Neurological and Stroke Assessment
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Neurological and Stroke Assessment

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Questions and Answers

Which cranial nerve is primarily responsible for eye movements and pupil reactivity?

  • Trigeminal (CN V)
  • Optic (CN II)
  • Vagus (CN X)
  • Oculomotor (CN III) (correct)

    • What is the primary function of the Glossopharyngeal nerve (CN IX)?

  • Regulation of heart rate
  • Control of facial expressions
  • Vision adjustment
  • Taste sensation from the posterior tongue (correct)

    • Which cranial nerve is responsible for the gag reflex?

  • Glossopharyngeal (CN IX) (correct)
  • Trigeminus (CN V)
  • Abducens (CN VI)
  • Hypoglossal (CN XII)

    • What cranial nerve is responsible for chewing and sensation in the face?

    <p>Trigeminal (CN V)</p> Signup and view all the answers

    Which cranial nerve is responsible for moving the tongue and maintaining its midline position?

    <p>Hypoglossal (CN XII)</p> Signup and view all the answers

    What is the primary function of the cerebellum?

    <p>Balance and coordination</p> Signup and view all the answers

    Which lobe of the brain is responsible for processing vision?

    <p>Occipital lobe</p> Signup and view all the answers

    What type of neurological function involves mental status and memory?

    <p>Cognitive function</p> Signup and view all the answers

    What is the onset of stroke symptoms typically characterized by?

    <p>Sudden, unilateral muscle weakness</p> Signup and view all the answers

    In which direction do contralateral deficits manifest following a stroke?

    <p>On the opposite side of the body from the stroke</p> Signup and view all the answers

    What does a positive Romberg test indicate?

    <p>Swaying or falling while standing</p> Signup and view all the answers

    Which behavior should a nurse exhibit when assessing a patient with the Romberg test?

    <p>Stand beside the patient for safety</p> Signup and view all the answers

    What does decerebrate posturing indicate?

    <p>Outward movement of the arms and legs</p> Signup and view all the answers

    What cognitive function does the cerebrum primarily support?

    <p>Emotional regulation and personality</p> Signup and view all the answers

    Which symptom is least likely to be associated with a stroke?

    <p>Bilateral muscle weakness</p> Signup and view all the answers

    What role does the parietal lobe play in neurological assessment?

    <p>Integrating sensory information from the body</p> Signup and view all the answers

    What does a 'positive' result on the Romberg test indicate?

    <p>The patient sways or falls when eyes are closed</p> Signup and view all the answers

    Which of the following best describes decerebrate posturing?

    <p>Extended arms and legs away from the body</p> Signup and view all the answers

    When is it most critical to conduct a neurological assessment?

    <p>As soon as entering the patient's room</p> Signup and view all the answers

    Which of the following correctly describes the role of the temporal lobe?

    <p>Interpreting smell, sounds, and language</p> Signup and view all the answers

    What is one of the primary reasons to address stroke symptoms promptly?

    <p>Residual deficits may occur if there is a delay in treatment</p> Signup and view all the answers

    What is the primary purpose of the cerebellum in motor function?

    <p>Coordinating balance and fine motor skills</p> Signup and view all the answers

    Which of the following is not an aspect of sensory neurological functions?

    <p>Creating emotional memories</p> Signup and view all the answers

    Which cranial nerve is NOT involved in eye movement or pupil reactivity?

    <p>Optic (CN II)</p> Signup and view all the answers

    What is the primary responsibility of the Vagus nerve (CN X)?

    <p>Sensory and muscular sensation of the heart</p> Signup and view all the answers

    What function is NOT associated with the Glossopharyngeal nerve (CN IX)?

    <p>Facial sensation</p> Signup and view all the answers

    Which of the following cranial nerves is responsible for facial expressions?

    <p>Facial (CN VII)</p> Signup and view all the answers

    Which cranial nerve is critical for assessing the gag reflex?

    <p>Glossopharyngeal (CN IX)</p> Signup and view all the answers

    Which cranial nerve is primarily responsible for the ability to move the tongue side to side?

    <p>Hypoglossal (CN XII)</p> Signup and view all the answers

    What type of assessment tool is the Glasgow Coma Scale used for?

