assessment-191120210548.pptx neurological assessment

neurology

1. .

2. MEANING

3. Neurological assessment is an assessment done to collect subjective as well as objective data related to neurological functioning of body

4. Neurological assessment is an assessment done to collect subjective as well as objective data related to neurological functioning of body It is done to

5. Neurological assessment is an assessment done to collect subjective as well as objective data related to neurological functioning of body It is done to collect baseline data

6. Neurological assessment is an assessment done to collect subjective as well as objective data related to neurological functioning of body It is done to collect baseline data Find out any problem or disesease related to neurology.

7. neurological assessment include:

8. neurological assessment include: - history taking

9. neurological assessment include: - history taking - history of present illness

10. neurological assessment include: - history taking - history of present illness - past medical history -

11. neurological assessment include: - history taking - history of present illness - past medical history - family history

12. neurological assessment include: - history taking - history of present illness - past medical history - family history - occupational and environmental history

13. neurological assessment include: - history taking - history of present illness - past medical history - family history - occupational and environmental history - any addiction - physical examination

14. Physical examination include:

15. Physical examination include: -MENTAL STATUS EXAMINATION

16. Physical examination include: -MENTAL STATUS EXAMINATION Level of conciousness

17. Physical examination include: -MENTAL STATUS EXAMINATION Level of conciousness orientation: ask question regarding time place or person

18. Physical examination include: -MENTAL STATUS EXAMINATION Level of conciousness orientation: observe patient is oriented to time place or person eg: what is time now?

19. Physical examination include: -MENTAL STATUS EXAMINATION Level of conciousness orientation: observe patient is oriented to time place or person eg: what is time now? where are you now?

20. Physical examination include: -MENTAL STATUS EXAMINATION Level of conciousness orientation: observe patient is oriented to time place or person eg: what is time now? where are you now? who accompanies you?

21. MENTAL STATUS EXAMINATION Language : assess the language of the person and voice of communication.

22. MENTAL STATUS EXAMINATION Language : assess the language of the person and voice of communication. Mood and affect : assess mood of patient eg: stable, short tempered, irritated

23. MENTAL STATUS EXAMINATION Language : assess the language of the person and voice of communication. Mood and affect : assess mood of patient eg: stable, short tempered, irritated Memory : patient ability to recall things

24. MENTAL STATUS EXAMINATION Language : assess the language of the person and voice of communication. Mood and affect : assess mood of patient eg: stable, short tempered, irritated Memory : patient ability to recall things - Immediate memory

25. MENTAL STATUS EXAMINATION Language : assess the language of the person and voice of communication. Mood and affect : assess mood of patient eg: stable, short tempered, irritated Memory : patient ability to recall things - Immediate memory - recent memory

26. MENTAL STATUS EXAMINATION Language : assess the language of the person and voice of communication. Mood and affect : assess mood of patient eg: stable, short tempered, irritated Memory : patient ability to recall things - Immediate memory - recent memory - remote memory

27. MENTAL STATUS EXAMINATION Language : assess the language of the person and voice of communication. Mood and affect : assess mood of patient eg: stable, short tempered, irritated Memory : patient ability to recall things - Immediate memory - recent memory - remote memory Thought process: assess patient ideas, feeling is relevant or irrelevant

28. CRANIAL NERVE EXAMINATION

29. Cranial Nerve I: OLFACTORY NERVE .

30. Cranial Nerve I: OLFACTORY NERVE . The sense of smell is tested by having the patient close his or her eyes.

31. Cranial Nerve I: OLFACTORY NERVE . The sense of smell is tested by having the patient close his or her eyes. give the patient something like coffee powder to smell

32. Cranial Nerve I: OLFACTORY NERVE . The sense of smell is tested by having the patient close his or her eyes. give the patient something like coffee powder to smell ask if the patient is able to identify the object or not

33. Cranial nerve II: OPTIC NERVE.

34. Cranial nerve II: OPTIC NERVE. The optic nerve testing includes assessment visual acuity

35. Cranial nerve II: OPTIC NERVE. The optic nerve testing includes assessment visual acuity tested by having the patient read a snellen chart from 20 feet away

36. CN III : OCOULOMOTOR NERVE

37. CN III : OCOULOMOTOR NERVE Test to check the pupillary reaction

38. CN III : OCOULOMOTOR NERVE Test to check the pupillary reaction shine light in eye of ptient and check the pupillary reaction to light.

