Neurologic System - NURS 190 Physical
Assessment
31 Pairs of spinal nerves - ANS 8 pairs of cervical nerves
12 pairs of thoracic nerves
5 pairs of lumbar nerves
5 pairs of sacral nerves
1 pair of coccygeal nerves
\Abdominal reflex testing pattern - ANS Use applicator/tongue blade, briskly stroke
abdomen from lateral aspect toward umbilicus.
2. Muscle should contract and umbilicus should move toward the stimulus.
3. Repeat in other 3 quadrants
\Abducens (CN VI) - ANS Extrinsic muscle movement of eye
\Accessory (CN XI) - ANS -Movement of the trapezius and sternocleidomastoid muscles.
-Some movement of larynx, pharynx, and soft palate.
\Amyotrophic lateral Disease - ANS -Chronic degenerative disease involving cerebral
cortex and motor neurons in the spinal cord
-Progressive wasting of muscles leading to death
\Assess ability to distinguish temperature - ANS -ONLY perform this if the patient has
decreased or absent pain sensation
-Randomly touch patient with test tubes of warm and cold water
-Ask pt to describe the temperature.
\Assess balance (Romberg Test) - ANS 1. Ask pt to stand with feet together and arms at
sides with eyes open.
2. Stand next to pt. to prevent falls.
3. Observe for swaying
4. Ask pt. to close both eyes
5. Observe for swaying.
-Swaying normally increases slightly when eyes are closed.
\Assess gait - ANS 1. Ask pt. to walk across the room and return.
2. Ask pt to walk heel-to-toe (tandem) by placing heel of left foot on front of the toes of
the right foot, etc).
-Make sure pt. is looking straight ahead and not at the floor.
\Assess upper cerebellar function
Finger-to-nose test - ANS Pass-point test
Assesses coordination and equilibrium
1. Ask pt to sit
2. Extend both arms from sides of body while eyes are open.
3. Touch tip of nose with right index finger, then return right arm to extended position.
4. Touch tip of nose with left index finger, then return left arm to extended position.
, 5. Repeat several times.
6. Repeat with eyes closed and see if the movement is smooth and if the finger touches
the nose.
\Assessment Techniques
Neurologic - ANS 1. Inspection
2. Palpation
3. Auscultation of carotid arteries
4. Sensory and motor function
5. Reflexes
**Don't need to do percussion**
\Ataxic Gait - ANS Wide base, uneven steps, feet slapping, and a tendency to sway
-Associated with posterior column disease or decreased proprioception regarding
extremities
-Seen in Multiple sclerosis and drug /alcohol intoxication
\Athetoid movement - ANS -A continuous, involuntary, repetitive, slow, "wormlike,"
arrhythmic muscular movement.
-Muscles are in a state hypotoxicity, producing a distortion to the limb.
-Seen in cerebral palsy.
\Babinsky response past the age of 2 could indicate - ANS upper motor neuron disease
1. Amyotrophic lateral sclerosis (Lou Gehrig disease)
2. Brain tumor or injury
3. Meningitis
4. Multiple sclerosis
5. Spinal cord injury, defect, or tumor
6. Stroke
\Brain abscess - ANS Accumulation of pus located anywhere in the brain tissue
\Brain stem - ANS 1. Midbrain
2. Pons
3. Medulla oblongata
\Cerebellum - ANS 1. Coordinates stimuli from the cerebrum and behind the brain stem.
2. Coordination, maintaining equilibrium, muscle tone
\Cerebrum - ANS Area of the brain responsible for all voluntary activities of the body
-Perceive, remember, communicate, initiate voluntary movement.
