Neurological Assessments Flashcards
What are the 7 Key Components to a Neurological Assessment?
Acronym= Mental HEMP MC
Neurological Assessment:
Mental- Mental Status (AVPU, GCS, Memory, Amnesia)
H- History
E- Eye Assessment (pupils, gaze, tracking, nystagmus, accomodation)
M- Motor Assessment (motor function, sensory function, movement disorders [eg. tics, tremors, jerks, athetosis]
P- Pyramidal Dysfunctions (dystonia, akinesia, akathesia, tardive dyskinesia)
M- Meningism (neck stiffness, kernigs sign, brudzinski sign)
C- Cranial Nerves (assess smell, eyes, face, hearing, mouth, neck/shoulders)
What are the two ways of assessing: Mental Status
(Hint- think of the 2 acronyms)
**AVPU- **Pt is alert, pt responds to voice, pt responds to pain, pt is unconscious
**GCS- **Assessment of Eyes (/4), Verbal (/5), Motor (/6)- Total= 3-15 [see image]
Following assessment of memory, What are the 2 words used to describe amnesia?
Assessment of Memory:
Retrograde Amnesia= pt cant remember events leading up to the incident
Anterograde Amnesia= pt cant remember the events after the event
When assessing for sensory issues you may find the patient has tingling/’pins & needles’ in a limb/hands/feet.
Question- What is the name for this tingling ?
& what type of nerves does it indicate an issue with?
Tingling is called Paraesthesia
Paraesthesia indicates issues with the **Peripheral nerves **
What are the 2 words do describe the constriction & dilation of pupils?
Pupil constriction= Miosis
Pupil dilation= Mydriasis
When shining a light into the pupils, both pupils should constrict.
**Q- **What is it called when the pupil recieving the light constricts, and what is it called when the pupil not recieving the light constricts?
Direct Response= constriction of pupil recieving light
**Consensual Response= **constriction of other pupil not receiving light
What is the word used when the pupils are both different sizes?
Anisocoria= when the pupils are two different sizes
What causes:
a) Unilaterally dilated pupils (1 pupil is dilated)
b) Bilaterally dilated pupils (both pupils dilated)
c) Bilaterally pinpoint pupils (both pupils are constricted)
Unilateral dilated pupil= (One pupil is dilated)- Cause= head trauma/stroke
Bilateral dilated pupils= *(Both pupils are dilated)- *Cause= epilepsy, stroke, trauma, tumour, adrenergics (eg. salbutamol, adrenaline)
Bilateral pinpoint pupils= *(Both pupils are small)- *Cause- opioids (heroin, morphine, fentanyl), nicotine, antipsychotics, ondans
What are the terms used to describe eye gaze?
[Hint- 2 terms that describe when eyes do/dont move together]
Assessment of Eye Gaze:
**Conjugate Gaze= **eyes move together
Dysconjugate Gaze= eyes dont move together
Assessment of Eye Movement:
1. What is Nystagmus?
2. What are some types of Nystagmus?
3. What can cause Nystagmus?
- Nystagmus= Rhythmic oscillation of the eyes
- Types of Nystagmus:
Vertical Nystagmus= up & down movement
Horizontal Nystagmus= side to side movement
Rotary Nystagmus= circle movement
**Physiological Nystagmus= **normal nystagmus seen at extreme ranges of gaze - Causes= stroke, head injury, MS, congenital (born with it)
If the patients eyes are described as ‘lacking accomodation’, what does this mean?
**Lacking Accomodation= **Means the eyes dont cross equally & constrict when you put your finger in front of their nose & ask them to look at it
**To test for Meningitis, there are 5 things we can look for. What are these? **
Hint:
**#1- **3 generalised symtoms
#2 & #3- ….’signs’
#4- A movement done that looks at the mouth
#5- A movement done that uses the knee
Testing for Meningitis:
1. Symptoms= Neck stiffness (nuchal rigidity), fever, headache
2. Kernig Sign= inability to straighten leg/knee when held up 90 degrees
3. Brudzinskis Sign= when neck is flexed forward while supine, hips/knees flex/come up
4. Movement 1- When trying to tocuh chin to chest, mouth stays open & can’t close
5. Movement 2- Chin unable to touch knee
When assessing for Movement Disorders, what 4 disorders are you assessing for?
**Movement Disorders: **
1. Tics
2. Tremors
3. Jerks
4. Athetosis (withering, slow movements of fingers/ hands/ wrists)
When assessing for Pyramidal Dysfunctions, what 4 conditions/movement issues are you assessing for?
Pyramidal Dysfunctions:
1. Dystonia
2. Akathesia (An inability to sit still- motor restlessness, constantly moving arms/legs/feets- semi-purposeful movements)
3. Akinesia (inability to move muscles)
4. Tardive Dyskinesia (repetitive involuntary movements of tongue, lips, face)
When assessing reflexes, you can test the Babinski Reflex by applying an upward motion/pressure to the sole of the foot.
Q- What would a Normal & Abnormal ‘Babinski response’ look like? & what does an abnormal response indicate?
Testing the Babinski Reflex:
Normal Babinski Response= Plantar flexion of foot (foot/toes point down)
Abnormal Babinski Response= Dorsiflexion/ extension of foot (toes point upwards toward face) [normal for under 2yo]
**What does this indicate? **Damage to spinal cord/ CST (neural pathway between brain & spinal cord)
There are 12 Cranial Nerves:
Q1- What is the name of each nerve?
Q2- What is the basic/key function of each nerve?
Q3- How can you assess each nerve?
*[Hint- think of the mneumonic: Oh, Oh, Oh, To Touch And Feel A Girls Vagina, Ah Heaven] *
Look at Image:
