Exam (elaborations)
NSG 6020 Neuro Week 10 Exam 2024/2025
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NSG 6020 Neuro Week 10 Exam 2024/2025
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NSG 6020 Neuro Week 10 Exam2024/2025
HPI seizures - -did you fall, shrill cry, motor activity, loss of consciousness,
chewing or lip smacking, post-ictal
-HPI pain - -sudden or progressive, deep aching, throb or stabbing, where is
pain, radiate
-HPI gait coordination - -lose balance, fall forward\backward, feel stiff, legs
give way
-HPI weakness parathesia - -sudden onset, with activity, tingling, numbness
or confusion, chronic illness, medications like zidovudien or chemotherapy
-CNI - -test the patient's ability to identify familiar odors, such as coffee &
mint extract, one naris at a time with the eyes closed
-CNII - -test visual acuity and the visual fields
-CNIII, IV, VI - -assess the 6 cardinal points of gaze; inspect eyelids for
drooping; & observe pupils for equality of size, shape, & reaction to light &
accommodation
-Headaches -severe unremitting - -evaluate movement of the eyes for the
presence or absence of lateral (temporal) gaze. The 6th cranial nerve is
commonly one of the first to lose function in the presence of increased
intracranial pressure.
-legal blindness - -Vision not correctable to better than 20/200
-CNV - -four assessments:
1. inspect face for muscle atrophy, jaw deviation, & tremors.
2. palpate clenched jaw muscles for tone & strength.
3. test superficial pain & touch sensations in each branch of the nerve.
4. test the corneal reflex
-CNVII - -observe for facial symmetry while the pt makes a series of facial
expressions. test taste on sides of the tongue
-signs of muscle weakness - -Drooping of one side of the mouth, a flattened
nasolabial fold, & a sagging lower eyelid for CNVII
, -CNVIII - -test the sense of hearing & bone & air conduction of sound & note
sound lateralization
-CNIX - -tastes on the posterior 3rd of the tongue. eval of the vagus nerve
for nasopharyngeal sensation (gag reflex) & the motor function of swallowing
-CNX - -inspect the palate & uvula for symmetry with speech sounds. Check
gag reflex & ability to swallow; say AH
-CNXI - -evaluate the size, shape & strength of the trapezius &
sternocleidomastoid muscles; shrug
-CNXII - -4 assessments:
1. inspect tongue
2. movement side to side nose to chin
3. tongue against cheek; pressing
4. say l, t, d, n
-evaluate proprioception & cerebellar function - -rapid rhythmic alternating
movements; slowed nonrhythmic, or jerky clonic movements are unexpected
-types of movements for proprioception - -finger-to-finger test, finger-to-
nose test, & heel-to-shin test on both sides of the body
-Romberg test - -patient stand with the eyes closed, feet together, & arms
at the sides (also seen with arms out)
-stereognosis - -hand the pt a familiar object, such as a coin or key
-graphesthesia - -tracing a letter, number, or shape on the palm of the hand
-pronator drift - -push arms down & observe rebound; strong rebound = ok
-primary sensory functions - -superficial touch & pain; temp, vibration on
joints, joint position
-cortical sensory functions - -stereognosis, 2 pt discriminication, extinction
phenomenon, graphesthesia, point location
-superficial reflexes - -abdominal, cremasteric & plantar reflexes
-Babinski reflex - -plantar flexion of all toes
-deep tendon reflexes - -biceps, triceps, brachioradial, patellar, achilles,
ankle clonus
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