    <p>Mental status evaluation</p> Signup and view all the answers

    Which cranial nerve is responsible for clenching teeth?

    <p>Trigeminal (CN V)</p> Signup and view all the answers

    Which cranial nerve is primarily involved in monitoring taste sensation from the posterior tongue?

    <p>Glossopharyngeal (CN IX)</p> Signup and view all the answers

    Which cranial nerve is mainly involved in vision?

    <p>Optic (CN II)</p> Signup and view all the answers

    What is the primary function of the frontal lobe in the brain?

    <p>Regulating emotions and cognition</p> Signup and view all the answers

    Which symptoms are indicative of a stroke and should be addressed immediately?

    <p>Sudden unilateral muscle weakness and slurred speech</p> Signup and view all the answers

    In which scenario would a nurse perform a complete neurological assessment?

    <p>If a patient displays any stroke-like symptoms</p> Signup and view all the answers

    What does a negative Romberg test result indicate?

    <p>Successfully maintains posture without swaying</p> Signup and view all the answers

    Which lobe is primarily responsible for processing auditory information and smells?

    <p>Temporal lobe</p> Signup and view all the answers

    What underlying issue does decerebrate posturing suggest?

    <p>Severe brain dysfunction or injury</p> Signup and view all the answers

    What type of neurological function does the ability to feel touch and pain represent?

    <p>Sensory function</p> Signup and view all the answers

    What is the significance of the contralateral deficit observed in stroke patients?

    <p>Weakness occurs on the opposite side of the stroke</p> Signup and view all the answers

    During the Romberg test, what is the role of the nurse standing beside the patient?

    <p>To prevent falls in case of loss of balance</p> Signup and view all the answers

    Which cerebral lobe integrates sensory information from various modalities?

    <p>Parietal lobe</p> Signup and view all the answers

    Which cranial nerve is primarily responsible for motor functions of the face, including smiling and frowning?

    <p>Facial: CN VII (7)</p> Signup and view all the answers

    What is the primary equipment needed to assess the gag reflex?

    <p>Tongue depressor</p> Signup and view all the answers

    Which cranial nerve is NOT involved with the sensation and motor function of the digestive system?

    <p>Hypoglossal: CN XII (12)</p> Signup and view all the answers

    Which cranial nerves are responsible for eye movements and are collectively known for pupil reactivity?

    <p>Oculomotor: CN III (3), Trochlear: CN IV (4), Abducens: CN VI (6)</p> Signup and view all the answers

    What unique sensory role does the Glossopharyngeal nerve (CN IX) serve that is distinct from other cranial nerves?

    <p>Taste from the posterior tongue</p> Signup and view all the answers

    What is a primary responsibility of the Vagus nerve (CN X)?

    <p>Sensory and muscular functions of the heart and lungs</p> Signup and view all the answers

    Which cranial nerve primarily facilitates the motor function of clenching teeth?

    <p>Trigeminal: CN V (5)</p> Signup and view all the answers

    What function is specifically NOT associated with the cranial nerve responsible for the gag reflex?

    <p>Speech production</p> Signup and view all the answers

    Which cranial nerve ensures the ability to move the tongue side to side?

    <p>Hypoglossal: CN XII (12)</p> Signup and view all the answers

    Which of the following cranial nerves is responsible for transmitting visual information?

    <p>Optic: CN II (2)</p> Signup and view all the answers

    Which symptom suggests a more serious underlying issue when evaluating extremity conditions?

    <p>Numbness or tingling</p> Signup and view all the answers

    What defines osteoporosis?

    <p>Decreased bone density</p> Signup and view all the answers

    Which spinal deformity is characterized by an exaggerated curvature in the lumbar region?

    <p>Lordosis</p> Signup and view all the answers

    Which type of arthritis is classified as autoimmune?

    <p>Rheumatoid arthritis</p> Signup and view all the answers

    What distinguishes Bouchard’s nodes in arthritis?

    <p>Located at the proximal interphalangeal joints</p> Signup and view all the answers

    Why is Vitamin D important in relation to osteoporosis?