39. CN IV : TROCHLEAR NERVE

40. CN IV : TROCHLEAR NERVE helps in eye movement

41. CN IV : TROCHLEAR NERVE helps in eye movement ask the patient to follow the finger without moving head

42. CN V: TRIGEMINAL NERVE.

43. CN V: TRIGEMINAL NERVE. 1. have both sensory and motor function

44. CN V: TRIGEMINAL NERVE. 1. have both sensory and motor function 2.sensory function assessment

45. CN V: TRIGEMINAL NERVE. 1. have both sensory and motor function 2.sensory function assessment use cotton swab or wisp or finger tips to touch the face of patient

46. CN V: TRIGEMINAL NERVE. 1. have both sensory and motor function 2.sensory function assessment use cotton swab or wisp or finger tips to touch the face of patient 3. motor function test

47. CN V: TRIGEMINAL NERVE. 1. have both sensory and motor function 2.sensory function assessment use cotton swab or wisp or finger tips to touch the face of patient 3. motor function test have patient hold mouth open

48. CN VI : ABDUCENS NERVE.

49. CN VI : ABDUCENS NERVE. motor function

50. CN VI : ABDUCENS NERVE. motor function Abducens - Test for lateral eye movement

51. CN VI : ABDUCENS NERVE. motor function Abducens - Test for lateral eye movement check the patient ability to move the eye side to side and in all direction.

52. CN VII: FACIAL NERVE.

53. CN VII: FACIAL NERVE. The facial nerve is also a mixed cranial nerve with both sensory and motor components.

54. CN VII: FACIAL NERVE. The facial nerve is also a mixed cranial nerve with both sensory and motor components. Motor function :

55. CN VII: FACIAL NERVE. The facial nerve is also a mixed cranial nerve with both sensory and motor components. Motor function: ask the patient to perform the following movements: raise his or her eyebrows, puff out his or her cheeks, smile, Observe for weakness or asymmetry of muscle movement.

56. CN VII: FACIAL NERVE. The facial nerve is also a mixed cranial nerve with both sensory and motor components. Motor function: ask the patient to perform the following movements: raise his or her eyebrows, puff out his or her cheeks, smile, Observe for weakness or asymmetry of muscle movement. Sensory test

57. CN VII: FACIAL NERVE. Motor function: ask the patient to perform the following movements: raise his or her eyebrows, puff out his or her cheeks, smile, Observe for weakness or asymmetry of muscle movement. Sensory test The sensory component includes the sense of taste

58. CN VIII : ACOUSTIC NERVE.

59. CN VIII : ACOUSTIC NERVE. The acoustic nerve has two divisions: hearing and balance

60. CN VIII : ACOUSTIC NERVE. The acoustic nerve has two divisions: hearing and balance assessment of hearing-

61. CN VIII : ACOUSTIC NERVE. The acoustic nerve has two divisions: hearing and balance assessment of hearing- snap fingers by the ear of patient

62. CN VIII : ACOUSTIC NERVE. The acoustic nerve has two divisions: hearing and balance assessment of hearing- snap fingers by the ear of patient assessment of balance :

63. CN VIII : ACOUSTIC NERVE. The acoustic nerve has two divisions: hearing and balance assessment of hearing- snap fingers by the ear of patient assessment of balance : rhomberg’s test

64. CN IX: GLOSSOPHARYNGEAL NERVE

65. CN IX: GLOSSOPHARYNGEAL NERVE this nerve helps in swallowing and voice

66. CN IX: GLOSSOPHARYNGEAL NERVE this nerve helps in swallowing and voice Assess patient’s ability to swallow and

67. CN X: VAGUS NERVE.

68. CN X: VAGUS NERVE. helps in gag reflex

69. CN X: VAGUS NERVE. helps in gag reflex Depress a tongue blade on tongue to elicit gag reflex.

70. XI SPINAL ACCESSORY

71. XI SPINAL ACCESSORY helps in neck motion

72. XI SPINAL ACCESSORY helps in neck motion ask the patient TO shrug his /her shoulder. Observe strength

73. CN XII: HYPOGLOSSAL NERVE. .

74. CN XII: HYPOGLOSSAL NERVE. helps in tongue movement .

75. CN XII: HYPOGLOSSAL NERVE. helps in tongue movement The hypoglossal nerve is tested by asking the patient to open his or her mouth, stick out his or her tongue, and wiggle it side to side. .

