SOLUTION
◉ extinction. Answer: simultaneously touch both sides of body at
the same time, both sensations should be felt
◉ point location. Answer: touch skin and withdraw stimulus
promptly; ask person to put finger where you touched
◉ peripheral neuropathy. Answer: Loss of sensation involves all
modalities; loss most severe distally at feet and hands
◉ individual nerves or roots. Answer: Decrease or loss of all sensory
modalities; corresponds to distribution of involved nerve
◉ Spinal Cord Hemisection (Brown-Sequard Syndrome). Answer:
injury to one-half of the cord, causing contralateral loss of pain and
temp
the ipsilateral side side of the lesion has paralysis and loss of
vibration and touch sensation
◉ Complete transection of spinal cord. Answer: Complete loss of all
sensory modalities below level of lesion; associated with motor
paralysis and loss of sphincter control
,◉ thalamus. Answer: loss of all sensory modality son the face, arm
and leg on the side contrateral to lesion
◉ cortex lesion. Answer: loss of discrimination on contralateral side;
loss of graphesthesia, stereognosis, recognition of shapes and
weights, finger findings
◉ deep tendon reflexes (DTR). Answer: measurement of stretch
reflex reveals intactness of reflex arc at specific spinal levels and
normal override on reflex of higher cortical levels
◉ DTR scale. Answer: 0 - no response
1+ - diminished low normal or occurs w reinforcement
2+ - normal
3+ - brisker than average may indicate disease
4+ - hyperactive w/ clonus, very brisk, indicative of disease
◉ Clonus. Answer: test when reflex are hyperactive
◉ how do you test clonus?. Answer: support lower leg in one hand
and with other hand move foot up and down to relax muscle; then
stretch muscle by briskly dorsiflexing fort, hold stretch
, ◉ what do you normally and abnormally see in a clonus test?.
Answer: NORMALLY: you feel no further movement
ABNORMALLY: note rapid rhythmic contractions of calf and foot
◉ Tempomandibular Joint (TMJ) assessment. Answer: note smooth
movement without limitations or tenderness, clicking or popping
when jaw opens and closes
◉ how do you assess the thyroid gland?. Answer: ask client to take a
sip of water, hold in mouth, the swallow while palpating thyroid
gland
-one hand palpates and the other displaces
◉ what is abnormal in palpating the thyroid gland?. Answer: an
enlarged thyroid
◉ What does the nurse do next if the thyroid gland is enlarged?.
Answer: LISTEN FOR BRUIT (turbulent blood flow)
check the area they drain from for source of the problem
◉ how do you examine lymph nodes?. Answer: gentle circular
motion of finger, palpate lymph nodes