    <p>It enhances calcium absorption</p> Signup and view all the answers

    Which deformity causes a hunchback appearance commonly seen in older adults?

    <p>Kyphosis</p> Signup and view all the answers

    What symptom indicates a sudden onset and should be treated as a priority finding?

    <p>Sudden numbness</p> Signup and view all the answers

    Which finger deformity is specifically associated with osteoarthritis?

    <p>Bouchard’s nodes</p> Signup and view all the answers

    Which characteristic is true for osteoarthritis?

    <p>Wear and tear of the cartilage</p> Signup and view all the answers

    What should be assessed first during a physical assessment of mobility limitations?

    <p>Health history</p> Signup and view all the answers

    What is the primary purpose of asking about persistent pain and swelling after an injury?

    <p>To determine if a fracture is likely</p> Signup and view all the answers

    Which factor most significantly increases the risk of falls in aging individuals?

    <p>Declining muscle mass</p> Signup and view all the answers

    What type of gait is most commonly associated with Parkinson's disease?

    <p>Shuffling gait</p> Signup and view all the answers

    Which of the following movements is NOT part of basic terms used to describe range of motion?

    <p>Inversion</p> Signup and view all the answers

    What does a muscle strength grade of '2' indicate?

    <p>Able to move joint without gravity</p> Signup and view all the answers

    Which finding would suggest a need for neurovascular assessment after an injury?

    <p>Numbness or tingling in the extremity</p> Signup and view all the answers

    Which symptom is most likely experienced when stopping ibuprofen abruptly?

    <p>Pain/Stiffness</p> Signup and view all the answers

    What part of the brain dysfunction might be indicated by ataxia?

    <p>Cerebellum</p> Signup and view all the answers

    Which of the following ranges of motion occurs when a person sits down?

    <p>Flexion of the hip</p> Signup and view all the answers

    What is the likely effect of aging on muscle mass?

    <p>Muscle mass declines progressively.</p> Signup and view all the answers

    Which of the following is NOT a term used to describe basic movements?

    <p>Circumduction</p> Signup and view all the answers

    In a neurovascular assessment, which 'P' signifies the sensation of tingling or numbness?

    <p>Paresthesia</p> Signup and view all the answers

    What does a strength grading of '4' indicate?

    <p>Full range of motion against gravity with some resistance.</p> Signup and view all the answers

    What type of gait is commonly associated with Parkinson's disease?

    <p>Shuffling gait</p> Signup and view all the answers

    Which of the following is most critical to assess after a fall or injury?

    <p>Neurovascular status</p> Signup and view all the answers

    If a patient stops taking ibuprofen, what would they likely experience?

    <p>Pain and stiffness</p> Signup and view all the answers

    What condition may be implied by persistent pain and swelling after a fall?

    <p>Fracture</p> Signup and view all the answers

    Which action is assessed before strength and range of motion during a physical exam?

    <p>Patient's mobility limitations</p> Signup and view all the answers

    What is considered an abnormal gait that may indicate weakness in the lower extremities?

    <p>Ataxia</p> Signup and view all the answers

    What is a common consequence of osteoporosis that underscores the importance of fall prevention?

    <p>Height loss</p> Signup and view all the answers

    Which spinal deformity is characterized by a significant forward curvature, often leading to a hunchback appearance?

    <p>Kyphosis</p> Signup and view all the answers

    In which type of arthritis do you find the presence of Heberden’s nodes?

    <p>Osteoarthritis</p> Signup and view all the answers

    Which note is associated with the proximal interphalangeal joints and can be seen in both osteoarthritis and rheumatoid arthritis?

    <p>Bouchard’s nodes</p> Signup and view all the answers

    Which deficiency is critical for the body's absorption of calcium, particularly in the context of bone growth?

    <p>Vitamin D</p> Signup and view all the answers

    Which joint deformity primarily affects the proximal interphalangeal joints and is a characteristic of rheumatoid arthritis?

    <p>Bouchard’s nodes</p> Signup and view all the answers

    What is the term for the

    <p>Osteoporosis</p> Signup and view all the answers

    What should be a primary concern when a symptom has a sudden onset?