76. T o uch sens a ti on P ain sens a ti on

77. T o uch sens a ti on

78. T o uch sens a ti on P ain sens a ti on

79. T o uch sens a ti on P ain sens a ti on T empe r a tu r e sensation

80. SENSATION

81. SENSATION Tactile sensation is assessed by lightly touching a cotton wisp or fingertip to corresponding areas on each side of the body. The sensitivity of proximal parts of the extremities is compared with that of distal parts, and the right and left sides are compared.

82. PAIN AND TEMPERATURE SENSATIONS

83. PAIN AND TEMPERATURE SENSATIONS Determining the patient’s sensitivity to a sharp object can assess superficial pain perception.

84. PAIN AND TEMPERATURE SENSATIONS Determining the patient’s sensitivity to a sharp object can assess superficial pain perception. ask the patient to differentiate between two sides

85. PAIN AND TEMPERATURE SENSATIONS Determining the patient’s sensitivity to a sharp object can assess superficial pain perception. ask the patient to differentiate between two sides Use the hot and cold object for skin to determine the hot and clod sensation.

86. Mo t or abi l ity Muscle s t r en g th Balance & c oo r di n a ti o n Gait

87. Mo t or abi l ity

88. Mo t or abi l ity Muscle s t r en g th

89. Mo t or abi l ity Muscle s t r en g th Balance & c oo r di n a ti o n t

90. Mo t or abi l ity Muscle s t r en g th Balance & c oo r di n a ti o n Gait

91. MOTOR ABILITY

92. MOTOR ABILITY A thorough examination of the motor system includes an assessment of muscle size and tone as well as strength, coordination, and balance.

93. MOTOR ABILITY A thorough examination of the motor system includes an assessment of muscle size and tone as well as strength, coordination, and balance. The patient is instructed to walk across the room, if possible, while the examiner observes posture and gait. The muscles are inspected, and palpated if necessary, for their size and symmetry.

94. MUSCLE STRENGTH

95. MUSCLE STRENGTH Assessing the patient’s ability to flex or extend the extremities against resistance tests muscle strength.

96. 5-point scale to rate muscle strength.

97. 5-point scale to rate muscle strength. 5 indicates full power of contraction against gravity and resistance or normal muscle strength;

98. 5-point scale to rate muscle strength. 5 indicates full power of contraction against gravity and resistance or normal muscle strength; 4 indicates fair but not full strength against gravity and a moderate amount of resistance or slight weakness;

99. 5-point scale to rate muscle strength. 5 indicates full power of contraction against gravity and resistance or normal muscle strength; 4 indicates fair but not full strength against gravity and a moderate amount of resistance or slight weakness; 3 indicates just sufficient strength to overcome the force of gravity or moderate weakness;

100. 5-point scale to rate muscle strength. 5 indicates full power of contraction against gravity and resistance or normal muscle strength; 4 indicates fair but not full strength against gravity and a moderate amount of resistance or slight weakness; 3 indicates just sufficient strength to overcome the force of gravity or moderate weakness; 2 indicates the ability to move but not to overcome the force of gravity or severe weakness;

101. 5-point scale to rate muscle strength. 5 indicates full power of contraction against gravity and resistance or normal muscle strength; 4 indicates fair but not full strength against gravity and a moderate amount of resistance or slight weakness; 3 indicates just sufficient strength to overcome the force of gravity or moderate weakness; 2 indicates the ability to move but not to overcome the force of gravity or severe weakness; 1 indicates minimal contractile power (weak muscle contraction can be palpated but no movement is noted) or very severe weakness;

102. 5-point scale to rate muscle strength. 5 indicates full power of contraction against gravity and resistance or normal muscle strength; 4 indicates fair but not full strength against gravity and a moderate amount of resistance or slight weakness; 3 indicates just sufficient strength to overcome the force of gravity or moderate weakness; 2 indicates the ability to move but not to overcome the force of gravity or severe weakness; 1 indicates minimal contractile power (weak muscle contraction can be palpated but no movement is noted) or very severe weakness; indicates no movement.

