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    Neurologica L Assessment: Lijo Joseph Msc. Nursing Ist Yr

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    Bibi Renu
    The document provides information on neurological assessment including: 1. The assessment involves obtaining a health history, physical examination assessing things like cranial nerves and motor/sensory systems, and diagnostic evaluations like CT scans, MRIs, and angiograms. 2. The physical examination involves assessing cranial nerves, motor function, reflexes, and sensory systems by testing things like strength, coordination, balance, and sensation. 3. Diagnostic evaluations include radiological studies like CT scans and MRIs to detect abnormalities as well as angiography to visualize blood vessels.

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    Neurologica L Assessment: Lijo Joseph Msc. Nursing Ist Yr

    Uploaded by

    Bibi Renu
    374 views38 pages
    The document provides information on neurological assessment including: 1. The assessment involves obtaining a health history, physical examination assessing things like cranial nerves and motor/sensory systems, and diagnostic evaluations like CT scans, MRIs, and angiograms. 2. The physical examination involves assessing cranial nerves, motor function, reflexes, and sensory systems by testing things like strength, coordination, balance, and sensation. 3. Diagnostic evaluations include radiological studies like CT scans and MRIs to detect abnormalities as well as angiography to visualize blood vessels.

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    Neurological Assessment

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    The document provides information on neurological assessment including: 1. The assessment involves obtaining a health history, physical examination assessing things like cranial nerves and motor/sensory systems, and diagnostic evaluations like CT scans, MRIs, and angiograms. 2. The physical examination involves assessing cranial nerves, motor function, reflexes, and sensory systems by testing things like strength, coordination, balance, and sensation. 3. Diagnostic evaluations include radiological studies like CT scans and MRIs to detect abnormalities as well as angiography to visualize blood vessels.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    374 views38 pages

    Neurologica L Assessment: Lijo Joseph Msc. Nursing Ist Yr

    Uploaded by

    Bibi Renu
    The document provides information on neurological assessment including: 1. The assessment involves obtaining a health history, physical examination assessing things like cranial nerves and motor/sensory systems, and diagnostic evaluations like CT scans, MRIs, and angiograms. 2. The physical examination involves assessing cranial nerves, motor function, reflexes, and sensory systems by testing things like strength, coordination, balance, and sensation. 3. Diagnostic evaluations include radiological studies like CT scans and MRIs to detect abnormalities as well as angiography to visualize blood vessels.

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    NEUROLOGICA

    L ASSESSMENT
    LIJO JOSEPH
    MSc. NURSING IST YR
    ANATOMY & PHYSIOLOGY OF BRAIN
    NEURON
    Introduction
    *When assessing the patient, always compare left to right

    *Asymmetry is abnormal
    *Do your exam the same way every time;
    start at the top and work down
    *Assess: LOC and Language,
    Cranial Nerves
    Motor Cerebellar
    Sensory
    ASSESSMENT
    1. HEALTH HISTORY

    2. PHYSICAL EXAMINATION

    3. CLINICAL MANIFESTATION

    4. DIAGNOSTIC EVALUATION
    HEALTH HISTORY
     HISTORY OF PRESENT ILLNESS
     DETAILS OF SYMPTOMS
     ONSET
     CHARACTER
     SEVERITY

     LOCATION
     DURATION

     FREQUANCY OF SYMPTOMS
    Cont……
     PRECEPITATING,AGGRAVATING & RELIEVING
    FACTORS
     SIMILAR SYMPTOMS AMONG FAMILY MEMBERS.
     FAMILY HISTORY OF GENETIC DISEASES
     HISTORY OF HEAD & SPINAL CORD TRAUMA
     HISTORY OF USE OF ALCOHOL & MEDICATION
    PHYSICAL EXAMINATION

    ASSESS
    i. CEREBRAL FUNCTION
    ii. CRANIAL FUNCTION
    iii. MOTOR SYSTEM
    iv. SENSORY SYSTEM
    v. REFLEXES
    ASSESSING CEREBRAL FUNCTION
    Mental status
    Intellectual
    function
    Emotional status
    Thought content
    Perception
    Motor ability
    Language ability
    EXAMINIG CRANIAL FUNCTION
    Olfactory
    Optic
    Oculomotor
    Trochlear
    Abducens
    Trigeminal
    Facial
    Acoustic
    Cont……
    Glossopharyngeal
    Vagus
    Accessory
    Hypoglossal
    Neuro Assessment
    CN I Olfactory: smell; skip except in facial trauma

    CN II Optic:
     vision
     count fingers
     Snellen eye chart
     Visual fields
     Ophthalmoscopy
    CN III Oculomotor:
    moves eyes in all
    directions except
    outward and down &
    in; opens eyelid;
    constricts pupil

