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14 Cards in this Set

  • Front
  • Back
Cranial Nerve I
Olfactory

To assess:
1) have pt close eyes and hold one side of nostril
2) waive coffee (or another scent) under open nostril and ask pt to recognize smell
3) repeat for other nostril using a different smell

Expected Outcome: both scents will be recognized
Cranial Nerve II
Optic

To assess:
1) Long Distance with be with Snellon Chart
2) Close Distance - ask patient to read note out loud

Expected Outcome: Pt will be able to read / recognize on both tests (distance and close-up)
Cranial Nerve III
Oculomotor

To assess: (Done simultaneously with IV & VI)
1) This also include pupillary response that was previously done **do not have to repeat**
2) After asking pt to keep head still and while holding an object approx 10 - 12 in away from the face, complete a six point check (Making an astrick shaped motion - left to right, Up and down, and diagonally at both angles)

Expected Outcome: Pt will be able to follow the object in a smooth fashion with the eyes
Cranial Nerve IV
Trochlear

To assess: completed with CNIII
Cranial Nerve V
Trigeminal

To assess:
1) While palpating the corners of the jaw ask pt to "clinch" jaws and feel for response
2) Ask pt to clothes his eyes.
3) With a soft and a sharp object touch the pt at random locations on the face and ask pt to point to where he felt it and to state sharp or soft

Expected Outcome:
Pt will be able to locate and recognize the place and texture of the object
Cranial Nerve VI
Abducens

Assessment completed with CN III and CN VI
Cranial Nerve VII
Facial

To assess:
1) Ask patient to complete the following actions
* Smile, Frown, Raise eyebrows, and Puff Out Cheeks

Expected Outcome:
There will be symmetry in each of these movements
Cranial Nerve VIII
Auditory

To assess:
1) Ask pt to cover one ear and whisper a word in the open ear.
2) Ask pt to repeat word
3) Perform same task on opposite ear

Expected Outcome:
Pt will be able to hear and repeat whispered word
Cranial Nerve IX
Glossopharyngeal

To assess:
1) With a tongue depressor, ask pt to say "aaahhh" while opening mouth wide. Observe soft palate and uvula for smooth rise and fall. Note: Use pen light to illuminate area

Expected Outcome:
Soft palate and uvula at back of mouth will rise and fall
Cranial Nerve X
Vagus

To assess:
***Done while assessing CN IX***
1) At the same time as observing the rise and fall of the soft palate, quickly push the tongue depressor to the back of the mouth far enough to elicit the "gag" reflex.

Expected Outcome:
Pt will "gag"

Caution: do not "over do" it...
Cranial nerve XI
Spinal Accessory

To assess:
1) While applying sufficient pressure to the shoulders, have patient "shrug"
2) Apply pressure to the side of the face with the back of the hand and have patient push against. Repeat on opposite side

Expected outcome:
Pt will be able to press against hands as pressure is being applied. Should be symmetrical
Cranial Nerve XII
Hypoglossal

To assess:
Ask pt to stick out tongue; move up and down, and then side to side

Expected Outcome:
Pt will be able to perform in smooth fashion
Neurological Assessment:
Physical examination
1) Assess LOC and Orientation; Observe patient as enter the room; (After introducing self) ask patient to state name, date, and location. Pt should be able to state accurately name, date, and location (AAOX3 documented if appropriate)

2) Assess appearance and behavior while responding to questions. Pt should be dressed appropriately for the weather/season and should respond with appropriate facial expressions and body language.

3) Assess pupillary response (PERRLA). Measure pupil size using legend on pen light. Quickly shine light in each eye and observe for dilation. Test for accomodation by asking pt to focus on a point far away. Then place object 10 - 12 in away from eyes and have pt focus on this. observe for convergence and dilation and return to normal.

4) Assess upper extremity function (bilaterally) by having pt squeeze three fingers of each hand and provide resistence. Pt should be able to pull with same strength bilaterally

5) Assess lower extremity by applying pressure to the dorsal and plantar side of each foot bilaterally and have pt provide pressure against hand. Should be equally resistant on both legs.

6) Conduct Babinski reflex test on bottom of each foot. Should get negative response which is toes curling when test is done.

7) Complete Glasgow coma scale
Neuro Assess Health Hx Questions
Ask these questions in the first portion of the physical examination along with "orientation" questions:

Do you have any allergies?
Any history of surgeries?
Are you taking any medications?
Are you in pain? If yes, on a scale of 0 - 10 what level? With 0 being no pain and 10 being unbearable.
Do you suffer from any of the following: H/A, seizures, dizziness, tremors, or weakness?
Any numbness or tingling?
Any problems swallowing? speaking? (Obviously not)
Any other Hx of neurological disorders or medications for neurological disorders?