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Exploring Neurological & Sensory Functions: Assessment & Examination

Learn to assess and document neuro/sensory findings, identify health problems, and differentiate normal from abnormal assessments. Understand the structures and functions of the cerebral cortex, lobes, brainstem, and more. Discover the relationships to other systems, developmental and cultural variations, history taking, symptoms, and conduct a thorough physical assessment for sensory, motor, and reflex functions.

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Exploring Neurological & Sensory Functions: Assessment & Examination

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  1. ASSESSING THE SENSORY-NEUROLOGICAL SYSTEM

  2. Outcomes • Identify pertinent neuro/sensory history questions. • Obtain a neuro/sensory history. • Perform a neuro/sensory physical assessment. (Continued)

  3. Outcomes • Document pertinent neuro/ sensory assessment findings. • Identify actual/potential health problems stated as nursing diagnosis. • Differentiate between normal and abnormal findings.

  4. Structures • Cerebrum  Cortex • Frontal lobe  Temporal lobe • Limbic system  Parietal lobe • Occipital lobe  RAS • Thalamus  Hypothalamus • Cerebellum  Brainstem • Midbrain  Medulla • Meninges  Ventricles

  5. FunctionsWhat are the functions of… Cerebrum: Largest part of brain Cortex: Outer layer of cerebrum; controls most conscious processes Frontal Lobe: Emotional expression, Broca’s area (expressive language) (Continued)

  6. FunctionsWhat are the functions of… Temporal lobe: Hearing, taste, smell, memory, Wernike’s (language comprehension) Limbic system: Emotions, sexual arousal, behavioral expression, recent memory (Continued)

  7. FunctionsWhat are the functions of… Parietal: Sensory input Occipital lobe: Vision and spatial relationships RAS: Wakefulness (Continued)

  8. FunctionsWhat are the functions of… Thalamus: Clusters multiple sensory stimuli Hypothalamus: Controls autonomic nervous system and pituitary gland Cerebellum: Coordination, equilibrium (Continued)

  9. FunctionsWhat are the functions of… Brainstem: Involuntary survival behaviors; includes midbrain, medulla and pons Midbrain: Visual, auditory, pupils, and eye movements (Continued)

  10. FunctionsWhat are the functions of… Medulla: Regulates heart, respiratory rates, B/P, and protective reflexes Pons: Helps with respiratory function, facial sensation and movement (Continued)

  11. FunctionsWhat are the functions of… Meninges: 3 layers (pia, arachnoid, dura); protect brain and spinal cord Ventricles: 4 cavities; capillaries produce and reabsorb CSF (Continued)

  12. Relationship to Other Systems What is the relationship of the neurologic/ sensory system to other systems? • Integumentary  Respiratory • HEENT  Musculoskeletal • Lymphatic  Genitourinary • Cardiovascular  Endocrine • Hematological  Gastrointestinal

  13. DevelopmentalVariations What developmental variations of the neurologic/sensory system might you seen with: • Children • Pregnant clients • Older adults

  14. Cultural Variations What cultural variations of the neurologic/sensory system might be seen with: • African Americans • Irish • Native Americans

  15. HistoryWhat can the history tell you about the neurologic/sensory system? • Biographical data • Current health status • Past health history • Family history • Review of systems • Psychosocial history

  16. SymptomsWhat symptoms would signal a problem with the neurologic/sensory system? • Headache • Mental status change • Dizziness, vertigo, syncope • Numbness or loss of sensation • Deficits of the 5 senses

  17. Physical Assessment Approach: inspection, palpation, and auscultation Position: sitting Tools: stethoscope, B/P cuff, penlight, gloves, cotton, sharp object, coin, fragrance, sweet and sour substance, tongue blade, test tubes, reflex hammer, ophthalmoscope General Survey and head-to-toe scan

  18. Cerebral Function • Behavior • Level of consciousness: time, place, person • Glasgow Coma Scale • Memory: immediate, recent, remote • Mathematical ability • Thought process  Judgement • General knowledge  Communication

  19. Sensory Function Superficial sensations: • Light touch • Pain • Temperature Deep sensations: • Vibratory sensations • Kinesthetics (Continued)

  20. Sensory Function Discriminatory sensations: • Stereognosis • Graphesthesia • 2 point discrimination • Point localization • Extinction

  21. Deep Tendon Reflexes • Biceps • Triceps • Brachioradialis • Patellar • Achilles

  22. Superficial Reflexes • Plantar • Abdominal • Anal • Cremasteric • Bulbocavernosus

  23. Protective Reflexes • Gag • Cough • Swallow • Blink • Corneal

  24. Primitive Reflexes • Babinski • Sucking • Grasp • Rooting • Snout • Glabellar

  25. Meningeal Signs • Nuchal rigidity • Kernig’s Sign • Brudzinski’s Sign

  26. Motor Function • Finger-to-nose • Heel-to-shin • Rapid alternating movements • Romberg • Gait: heel-to-toe

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