    <p>It likely warrants immediate attention</p> Signup and view all the answers

    Which of the following accurately describes the condition of lordosis?

    <p>Outward curvature of the lower back</p> Signup and view all the answers

    In osteoarthritis, where are the Bouchard’s nodes typically found?

    <p>Proximal interphalangeal joints</p> Signup and view all the answers

    Study Notes

    Neurological Assessment

    • Brain Anatomy:

      • Cerebrum: Responsible for higher-level functions (emotions, cognition, personality) divided into four lobes:
        • Frontal: Emotions, cognition, personality, Broca's area
        • Parietal: Sensory information integration
        • Temporal: Smell, sound, language
        • Occipital: Vision
      • Cerebellum: Balance and coordination
      • Brainstem: Vital functions

    • Neurological Functions:

      • Sensory: Sight, hearing, smell, touch, etc.
      • Motor: Movement, strength, range of motion (ROM), gait
      • Cognitive: Mental status, orientation, memory

    • Neurological Assessment Timing: Neurological assessment begins immediately upon entering the room. Mental status is prioritized, especially in older adults, as an early indicator of potential problems.

    Stroke Assessment

    • Stroke Symptoms:

      • Sudden, unilateral muscle weakness
      • Slurred speech
      • Facial droop
      • Aphasia (difficulty speaking or understanding speech)
      • Unequal strength/movement on one side of the body/face

    • Stroke Onset: Symptoms onset can be sudden, and any asymmetry in strength or movement between sides of the body or face should be immediately evaluated.

    • Priority of Stroke Assessment: Immediate assessment is crucial to minimize potential permanent deficits.

    • Unilateral vs. Bilateral Symptoms: Unilateral symptoms (one side) are more concerning for stroke.

    • Assessment for Stroke Suspicion: Complete neurologic assessment is required if stroke is suspected.

    • Side of Body Deficit: Stroke deficits typically manifest on the opposite side of the body compared to the damaged brain region (contralateral).

    Posturing

    • Decorticate Posturing: Inward arm positioning
    • Decerebrate Posturing: Outward arm positioning

    Romberg Test

    • Procedure: Patient stands with feet together, eyes closed.
    • Nurse Positioning: Nurse stands beside the patient, positioned to prevent falls.
    • Instructions: Patient closes eyes.
    • Assessment: Assessing balance, coordination, and proprioception (position sense).
    • Positive Test: Swaying or falling, using arms to maintain balance.
    • Negative Test: Maintains posture without assistance.
    • Normal Result: Negative test.
    • Positive Result Indication: Cerebellar dysfunction.

    Mental Status Assessment

    • Glasgow Coma Scale (GCS): Scale used to assess the level of consciousness and cognitive function in patients with a possible brain injury.
    • Interpretation & Scoring: GCS scores help determine the severity of a possible brain injury (mild, moderate, and severe).

    Cranial Nerves

    • Eye Movement & Pupil Reactivity (3, 4, 6):

      • Oculomotor (CN III): Eye movement, pupil reactivity
      • Trochlear (CN IV): Eye movement
      • Abducens (CN VI): Eye movement, pupil reactivity

    • Gag Reflex (9):

      • Glossopharyngeal (CN IX): Gag reflex. Taste. Posterior tongue, tonsils, pharynx, and pharynx muscles
      • Necessary Equipment: Tongue depressor
      • Next Assessment If Gag Absent: Check pharyngeal sensation
      • Additional Functions: Taste - does not include speech/chewing. Distiguishing CN IX and X is critical.

    • Tongue Position & Movement (12):

      • Hypoglossal (CN XII): Midline positioning and side-to-side movement of the tongue.

    • Chewing (5):

      • Trigeminal (CN V): Chewing (clenching teeth)

    • Facial Movement (7):

      • Facial (CN VII): Facial expressions (smiling, frowning, puffing cheeks)

    • Vision (2):

      • Optic (CN II): Vision

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    Description

    This quiz assesses knowledge of brain anatomy, neurological functions, and stroke symptoms. It covers key concepts related to the assessment of cognitive, sensory, and motor functions, with an emphasis on early detection, especially in older adults. Test your understanding of these crucial neurological topics.

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