Neurologic Assessment: Cranial Nerve Examination

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to Lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

When integrating the neurologic examination into a broader physical assessment, which strategy optimizes efficiency?

  • Defer all cranial nerve assessments until the end to avoid disrupting the flow of the examination.
  • Perform neurologic tests, such as cranial nerve assessments, while examining related body areas. (correct)
  • Rely solely on patient history to guide the neurologic examination, foregoing physical tests unless specifically indicated.
  • Isolate each component of the neurologic exam to ensure thoroughness and minimize potential oversights.

A patient reports a recent head trauma. What olfactory nerve assessment technique would be most appropriate?

  • Presenting various odors sequentially to each nostril while the patient's eyes are open.
  • Testing the patency of the nasal passages using a light source
  • Recommending they seek evaluation with ENT (Ear Nose and Throat) specialist.
  • Occluding one nostril and presenting a familiar, non-irritating aromatic substance to the open nostril with eyes closed. (correct)

When assessing visual fields by confrontation, which instruction to the patient is most important for ensuring accurate results?

  • Ask them to report when they first detect a moving target in their peripheral vision.
  • Ensure they cover both eyes alternately to compare each side.
  • Instruct them to focus on your nose during the test. (correct)
  • Request they to follow the target with their eyes as it moves through each visual field.

During an eye exam, the assessment of palpebral fissures helps evaluate which cranial nerves?

<p>Oculomotor, Trochlear, and Abducens Nerves (C)</p> Signup and view all the answers

During an assessment of cranial nerve V (trigeminal nerve), a patient cannot feel light touch on their forehead. What is the most appropriate next step?

<p>Test light touch sensation on the patient's cheeks and chin to assess all three divisions of the trigeminal nerve. (B)</p> Signup and view all the answers

What is the purpose of the corneal reflex test, and which cranial nerves are involved?

<p>To assess sensory and motor functions, involving cranial nerves V and VII. (A)</p> Signup and view all the answers

During an examination of cranial nerve VII (facial nerve), which of the following observations would indicate dysfunction?

<p>Asymmetrical movement of the face when smiling or frowning. (A)</p> Signup and view all the answers

Which assessment technique is most appropriate for evaluating cranial nerve VIII (acoustic nerve)?

<p>Testing the patient's ability to hear a whispered voice at a distance. (A)</p> Signup and view all the answers

You are assessing cranial nerves IX and X. How should you interpret it if the patient's uvula deviates to the right when they say 'ahhh'?

<p>This suggests weakness of the left side of cranial nerves IX and/or X. (B)</p> Signup and view all the answers

What finding during cranial nerve XI assessment warrants further investigation?

<p>Asymmetrical size or strength of the sternomastoid and trapezius muscles. (B)</p> Signup and view all the answers

A patient is asked to stick out their tongue, and it deviates to the left. This observation suggests an issue with which cranial nerve?

<p>The hypoglossal nerve (XII). (D)</p> Signup and view all the answers

When documenting muscle strength, the evaluation should include what two elements?

<p>Strength testing and comparison bilaterally (C)</p> Signup and view all the answers

What observation during gait assessment suggests cerebellar dysfunction?

<p>An uneven and unsteady gait with a widened base of support. (C)</p> Signup and view all the answers

The Romberg test assesses?

<p>Cerebellar function related to balance. (B)</p> Signup and view all the answers

A patient struggles with rapid alternating movements. What does this suggest?

<p>Compromised cerebellar function. (B)</p> Signup and view all the answers

During sensory system assessment, what tests evaluate discrimination, specifically the ability to recognize objects by touch?

<p>Stereognosis and graphesthesia. (D)</p> Signup and view all the answers

In the context of reflexes, what best describes a 'reflex arc'?

<p>A direct sensory and motor neuron pathway that bypasses the brain for quick motor response. (C)</p> Signup and view all the answers

When grading reflexes, a score of 2 indicates?

<p>Average, normal reflex. (D)</p> Signup and view all the answers

When assessing superficial reflexes, stimulating the abdomen should result in?

<p>Contraction of the abdominal muscle with deviation of the umbilicus towards the stimulus (A)</p> Signup and view all the answers

The Babinski reflex is elicited by?

<p>Stimulating the lateral aspect of the sole of the foot. (A)</p> Signup and view all the answers

For patients with head trauma or neurologic deficits, what is the significance of frequent neurologic rechecks?

<p>To identify subtle changes, guiding early intervention. (B)</p> Signup and view all the answers

What is the Glasgow Coma Scale (GCS) used for?

<p>Grading eye opening, verbal response, and motor response. (C)</p> Signup and view all the answers

What is the AVPU scale designed to evaluate?

<p>Level of Consciousness. (A)</p> Signup and view all the answers

If the AVPU scale indicates that the patient is alert, what additional assessment is required?

<p>Checking their orientation to person, place, time, and events. (D)</p> Signup and view all the answers

Which of the following best describes 'apraxia'?

<p>Inability to perform purposeful movements or use objects properly. (D)</p> Signup and view all the answers

Which of the following is the MOST critical component of the Cincinnati Prehospital Stroke Scale?

<p>Facial droop, arm drift, and speech. (D)</p> Signup and view all the answers

The BEFAST acronym helps health professionals to?

<p>Identify stroke symptoms quickly. (B)</p> Signup and view all the answers

What signs are indicative of Cushing's Triad?

