Neurological Assessment

1
Neurological Assessment

• Prof. Valerie Bosco
• USF, School of Nursing
• N241

2
Level of Consciousness (LOC)

• How awake is your client?
• Cooperative?
• Attention span?
• Short-term memory?
• Recognize relatives or objects?
• Overall behavior?
• Glasgow Coma Scale and MMSE (cognition)

3
Glasgow Coma Scale (GCS)
4
Cranial Nerves (I - XII)

• Cranial Nerves
• CN I Olfactory
• CN II Optic
• CN III Pupillary
• CN III, IV, VI EOMs
• CN V Trigeminal
• CN VII Facial
• CN VIII Acoustic
• CN IX, X Glossopharyngeal
• CN XI Accessory
• CN XII Hypoglossal

5
Deep Tendon Reflexes (DTR)

• DTRs
• Biceps
• Triceps
• Brachioradialis (supinator)
• Abdomen
• Quadriceps (knee-jerk)
• Achilles (ankle jerk)
• Grasp/Plantar (Babinski)

6
Developmental Considerations

• Infant Primary Reflexes
• Rooting
• Sucking
• Moro
• Palmar Grasp
• Plantar Grasp
• Babinski

7
Assessing Cerebellar Function

• Romberg Test
• Heel-to-Shin Test
• Heel and Toe Walking
• Rapid Alternating Movements
• Point-to-Point Localization

8
Sensory Assessment

• Superficial Pain
• Temperature Sensation
• Sense of Position
• Stereognosis and Graphesthesia
• Two-point Discrimination
• Number Identification

9
You tell me.

• Paramedics bring in an 80 yr. old male who was
  unable to recognize his wife. He could not move
  his left side. Speech is garbled, pupils are
  reactive. Hx of HTN, MI in 90. What else?