Neurological System

Question 1

what are the 12 areas to ask about when collecting subjective data for the neurological examination?

Answer 1

1. headache
2. head injury
3. dizziness/vertigo
4. seizures
5. tremors
6. weakness
7. incoordination
8. numbness or tingling
9. difficulty swallowing
10. difficulty speaking
11. significant past history
12. environmental and occupational hazards

Question 2

what is the proper sequence for the complete neurological examination?

Answer 2

1. mental health
2. cranial nerves
3. motor system
4. sensory system
5. reflexes

Question 3

when testing the motor system, what is the sequence of inspection and palpation?

Answer 3

size
strength
tone
involuntary movements

Question 4

when inspecting and palpating the size of the major muscle groups during neurological exams, what is being assessed?

Answer 4

muscle groups should be within normal size limits for age and should be symmetric bilaterally. any differences in size greater than about 1 cm should be measured and recorded.

atrophy or hyperatrophy are not expected.

Question 5

what are the balance tests for cerebellar function in the neurological system?

Answer 5

Gait
Tandem Walking
Toe and Heel Walking
Romberg Test
Shallow Knee Bend or Hop (one leg at a time)

Question 6

when assessing gait as a balance test during the neurological exam, what is tested and what are the expected findings?

Answer 6

observe the patient walking 3-6 m, turns, and returns to the starting point. gait should be SMOOTH, RHYTHMIC, and EFFORTLESS; opposing arm swing is coordinated and turns are smooth. step length is approximately 30 cm from heel to heel

Question 7

when assessing gait using the tandem walking test, how is the test performed and what are the expected findings?

Answer 7

patient walks in a straight line in a heel-to-toe manner

heel-to-toe walking decreases base of support, accentuating any problems in balance

normally, a person can walk straight and stay balanced

Question 8

when using the Romberg Test, what is being assessed and how?

Answer 8

the Romberg test is part of the neurological assessment and tests balance.

the test is done by having patient stand with feet together and arms at sides. once in position, you should stand close to the patient and be prepared to catch them. ask patient to close eyes and wait approximately 20 seconds

positive Romberg sign is loss of balance and can indicate cerebellar ataxia(caused by alcohol intoxication or multiple sclerosis), loss of propreoception, and loss of vestibular function

Question 9

when having a patient perform a shallow knee bend or hop in place on one leg as part of the neurological examination, what is being assessed and what are the normal findings?

Answer 9

balance is being assessed