Neurologic Function Assessment Techniques

Health history

Initial interview explores patient's neurologic condition.

Neurologic disease

Can be stable or progressive with symptom fluctuations.

Common symptoms

Includes pain, seizures, dizziness, visual disturbances.

Pain

Unpleasant sensory perception linked to potential damage.

Seizures

Abnormal discharges in cortex altering sensation or behavior.

Dizziness

Abnormal sensation of imbalance or movement.

Vertigo

Illusion of movement, often due to vestibular dysfunction.

Visual disturbances

Defects range from decreased acuity to sudden blindness.

Muscle weakness

Common neurologic symptom affecting various muscles.

Abnormal sensation

Altered sensation indicating central or peripheral disease.

Mental status

Observing appearance and behavior for cognitive assessment.

Orientation

Evaluates awareness of time, place, and person.

Acute pain

Short-term pain signaling immediate harm.

Chronic pain

Long-lasting pain affecting daily life.

Cerebral cortex

Brain region involved in seizures and sensation.

Neuromuscular diseases

Progressive conditions causing muscle weakness.

Nystagmus

Involuntary eye movement affecting vision.

Diplopia

Double vision resulting from eye movement abnormalities.

Vestibular dysfunction

Disorder affecting balance and spatial orientation.

Hypoglycemia

Low blood sugar potentially causing seizures.

Emotional status

Assessment of mood and affect during evaluation.

Intellectual function

Cognitive abilities assessed through various tasks.

Language ability

Evaluates communication skills and comprehension.

Orientation

Awareness of time, place, and person.

Delirium

Acute confusion with hallucinations and delusions.

Intellectual Function

Ability to interpret proverbs and recognize similarities.

Judgment

Capacity to make decisions in situations.

Thought Content

Spontaneity and coherence of patient's thoughts.

Unusual Thoughts

Fixed ideas or preoccupations needing evaluation.

Emotional Status

Assessment of mood and affect during interaction.

Affect

Emotional expression matching verbal communication.

Language Ability

Understanding and communication in spoken/written forms.

Aphasia

Deficiency in language function affecting communication.

Sensory Aphasia

Inability to comprehend spoken or written language.

Auditory Aphasia

Loss of understanding sounds' symbolic content.

Visual Aphasia

Loss of understanding printed or written figures.

Motor Aphasia

Inability to express oneself through speech or writing.

Level of Consciousness

Patient's wakefulness and environmental responsiveness.

Glasgow Coma Scale

15-point scale assessing level of consciousness.

Reflex

Automatic body response to a stimulus.

Reflex Testing

Evaluating reflexes for symmetry and response quality.

Reflex Scale

0 to +4 grading reflex response intensity.

Biceps Reflex

Test of biceps muscle response to stimulus.

Triceps Reflex

Test of triceps muscle response to stimulus.

Patellar Reflex

Knee jerk response tested during physical examination.

Achilles Reflex

Ankle jerk response tested during physical examination.

Plantar Reflex

Superficial reflex, toes bend down normally.

Babinski Reflex

Positive response: toes spread, big toe upward.

Biceps Reflex

Tests spinal levels C-5, C-6; elbow flexion observed.

Triceps Reflex

Tests spinal levels C-7, C-8; elbow extension observed.

Brachioradialis Reflex

Tests spinal levels C-5, C-6; forearm flexion observed.

Patellar Reflex

Tests spinal levels L-2, L-3, L-4; leg extension observed.

Achilles Reflex

Tests spinal levels S-1, S-2; plantar flexion of foot.

Reflex Hammer

Tool used to elicit deep tendon reflexes.

Cranial Nerves

Nerves assessed for brain stem or PNS issues.

Cranial Nerve 1

Olfactory nerve; tests smell with aromas.

Cranial Nerve 2

Optic nerve; tests vision and visual fields.

Cranial Nerve 3

Oculomotor nerve; assesses eye movements and pupils.

Cranial Nerve 4

Trochlear nerve; controls superior oblique muscle.

Cranial Nerve 5

Trigeminal nerve; tests facial sensation and motor function.

Cranial Nerve 6

Abducens nerve; controls lateral eye movement.

Cranial Nerve 7

Facial nerve; tests facial expressions and taste.

Cranial Nerve 8

Acoustic nerve; assesses hearing and balance.

Cranial Nerve 9

Glossopharyngeal nerve; tests taste on posterior tongue.

Cranial Nerve 10

Vagus nerve; controls autonomic functions.

Romberg's Test

Balance test assessing vestibular function.

Ophthalmoscopic Examination

Visual inspection of the retina and optic nerve.

Confrontation Test

Checks visual fields by direct confrontation.

Vagus Nerve (X)

Assesses speech for hoarseness.

Accessory Nerve (XI)

Controls shoulder shrug and head turning.

Hypoglossal Nerve (XII)

Controls tongue movement and protrusion.

Gross Motor Tests

Evaluate overall motor function and balance.

Walking Gait

Client walks across room; posture and balance assessed.

Normal Gait

Upright posture, steady gait, arm swing present.

Gait Deviation

Poor posture, unsteady, irregular, wide stance.

Romberg Test

Balance test with eyes closed on one foot.

Normal Romberg Findings

Maintains stance for at least 5 seconds.

Romberg Deviation

Cannot maintain balance for 5 seconds.

Heel-Toe Walking

Walks straight line, heel in front of toes.

Normal Heel-Toe Walking

Maintains straight line without wider stance.

Heel-Toe Deviation

Assumes wider gait to maintain balance.

Toe Walking

Client walks several steps on toes.

Heel Walking

Client walks several steps on heels.

Normal Toe or Heel Walking

Able to maintain balance on toes and heels.

Muscle Atrophy

Muscle wasting due to inactivity or injury.

Intrinsic Hand Muscles

Control fine motor movements in the hand.

Finger-to-Nose Test

Client touches nose alternately with fingers.

Normal Finger-to-Nose Performance

Touches nose repeatedly and rhythmically.

Finger-to-Nose Deviation

Misses nose or responds slowly.

Alternating Supination and Pronation

Client pats knees with palms and backs alternately.

Normal Supination/Pronation Performance

Can alternate rapidly without clumsiness.

Supination/Pronation Deviation

Slow, clumsy movements with irregular timing.

Fingers to Fingers Test

Client brings fingers together at midline.

Normal Fingers to Fingers Performance

Coordinates rapidly with eyes open and closed.

Normal Performance

Accurate and rapid execution of tasks.

Deviations in Movement

Slow movement; inconsistent finger coordination.

Fingers to Thumb Test

Touch each finger to thumb rapidly.

Heel Down Opposite Shin Test

Run heel down opposite shin; assess coordination.

Normal Heel Test Result

Bilateral equal coordination demonstrated.

Deviation in Heel Test

Tremors; heel moves off shin.