Assessment of the Neurologic System

Cerebrum and cerebellum

Worksheet
Health History Assessment

A 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

Equipment
Aromatic material
Penlight
Tuning Fork
Cotton-tipped applicator

Tongue blade
Disposable gloves
Paper clip
Cotton ball

Percussion hammer

Snellens chart

Assessment of the function of the Cerebrum

Frontal Lobes
Mental Status
Level of consciousness
Ale
rt

Let
har
gic

Stu
por

Se
mi
co
ma

Co
ma

The Glasgow Coma Scale

Best eye opening
response
Spontaneously
To verbal
command
To pain
No response

Best verbal
response

Oriented,
converses
Disoriented,
converses
Inappropriate
words
Incomprehensib
le sounds
No response

Score: 3 15

Best motor
response to voice
or pain
Obeys
Localizes pain
Flexion
withdrawal
Flexion
decorticate
Extension
decerebrate
No response

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 Lobes
a. 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 Lobes

a. Visual object recognition

b. Visual verbal comprehension

c. Visual acuity and visual fields

Temporal Lobes
a. Visual Fields
b. Speech understanding

c. Recent memory

Extensive Neurologic Assessment

a. Two point discrimination

b. Point localization

c. Texture discrimination

d. Extinction phenomenon

e. Graphesthesia

Assessment of the Function of the Cerebellum

Balance assessment
A. Gait and posture


B. Rombergs sign

C. Tandem walking

Coordination assessment
a. Upper extremities
a. Finger to Finger Test

b. Finger to nose test

c. Rapid alternating movements

b. Lower extremities
a. Heel to shin

b. Figure eight

c. Toe to finger