Question

Discuss components of a neurological assessment. Include assessment technique, normal findings, and 1 abnormal finding for each and what it can indicate. Include two scholarly references (journal articles, textbooks, NOT wikipedia).

Answer 1

Neurological assessment can be made on taking a detailed history as well as examination of the patient .

History :

1. Personal details like name, age and sex

2.Duration of the disease

3.What treatment he is on and if any procedure if he has underwent and you can understand the impression made by the doctor.

4 is he on medication properly and with appropriate dosing

Next is the Examination

General examination : 1) Whether the patient is conscious /drowsy/ coma and record the Glasgow coma scale ( it includes eye response, motor response and verbal response and give a score out of 15)

2) orientation in time , place and person

3) Memory: can ask about his age

Look for pallor, cyanosis, clubbing, gum hypertrophy

Check his Pulse and note it's rate, regularlity

Check his Blood pressure

Check is respiratory rate

Check his pupik whether it is reacting to light or not

Going to neurological examination

Inspection : along with general examination check for symmetry of muscle on both side if atrophy present that side indicates weakness.

1) motor examination: ; generally can test group of muscle example : flexors of elbow, flexors of knee.

It is tested by asking the patient to push against resistance.

2) Cranial nerve examination

Cranial nerve One ( olfactory) identify two substances by smell by their eyes closed.

Cranial nerve 2(optic) check for visual acuity by snellan's chart

Cranial nerve 3( occulomotor), 4( trochlear) and 6 ( abducens) look for eye movements

Cranial nerve 5( trigeminal) sensory is tested by using a cotton wisp and checking the sensation in forehead, cheek and jaw on each side and cmpare

Motor function is tested by clenching the teeth.

Cranial nerve 7( facial) sensory function by testing taste sensation On the anterior third of tongue

Motor function : look for symmetry of face and ask him to close his eyes and try to open it

Cranial nerve 8 ( VESTIBULOCOCHLEAR) the tunning fork test

Cranial nerve 9( glossopharyngeal) and 10( vagus) : look for gag reflex and check the palatal symmetry

Cranial nerve 11(spinal accessory) check the power of sternocleidomastoid muscles.

Cranial nerve12( hypoglossal) :check the tongue for an deviation and symmetry

3) Pupillary examination :look for light reflex