Assessment of the Neurologic SystemCerebrum and cerebellum

Worksheet

Health History AssessmentA neurological health history can be obtained if the patient is alert enough and oriented to person, place, and time. If the person appears to be disoriented or confused upon questioning, ask family members and friends to confirm the information.

Common Symptoms:

Health History: Present Health Status

Health History: Past History

Health History: Family History

EquipmentAromatic materialPenlightTuning ForkCotton-tipped applicatorTongue blade

Disposable glovesPaper clipCotton ballPercussion hammerSnellen’s chart

Assessment of the function of the CerebrumFrontal LobesMental StatusLevel of consciousness

Alert

Lethargic

Stupor

Semi coma

Coma

The Glasgow Coma Scale

Best eye opening response Best verbal response Best motor response – to voice or pain

SpontaneouslyTo verbal commandTo pain No response

4321

Oriented, converses Disoriented, conversesInappropriate wordsIncomprehensible soundsNo response

54321

ObeysLocalizes pain Flexion withdrawal Flexion decorticate Extension decerebrateNo response

654321

Score: 3 – 15

Calculations in basic mathematics

Affect/mood

- During the physical part of the examination, note the patient's mood and emotional expressions which you can observe by his verbal and nonverbal behavior.

- Notice if he has mood swings or behaves as though he is anxious or depressed. - Notice whether or not the patient's feelings are appropriate for the situation. - Disturbances in mood, affect, and feelings may be indicated by a patient who exhibits

unresponsiveness, hopelessness, agitation, euphoria, irritability, or wide mood swings.

Memory (recent and remote)

Orientation

Knowledge (normal intellect)

Parietal Lobesa. Sensory status

Stimuli applied in dermatomal areas of the body and ask client to identify the sensation - Pain (pinprick)

- Temperature (test tubes of hot and cool water)

- Light touch (cotton wisp applied to body)

b. Vibration

c. Proprioception

d. Stereognosis

Occipital Lobesa. Visual object recognition

b. Visual verbal comprehension

c. Visual acuity and visual fields

Temporal Lobesa. Visual Fieldsb. Speech understanding

c. Recent memory

Extensive Neurologic Assessmenta. Two point discrimination

b. Point localization

c. Texture discrimination

d. Extinction phenomenon

e. Graphesthesia

Assessment of the Function of the CerebellumBalance assessment

A. Gait and posture

B. Romberg’s sign

C. Tandem walking

Coordination assessmenta. Upper extremities

a. Finger to Finger Test

b. Finger to nose test

c. Rapid alternating movements

b. Lower extremitiesa. Heel to shin

b. Figure eight

c. Toe to finger