Week 1 - Intro to Neurologic Examination Flashcards
(36 cards)
What are the 8 parts of assessing mental status?
- Level of consciousness
- Orientation
- Attention/Concentration
- Calculation
- Language
- Speech
- Memory
- Fund of Knowledge
What are the 8 basic components of a neurologic exam?
- Mental status
- Cranial nerves
- Motor
- Strength
- Sensory
- Reflexes
- Coordination
- Gait & Station
What are some ways to describe a patient’s Level of Consciousness?
Awake, Drowsy, Somnolent, Lethargic, Coma
How do you test a patient’s orientation?
Ask patient their name. Do they know where they are? What day/time is it?
How do you assess a patient’s Attention/Concentration?
Ask pt to spell “world” backwards.
Ask pt to say months of the year backwards.
How do you assess a patient’s Calculation abilities?
Serial 7’s
Calculate change after hypothetical purchase
How do you assess a patient’s Language?
Listen to them!
Naming, fluency, vocabulary
How do you assess a patient’s memory?
Ability to comprehend
Recall 5 words after distraction
How do you assess Fund of Knowledge?
Current president, recent events
What abnormalities does a physician look for in fundoscopic exam?
- blurring of disk margins
- loss of venous pulsations
- color of optic nerve head
How do you test CN I?
Olfactory - smell
- Pass odors under nose with patient’s eyes closed
- More important to perceive stimulus than to identify correct odor
How do you test CN II?
Optic - visual acuity, visual fields, pupils
Pocket card/wall chart
Confrontation or threat (wiggle fingers in periphery)
How do you test CN III?
Oculomotor - pupils, eye movements
- Direct, consensual, accomodation
- Swinging flash light
How do you test CN IV?
Trochlear - superior oblique eye muscle
-“H” movement, follow finger
How do you test CN V?
Trigeminal - facial sensation, corneal response, muscles of mastication
- Cotton, pin, tuning fork to compare side by side
- Bite down, open jaw, feel TMJ
How do you test CN VI?
Abducens - lateral rectus eye muscle
“H” movement
How do you test CN VII?
Facial - facial muscle movements
- At rest observe palpebral fissures and nasolabial folds
- Squeeze eye shut
- Smile, puff out cheeks
How can you tell Peripheral vs. Central facial weakness?
Forehead is spared in a central lesion (i.e. stroke)
How do you test CN VIII?
Vestibulocochlear - inner/middle ear
- Test for dizziness/vertigo, abnormal nystagmus, or coma
- Fine finger rubbing or watch ticking
- Weber and Rinne tests
How do you test CN X?
Vagus - pharynx, oropharynx, & larynx
- Palate elevation, gag, swallow
- Listen for hoarseness
How do you test CN XI?
Accessory - sternocleidomastoid & trapezius muscle
-Turn head against resistance at chin
How do you test CN XII?
Hypoglossal - tongue muscles
- Listen to articulation, slurring
- Observe at rest for fasciculations
- Observe for protrustion and movement for deviation to one side/slowness
How do you assess patient’s Motor control?
- Observe for atrophy
- Disuse
How do you assess a patient’s Tone?
- Passive motion about a joint
- Decreased tone = flaccid
- Increased tone = spastic, rigid “lead pipe”, or paratonia (can’t relax)
