Neurologic Assessment Techniques and GCS Scoring

GCS Score 3 to 8

Indicates severe injury severity level.

GCS Score 9 to 12

Indicates moderate injury severity level.

GCS Score 13 to 15

Indicates mild injury severity level.

Level of Consciousness

Key aspect of neurologic examination.

Arousal

Refers to alertness in consciousness.

Awareness

Refers to content in consciousness.

Orientation

Ability to recognize person, place, time.

Disorientation

Inability to recognize person, place, time.

Full Consciousness

Patient is alert and attentive.

Lethargy

Patient is drowsy but can be awakened.

Obtundation

Patient needs constant stimulation to respond.

Stupor

Patient responds only to vigorous stimulation.

Coma

Patient does not respond to stimuli at all.

Olfactory Nerve (I)

Responsible for the sense of smell.

Optic Nerve (II)

Responsible for vision.

Auditory Nerve (VIII)

Responsible for hearing.

Oculomotor Nerve (III)

Controls eyeball movement and pupil constriction.

Trochlear Nerve (IV)

Moves eyes to side and down.

Abducens Nerve (VI)

Moves eyes laterally.

Trigeminal Nerve (V)

Controls chewing and facial sensations.

Facial Nerve (VII)

Controls facial expressions and taste.

Glossopharyngeal Nerve (IX)

Involved in gag reflex and taste.

Vagus Nerve (X)

Controls functions of visceral organs.

Cranial Nerve II

Optic nerve

tests visual acuity and fields.

Snellen Chart

Tool for testing visual acuity at distance.

Jaeger Card

Used for testing near vision at 14 inches.

Cranial Nerve III

Oculomotor nerve

controls pupil reactions.

Pupillary Reaction

Response of pupils to light and accommodation.

Cranial Nerve IV

Trochlear nerve

controls superior oblique muscle.

Cranial Nerve VI

Abducens nerve

controls lateral eye movement.

Cardinal Positions of Gaze

Tests eye movement in six directions.

Nystagmus

Involuntary eye movement

assessed during gaze.

Cranial Nerve VII

Facial nerve

assesses hearing and facial movement.

Cochlear Branch

Part of facial nerve for hearing assessment.

Cranial Nerve IX

Glossopharyngeal nerve

tests tongue movement and taste.

Gag Reflex

Involuntary response to touch on pharyngeal wall.

Cranial Nerve X

Vagus nerve

controls swallowing and speech.

Hoarseness

Change in voice quality

indicates possible nerve issue.

Cranial Nerve XI

Spinal accessory nerve

assesses neck and shoulder strength.

Sternocleidomastoid Muscle

Muscle tested for strength in head movement.

Cranial Nerve XII

Hypoglossal nerve

tests tongue strength and movement.

Dysmetria

Inability to control the distance of movements.

Reflex Action

Involuntary response to a stimulus via reflex arcs.

Dysdiadokinesia

Inability to perform rapid alternating movements.

Heel-To-Shin Test

Tests coordination by moving heel along shin.

Stimulus

Change detected by a receptor in environment.

Receptor

Transforms stimuli into nerve impulses for processing.

Nerve Impulse

Electrical signal transmitted along neurons.

Brain Decision-Making

Process of evaluating stimuli and selecting responses.

Effector

Muscle or gland that executes a response.

Reflex

Involuntary response occurring without conscious thought.

Oculo-cephalic Reflex (OCR)

Eye movement stabilizing images during head movement.

Romberg Test

Balance test assessing postural stability.

Tandem Gait

Walking heel-to-toe to evaluate balance.

Truncal Ataxia

Unsteady gait due to cerebellar vermis damage.

Rapid Head Impulse Test

Evaluates eye movement response to head motion.

Doll's Eye Reflex

Eyes move opposite to head movement direction.

Positive Doll's Eye Reflex

Eyes move opposite head movement

indicates normal function.

Negative Doll's Eye Reflex

Eyes move with head

indicates severe brain damage.

Vestibulo-Ocular Reflex (VOR)

Stabilizes vision during head movements.

Oculovestibular Reflex

Eye movement response to caloric stimulation.

Caloric Ice-Water Test

Test using cold/warm water in ear for reflex.

COWS Rule

Cold water causes opposite eye movement

warm same.

Conjugate Eye Movements

Both eyes move together in the same direction.

Dysconjugate Eye Movements

Eyes move in different directions

indicates abnormality.

Absent Eye Movement

No eye movement in response to stimuli.

Brainstem Dysfunction

Injury causing specific reflex abnormalities.