Neruo

Instruct patient to stand with the feet together, first with the eyes open and then with the eyes closed. Slight swaying is normal.

• Stand close enough to the client to
• prevent falling.

• Normal:client is able to do this for about 20
• seconds with the eyes closed

•Client pats his knees with palms of the hands followed by backs of the hands at an ever increasing rate.

•Assessing Coordination

•Client touches each finger of one hand to the thumb of the same hand as rapidly as possible.

Finger to Nose

Finger to Finger

Heel to Shin

Use a reflex hammer to tap a tendon. Record symmetry comparing one side to the other.

Use a stick figure representation to document the reflex findings.

Reinforcement is done to enhance a reflex. Person performs an isometric exercise in a muscle group somewhat away from the one being tested

• Achilles Reflex
• Bicep Reflex
• Tricep Reflex
• Brachioradialis Reflex
• Quadricep Reflex

4+ = Very brisk, hyperactive with clonus, indicative of disease

3+ = Brisker than average, may indicate disease

2+ = Average, normal

1+ = Diminished, low normal

0 = No response

(tests spinal cord levels T8 - T12)

(stroke skin of inner upper thigh which results in testicular movement on the same side)

• Plantar reflex (L4, L5, S1, S2) elicited by firmly stroking the lateral surface of the
• sole of the foot

Normal:plantar flexion of the toes

Abnormal: Positive Babinski: extension of the great toe and fanning of the other toes

Before a child can walk, fanning and extension of the toes are a normal finding.

Apply stimuli to test major peripheral nerves.

Minimal number of test sites includes areas on the forehead, cheek, hand, and foot.

In the screening exam, assume the nerve to be intact if sensation is normal at its most distal area.

When there is evidence of dysfunction, localize the site of the dysfunction and map the boundaries. Sketch the region involved and describe the sensory change.

Client closes his eyes

ability to recognize objects by touching and manipulating them.

by asking the client to identify letters or numbers written on each palm with a blunt point.

• Interpretation by the cerebral cortex. Three types are tested
• -Stereogenesis
• -Graphesthesia
• -

• Ability to sense whether one or two
• areas of the skin are being stimulated by pressure. To test this, apply disposable pins or a paperclip bent into a “u” shape to the skin simultaneously. Ask if client feels one or two pinpricks

awake, alert, and oriented to person place and time

Acute Nerve damage

fists at the chest

happens when you get hit and fall to the ground

more long standing

fists to the sides

• Inequality of pupils >1mm indicates
• pathology

assessed in unconscious patients to evaluate cranial nerves 3,4,6 (can’t do this with a cord injury)

personality, behavior, emotions, & intellectual functions

• Broca’s Area: motor speech
• → expressive aphasia

Sensation

cant feel hot and cold

visual receptor center

auditory reception center

Wernicke’s Area: language comprehension → receptive aphasia.

Mimicks a stroke usually precipitated after viral illness however do not have long standing …., can come and go


Symptom of lymes disease

Deminished sensation to the periphery hands and feet