kernig's sign test

test for meningitits

lift leg from him flex knee

no pain is negative

goniometer

measures ROM

(range of motion)

test for meningitis

nurse flexes clients neck

positive sign would be clients passively flexes the hip and knee in response to head flexion and reports pain along vertebral column 

tests hearing by comparing conduction

Abnormal finding 

Conduction loss- sound heard longer with bone

Sensorial Loss- sound heard longer with air

Weber's Test

Test of CN VIII

auditory function

abnormal finding would be for the tone to laterlize

Light Touch sensation test

tests CN5 

patient eyes close touch with cotton ball over both side of the face

abnormal findings would be absence of sensation

Achilles Reflex test

flex patient's knee and dosiflex the ankle 90 degrees. Hold the bottom of the foot in one hand while you use the flat end of the reflex hammer to strike the achilles tendon at the level of the ankle malleolus

Abnormal finding- Range from hyperactive to a diminished response

Babinski Test

stroke lateral aspect of the sole of the foot from the heel to ball, curving medially across the ball of the foot.

Abnormal finding- dorsiflexion of the great to with fanning of the other toes. Test would be positive

Use two points of a paper clip so that the two prongs can be lightly pressed against the clients skin simultaneously. 

Abnormal finding- inability to distinguish 

pupils equal round reactive light accomodation

Abnormal finding- failure of either one or both eyes to constrict to light in speed or magnitude indicates dysfunction of the oculomotor nerve

CNIII

Hirshberg Test 

(Corneal reflex test)

Test used to determine whether a person has ocular misalignment

Abnormal finding- esotropia, extropia, hypertropia, hypotropia

with patients eyes closed place vibrating tuning fork over the bony area of the lower extremities. Ask the patient to describe sensation

Abnormal findings- decreased,absent or unequal sensation

impairment of sensory nerves or parietal lobe

McMurray Test

to evaluate presence of a damaged medial or lateral meniscus

patient laying down will flex knee with foot flat on table, place thumb and index finger of one hand along side of the joint space to maintain flexion and stability. Grasp patient heel raise the lower leg parallel with the table and rotate the knee

positive test is pain, audible clicking or locking of the knee on movement 

Confrontation test

(optic nerve CNII)

slowly move object inward from the periphery in four directions have patient report when they can see the object

Six cardinal fields of gaze

CN III

CN IV

CN VI

Patient looking at you position your finger 10 to 12 inches from the clients nose. Ask the client to keep the head still and follow finger with eyes only

Abnormal finding- eye movements that are not parallel indicate extraocular muscle weakness or dysfunction of CN III, IV, and VI

Patient lays supine

Elicit the bulge sign by extending the knee and milking the medial aspect upward two or three times. Then tap on the lateral side of the patella. no fluid waves or bulging should be seen on the opposite side of the joint

Romberg Test

Have patient stand with feet together, arms resting at sides and eyes open then closed.

Positive Rombergs test when patient sways with eyes opened and closed

eyes closed stand on one foot then other

walk in tandem heel to toe

hop on one foot then the other

one hand out and perform several knee bends

walk on toes the heels

dermis 

epidermis

subcutaneous

Turgor

pallor-

cyanosis-

erythema-

jaundice-

pale

blue

red

yellow

ABCDE rule

asymemetry

border

color

diameter

elevation and enlargement

Neuropathy Distal Assessments

monofilament test

light touch

sharp/dull

vibration

kinesthetic

stereognosis

2 point discrimination

graphesthesia

graphesthesia

Reflex 

Upper Abdominal

superficial

T7, T8, T9

Reflex 

Lower Abdominal

superficial

T10 T11

Reflex

Cremasteric

superficial

T12, L1, L2

Reflex

Plantar

superficial

L4, L5, S1, S2

Reflex

Biceps

Deep

C5, C6

Reflex

Brachioradial

Deep

C5 C6

Reflex

Triceps

Deep

C6 C7 C8

Reflex

Patellar

Deep

L2 L3 L4

Reflex

Achilles

Deep

S1 S2

Cerebrovascular Accident

Death of brain cells due to blockage and lack of oxygen. Also refered to as a stroke

primary motor cortex

broca's area

parietal lobe

primary auditory cortex

wernickes area

evaluation of cerebellar function for balance and coordination

with client lying supine ask them to place the heel of one foot on the knee of the opposite leg and slide it down to the ankle. Repeat on opposite leg

Abnormal finding- cerebellar disease may cause overshooting of the knee and oscillate back and forth. loss of position sense patient my have to look to make sure heel is going down shin

Phanlens sign

flex both wrists and press the dorsum of the hands againist each other for 1 minute

Positive test- report of numbness pain and a paresthesia over palmar surface

tap on the median nerve where it passes through the carpal tunnel under the carpal ligament and volar carpal ligament

Positive test- report of tingling sensation or pain radiating from the wrist to the hand along the median nerve

neurological assessment testing of he cerebellar function of coordination of fine motor movements

rapid alternating hand pronation/supanation

rapid alternating nose touching

alternating finger movement to the thumb

rapid movements of index finger from nose to examiners finger

motor response- 6 to 1 (6 obeys commands fully)

Verbal response- 5-1 (5 alert and oriented)

eye opening 4 to 1 (4 spontaneous eye opening)

final score is determined by adding the three

mild 13-15

vegetative 0-3

evaluation deep tendon reflexes of triceps and biceps

Triceps- strike tendon just above the elbow with reflex hammer

Biceps- use pointed end of reflex hammer, strike your thumb instead of striking tendon directly

Temporomandibular Joint

(tmj)