and the eyes. It plays a major role in several forms of motor learning. The evidence for a role for the cerebellum in cognitive functions is rather weak.

Question 5

What is the brain stem responsible for?

Answer 5

Is in charge of all the functions your body needs to stay alive, like breathing air, digesting food, and circulating blood.

Question 6

How many hemispheres does the brain have?

Answer 6

Two- A longitudinal fissure or division separates the brain into two distinct cerebral hemispheres, connected by the corpus callosum. The sides resemble each other and each hemisphere’s structure is generally mirrored by the other side.

Question 7

How many lobes does the brain have?

Answer 7

Four lobes- Each side of your brain contains four lobes. The frontal lobe is important for cognitive functions and control of voluntary movement or activity. The parietal lobe processes information about temperature, taste, touch and movement, while the occipital lobe is primarily responsible for vision.

Question 8

What are the names of the four lobes?

Answer 8

Parietal, frontal, temporal and occipital

Question 9

What is the frontal lobe responsible for?

Answer 9

Important for cognitive functions and control of voluntary movement or activity.

Question 10

What is the parietal lobe responsible for?

Answer 10

Processes information about temperature, taste, touch and movement.

Question 11

What is the temporal lobe responsible for?

Answer 11

Processes memories, integrating them with sensations of taste, sound, sight and touch.

Question 12

What is the occipital lobes responsible for?

Answer 12

Primarily vision.

Question 13

When might you do a neurological assessment?

Answer 13

• Stroke (Infarct, Haemorrhagic)
• Alzheimer’s
• Parkinsons
• Concussion
• Brain tumour/abscess
• Migraine
• Epilepsy
• Traumatic brain injury (TBI)
• Intracranial haematoma
• Encephalitis (viral, inflammatory)
• Reye’s syndrome
• Meningitis
• Medication misuse i.e. opiods

Question 14

What is ACBDE?

Answer 14

A= Airways
B= Breathing
C= Circulation
D=Disability
E= Exposure/Environment

Question 15

What is AVPU?

Answer 15

A= Alert
V= Voice
P= Pain
U= Unresponsive

Question 16

What is the GCS (Glasgow Coma Scale)?

Answer 16

Allows healthcare professionals to consistently evaluate the consciousness level of a patient. By regularly assessing a patient’s GCS, a downward trend in consciousness level can be recognised early, allowing time for appropriate interventions to be performed.

Question 17

What does the GCS look at?

Answer 17

The scale looks at responses in eye opening, verbal responses and motor responses.

Question 18

What is the the GCS scale out of?

Answer 18

Out of 15

Question 19

What is a severe GCS score?

Answer 19

Less than 8

Question 20

What is a moderate GCS score?

Answer 20

9-12

Question 21

What is a mild GCS score?

Answer 21

> 13

Question 22

What would you do for a patient with a severe GCS score ?

Answer 22

Intubation and ventilation

Question 23

When would you use painful stimuli in GCS?

Answer 23

• Painful stimuli should only be introduced to assess GCS if the patient does not respond to clear verbal commands.
• Should last 10 seconds to avoid soft tissue damage and unnecessary pain.
• Central stimuli include: Trapezium pinch/squeeze and supraorbital pressure.

Question 24

What are pupils?

Answer 24

Pupils are located in the centre of the iris, function is to control light entering the eye, it does this by contraction and dilation.

Question 25

How are pupils assessed in GCS?

Answer 25

• Pupils are assessed individually
• Size and reactivity provides insight into the function of the 3rd cranial nerve
• Normal pupils may vary in size but should be equal and will react by briskly constricting when a light source is introduced

Question 26

How is limb power assessed in GCS?

Answer 26

• Each limb assessed individually
• Normal power/strength
• Mild weakness
• Severe weakness
• Extension
• No response

Question 27

What does a neurological assessment also look at?

Answer 27

History Taking/ vital observations - You may need input from the patients friends, relative etc. if the patient has an altered state of consciousness.