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Miss M. N. PRIYADARSHANIE ( BSc . Nursing ) Neurological Assessment

Miss M. N. PRIYADARSHANIE ( BSc . Nursing ) Neurological Assessment . Why we are doing a neurological assessment?. Assessment of neurological system Evaluation of mental status Evaluation of cranial nerve functions Evaluation of cerebellar functions

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Miss M. N. PRIYADARSHANIE ( BSc . Nursing ) Neurological Assessment

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  1. Miss M. N. PRIYADARSHANIE ( BSc . Nursing ) Neurological Assessment

  2. Why we are doing a neurological assessment?

  3. Assessment of neurological system • Evaluation of mental status • Evaluation of cranial nerve functions • Evaluation of cerebellar functions • Evaluation of reflexes • Evaluation of motor, sensory functions • Assessment of level of consciousness by using GCS - The GCS is a tool for assessing a patient’s response to stimuli. Score range from 3-15.

  4. Glasgow Coma Scale

  5. Best eye response • No eye opening • Eye opening in response to pain. (Patient responds to pressure on the patient’s fingernail bed; if this does not elicit a response, supraorbital and sternal pressure or rub may be used.) • Eye opening to speech. (Not to be confused with an awaking of a sleeping person; such patients receive a score of 4, not 3.) • Eyes opening spontaneously

  6. Best verbal response • No verbal response • Incomprehensible sounds. (Moaning but no words.) • Inappropriate words. (Random or exclamatory articulated speech, but no conversational exchange) • Confused. (The patient responds to questions coherently but there is some disorientation and confusion.) • Oriented. (Patient responds coherently and appropriately to questions such as the patient’s name and age, where they are and why, the year, month, etc.)

  7. Best motor response • No motor response • Extension to pain (abduction of arm, external rotation of shoulder, supination of forearm, extension of wrist, decerebrate response) • Abnormal flexion to pain (adduction of arm, internal rotation of shoulder, pronation of forearm, flexion of wrist, decorticate response) • Flexion/Withdrawal to pain (flexion of elbow, supination of forearm, flexion of wrist when supra-orbital pressure applied ; pulls part of body away when nailbed pinched) • Localizes to pain. (Purposeful movements towards painful stimuli; e.g., hand crosses mid-line and gets above clavicle when supra-orbital pressure applied.) • Obeys commands.

  8. Generally, brain injury is classified as: • Severe, with GCS ≤ 8 • Moderate, GCS 9 - 12 • Minor, GCS ≥ 13 • GCS = 3 Brain death or pharmacological inhibition of neurological response • GCS = 15 Patient fully responsive

  9. Thank you !

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