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Comprehensive Overview of Neurological Functions and Assessments

This document explores critical aspects of neurological evaluations, focusing on intellectual function, thought content, emotional status, perception, motor ability, language ability, and cranial nerve assessments. It details various cognitive tests, such as backward counting, memory recall, and judgment scenarios, as well as terminology related to neurological conditions. The text further discusses hallucinations, delusions, and assessments of cranial nerves, providing a thorough understanding of neurological health and disorders.

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Comprehensive Overview of Neurological Functions and Assessments

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  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

  8. Delusions • False beliefs

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

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

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

  12. Language Ability • Spoken and written • Aphasia • Expressive • Motor aphasia • Broca’s aphasia • Receptive • Sensory aphasia • Wernicke’s aphasia • Global

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

  14. 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

  15. 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

  16. 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 lower extremities

  17. 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.

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

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

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

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

  22. Nystagmus: • Involuntary osculation of the eyeball

  23. Ptosis • Drooping eyelid

  24. Papillary reflexes • Pupil changing in size when exposed to light

  25. 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

  26. 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

  27. 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

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

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

  30. 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

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

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

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

  34. Sample quiz questions What cranial nerve is responsible for hearing and equilibrium? • Vagus • Acoustic • Glossopharyngeal • Accessory

  35. Sample Quiz Questions What Cranial nerve is responsible for tongue movement? • 6 • 8 • 10 • 12 • None of the above

  36. 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

  37. 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

  38. Sample Quiz Questions When you check someone's shoulder strength, what cranial nerve are you assessing? • 6 • 8 • 10 • 12 • None of the above

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

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