Neurologic & Mental Status Assessment – Lecture Review

50 question-and-answer flashcards covering neuroanatomy basics, cranial nerves, reflexes, coordination tests, sensory assessment, Glasgow Coma Scale, stroke education, mental status concepts, and aging considerations from the lecture transcript.

What is collected, processed, and responded to by the Central Nervous System (CNS)?

Incoming stimuli

Which cerebral lobe is primarily responsible for personality and behavior changes?

Frontal lobe

Which cerebral lobe interprets touch and identifies shapes?

Parietal lobe

In which lobe is vision processed?

Occipital lobe

Which lobe contains centers for hearing, taste, smell, and much of language?

Temporal lobe

What structure acts as a relay station for sensory impulses within the CNS?

Thalamus

Which CNS structure regulates body temperature, hunger, and some endocrine functions?

Hypothalamus

What is the function of the cerebellum?

Balance and coordination

Which brain-stem structure controls breathing and heart-rate?

Medulla/brain stem (overall)

Which cranial nerves are housed in the brain stem?

Cranial nerves III through XII

How many pairs of spinal nerves exist and how are they named?

31 pairs, named for the spinal region from which they exit (C, T, L, S, Coccygeal)

What mnemonic helps recall cranial nerve NAMES?

“On Old Olympus’ Towering Top…” etc. (any preferred mnemonic acceptable)

What mnemonic gives cranial nerve FUNCTIONS (sensory/motor/both)?

“Some Say Money Matters, But My Brother Says Big Brains Matter More”

Which cranial nerve is tested by identifying familiar odors?

CN I – Olfactory

Which cranial nerve controls most extra-ocular movements and pupillary constriction?

CN III – Oculomotor

What is the primary test for CN VIII (Vestibulocochlear)?

Whisper or other simple hearing test; gait & Romberg for equilibrium

Flaccidity refers to what kind of muscle tone?

Decreased/absent muscle tone

Spasticity is defined as:

Increased muscle tone with velocity-dependent resistance

Cogwheel rigidity is most characteristic of which disease?

Parkinson’s disease

Name two common involuntary movements seen in neurologic disorders.

Examples: tics, myoclonus, fasciculations, chorea, athetosis, tremors

What differentiates a resting tremor from an intention tremor?

Resting occurs at rest; intention appears or worsens with movement

Describe the Finger-Nose-Finger test.

Patient alternately touches examiner’s finger and own nose to assess coordination

What does tandem walking (heel-to-toe) primarily assess?

Cerebellar function and balance

How long is the patient’s balance typically observed during the Romberg test?

20 seconds with eyes closed

Which two descriptors are used for pain discrimination in the spinothalamic tract test?

Sharp and dull

How is vibration sense assessed?

Place a vibrating tuning fork on a bony prominence and ask when it starts/stops

Define stereognosis.

Ability to identify a familiar object placed in the hand with eyes closed

Define graphesthesia.

Ability to recognize numbers/letters traced on the skin

What spinal levels correspond to the patellar (knee-jerk) reflex?

L2 to L4

State the correct documentation for a normal knee-jerk reflex.

“Patellar reflex 2+; L2–L4 intact”

Which spinal levels are assessed by the Achilles reflex?

L5 to S2

What grading scale is used for deep tendon reflexes?

0 = none, 1+ diminished, 2+ normal, 3+ brisk, 4+ hyperactive/clonus

What response is normal when testing the plantar reflex in adults?

Toe flexion (plantar response)

What does an up-going big toe (Babinski sign) indicate in an adult?

Upper motor neuron lesion / abnormal corticospinal tract

Name the three components and maximum score of the Glasgow Coma Scale (GCS).

Eye (4), Motor (6), Verbal (5); maximum total = 15

Within how many hours of stroke onset can most ‘clot-buster’ drugs be administered?

Within 4 hours (time-window may vary slightly by agent)

List the FAST acronym for stroke warning signs.

Face drooping, Arm weakness, Speech difficulty, Time to call 911

What is the primary purpose of a mental status examination?

Document dysfunction and decide how it affects self-care and daily life

Differentiate subjective from objective data in assessment.

Subjective = what patient says; Objective = what nurse observes/measures

Give one example of an organic mental disorder.

Delirium from UTI, dementia from Alzheimer’s, etc.

Delirium is typically (acute/chronic) and (reversible/irreversible).

Acute and potentially reversible

Dementia is typically (acute/chronic) and (reversible/irreversible).

Chronic and irreversible/progressive

List four common levels of consciousness used in documentation.

Alert, Lethargic, Obtunded, Stupor, Coma (any four)

What behavioral term describes a lack of emotional expression?

Flat affect

Define ‘euphoric’ mood.

Excessive sense of well-being or elation

Why is response time slower in many older adults?

General neurologic processing speed declines with age

Which type of memory usually declines first in normal aging?

Recent (short-term) memory

Name three factors that can confound mental-status findings.

Examples: medications, alcohol/drug use, chronic renal disease, sensory loss

How many key behaviors are evaluated in a formal mental status exam?

Ten (consciousness, language, mood/affect, orientation, attention, memory, abstract reasoning, thought process, thought content, perception)

What quick bedside test screens CN V (trigeminal) motor function?

Patient clenches teeth while examiner palpates temporal & masseter muscles

Which cranial nerve is assessed by asking the patient to shrug shoulders against resistance?

CN XI – Spinal Accessory

When testing extra-ocular movements, how many cardinal fields of gaze are used?

Six

What is the normal finding for the Romberg test?

Minimal sway while standing with eyes closed for 20 seconds