Neurological Assessment Quiz

Study Notes

Level of Consciousness (LOC)

LOC is a key assessment for evaluating a patient's alertness and cognitive response.
Categorized into alert, lethargic, obtunded, stuporous, and comatose states.
The Glasgow Coma Scale (GCS) evaluates LOC based on eye-opening, verbal response, and motor response.

Extremities Assessment

Involves assessing circulation, motion, and sensation in hands and feet.
Normal findings include warm, dry skin, full range of motion, and symmetrical muscle strength.
Abnormal findings may show cold extremities, weak pulses, or loss of sensation, indicating potential circulation issues.

Digital Clubbing

Clubbing is the thickening of fingers and nails, often indicating chronic hypoxia.
Common conditions leading to clubbing include COPD, lung cancer, and congenital heart diseases.

Capillary Refill

A test for assessing peripheral perfusion by pressing on the nail bed and measuring time for color return.
Normal capillary refill time is less than 2 seconds, while delayed refill (over 2 seconds) can indicate shock or peripheral vascular disease.

Pedal Edema

Swelling in lower extremities, often a result of heart failure or venous insufficiency.
Graded from +1 to +4 based on depth and persistence of pitting after pressure application.

Conditions That Cause Abnormal Assessment

Heart failure can lead to pedal edema and jugular venous distention (JVD).
Lung diseases such as COPD or pneumonia may cause digital clubbing, altered tactile fremitus, or abnormal percussion findings.

Tactile Fremitus

A chest wall vibration felt during speech, often assessed with "99."
Increased fremitus may indicate lung consolidation (e.g., pneumonia), while decreased fremitus may result from pneumothorax or pleural effusion.

Subcutaneous Emphysema

Condition characterized by trapped air under the skin, commonly due to trauma or chest tubes.
Present as a crackling sensation when pressing the skin, resembling bubble wrap.

Percussion

Normal percussion results in a resonant sound, indicating air-filled lungs.
Dullness suggests fluid or solid tissue, often seen in pleural effusion or pneumonia.
Hyperresonance indicates overinflation of lungs, as in emphysema or pneumothorax.

Spinal and Chest Abnormalities

Kyphosis refers to abnormal forward spine curvature, affecting respiratory function in elderly patients.
Scoliosis involves a lateral curvature of the spine, potentially compromising lung function.

Jugular Venous Distention (JVD)

Increased venous pressure in the neck that is prominent in right-sided heart failure.
Assessment performed with the patient elevated at a 45-degree angle; distended veins indicate higher central venous pressure.

Chest Expansion

Normal chest expansion should be equal on both sides during inspiration.
Unequal expansion indicates possible conditions like pneumothorax, pleural effusion, or lung collapse.

Anterior-Posterior (A/P) Diameter

Normal chest width to depth ratio is about 2:1.
In conditions like emphysema, a barrel chest appearance with a 1:1 ratio suggests hyperinflation.

Tracheal Deviation

The trachea shifts towards the affected side in atelectasis or lung collapse.
It moves away from the affected side in conditions like tension pneumothorax or large pleural effusion.

Description

This quiz focuses on the assessment of level of consciousness (LOC) and extremities assessment in neurological evaluations. It covers definitions, types of LOC, and assessment techniques like the Glasgow Coma Scale. Test your knowledge on how to evaluate alertness and cognitive responses effectively.