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ASSESSING THE SENSORY-NEUROLOGICAL SYSTEM

ASSESSING THE SENSORY-NEUROLOGICAL SYSTEM. Outcomes. Identify pertinent neuro/sensory history questions. Obtain a neuro/sensory history. Perform a neuro/sensory physical assessment. (Continued). Outcomes. Document pertinent neuro/ sensory assessment findings.

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ASSESSING THE SENSORY-NEUROLOGICAL SYSTEM

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  1. ASSESSING THE SENSORY-NEUROLOGICAL SYSTEM

  2. Outcomes • Identify pertinent neuro/sensory history questions. • Obtain a neuro/sensory history. • Perform a neuro/sensory physical assessment. (Continued)

  3. Outcomes • Document pertinent neuro/ sensory assessment findings. • Identify actual/potential health problems stated as nursing diagnosis. • Differentiate between normal and abnormal findings.

  4. Structures • Cerebrum  Cortex • Frontal lobe  Temporal lobe • Limbic system  Parietal lobe • Occipital lobe  RAS • Thalamus  Hypothalamus • Cerebellum  Brainstem • Midbrain  Medulla • Meninges  Ventricles

  5. FunctionsWhat are the functions of… Cerebrum: Largest part of brain Cortex: Outer layer of cerebrum; controls most conscious processes Frontal Lobe: Emotional expression, Broca’s area (expressive language) (Continued)

  6. FunctionsWhat are the functions of… Temporal lobe: Hearing, taste, smell, memory, Wernike’s (language comprehension) Limbic system: Emotions, sexual arousal, behavioral expression, recent memory (Continued)

  7. FunctionsWhat are the functions of… Parietal: Sensory input Occipital lobe: Vision and spatial relationships RAS: Wakefulness (Continued)

  8. FunctionsWhat are the functions of… Thalamus: Clusters multiple sensory stimuli Hypothalamus: Controls autonomic nervous system and pituitary gland Cerebellum: Coordination, equilibrium (Continued)

  9. FunctionsWhat are the functions of… Brainstem: Involuntary survival behaviors; includes midbrain, medulla and pons Midbrain: Visual, auditory, pupils, and eye movements (Continued)

  10. FunctionsWhat are the functions of… Medulla: Regulates heart, respiratory rates, B/P, and protective reflexes Pons: Helps with respiratory function, facial sensation and movement (Continued)

  11. FunctionsWhat are the functions of… Meninges: 3 layers (pia, arachnoid, dura); protect brain and spinal cord Ventricles: 4 cavities; capillaries produce and reabsorb CSF (Continued)

  12. Relationship to Other Systems What is the relationship of the neurologic/ sensory system to other systems? • Integumentary  Respiratory • HEENT  Musculoskeletal • Lymphatic  Genitourinary • Cardiovascular  Endocrine • Hematological  Gastrointestinal

  13. DevelopmentalVariations What developmental variations of the neurologic/sensory system might you seen with: • Children • Pregnant clients • Older adults

  14. Cultural Variations What cultural variations of the neurologic/sensory system might be seen with: • African Americans • Irish • Native Americans

  15. HistoryWhat can the history tell you about the neurologic/sensory system? • Biographical data • Current health status • Past health history • Family history • Review of systems • Psychosocial history

  16. SymptomsWhat symptoms would signal a problem with the neurologic/sensory system? • Headache • Mental status change • Dizziness, vertigo, syncope • Numbness or loss of sensation • Deficits of the 5 senses

  17. Physical Assessment Approach: inspection, palpation, and auscultation Position: sitting Tools: stethoscope, B/P cuff, penlight, gloves, cotton, sharp object, coin, fragrance, sweet and sour substance, tongue blade, test tubes, reflex hammer, ophthalmoscope General Survey and head-to-toe scan

  18. Cerebral Function • Behavior • Level of consciousness: time, place, person • Glasgow Coma Scale • Memory: immediate, recent, remote • Mathematical ability • Thought process  Judgement • General knowledge  Communication

  19. Sensory Function Superficial sensations: • Light touch • Pain • Temperature Deep sensations: • Vibratory sensations • Kinesthetics (Continued)

  20. Sensory Function Discriminatory sensations: • Stereognosis • Graphesthesia • 2 point discrimination • Point localization • Extinction

  21. Deep Tendon Reflexes • Biceps • Triceps • Brachioradialis • Patellar • Achilles

  22. Superficial Reflexes • Plantar • Abdominal • Anal • Cremasteric • Bulbocavernosus

  23. Protective Reflexes • Gag • Cough • Swallow • Blink • Corneal

  24. Primitive Reflexes • Babinski • Sucking • Grasp • Rooting • Snout • Glabellar

  25. Meningeal Signs • Nuchal rigidity • Kernig’s Sign • Brudzinski’s Sign

  26. Motor Function • Finger-to-nose • Heel-to-shin • Rapid alternating movements • Romberg • Gait: heel-to-toe

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