Neurology - 2

1. Neurology - 2 Part 2

2. Intellectual Function Calculations Count backwards from 100 Spell backwards Integrative capacity How are a cat and a wolf alike? Judgment Interpret a well known proverb A bird in the hand is worth more than two in the bush. The early bird catches the worm

3. Intellectual Function Judgment You arrive home without a house key, what alternatives do you have? Short term memory test? 3 words Repeat in 5 minutes Amnesia Loss of memory

4. Thought Content Are the thoughts�? Spontaneous Natural Clear Relevant Coherent

5. Thought Content Fixed ideas Preoccupations

6. Hallucinations False perceptions (sensory) Does not have an external stimuli Patients see, hear, taste things that are not really there

7. Illusions Has a real external stimuli, but the patient misinterprets the stimuli

10. Delusions False beliefs

12. Emotional Status Affect/ Mood Consistent Appropriate Facial expressions, body language

13. Perception Agnosia The inability to interpret or recognize objects Visual Occipital Auditory Temporal Tactile Parietal lobe

14. Motor Ability Ask to perform a small task Understanding + motor strength Movement smooth, coordinated Involuntary movements Gait

15. Language Ability Spoken and written Aphasia Expressive Motor aphasia Broca�s aphasia Receptive Sensory aphasia Wernicke�s aphasia Global

16. Language ability Dysphasia / aphasia Dysphagia / aphagia Dysarthria Imperfect articulation of speech

17. Terminology Anosmia I - Inability to smell Anisocoria J - Inequality of pupil size Agnosia F - Inability to determine meaning or significance of sensory stimulus Apraxia G - Inability to performed learned movements, defect in motor planning Analgesia M - Loss of pain sensation Anesthesia A - Absence of sensation

18. Terminology Astereognosis H - Inability to recognize form of object by touch Ataxia L - Lack of coordination of movement Diplopia C - Double vision Dysarthria K - Lack of coordination in articulating speech Dyskinesia E - Impairment of power of voluntary movement, resulting in fragmentary on incomplete movements

19. Terminology Dysphagia B - Difficulty swallowing Homonymous hemianopsia N - Loss of vision in one side of visual field Ophthalmoplegia P - Paralysis of eye muscles Opisthotonus D - Extreme arching of back with retraction of head Paraplegia O - Paralysis of all extremities

20. Small group Questions What does battle�s sign indicate What does raccoon eyes indicate What is rhinorrhea and how do you know they have it? What is Otorrhea and what does it indicate? Described decorticated and Decerebrated posturing and what they each indicate What are the three areas of orientation How do you test judgment? Short term memory Differentiate be hallucinations, delusions and illusions.

21. Cranial Nerves 12 pairs PNS You must know: The name The number The order The function S/M How to assess

22. Cranial Nerves Number -1 Name: Olfactory Sensory Function Sense of smell Assessment Identify familiar odor

23. Cranial Nerves Number -2 Name: Optic Sensory Function Visual Acuity Assessment Snellen eye chart

24. Cranial Nerves Number -3 Name: Oculomotor Motor Function Muscles the move the eye, lid, papillary constriction, lens accommodation Assessment Test for ocular rotation, nystagmus, Papillary reflexes, check for ptosis

25. Nystagmus: Involuntary osculation of the eyeball

26. Ptosis Drooping eyelid

27. Ptosis

28. Papillary reflexes Pupil changing in size when exposed to light

29. Cranial Nerves Number -4 Name: Trochlear Motor Function Muscles the move the eye, lid, papillary constriction, lens accommodation Assessment Test for ocular rotation, nystagmus, Papillary reflexes, check for ptosis

30. Cranial Nerves Number -5 Name: Trigeminal Sensory & Motor Function Facial sensation, corneal reflex, mastication Assessment Distinguish between sharp and dull on face Check blink reflex Have patient clinch and move jaw from side to side, feel jaw strength

33. Cranial Nerves Number -6 Name: Abducens Motor Function Muscles the move the eye, lid, papillary constriction, lens accommodation Assessment Test for ocular rotation, nystagmus, Papillary reflexes, check for ptosis

34. Cranial Nerves Number - 7 Name: Facial Sensory & Motor Function Facial expression and muscle movement Salivation and tearing Taste Sensation in the ear Assessment Observe for symmetry while pt performs facial movement Stick out tongue Distinguish between sugar and salt

36. Cranial Nerves Number -8 Name: Acoustic Sensory Function Hearing & equilibrium Assessment Simple hearing test

38. Cranial Nerves Number -9 Name: Glossopharyngeal Sensory & Motor Function Taste Sensation in pharynx and tongue Pharyngeal muscles Assessment Ability to discriminate btw sugar and salt

39. Cranial Nerves Number -10 Name: Vagus Sensory & Motor Function Muscle of pharynx, larynx, thoracic and abdominal viscera Parasympathetic innervations of thoracic and abdominal organs Assessment Gag response Have person say �Ah�.� Symmetrical rise of uvular and soft palate Assess swallowing

41. Cranial Nerves Number -11 Name: Accessory Motor Function Shoulder movement Assessment Strength of muscle, shrug

42. Cranial Nerves Number -12 Name: Hypoglossal Motor Function Tongue movement Assessment Check tongue strength and movement

43. Sample quiz questions What cranial nerve is responsible for hearing and equilibrium? Vagus Acoustic Glossopharyngeal Accessory Vagus � parasym and pharynx Accessory � shoulder movement Glossopharygeal � taste, AcessVagus � parasym and pharynx Accessory � shoulder movement Glossopharygeal � taste, Acess

44. Sample Quiz Questions What Cranial nerve is responsible for tongue movement? 6 8 10 12 None of the above 6 � abducens � eye movemetn 8 acoustic � hearing and equilibrium 10 vagus � parasympathetic and phrynx 12 hypoglossal � tongue*****6 � abducens � eye movemetn 8 acoustic � hearing and equilibrium 10 vagus � parasympathetic and phrynx 12 hypoglossal � tongue*****

45. Sample Quiz Questions How do you test for cranial nerve number 3? Snellen eye chart Hearing test Have them follow your pen with their eyes as you move it about Have them stick out their tongue No, hypoglossal � 12 No, 8 acoustic A. optic, 2 � visual acoutyNo, hypoglossal � 12 No, 8 acoustic A. optic, 2 � visual acouty

46. Sample Quiz Questions When you check for nystagmus, what cranial nerve are you assessing? Olfactory Optic Abducens All of the above None of the above Olfactory � smell All of the above � no Optic � vision Abducens yes! Olfactory � smell All of the above � no Optic � vision Abducens yes!

47. Sample Quiz Questions When you check someone's shoulder strength, what cranial nerve are you assessing? 6 8 10 12 None of the above 6 abducens � eye movement Acoustic � hearing and equilibrium 10 vagus � parasympathetic and pharynx 12 � hypoglossal � tongue None of the above6 abducens � eye movement Acoustic � hearing and equilibrium 10 vagus � parasympathetic and pharynx 12 � hypoglossal � tongue None of the above

48. Learning Tip On Old Olympus Towing Top a Finn and German Viewed A Hawk