CN II Optic
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Test visual acuity (Snellen Alphabet Chart) and visual fields by
confrontation
ABNORMAL: Visual field loss & Papilledema with increased intracranial
pressure; optic atrophy
cerebellar ataxia
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Uncoordinated or unsteady gait Ex: staggering, wide-based gait; difficulty
with turns; uncoordinated movement with positive Romberg sign
,tinnitus
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ringing in the ears
entropion
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inward turning of the rim of the eyelid
neurologic recheck exam
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Persons with demonstrated neurologic deficits who require periodic
assessments Ex: hospitalized persons or those in extended care (person
may be discharged then asked to come back for reassessment). After
certain procedures or surgeries that can cause neuro complications
1. *Level of consciousness (LOC) = A change in the level of consciousness is
the single most important factor in this examination. PersonxPlacexTime
2. Motor function = Check the voluntary movement of each extremity by
giving the person specific commands. (This procedure also tests level of
consciousness by noting the person's ability to follow commands.)
3. Pupillary response = Note the size, shape, and symmetry of both pupils.
Shine a light into each pupil, and note the direct and consensual light
reflex. Both pupils should constrict briskly.
4. Vital signs = Measure the temperature, pulse, respiration, and BP as often
as the person's condition warrants. pulse and BP are notoriously unreliable
, parameters of CNS deficit. Any changes are late consequences of rising
intracranial pressure.
conductive hearing loss
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Vibration to the bone so if there's fluid foreign objects, allergies, ruptured
eardrum, or impacted earwax (Cerumen) then it can cause this type of
hearing loss.
partial loss caused by impacted cerumen, pus, perforated TM, decrease
mobility of ossicles
Balance Test (Gait)
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-observe as the person walks 10 to 20 feet, turns and returns to the starting
point
NORMALLY: gait is smooth, rhythmic and effortless opposing arm swing is
coordinating
ABNORMALLY: Stiff, immobile posture. Staggering or reeling. Wide base of
support.
Lack of arm swing or rigid arms.
Unequal rhythm of steps. Slapping of foot. Scraping of toe of shoe.
dyskinesia
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, difficult movement
older adults: repetitive stereotyped movements in jaw, lips, or
tongue may accompany senile tremors; no associated rigidity
present
scissors
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knees cross or are in contact, like holding an orange between the thighs.
normal response: abdominal reflexes
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ipsilateral contraction of abdominal muscle with observed deviation of
umbilicus toward stroke
palpation of the sinus area
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Using thumbs, press frontal sinuses by pressing up and under the eyebrows
and over maxillary sinuses below cheekbones
tuning fork test
Give this one a try later!
Test visual acuity (Snellen Alphabet Chart) and visual fields by
confrontation
ABNORMAL: Visual field loss & Papilledema with increased intracranial
pressure; optic atrophy
cerebellar ataxia
Give this one a try later!
Uncoordinated or unsteady gait Ex: staggering, wide-based gait; difficulty
with turns; uncoordinated movement with positive Romberg sign
,tinnitus
Give this one a try later!
ringing in the ears
entropion
Give this one a try later!
inward turning of the rim of the eyelid
neurologic recheck exam
Give this one a try later!
Persons with demonstrated neurologic deficits who require periodic
assessments Ex: hospitalized persons or those in extended care (person
may be discharged then asked to come back for reassessment). After
certain procedures or surgeries that can cause neuro complications
1. *Level of consciousness (LOC) = A change in the level of consciousness is
the single most important factor in this examination. PersonxPlacexTime
2. Motor function = Check the voluntary movement of each extremity by
giving the person specific commands. (This procedure also tests level of
consciousness by noting the person's ability to follow commands.)
3. Pupillary response = Note the size, shape, and symmetry of both pupils.
Shine a light into each pupil, and note the direct and consensual light
reflex. Both pupils should constrict briskly.
4. Vital signs = Measure the temperature, pulse, respiration, and BP as often
as the person's condition warrants. pulse and BP are notoriously unreliable
, parameters of CNS deficit. Any changes are late consequences of rising
intracranial pressure.
conductive hearing loss
Give this one a try later!
Vibration to the bone so if there's fluid foreign objects, allergies, ruptured
eardrum, or impacted earwax (Cerumen) then it can cause this type of
hearing loss.
partial loss caused by impacted cerumen, pus, perforated TM, decrease
mobility of ossicles
Balance Test (Gait)
Give this one a try later!
-observe as the person walks 10 to 20 feet, turns and returns to the starting
point
NORMALLY: gait is smooth, rhythmic and effortless opposing arm swing is
coordinating
ABNORMALLY: Stiff, immobile posture. Staggering or reeling. Wide base of
support.
Lack of arm swing or rigid arms.
Unequal rhythm of steps. Slapping of foot. Scraping of toe of shoe.
dyskinesia
Give this one a try later!
, difficult movement
older adults: repetitive stereotyped movements in jaw, lips, or
tongue may accompany senile tremors; no associated rigidity
present
scissors
Give this one a try later!
knees cross or are in contact, like holding an orange between the thighs.
normal response: abdominal reflexes
Give this one a try later!
ipsilateral contraction of abdominal muscle with observed deviation of
umbilicus toward stroke
palpation of the sinus area
Give this one a try later!
Using thumbs, press frontal sinuses by pressing up and under the eyebrows
and over maxillary sinuses below cheekbones
tuning fork test
