Download as PDF, PPTX
More Related Content
Similar to NEUROLOGICAL EXAMINAITION, BSN LEVEL 3 LESSON
![5._CNS_ _MSK_(1)[1].pdf central nerveous](https://cdn.slidesharecdn.com/ss_thumbnails/5-251222065741-742ca3b9-thumbnail.jpg?width=640&height=640&fit=bounds)
NEUROLOGICAL EXAMINAITION, BSN LEVEL 3 LESSON
- 3. The cranial nervesare a set of 12 paired nerves in the back of your brain. Cranial nerves send electrical signals between your brain, face, neck and torso. Your nerves help you taste, smell, head and feel sensations. They also help you make facial expressions, blink your eyes and move your tongue.
- 5.
- 6. With the, a patient should be able to identify common, familiar and non- irritating odors coffee soap flowers fresh orange / kalamansi camphor (Vicks)
- 7. such asalcohol, ammonia, perfume, etc. this will stimulate pain rather than olfaction which tests CN V rather than CN I
- 8. CN I(OLFACTORY) N: Identify scent in each nostril Abn: Neurogenic Anosmia
- 9. VISION Visualacuity Snellen’s chart* Visual fields Confrontational test*
- 10. VISUAL ACUITY have the patient read a Snellen’s eye chart from a distance of patient covers one eye at a time and reads to smallest line possible
- 11. VISUAL ACUITY if Snellen’s chart is unavailable: let the from his face one eye at a time let the patient wear eyeglasses
- 13. RAISES UPPERLID CONSTRICTS PUPIL
- 14. Check pupillaryresponses by on one pupil both pupils should constrict do the same for the other eye
- 16.
- 17. EXTRA-OCULAR MOVEMENTS Motor to extrinsic eye muscles
- 19. have thepatient hold his head steady while you move your finger about 1 foot from his nose forming a large capital-H watch both of his eyes move
- 20. If oneeye appears to have the inability to track the motion of the object cover the eye that was able to track the motion repeat the procedure
- 21. Abn: Nystagmus –cerebellar disorders limited eye movement – increased ICP paralytic strabismus -
- 25. SENSORY TOFACE AND TEETH pain touch MOVEMENT OF MUSCLES OF MASTICATION temporal muscles masseter muscles
- 26. palpate theMasseter instruct the patient to bite down hard next, ask the patient to against resistance applied by the instructor
- 27. Corneal Reflex use a large Q-tip with the cotton extended into a wisp ask the patient to look at a distant object then approaching laterally,
- 28. look forthe eye to blink Repeat this on the other eye
- 30. MOVEMENT OFTHE MUSCLES OF FACIAL EXPRESSION
- 31. Initially, inspectthe face during conversation and rest including: drooping sagging smoothing of normal facial creases
- 32. Next, askthe patient to: raise their eyebrows smile showing their teeth frown puff out both cheeks close both eyes tightly
- 35. When you wispa piece of cotton on your patient’s eyes, you are assessing for the function of A.CN III B.CN IV C.CN V D.CN VI
- 36.
- 37. Equilibrium canbe tested using the : have the patient stand erect with his feet close together and his eyes closed he might sway slightly, but should not fall stay close to the patient in case he does begin to fall
- 39. Taste andTouch at the back of the tongue Movement of Pharyngeal muscles
- 40. Sensory toPharynx, larynx, and viscera Movement of palate, pharynx, and larynx
- 41. Ask thepatient to and note any difficulty doing so Next, note the quality and sound of the patient's
- 42. Ask thepatient to open their mouth wide, protrude tongue, and while the patient is performing this task, flash your penlight into the patient's mouth observe the soft palate, uvula and pharynx for symmetry
- 43. Next tellthe patient you're going to test his use a tongue depressor or the butt of a long Q-tip perform this test by touching the pharynx on both the left and right sides, observing the normal gag or cough
- 45. Motor to: Neck muscles Upper back muscles
- 46. Place yourhands on the patients shoulders Have him upward while you exert slight resistance the strength and contraction should be symmetrical
- 47. Next, placeone hand on the side of the and the other on the opposite SCM muscle Have the patient turn his head towards the hand on his jaw while you apply slight resistance
- 48. have thepatient and move it side to side normally, the tongue will be protruded from the mouth and remain midline
- 49. Note: deviationsof the tongue from midline a complete lack of ability to protrude the tongue tongue atrophy fasciculation on the tongue
- 54. The GlasgowComa Scale (GCS) is a neurological scale used to assess a person’s level of consciousness after a brain injury. It is commonly used in emergency and intensive care settings to evaluate the severity of brain injury based on eye response, verbal response and motor response.
