Neurological Assessment

    Cards (39)

    • 12 Cranial Nerves & Their Functions
      • Olfactory
      • Optic
      • Oculomotor
      • Trochlear
      • Trigeminal
      • Abducens
      • Facial
      • Acoustic / Vestibulocochlear
      • Glossopharyngeal
      • 10. Vagus
      • 11. Spinal Accessory
      • 12. Hypoglossal
    • Cranial Nerve 1 - Olfactory
      Carries smell impulses from nasal mucous membrane to brain
    • Cranial Nerve 1 - Olfactory Procedure

      1. Have client sit in comfortable position
      2. Ask client to clear nose
      3. Close eyes, occlude one nostril, identify scented object
      4. Repeat for other nostril
    • Cranial Nerve 1 - Olfactory Normal
      • Client correctly identifies scents
      • Older clients may have decreased sense of smell
    • Cranial Nerve 1 - Olfactory Abnormal

      • Neurological Anosmia - inability to smell
      • Neurogenic Anosmia - olfactory tract lesion, frontal lobe tumor, congenital, nasal/sinus problems, nerve tissue injury, smoking, cocaine use
    • Cranial Nerve 2 - Optic
      Carries visual impulses from eye to brain
    • Cranial Nerve 2 - Optic Procedure
      1. Use Snellen chart to assess vision
      2. Ask client to read paragraph to assess near vision
      3. Assess visual fields by confrontation
      4. Use ophthalmoscope to view retina and optic disc
    • Cranial Nerve 2 - Optic Normal
      • 20/20 vision, reads at 14 inches, normal peripheral vision, normal retina and optic disc
    • Cranial Nerve 2 - Optic Abnormal

      • Difficulty reading Snellen chart, missing letters, squinting, reads print by holding closer/further, loss of visual fields, papilledema, optic atrophy
    • Cranial Nerves 3, 4, 6 - Oculomotor, Trochlear, Abducens
      Control eye movements
    • Cranial Nerves 3, 4, 6 Procedure
      1. Inspect eyelids
      2. Assess extraocular movements
      3. Assess pupillary response to light and accommodation
    • Cranial Nerves 3, 4, 6 Normal
      • Eyelids cover 2mm of iris, eyes move smoothly in all directions, pupils constrict simultaneously
    • Cranial Nerves 3, 4, 6 Abnormal
      • Ptosis, myasthenia gravis, abnormal eye movements, pupil abnormalities
    • Cranial Nerve 5 - Trigeminal
      Carries sensory impulses of pain, touch, temperature from face to brain, influences jaw movements
    • Cranial Nerve 5 Procedure
      1. Test motor function by palpating temporal and masseter muscles
      2. Test sensory function by touching face with sharp/dull stimuli
      3. Test corneal reflex
    • Cranial Nerve 5 Normal
      • Temporal and masseter muscles contract bilaterally, can correctly identify sharp/dull and light touch, corneal reflex present
    • Cranial Nerve 5 Abnormal

      • Decreased muscle contraction, inability to feel facial stimuli, absent corneal reflex
    • Cranial Nerve 7 - Facial
      Stimulates facial movements and expressions, provides taste sensation to anterior tongue
    • Cranial Nerve 7 Procedure
      1. Test motor function by having client smile, frown, etc.
      2. Test sensory function by touching anterior tongue with flavored stimuli
    • Cranial Nerve 7 Normal
      • Symmetric facial movements, can correctly identify flavors
    • Cranial Nerve 7 Abnormal
      • Inability to close eye, wrinkle forehead, or raise eyebrow, paralysis of lower face, inability to identify flavors
    • Cranial Nerve 8 - Acoustic/Vestibulocochlear

      Contains sensory fibers for hearing and balance
    • Cranial Nerve 8 Procedure
      1. Test hearing ability, perform Weber and Rinne tests
      2. Perform Romberg test to assess equilibrium
    • Cranial Nerve 8 Normal

      • Client hears whispered words, Weber test lateralizes equally, Rinne test AC>BC, maintains balance with eyes closed
    • Cranial Nerve 8 Abnormal

      • Weber test lateralizes to good ear, AC<BC, loss of balance with eyes closed
    • Cranial Nerves 9 & 10 - Glossopharyngeal, Vagus
      Influence swallowing, gag reflex, and voice
    • Cranial Nerves 9 & 10 Procedure
      1. Test motor function by having client say "ah"
      2. Test gag reflex
      3. Observe ability to swallow
    • Cranial Nerves 9 & 10 Normal
      • Soft palate rises bilaterally, gag reflex present, swallows without difficulty
    • Cranial Nerves 9 & 10 Abnormal
      • Soft palate does not rise, absent gag reflex, dysphagia or hoarseness
    • Cranial Nerve 11 - Spinal Accessory
      Innervates neck muscles that promote shoulder and head movement
    • Cranial Nerve 11 Procedure
      Assess strength of trapezius and sternocleidomastoid muscles
    • Cranial Nerve 11 Normal
      • Symmetric, strong muscle contraction
    • Cranial Nerve 11 Abnormal
      • Asymmetric muscle contraction, atrophy, fasciculations
    • Cranial Nerve 12 - Hypoglossal
      Innervates tongue muscles that promote movement of food and talking
    • Cranial Nerve 12 Procedure
      Assess strength and mobility of tongue
    • Cranial Nerve 12 Normal
      • Symmetric, smooth tongue movement and bilateral strength
    • Cranial Nerve 12 Abnormal

      • Fasciculations, atrophy, deviation of tongue
    • Level of Consciousness
      Alert, Lethargic, Stuporous, Comatose
    • Glasgow Coma Scale

      Measures eye opening, verbal, and motor responses