-Frontal, parietal, occipital (visual cortex)
-Temporal
-Cerebral cortex (outermost layer composed of gray matter)
\CNI (Olfactory) Dysfunction - ANS -Unilateral or bilateral anosmia: Can't smell
\CNII (Optic) Dysfunction - ANS -Optic atrophy
Assessment
31 Pairs of spinal nerves - ANS 8 pairs of cervical nerves
12 pairs of thoracic nerves
5 pairs of lumbar nerves
5 pairs of sacral nerves
1 pair of coccygeal nerves
\Abdominal reflex testing pattern - ANS Use applicator/tongue blade, briskly stroke
abdomen from lateral aspect toward umbilicus.
2. Muscle should contract and umbilicus should move toward the stimulus.
3. Repeat in other 3 quadrants
\Abducens (CN VI) - ANS Extrinsic muscle movement of eye
\Accessory (CN XI) - ANS -Movement of the trapezius and sternocleidomastoid muscles.
-Some movement of larynx, pharynx, and soft palate.
\Amyotrophic lateral Disease - ANS -Chronic degenerative disease involving cerebral
cortex and motor neurons in the spinal cord
-Progressive wasting of muscles leading to death
\Assess ability to distinguish temperature - ANS -ONLY perform this if the patient has
decreased or absent pain sensation
-Randomly touch patient with test tubes of warm and cold water
-Ask pt to describe the temperature.
\Assess balance (Romberg Test) - ANS 1. Ask pt to stand with feet together and arms at
sides with eyes open.
2. Stand next to pt. to prevent falls.
3. Observe for swaying
4. Ask pt. to close both eyes
5. Observe for swaying.
-Swaying normally increases slightly when eyes are closed.
\Assess gait - ANS 1. Ask pt. to walk across the room and return.
2. Ask pt to walk heel-to-toe (tandem) by placing heel of left foot on front of the toes of
the right foot, etc).
-Make sure pt. is looking straight ahead and not at the floor.
\Assess upper cerebellar function
Finger-to-nose test - ANS Pass-point test
Assesses coordination and equilibrium
1. Ask pt to sit
2. Extend both arms from sides of body while eyes are open.
3. Touch tip of nose with right index finger, then return right arm to extended position.
4. Touch tip of nose with left index finger, then return left arm to extended position.
, 5. Repeat several times.
6. Repeat with eyes closed and see if the movement is smooth and if the finger touches
the nose.
\Assessment Techniques
Neurologic - ANS 1. Inspection
2. Palpation
3. Auscultation of carotid arteries
4. Sensory and motor function
5. Reflexes
**Don't need to do percussion**
\Ataxic Gait - ANS Wide base, uneven steps, feet slapping, and a tendency to sway
-Associated with posterior column disease or decreased proprioception regarding
extremities
-Seen in Multiple sclerosis and drug /alcohol intoxication
\Athetoid movement - ANS -A continuous, involuntary, repetitive, slow, "wormlike,"
arrhythmic muscular movement.
-Muscles are in a state hypotoxicity, producing a distortion to the limb.
-Seen in cerebral palsy.
\Babinsky response past the age of 2 could indicate - ANS upper motor neuron disease
1. Amyotrophic lateral sclerosis (Lou Gehrig disease)
2. Brain tumor or injury
3. Meningitis
4. Multiple sclerosis
5. Spinal cord injury, defect, or tumor
6. Stroke
\Brain abscess - ANS Accumulation of pus located anywhere in the brain tissue
\Brain stem - ANS 1. Midbrain
2. Pons
3. Medulla oblongata
\Cerebellum - ANS 1. Coordinates stimuli from the cerebrum and behind the brain stem.
2. Coordination, maintaining equilibrium, muscle tone
\Cerebrum - ANS Area of the brain responsible for all voluntary activities of the body
-Perceive, remember, communicate, initiate voluntary movement.
-Frontal, parietal, occipital (visual cortex)
-Temporal
-Cerebral cortex (outermost layer composed of gray matter)
\CNI (Olfactory) Dysfunction - ANS -Unilateral or bilateral anosmia: Can't smell
\CNII (Optic) Dysfunction - ANS -Optic atrophy