- 56. Obeys commands6 Localizes pain 5 Withdraws to pain 4 Flexion to pain (Decorticate) 3 Extension to pain (Decerebrate) 2 None 1
- 59. Oriented 5 Confused 4 Inappropriate (Random speech) 3 Incomprehensible (Moaning) 2 None 1
- 60. Spontaneous 4 To speech 3 To pain 2 None 1
- 61. interpretation: Severebrain injury GCS = 3 to 8 Moderate brain injury GCS = 9 to 12 Minor brain injury GCS ≥ 13
- 62. N: score of14-15 indicates optimal LOC Abn: less than 14 – some impairment less than 10 – emergency attention less than 7 - coma 3 – deep coma
- 63. definition ofterms (levels of consciousness):
- 64.
- 65. disoriented; impairedthinking and responses people who do not respond quickly with information about their name, location, and the time caused by sleep deprivation, malnutrition, allergies, environmental pollution, drugs, and infection
- 66. disoriented; restlessness,hallucinations, sometimes delusions person may be restless or agitated exhibit a marked deficit in attention
- 67. sleepy showsexcessive drowsiness responds to stimuli only with incoherent mumbles or disorganized movements
- 68. decreased alertness;slowed psychomotor responses has a decreased interest in their surroundings, slowed responses, and sleepiness
- 69. sleep-like state(not unconscious); little/no spontaneous activity only respond by grimacing or drawing away from painful stimuli
- 70. cannot bearoused noresponse to stimuli have no corneal or gag reflex may have no pupillary response to light
- 71. Using the Glascowcoma scale, a patient is given a score of 5. This is interpreted as A.Deep coma B.Some impairment C.Coma D.Emergency attention
- 72. Upon determining Mr.X’s level of consciousness utilizing the Glasgow coma scale, he flexes to pain, produces incomprehensible words, and opens eyes spontaneously, his score is A.13 B.9 C.7 D.8
- 75. The deep tendonreflex is sometimes called the stretch reflex or myotatic reflex because of the stretch action and the muscle response involved. Some authors argue that they are not the same reflex. They believe the tendon reflex occurs after the tendon's active stretching when it is tapped with the hammer.
- 76. automatic /involuntary reaction in response to a stimulus does NOT require conscious thought does NOT reach higher brain centers
- 77. *use neurohammer on your own fingers to minimize trauma to the patient to give the nurse better control
- 78. KNEE-JERK REFLEX/ PATELLAR REFLEX muscles contract in response to stretching force applied to it
- 79. KNEE-JERK REFLEX/ PATELLAR REFLEX If (–) or exaggerated Brain or SC defect muscle stretch muscle contraction
- 80. 5+ :sustained clonus 4+ : non-sustained clonus (repetitive vibratory movements) 3+ : brisk 1+ : trace, or seen only with reinforcement 0 : absent reflex
- 81.
- 82.
- 83.
- 84.
- 85.
- 88. Plantar Reflex N: Flexion of toes Abn: Fanning/Babinski
- 89. Abdominal Reflex N: Contraction Abn: no response May be absent in obese clients and pregnant
- 90.
- 92. Which among thesereflexes does not belong to the classification of superficial reflexes? A.Plantar reflex B.Patellar reflex C.Cremasteric reflex D.Abdominal reflex
- 94. Grade: 5/5: normal strength 4/5 : movement possible against some resistance by the examiner 3/5 : movement possible against gravity, but not against resistance by the examiner
- 95. Grade: 2/5: movement possible, but not against gravity 1/5 : muscle flicker, but no movement 0/5 : no contraction