    CN IV Trochlear:
    moves eyes down & in
    Neuro Assessment
    CN VI Abducens:

     moves eyes outward


     test for pupillary reflexes
     Inspect eyelid for ptosis
    CN V Trigeminal:
    3 branches;
    1. sensation to the face,
    2. cornea and scalp;
    3. opens jaw against resistance

    Check sensation by sharp & dull ended instruments


    Facial:
    CN VII
    Observe
    Symmetry in facial movement
    • Eg: smile , elevate eye brow
    CN VIII Acoustic:
    2 branches,
    1. acoustic (hearing)
    2. vestibular (balance)
    Test for air & bone conduction(Rinne)
    Test for lateralization(weber).
    CN IX Glossopharyngeal:

    Assess ability to discriminate


    between sugar & salt on the
    posterior third of the tongue
    CN X Vagus:

    Depress the tongue blade


    on posterior tongue or
    stimulate posterior pharynx
    to elicit gag reflex.
    CN XI Spinal Accessory:
    turns head and elevates shoulders.
    That is;
    palpate & note the strength
    of each stenocleidomastoid
    muscles as patient turns
    head against opposing pressure
    of the examiner hand.
    CN XII Hypoglossal:
    moves tongue
    That is
     While patient protrudes the
    tongue, any deviation or
    tremors are noted.
     The strength of the tongue
    is tested by, move the protruded
    tongue from side to side against
    tongue depressor.
    EXAMINING MOTOR SYSTEM
    Muscle ●
    Resistance test
    ●
    Hanlon Nichols(rate muscle strength)
    strength
    ●
    Upper extremities test
    Coordination ●
    Lower extremities test

    Balance ●
    Romberg test
    EXAMINIG THE REFLEXES

    Superficial reflexes

    Corneal Gag Babinski


    reflex reflex response
    REFLEXES BABINSKI REFLEX
    EXAMINIG SENSORY SYSTEM
    Tactile sensation

    Superficial pain & vibration

    Position test
    DIAGNOSTIC STUDIES
    RADIOLOGICAL ELECTROGRAPHIC
    ULTRA SOUND
    STUDIES STUDIES

    CT scan Evoked potential


    studies Transcranial
    MRI
    doppler
    SPECT
    Electro myography
    PET
    myelography Electro
    cerebral angiography Encephalography
    Radiological studies
    CT SCAN USES
    SYNONYMOUS To detect displacement of
     CAT scan ventricles & cortical
     Computed Axial Tomography atrophy.
    WHAT IS IT ? To detect tumor and Brain
     It is a noninvasive imaging infraction.
    study by the uses x-rays. To visualize sections of
     It produce images of the spinal cord (LP
    internal parts of the body. Procedure).
    Mainly brain and other
    To identify herniated
    structures in the head.
    lumbar disk.
    HOW CT WORKS ?
    NURSING INTERVENTIONS
     Preparation & monitoring of the patient.
     Teach the patient about the need to lie quietly
    throughout the procedure.
     Use of relaxation technique (claustrophobic patients)
     Assess for iodine allergy (if contrast agent is using)
     Monitor the patient during and after the procedure for
    allergic reaction
    Nausea,vomiting,flushing.
    MAGNETIC RESONANCE IMAGING (MRI)
    USES
    To reveal brain
    abnormality.
    To detect tumor and
    artery clogging
    To measure blood flow
    To detect variety of
    musculoskeletal, liver,&
    kidney disorders.
    Cont….
    NURSING RESPONSIBILITY
    Screen or removed all the metal parts & pacemaker in
    the body(if present)
    Patient history is obtained to determine the presence of
    any metal object
    Sedation may be necessary if patient is claustrophobic
    MYELOGRAPHY
    Nursing intervention
     X-ray of spinal cord & Clear explanation & clarify
    vertebral column after the doubt.
    injection of contrast medium Patient lie in the bed with the
    into subarachinoid space head of the bed elevated 30-
     USES 45 degree(after myelogram)
     Spinal lesions Increases patient fluid intake
     Ruptured disk Check vital sign
     Tumor
    CEREBRAL ANGIOGRAPHY
    Nursing responsibility
     Serial x-ray study to Explain the procedure
    visualization of intracranial & Administer pre medication(if
    extra cranial blood vessel prescribed)
     Contrast medium is using Maintain pressure dressing &
     Uses ICE to injection sites
    vascular disease Maintain patient bed rest
    vascular lesions Report any changes in
    tumor of brain neurological status.
    POSITRON EMISSION
    SPECT
    TOMOGRAPHY
    QUESTIONS
    DON”T SHOUT OUT Please raise your
    hand
    Question 1
    What’s the earliest and most reliable indicator of
    increased intracranial pressure?
    Question 2
    Which cranial nerves control eye movements?
    THANK YOU

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