103. COORDINATION

104. COORDINATION Coordination in the hands and upper extremities is tested by having the patient perform rapid, alternating movements and point-to- point testing.

105. COORDINATION Coordination in the hands and upper extremities is tested by having the patient perform rapid, alternating movements and point-to- point testing. First, the patient is instructed to pat his or her thigh as fast as possible with each hand separately.

106. COORDINATION Coordination in the hands and upper extremities is tested by having the patient perform rapid, alternating movements and point-to- point testing. First, the patient is instructed to pat his or her thigh as fast as possible with each hand separately. Then the patient is instructed to alternately pronate and supinate the hand as rapidly as possible.

107. COORDINATION Coordination in the hands and upper extremities is tested by having the patient perform rapid, alternating movements and point-to- point testing. First, the patient is instructed to pat his or her thigh as fast as possible with each hand separately. Then the patient is instructed to alternately pronate and supinate the hand as rapidly as possible. Last, the patient is asked to touch each of the fingers with the thumb in a consecutive motion. Speed, symmetry, and degree of difficulty are noted.

108. COORDINATION Coordination in the hands and upper extremities is tested by having the patient perform rapid, alternating movements and point-to- point testing. First, the patient is instructed to pat his or her thigh as fast as possible with each hand separately. Then the patient is instructed to alternately pronate and supinate the hand as rapidly as possible. Last, the patient is asked to touch each of the fingers with the thumb in a consecutive motion. Speed, symmetry, and degree of difficulty are noted. Point-to-point testing is accomplished by having the patient touch the examiner’s extended finger and then his or her own nose. This is repeated several times.

109. BALANCE /ROMBERG TEST

110. BALANCE /ROMBERG TEST Ask the clients stand still with their heels together. Ask the clients to remain still and close their eyes.

111. BALANCE /ROMBERG TEST Ask the clients stand still with their heels together. Ask the clients to remain still and close their eyes. Result: if the clients loses their balance after standing still with their eye closed. This is positive Romberg.

112. GAIT TESTING

113. GAIT TESTING To check ability to stand and walk:

114. GAIT TESTING To check ability to stand and walk: Ask the patient to walk across the room, turn, and come back towards you. Pay particular attention to, difficult to walk and indicate upper extremities weakness.

115. GAIT TESTING To check ability to stand and walk: Ask the patient to walk across the room, turn, and come back towards you. Pay particular attention to, difficult to walk and indicate upper extremities weakness. Difficulty getting up from a chair, Can the patient easily arise from a sitting position. Problems with this activity might suggest proximal muscle weakness, a balance problem, or difficulty initiating movements.

116. Biceps reflex

117. Biceps reflex Triceps reflex

118. Biceps reflex Triceps reflex Brachio radialis reflex

119. Biceps reflex Triceps reflex Brachio radialis reflex Patellar reflex

120. Biceps reflex Triceps reflex Brachio radialis reflex Patellar reflex Achilles reflex

121. BICEPS REFLEX TESTING:

122. BICEPS REFLEX TESTING: This is most easily done with the client seated.

123. BICEPS REFLEX TESTING: This is most easily done with the client seated. The biceps reflex is elicited by striking the biceps tendon over a slightly flexed elbow

124. BICEPS REFLEX TESTING: This is most easily done with the client seated. The biceps reflex is elicited by striking the biceps tendon over a slightly flexed elbow The examiner supports the forearm with one arm while placing the thumb against the tendon and striking the thumb with the reflex hammer.

