Neurologic Exam Lab

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Inver Hills Community College *

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2201

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Anatomy

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Feb 20, 2024

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ANATOMY AND PHYSIOLOGY LAB: NEUROLOGIC EXAMINATION Learning Objectives: After completing the following laboratory exercises, students will be able to: Understand the purpose and procedure of each part of the neurologic exam, including: Mental Status, Speech, Cranial Nerve Exam, Reflexes, Muscle Testing, Coordination, Gait and Station, and Sensation. Be able to carry out and interpret results from each section of the neurologic exam. Differentiate the functions of each of the 12 pairs of cranial nerves. Learner Outcomes: Students will be able to perform tests and interpret results from the neurologic exam in order to differentiate neurological disorders. Materials you will need for this lab from your lab kit: Reflex Hammer Cotton Tipped Applicator Pen Light Tuning Fork Materials you will need to acquire on your own for this lab: Two substances to test scent, such as: coffee, soap, wintergreen, or another that you determine Camera Scrap of paper with your name and the date to appear in all 13 photos Supplemental Materials: Neurologic Exam Video by Lisa Tracy: https://mediaspace.minnstate.edu/media/Neurologic+Exam/1_4dq2yjxh Video Link: Merck Manual – Cranial Nerves Exam - https://www.merckmanuals.com/professional/neurologic-disorders/neurologic-examination/ how-to-assess-the-cranial-nerves Time List Task 1: Intro Video (45 min) Task 2: Plan Your Neurological Exam (30 min) Task 3: Plan your Cranial Nerve Exam (30 min) Task 4: Carry out Neurologic Exam on a volunteer (20 min) Task 5: Carry out Cranial Nerve Exam on a volunteer (20 min) Task 6 and 7: Insert Photos (20 min)
ANATOMY AND PHYSIOLOGY LAB: NEUROLOGIC EXAMINATION Task 1: Neurologic Exam Overview Watch the Introduction to Neurologic Exam Video (40 min). Answer the following questions as you go along. Look ahead at Task 2 and 3 before you watch, as they will key you in to certain information you need to complete these tasks. You will want to pause after each of the 8 parts in the video and fill in the table in Task 2 to select which test you will do on your volunteer. In Task 2, you will perform 7 tests, one from each of the other 7 Parts of the Neurologic Exam (Task 3 will be more detail for the Cranial Nerve Exam). In Task 3, you will perform 7 tests from the Cranial Nerve Exam on a volunteer. Video Link: https://mediaspace.minnstate.edu/media/Neurologic+Exam/1_4dq2yjxh Part 1: Mental Status 1. What are some disorders people are concerned about if they want to check mental status? 2. What is one tool a neurologist can use to assess mental status? Part 2: Speech 3. What are some examples of disorders that can occur where disrupted speech is a symptom? Part 3: Cranial Nerve Exam 4. Cranial Nerve I is the olfactory nerve. Why would a medical professional check the olfactory nerve if there appears to be a cognitive problem? 5. What is one tool can be used to check Cranial Nerve II, the optic nerve? What can you see with this tool? 6. Cranial Nerve III: Oculomotor has two functions. List them. 7. Which other nerves work with the oculomotor nerve to control where our eyes look? 8. When checking cranial nerves III, IV, and VI, what are you looking for? 9. What is nystagmus? What could it mean if you have too much nystagmus?. 10. What kind of test(s) could you do to check function of Cranial Nerve V: Trigeminal? 11. What is Bell’s Palsy? Which cranial nerve test may indicate Bell’s Palsy? 12. Cranial Nerve VIII is the vestibulocochlear nerve. What tools could you use to test this nerve?
ANATOMY AND PHYSIOLOGY LAB: NEUROLOGIC EXAMINATION 13. What part of the tongue does Cranial Nerve IX: Glossopharyngeal sense? 14. How else do you check the glossopharyngeal nerve? 15. What two things should you see if the accessory nerve motor function is normal? 16. When testing Cranial Nerve XII, what is one movement pattern you could notice? What might it indicate? Part 4: Reflexes 17. What are the two main types of reflexes? In a healthy, normal person which type of reflex SHOULD be there? Which should not? 18. Give some examples of where the neurologist taps the reflex hammer to test deep tendon reflexes. 19. Give three examples of pathological reflexes? What does each indicate? 20. What is the palmomental reflex? What is the jaw jerk reflex? What is the snout reflex? What is a glabellar reflex? What do all four indicate? Part 5: Muscle Testing 21. Apart from symmetry, what are you looking for when testing a patient’s muscles? Part 6: Coordination 22. What part of the brain controls coordination? 23. What are some variables you are checking for when testing coordination? 24. What kind of actions could you have a patient do to check for coordination? 25. What kind of disorders could coordination tests help identify? 26. How many neurons are in the brain? How many of those are in the cerebellum? Calculate the approximate percentage of brain neurons that belong to the cerebellum. Part 7: Gait and Station 27. What are some normal features or patterns for a healthy person’s gait, or walking?
ANATOMY AND PHYSIOLOGY LAB: NEUROLOGIC EXAMINATION 28. If someone has an abnormal gait, what might it look like? For each example of abnormal gait, describe a part of the brain or condition that could cause the abnormality. 29. What is station? 30. What does it mean to have a “righting reflex?” 31. What is a positive Romberg? What area of the nervous system is affected? Part 8: Sensation 32. List the three types of sensation in the sensation exam. 33. How might you test superficial sensation? 34. What is a positive Tinel’s test? What does it indicate? 35. What is a Phalen’s test? What does it indicate? 36. Dermatomes are used in superficial sensation tests. What are dermatomes (from lecture)? 37. In what ways or with which tools can you touch a patient to determine superficial sensation. 38. List some ways you can test deep sensation.
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