Surgical Nursing Exam 3

Neurological Function Unit

Olfactory Nerve I

You ask the patient to identify common scents, such as cinnamon and coffee

Optic Nerve II

Ask the patient to read something or tell how many fingers you are holding up

Oculomotor Nerve III

Controls eye movement and pupil constriction. Check for pupils reaction and accommodation.

Trigerminal Nerve V

Sesantion of face, scalp, and teeth. Contraction of chewing muscles. To test, you can ask the patient to identify touch on different parts of the face with their eyes closed.

Trochlear nerve IV and Abducens VI

Controls eye movement.Test by checking upward and lateral gaze of the eyes.

Facial nerve VII

Controls sense of taste, contraction of facial muscles, secretion of saliva. Ask the patient to smile, wrinkle forehead, check for symmetry.

Vestibulochochleat nerve VII

Sense of hearing, sense of equilibrium

Glossopharyngeal nerve IX

Sense of taste, secretion of saliva, sensory input for cardiac, respiratory, and blood pressure reflexes. Contraction of the pharynx, swallowing. Test by touching the back of the throat with an applicator to elicit gag reflex.

Vagus nerve X

Decreased HR, increased digestive reflexes, perilstasis.

Accessory nerve XI

Contracts shoulder and neck movements, important for head rotation and elevating shoulders.

Hypoglossal Nerve XII

Movement of tongue. Ask patient to stick out tongue and move it from side to side.

Myelogram

X-ray examination of the spinal canal and its contents after injecting of contrast material.

Electroenchephalogram

Electrodes are placed on the scalp to record brain activity. Analysis of the tracing can identify areas of abnormality, such as a seizure focus or areas of slowed activityin the brain.

CT scan

Used to diagnose neurological disorders in the brain or spine. Used when MRI is contraindicated because of metal in the body.

MRI

Magnetic Resonance Imaging, a non-invasive imaging technique that uses strong magnetic fields and radio waves to create detailed images of organs and tissues in the body, particularly effective for visualizing soft tissue structures.

-Used to diagnose degenerative diseases

Angiogram

An xray following injection of dye that provides information about the structure of specific vessels as well as overall circulation of the area.

paresthesia

abnormal sensations, such as burning or tingling

Used to evaluate the level of consciousness in patients.What assessments are included in the FOUR score coma scale?

Eye response, motor response, brainstem reflexes, and respiration

What should be the first thing assessed when performing a neurological examination?

LOC

Level of consciousness

Patients response to verbal or tactile stimulation and orientation

Basic neurological assessment includes:

-History of neurologic problems

-LOC and orientation

-Vital signs

-Pupillary response to light

-Assess strength and equality of hand grip and movement of extremities

-Determine the ability to sense touch or pain in the extremities

Brainstem is evaluated using

pupillary and corneal reflexes

A decorticate posture indicates

damage to the nerve pathways in the midbrain,

A decerebrate posture indicates

severe damage to your brain or major disruptions in brain function. Some conditions that cause it are treatable, but most people with this symptom don’t survive.

Indicating the patient to close their eyes and ask where the nurse is touching the face is testing the

trigerminal nerve

When performing a neurological assessment, which of the following is a symptom of increasing inter-cranial pressure?

• Constricted pupils

• Decreasing level of consciousness

• narrowing blood pressure

• Bradyapnea

Decreasing level of consciousness. As the brain is under increasing pressure, it can't function properly, leading to confusion, drowsiness, lethargy, and eventually coma.

Normal effects of aging on the CNS

• reduced blood flow to the brain

• impaired short-term memory

• sleep disturbances

• decrease of acetylcholine

After a patient comes back from a CT scan, what should be encouraged ?

Drinking fluids

Using high top tennis shoes helps with ________ and should be included in patients care plan

foot drop