Professional Documents
Culture Documents
A. Neurological History
A. Neurological History
A. Neurological History
A. Neurological History
- Always confirm at the very beginning of your interview if the patient is mentally sound to provide correct and
rational information regarding his/her health. Check if the patient can cognitively recall.
1. Headache – increased intracranial pressure (caused of icp: abnormal buildup of cerebrospinal fluid, swelling in
the brain)
2. Seizures – Epilepsy, head injury loss of consciousness due to involuntary muscle movement and sensory
disturbance because of abnormal firing of neuron.
- What to ask if the patient experienced head injury/nabagok: Nagsuka ba? Saan banda yung tama sa
ulo, Nawalan ba ng malay, nangisay/seizure.
6. Problems with communication – injury to the cerebral cortex, nabulol ang patient
7. Lost bowel or bladder control –spinal cord injury or tumors, biglang naihi.
9. Muscle weakness or any loss of movements – Stroke, spinal cord compression, any neurological diseases.
NEUROLOGICAL ILLNESS
1. Parkinson’s Disease
- Long term degenerative central nervous system disorder (lost of dopamine in the midbrain.)
2. Myasthenia Gravis
- facial asymmetry
4. Multiple Sclerosis
5. Tourette’s Syndrome
6. Huntington’s Chorea
7. Cerebral Palsy
- Congenital illness and they have very poor prognosis that some of them do not reach adulthood
because of the paralysis that starts from the foot and as it reaches cervical spine, it creates problem in
breathing.
- Symptoms: poor coordination, weak muscles, and tremors. Problems with sensation, vision, hearing,
swallowing, and speaking may also be present.
8. Korsakoff’s Syndrome
- Sobra sa walwal
2. Meningitis
3. Encephalitis
Ischemic Stroke – Deprived of blood, blood clot blocks the blood flow
Hemorrhagic Stroke – Bleeding, blood spills out from break in blood vessels in brain
FAMILY HISTORY
1. Hypertension
3. Alzheimer’s Disease
- Inherited
4. Epilepsy
-Inherited
5. Brain Cancer
6. Huntington’s Chorea
LIFESTYLE AND HEALTH PRACTICES
2. Smoking habits
- Vasoconstriction
3. Safety Practices
4. Diet
- Low fat diet, low cholesterol, low salt is important for neuro because it prevents the occurrence of
hypertension. Dapat rich in vitamin b complex
- Altered LOC
- There may be spinal cord injury or peripheral nerve injuries, and symptoms.
B. Neurological Examination
- MSE must be performed at the beginning of the head-to-toe exam to ensure that the patient
is mentally sound/validity of client’s response.
- When assessing the elderly, make sure that the elderly can read and listen/check the vision
and hearing.
- SOME of the Components of MSE: LOC, Posture, gait, body movements, speech, mood, etc.,
A. Mini-mental State Exam (MMSE) aka FOLSTEIN TEST
- Tests five areas of cognitive function: 1. Orientation 2. Registration 3. Attention & Calculation
4. Recall 5. Language
LEVEL OF CONSCIOUSNESS
3. Obtunded- Opens eyes to loud voice, responds slowly with confusion, and seem unaware of the environment
4. Stupor – Awakens to vigorous shake or painful stimuli but returns to unresponsive sleep
Verbal Response
- If the patient’s score is 4 or 3, proceed to verbal response. 2 below for eye response, automatic 1
- 5 = ask for time, place, and person (sino kasama niyo, nasaan kayo, anong araw)
- 4 = kung may mali na isa sa tanong, kung hindi niya alam kung nasaan siya as long as he/she
understood the questions.
- 3 = Inappropriate response, mga sagot na walang kinalaman sa tanong (ex. Bigla kang minura)
- 2 = hindi words ang sinagot (ex. Growl or umubo lang)
- 1 = no response. Applicable sa naka-intubate (kapag nod, 1 lang)
Motor Response
- If the patient is oriented, proceed to motor response
- 6 = kapag nasunod yung pinagawa (pinataas yung kamay)
- 5 =kinurot mo si patient, pinigilan ka niya
- 4 = kinurot mo, nagtago lang or withdraws from pain
- 3 = kinurot, nag decorticate lang meaning nag curl inward ang kamay
- 2 = kinurot, nag decerebrate meaning nag curl outward ang kamay
- 1 = no reaction
Pain Stimulation
1. Fingertip Pressure – itutusok yung kuko sa pinky finger
2. Trapezius Pinch – Pinch yung sa may bandang collarbone
3. Supraorbital notch – sa may noo, above the nose
To test light touch sensation = use a wisp of cotton to touch the patient
To test pain sensation = use a safety pin or paper clip
To test temperature sensation = use test tubes filled with hot and cold water but it is not recommended
NORMAL: client correctly identifies sensation
Equipment: