NUR 225 Exam 4 with precise detailed answers ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Screening vs Complete neuro exam - correct answer✔✔Screening Neuro Exam: well people ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
w/ no neuro complaints
||//\\|| ||//\\|| ||//\\||
Complete Neuro Exam: those w/ neurologic concerns ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Cognitive exam: Appearance, behavior, cognition, thought processes - correct ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
answer✔✔Appearance, behavior (consistent & appropriate), cognition, thought processes ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Is patient alert? Lethargic? Comatose?
||//\\|| ||//\\|| ||//\\|| ||//\\||
Oriented x 4 (person, place, time, situation/purpose) ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Cognitive abnormalities: Dementia - correct answer✔✔Loss of intellectual abilities ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
(planning, judgement), reasoning, math ||//\\|| ||//\\|| ||//\\||
Memory: LTM (birthday) & STM (breakfast) ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Cognitive abnormalities: Confusion vs aphasia (how to differentiate) - correct ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
answer✔✔Aphasia (expressive- cannot get the words out to communicate, receptive- can ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
hear you but cannot make sense of it)
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Difficult to differentiate ||//\\|| ||//\\||
If speaks in 1 word sentences or repeats same sentence over & over...consider aphasia
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
(stroke, tumor in Broca's area) ||//\\|| ||//\\|| ||//\\|| ||//\\||
,Test by having them read or repeat a sentence
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Cranial nerve exam: Know the order for testing - correct answer✔✔CN 2, 3, 4, 6, 5, 7, 8, 9,
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
10, 12, 11
||//\\|| ||//\\||
CN I: what is it and how is it tested? - correct answer✔✔*olfactory nerve
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-not routinely tested
||//\\|| ||//\\||
CN II: what is it and how do we test it? - correct answer✔✔*optic nerve
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Snellen, confrontation, opthalmoscopic exam for papilledema ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Bulging/swelling optic disc - correct answer✔✔-papilledema ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-brain is pushing down into brainstem/herniated- get this patient into surgery
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
CN III, IV, VI: what are they and how do we test them? - correct answer✔✔*oculomotor,
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
trochlear, abducens ||//\\|| ||//\\||
-Palpebral folds (eyelids, any ptosis?- stroke/ Bell's palsy) ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-PERRLA
-EOM 6 cardinal fields of gaze ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Nystagmus and roving eye movements: what do they mean? - correct answer✔✔-abnormal ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
movement of eye when having them following pen light/finger ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Horizontal: cerebellar, drugs, ETOH ||//\\|| ||//\\|| ||//\\||
-Vertical: drugs, Wernicke's, brain stem ||//\\|| ||//\\|| ||//\\|| ||//\\||
, -Ocular Bobbing: brain stem ||//\\|| ||//\\|| ||//\\||
-Roving Eye Movements ||//\\|| ||//\\||
(eyes just kind of looking all over when you lift
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
eyelid)
--coma, sluggish brainstem ||//\\|| ||//\\||
CN V, VII, VIII: what are they and how do we test for them? - correct answer✔✔Trigeminal
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
nerve (feel 5)
||//\\|| ||//\\|| ||//\\|| ||//\\||
-Motor: palpate temporal, TMJ, masseter ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Sensory
--Light sensation: forehead, cheeks, chin (do in random order w/ eyes closed)
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Facial nerve (see 7) ||//\\|| ||//\\|| ||//\\||
-Nasolabial folds: asymmetry = stroke, Bell's Palsey ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Shut eyes & open against resistance ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Raise brows, smile, frown, puff out cheeks (should all be symmetric)
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Vestibulocochlear (whisper 8) ||//\\|| ||//\\|| ||//\\||
-Whisper test (whisper something behind the and have them cover their opposite ear) ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
CN IX and X: what are they and how to conduct basic (IX, X) and advanced exam (X) -
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
correct answer✔✔Glossopharyngeal ||//\\||
Basic Exam: ||//\\||
-Speech ...hoarseness ||//\\||
-Say "ah" ...uvula should rise midline
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Screening vs Complete neuro exam - correct answer✔✔Screening Neuro Exam: well people ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
w/ no neuro complaints
||//\\|| ||//\\|| ||//\\||
Complete Neuro Exam: those w/ neurologic concerns ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Cognitive exam: Appearance, behavior, cognition, thought processes - correct ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
answer✔✔Appearance, behavior (consistent & appropriate), cognition, thought processes ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Is patient alert? Lethargic? Comatose?
||//\\|| ||//\\|| ||//\\|| ||//\\||
Oriented x 4 (person, place, time, situation/purpose) ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Cognitive abnormalities: Dementia - correct answer✔✔Loss of intellectual abilities ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
(planning, judgement), reasoning, math ||//\\|| ||//\\|| ||//\\||
Memory: LTM (birthday) & STM (breakfast) ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Cognitive abnormalities: Confusion vs aphasia (how to differentiate) - correct ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
answer✔✔Aphasia (expressive- cannot get the words out to communicate, receptive- can ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
hear you but cannot make sense of it)
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Difficult to differentiate ||//\\|| ||//\\||
If speaks in 1 word sentences or repeats same sentence over & over...consider aphasia
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
(stroke, tumor in Broca's area) ||//\\|| ||//\\|| ||//\\|| ||//\\||
,Test by having them read or repeat a sentence
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Cranial nerve exam: Know the order for testing - correct answer✔✔CN 2, 3, 4, 6, 5, 7, 8, 9,
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
10, 12, 11
||//\\|| ||//\\||
CN I: what is it and how is it tested? - correct answer✔✔*olfactory nerve
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-not routinely tested
||//\\|| ||//\\||
CN II: what is it and how do we test it? - correct answer✔✔*optic nerve
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Snellen, confrontation, opthalmoscopic exam for papilledema ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Bulging/swelling optic disc - correct answer✔✔-papilledema ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-brain is pushing down into brainstem/herniated- get this patient into surgery
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
CN III, IV, VI: what are they and how do we test them? - correct answer✔✔*oculomotor,
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
trochlear, abducens ||//\\|| ||//\\||
-Palpebral folds (eyelids, any ptosis?- stroke/ Bell's palsy) ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-PERRLA
-EOM 6 cardinal fields of gaze ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Nystagmus and roving eye movements: what do they mean? - correct answer✔✔-abnormal ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
movement of eye when having them following pen light/finger ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Horizontal: cerebellar, drugs, ETOH ||//\\|| ||//\\|| ||//\\||
-Vertical: drugs, Wernicke's, brain stem ||//\\|| ||//\\|| ||//\\|| ||//\\||
, -Ocular Bobbing: brain stem ||//\\|| ||//\\|| ||//\\||
-Roving Eye Movements ||//\\|| ||//\\||
(eyes just kind of looking all over when you lift
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
eyelid)
--coma, sluggish brainstem ||//\\|| ||//\\||
CN V, VII, VIII: what are they and how do we test for them? - correct answer✔✔Trigeminal
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
nerve (feel 5)
||//\\|| ||//\\|| ||//\\|| ||//\\||
-Motor: palpate temporal, TMJ, masseter ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Sensory
--Light sensation: forehead, cheeks, chin (do in random order w/ eyes closed)
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Facial nerve (see 7) ||//\\|| ||//\\|| ||//\\||
-Nasolabial folds: asymmetry = stroke, Bell's Palsey ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Shut eyes & open against resistance ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Raise brows, smile, frown, puff out cheeks (should all be symmetric)
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Vestibulocochlear (whisper 8) ||//\\|| ||//\\|| ||//\\||
-Whisper test (whisper something behind the and have them cover their opposite ear) ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
CN IX and X: what are they and how to conduct basic (IX, X) and advanced exam (X) -
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
correct answer✔✔Glossopharyngeal ||//\\||
Basic Exam: ||//\\||
-Speech ...hoarseness ||//\\||
-Say "ah" ...uvula should rise midline
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||