125. BICEPS REFLEX TESTING: This is most easily done with the client seated. The biceps reflex is elicited by striking the biceps tendon over a slightly flexed elbow The examiner supports the forearm with one arm while placing the thumb against the tendon and striking the thumb with the reflex hammer. The normal response is flexion at the elbow and contraction of the biceps.

126. TRICEPS REFLEX

127. TRICEPS REFLEX To elicit a triceps reflex, the patient’s arm is flexed at the elbow and positioned in front of the chest.

128. TRICEPS REFLEX To elicit a triceps reflex, the patient’s arm is flexed at the elbow and positioned in front of the chest. The examiner supports the patient’s arm

129. TRICEPS REFLEX To elicit a triceps reflex, the patient’s arm is flexed at the elbow and positioned in front of the chest. The examiner supports the patient’s arm A direct blow on the tendon normally produces contraction of the triceps muscle and extension of the elbow.

130. BRACHIO RADIALIS

131. BRACHIO RADIALIS With the patient’s forearm resting on the lap or across the abdomen, the brachioradialis reflex is assessed.

132. BRACHIO RADIALIS With the patient’s forearm resting on the lap or across the abdomen, the brachioradialis reflex is assessed. A gentle strike of the hammer 2.5 to 5 cm (1 to 2 inches) above the wrist results in flexion and supination of the forearm

133. PATELLAR REFLEX TESTING

134. PATELLAR REFLEX TESTING This is most easily done with the clients seated, feet dangling over the edge of the exam table.

135. PATELLAR REFLEX TESTING This is most easily done with the clients seated, feet dangling over the edge of the exam table. The patellar reflex is elicited by striking the patellar tendon just below the patella.

136. PATELLAR REFLEX TESTING This is most easily done with the clients seated, feet dangling over the edge of the exam table. The patellar reflex is elicited by striking the patellar tendon just below the patella. The patient may be in a sitting or a lying position. If the patient is supine, the examiner supports the legs to facilitate relaxation of the muscles

137. PATELLAR REFLEX TESTING This is most easily done with the clients seated, feet dangling over the edge of the exam table. The patellar reflex is elicited by striking the patellar tendon just below the patella. The patient may be in a sitting or a lying position. If the patient is supine, the examiner supports the legs to facilitate relaxation of the muscle s Contractions of the quadriceps and knee extension are normal responses.

138. ACHILLES REFLEX TESTING

139. ACHILLES REFLEX TESTING To elicit an Achilles reflex, the foot is dorsiflexed at the ankle and the hammer strikes the stretched Achilles tendon

140. ACHILLES REFLEX TESTING To elicit an Achilles reflex, the foot is dorsiflexed at the ankle and the hammer strikes the stretched Achilles tendon If the examiner cannot elicit the ankle reflex and suspects that the patient cannot relax, the patient is instructed to kneel on a chair or similar elevated, flat surface.

141. ACHILLES REFLEX TESTING To elicit an Achilles reflex, the foot is dorsiflexed at the ankle and the hammer strikes the stretched Achilles tendon If the examiner cannot elicit the ankle reflex and suspects that the patient cannot relax, the patient is instructed to kneel on a chair or similar elevated, flat surface. This position places the ankles in dorsiflexion and reduces any muscle tension

142. ACHILLES REFLEX TESTING To elicit an Achilles reflex, the foot is dorsiflexed at the ankle and the hammer strikes the stretched Achilles tendon If the examiner cannot elicit the ankle reflex and suspects that the patient cannot relax, the patient is instructed to kneel on a chair or similar elevated, flat surface. This position places the ankles in dorsiflexion and reduces any muscle tension The Achilles tendons are struck in turn, and plantar flexion is usually demonstrated

143. BABINSKI REFLEX:

144. BABINSKI REFLEX: The clients may either sit or lies supine.

145. BABINSKI REFLEX: The clients may either sit or lies supine. Use the handle end of your reflex hammer, which is solid and comes to a point.

146. BABINSKI REFLEX: The clients may either sit or lies supine. Use the handle end of your reflex hammer, which is solid and comes to a point. Start at the lateral aspects of the foot, near the apply gentle, steady pressure with the end of the hammer