<p>Hypertension, Bradycardia, and Irregular Respirations (B)</p> Signup and view all the answers

Decerebrate posturing is more ominous than decorticate posturing because it indicates?

<p>Lesion in brain stem at midbrain or upper pons. (A)</p> Signup and view all the answers

An adult patient presents with irritability, restlessness, pale/cool/clammy skin, tachycardia, tachypnea, and hypotension. What condition should be suspected?

<p>Shock (A)</p> Signup and view all the answers

What is the clinical significance of observing 'doll's eyes' or absence of oculocephalic reflex?

<p>It indicates severe brainstem dysfunction. (B)</p> Signup and view all the answers

Compared to shock, what are the opposite symptoms of increased intracranial pressure?

<p>Bradycardia and Hypertension (C)</p> Signup and view all the answers

Which of the following findings would be MOST consistent with an upper motor neuron lesion?

<p>Weakness (paresis), spasticity, and hyperreflexia (A)</p> Signup and view all the answers

A person cannot distinguish faces but can recognize voices. What is the MOST likely diagnosis?

<p>Prosopagnosia (D)</p> Signup and view all the answers

What is the term for total paralysis?

<p>Quadriparesis (A)</p> Signup and view all the answers

Which mental status exam is performed if the appearance or behavior is abnormal?

<p>MMSE (A)</p> Signup and view all the answers

Flashcards

AVPU scale

A brief assessment to evaluate a patient's level of consciousness based on Alert, Verbal, Painful, and Unresponsive stimuli.

Glasgow Coma Scale (GCS)

A scale used to assess the level of consciousness in patients, based on eye-opening, verbal response, and motor response.

Apraxia

Inability to perform purposeful movements or make proper use of objects.

Agnosia

Inability to identify common objects.

Signup and view all the flashcards

Ataxia

Inability to walk, related to balance issues.

Signup and view all the flashcards

Expressive (Broca's) aphasia

Difficulty forming words, often associated with damage to Broca's area.

Signup and view all the flashcards

Receptive (Wernicke's) aphasia

Difficulty understanding words; comprehension issues, often associated with damage to Wernicke's area.

Signup and view all the flashcards

Global aphasia

Inability to understand or form words.

Signup and view all the flashcards

Facial Droop

Drooping of one side of the face, often a sign of stroke.

Signup and view all the flashcards

Arm Drift

When holding both arms out, one arm drifts downward compared to the other arm, often a sign of stroke.

Signup and view all the flashcards

Abnormal Speech

Slurred or inappropriate words; difficulty speaking. A sign of stroke.

Signup and view all the flashcards

BEFAST

Balance, Eyes, Face, Arms, Speech, Time. Acronym to recognize stroke symptoms and the importance of acting fast.

Signup and view all the flashcards

Olfactory Nerve (CN I)

Tests sense of smell; not typically performed routinely.

Signup and view all the flashcards

Optic Nerve (CN II)

Tests visual acuity and visual fields.

Signup and view all the flashcards

Oculomotor, Trochlear, Abducens Nerves (CN III, IV, VI)

CNs that control pupillary reaction and extraocular movements.

Signup and view all the flashcards

Trigeminal Nerve (CN V)

Tests muscles of mastication and facial sensation.

Signup and view all the flashcards

Facial Nerve (CN VII)

Tests motor function/facial symmetry and taste.

Signup and view all the flashcards

Acoustic Nerve (CN VIII)

Tests hearing acuity.

Signup and view all the flashcards

Glossopharyngeal and Vagus Nerves (CN IX and X)

CNs that control the gag reflex and swallowing.

Signup and view all the flashcards

Spinal Accessory Nerve (CN XI)

Tests sternomastoid and trapezius muscle strength.

Signup and view all the flashcards

Hypoglossal Nerve (CN XII)

Tests tongue movement and speech.

Signup and view all the flashcards

Gait Assessment

Observe as person walks, assessing smoothness and rhythm.

Signup and view all the flashcards

Romberg Test

Tests balance by having the person stand with feet together and eyes closed.

Signup and view all the flashcards

Rapid Alternating Movements (RAM)

Tests coordination of upper extremities.

Signup and view all the flashcards

Finger-to-Nose Test

Tests coordination by touching the finger to the nose.

Signup and view all the flashcards

Heel-to-Shin Test

Tests lower extremity coordination.

Signup and view all the flashcards

Stereognosis

Determines an object in the hand based on size, weight, texture, and shape.

Signup and view all the flashcards

Graphesthesia

Recognizing numbers traced on the palm.

Signup and view all the flashcards

Superficial Reflexes

Sensory receptors in skin cause localized muscle contraction.

Signup and view all the flashcards

Abdominal Reflexes

Normal response: ipsilateral contraction of abdominal muscle toward stroke.

Signup and view all the flashcards

Babinski Reflex

Normal response: Plantar flexion.

Signup and view all the flashcards

Cushing's Triad

Change in vital signs indicating increased pressure in the brain.

Signup and view all the flashcards

Late Signs ICP

Classic signs are fixed and dilated pupil; and loss of oculocephalic reflex.

Signup and view all the flashcards

Decorticate rigidity

Flexion of arm, wrist, and finger and adduction of upper arm. Indicates hemispheric lesion of cerebral cortex.

Signup and view all the flashcards

Decerebrate rigidity

Stiff extension, teeth clenched, hyperextended back. More ominous.

Signup and view all the flashcards

Related Documents

More Like This

Use Quizgecko on...
Browser
Browser