NU609 Advanced Health Assessment

Unit 12 Discussion – Neurological Evaluation

A 60-year-old man is brought to the ER by ambulance because of slurred speech and left side weakness. His wife states they went to bed at 11pm and woke up at 5am when she noticed his symptoms. He is right handed with a history of coronary artery disease, hypertension, and hypercholesterolemia and a heart attack at age 50. He currently is unable to move his left arm and leg. He had an episode of amaurosis fugux (blindness)in his right eye one month ago that lasted for 5 minutes. Around 3 months ago his wife states he had bilateral pain in his legs while they were on a walk that lasted about 15 minutes. He is taking a baby aspirin a day an ACE inhibitor, and statin as well. He does have a history of alcohol use and smoking in the past but stopped after his heart attack. His blood pressure is 195/118 Pulse 106, Respiratory rate 18, Temperature 99.8, o2 sat is 97% on room air. Although his pupils are equal and reactive, and the ocular movements are intact, he is unable to turn his eyes voluntarily toward the left side. The neck is supple, there is no jugular vein distension, and there are no bruits. The lungs are clear heart sounds regular without murmurs, and abdomen is normal. The limbs are not well perfused distally. The neurologic examination reveals that he is alert and oriented, although he does not recognize he is sick. He shows loss of awareness and attention with respect to objects or stimuli on his left side. He has mild dysarthria but, his speech is fluent, and he understands and follows commands very well. There is mild weakness on the left side of the face and left sided homonymous hemaianopsia, but there is no nystagmus or ptosis, and no tongue or uvula deviation. He is not able to move his left arm and leg, has hyperreflexia, and the left great toe is upgoing.

What are two questions you would ask this patient?

Identify the subjective data for this patient.

Identify the objective data for this patient.

What is the likely diagnosis?

Your response should include evidence of review of the course material, websites, and literature through proper citations using APA format.

 

MORE INFO 

Neurological Evaluation

Introduction

The evaluation of neurological function is an important step in the diagnosis of many disorders. This test can help determine if there are any signs that a patient may have a neurologic condition (such as dementia) or whether their symptoms are due to other medical causes.

Cranial Nerve Examination

Cranial nerve examination is a process that evaluates the function of nerves in your face, head and neck. The 12 cranial nerves are located on either side of your brainstem and provide sensory information to muscles around the eyes, nose and mouth.

The following tests may be used to evaluate cranial nerve function:

Motor examination

The motor examination is an important part of any neurological evaluation. The test can be used to assess muscle weakness, coordination and balance as well as tone. In addition, it may help determine whether there are other problems such as spasticity or atrophy (muscle wasting) that could influence your ability to function normally in daily life. A thorough assessment should include:

• Muscle strength

• Muscle bulk (fatigue when muscle contractions are done for long periods of time)

Reflexes Test

Reflexes are involuntary movements that occur in response to a stimulus. The reflex arc consists of an afferent nerve fiber (the stimulus), an efferent nerve fiber (the action), and an interposed muscle or part of the body. The efferent nerve fibers from the brain stem travel to their target organs, where they activate muscles and cause movement.

Reflexes can be assessed by testing for signs of abnormal functioning at each level along this chain:

• Afferent nerves—this section looks at how well your nervous system is working as a whole

Sensory System Test

The neurological evaluation is not just about the patient’s physical symptoms. It also involves a sensory system test, which measures how well your body can perceive pain, touch, temperature and vibration. These tests are done to determine whether any nerve damage has occurred in your nervous system and how severe it was.

A neurological examination is an important part of the evaluation process because it can help determine whether there is any permanent damage to nerves or muscles resulting from injury or disease. A thorough neurological evaluation will allow doctors to make accurate predictions about recovery time after surgery or other procedures such as those designed for treating chronic conditions like diabetes mellitus (DM), lupus erythematosus (LE), rheumatoid arthritis (RA) & multiple sclerosis (MS).

Takeaway:

This chapter is about the neurological evaluation. The takeaway from this chapter is that you should always be aware of your surroundings, and always have a backup plan if you need it. You can also make sure that your spouse or partner knows where you are going and what time you’re leaving home.

In case something happens to one of the people in your group, they should stay safe by staying together at all times! If someone gets hurt (or worse), they should call 911 immediately so an ambulance will arrive quickly to help them get better faster than ever before!

Conclusion

It is clear that the Brainbow test has great potential to be used as a tool for diagnosis of neurological disorders. In this article, we have described some of the standard tests and discussed their advantages and disadvantages. We hope that you will find this useful information when planning your child’s medical evaluation.