Ch. 30 Neurological System
Page 1: Health Assessment Overview
Neurological System
Introduction to the health assessment of the neurological system.
Page 2: Health History
Key health history elements include:
Headache: Document frequency, duration, and intensity.
Dizziness or Vertigo: Distinguish between subjective (patient's perception) and objective (clinician's observation) symptoms.
Seizure History: Record frequency, type, and duration of seizures.
LOC Changes: Document any loss of consciousness events.
Altered Mobility: Note any difficulties in physical movement.
Altered Sensation: Include changes in touch, pain, temperature perception.
Dysphagia and Aphasia: Assess and document any swallowing difficulties or language impairments.
Page 3: Physical Examination
Assessment Components
Cerebrum Function: Evaluate reasoning and judgment.
Cerebellar Function and Proprioception: Assess balance and coordination.
Cranial Nerves: Examine function through specific tests.
Sensory Function: Measure sensation across different modalities.
Motor Function: Evaluate strength and coordination of muscle movements.
Deep Tendon Reflexes: Test reflex responses for neurological health.
Page 4: FROMAJE (Cerebrum Function)
Functional Assessments:
ADLs: Activities of daily living performance.
Reasoning: Ability to interpret idioms or analogies.
Orientation: Assess temporal and spatial awareness (time, place, person).
Memory: Short-term (e.g., remember 3 words) vs. long-term recall.
Arithmetic: Ability to perform simple calculations (e.g., subtracting 7 from 100).
Judgment: Situational judgment responses.
Emotion: Inquiry about suicidal or homicidal thoughts.
Page 5: Mini-Mental State Exam (MMSE)
Exam Components
Orientation: Ask about year, season, date, and location.
Registration: Test recall of 3 objects after prompting.
Attention and Calculation: Serial sevens or spelling words backward.
Recall: Request the repeated objects again.
Language: Various tasks to assess language use and comprehension.
Total Score: Aggregate score from the MMSE.
Page 6: Cerebellar Function
Balance and Coordination Tests
Balance:
Perform Romberg test, heel-toe walk (duck walk).
Conduct hip-hop jump as a coordination exercise.
Coordination:
Use finger-nose test and rapid alternating motion.
Perform heel down shin test for lower extremity coordination.
Page 7: Finger-Nose Test
Specifically designed test for assessing coordination and cerebellar function.
Page 8: Cranial Nerves
Overview of the 12 Cranial Nerves
Cranial Nerves List:
Olfactory
Optic
Oculomotor
Trochlear
Trigeminal
Abducens
Facial
Acoustic
Glossopharyngeal
Vagus
Spinal Accessory
Hypoglossal
Mnemonic: Some say marry money but my brother says big benefits matter. (S=sensory, M=motor, B=both)
Page 9: Cranial Nerve Anatomy
Detailed anatomical pathways:
Olfactory nerve
Optic nerve
Oculomotor nerve
Trochlear nerve
Trigeminal nerve
Abducens nerve
Others listed sequentially.
Page 10: Cranial Nerve Summary
Numbering and functional arrangements of cranial nerves presented in a table format.
Page 11: Cranial Nerve Functions
Detailed roles of key cranial nerves with sensory and motor fibers:
Olfactory: Sensory to the nose.
Optic: Sensory to the eye.
Facial: Motor to facial muscles, sensory for taste anterior tongue.
Vestibulocochlear: Sensory for hearing and balance.
Continue categorizing others based on motor and sensory functions.
Page 12: Sensory Function Assessment
Evaluation Techniques
Sensory Assessment Types:
Tactile perception.
Pain perception.
Vibratory sense.
Position sense testing (proprioception).
Page 13: ASIA (American Spinal Injury Association)
Assessment of Neurological Function
Exam Components: Document sensory and motor responses.
Scoring based on key sensory points and muscle function for upper/lower limbs.
Page 14: Sensory Impairment and Spinal Cord Injury Levels
Dermal Segmentation and Key Indicators:
C5 - Anterolateral shoulder.
T4 - Nipple line.
T10 - Navel region.
Page 15: Stereognosis Test
Identification of small objects by touch to assess for parietal lobe dysfunction.
Page 16: Graphesthesia Test
Ability to recognize drawn letters/numbers to assess potential parietal damage.
Page 17: Two-Point Discrimination Test
Measure tactile sensitivity by identifying points on the skin when touched.
Page 18: Motor Function Evaluation
Key Assessments
Evaluate:
Muscle strength and tone.
Posture and body alignment.
Balance and coordination.
Fine motor control.
Page 19: Deep Tendon Reflexes
Testing List
Key reflexes include:
Triceps, biceps, brachioradialis, patellar, Achilles.
Babinski’s reflex noted as abnormal in adults (indicates motor tract issues).
Findings will be recorded on a 0-4+ scale.
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Placeholder Content
Additional data not readily identifiable from transcript.
Page 21: Achilles Reflex Testing
Methodology for performing Achilles reflex tests and expected responses.
Page 22: Babinski Sign Assessment
Interpretation of fanning toes in response to stimuli; normal in infants but abnormal in adults.
Page 23: The Glasgow Coma Scale
Scoring Criteria
Eye Opening: Various responses recorded on a scale.
Verbal Response: Levels from oriented to absent response.
Best Motor Response: Command obedience to localization of pain.
Total Coma Score: Aggregated score indicating consciousness level.
Page 24: Overview of Neurological Assessment
Components
Comprehensive evaluation aspects:
Assess mental status and cognitive function.
Motor capabilities with emphasis on coordination.
Cranial nerve testing for functionality.
Assess sensory capabilities.
Test reflex activities for neurological integrity.
Page 25: Additional Skills Resources
Skills Video
ATI Skills Module 3.0 for comprehensive physical assessments.
Review of head to toe assessment techniques available.