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Part of the power of the neurological exam is this link between structure and function. Testing the various functions represented in the exam allows an accurate estimation of where the nervous system may be damaged. Consider the patient described in the chapter introduction. In the emergency department, he is given a quick exam to find where the deficit may be localized. Knowledge of where the damage occurred will lead to the most effective therapy.

In rapid succession, he is asked to smile, raise his eyebrows, stick out his tongue, and shrug his shoulders. The doctor tests muscular strength by providing resistance against his arms and legs while he tries to lift them. With his eyes closed, he has to indicate when he feels the tip of a pen touch his legs, arms, fingers, and face. He follows the tip of a pen as the doctor moves it through the visual field and finally toward his face. A formal mental status exam is not needed at this point; the patient will demonstrate any possible deficits in that area during normal interactions with the interviewer. If cognitive or language deficits are apparent, the interviewer can pursue mental status in more depth. All of this takes place in less than 5 minutes. The patient reports that he feels pins and needles in his left arm and leg, and has trouble feeling the tip of the pen when he is touched on those limbs. This suggests a problem with the sensory systems between the spinal cord and the brain. The emergency department has a lead to follow before a CT scan is performed. He is put on aspirin therapy to limit the possibility of blood clots forming, in case the cause is an embolus    —an obstruction such as a blood clot that blocks the flow of blood in an artery or vein.

Watch this video to see a demonstration of the neurological exam—a series of tests that can be performed rapidly when a patient is initially brought into an emergency department. The exam can be repeated on a regular basis to keep a record of how and if neurological function changes over time. In what order were the sections of the neurological exam tested in this video, and which section seemed to be left out?

Causes of neurological deficits

Damage to the nervous system can be limited to individual structures or can be distributed across broad areas of the brain and spinal cord. Localized, limited injury to the nervous system is most often the result of circulatory problems. Neurons are very sensitive to oxygen deprivation and will start to deteriorate within 1 or 2 minutes, and permanent damage (cell death) could result within a few hours. The loss of blood flow to part of the brain is known as a stroke    , or a cerebrovascular accident (CVA).

There are two main types of stroke, depending on how the blood supply is compromised: ischemic and hemorrhagic. An ischemic stroke    is the loss of blood flow to an area because vessels are blocked or narrowed. This is often caused by an embolus, which may be a blood clot or fat deposit. Ischemia may also be the result of thickening of the blood vessel wall, or a drop in blood volume in the brain known as hypovolemia    .

Questions & Answers

what is hypoxia
Akas Reply
I guess it's low supply the oxygen to the tissues
famuyiwa
yup
Natalie
A condition in which tissues (especially the blood) are deprived of an adequate supply of oxygen
Panthera
hanifa pia uko hapa
Panthera
where is present Glenoid Cavity ?
A- Reply
what is the muscular tissue
Md Reply
muscular tissue is a type of tissue that provide to help in cotraction to aur body.
A-
What's the difference in epithelial, connective, muscular and muscle tissue
Gifty
and it's similarities
Gifty
what is limb bone
Akshu Reply
this are bone attaching or joining to the axial bone.axial bone including skull,vertebrate and ribcage
Eliasi
how many bones make up the skull?
Matthew
22 bones
Husna
22bones
Bhanu
where is present Glenoid cavity ?
A-
how many bone in skull
Md
Explain the stages of mitosis and cell division
Bella Reply
systems of human body
Udezue Reply
define lymphatic system And give the composition of lymphatic fluid
sakshi Reply
the network of vessels through which lymphatic drains From the tissue into blood.lymph contain variety of substance like salts, glucose, proteins and fatsand water, white blood cells
Bhanu
yeah
Hassan
what is lymphatic system
Adie Reply
the network of vessels through which lymph drains from tissue into the blood
Bhanu
to describe the boundaries of four cavity
Pius Reply
homeostatic variables such as body temperature fluctuates within a normal range around the set point, or ideal, for a given homeostatic condition. for example, 98.6°F is a set point for body temperature. The response of the effector determines whether or not the homeostatic variable remains in the n
Chidinma Reply
why rbc is biconcave?
Sudhakar Reply
to carry oxygen easily
anwaar
What part of the brain controls the body temp
Ridwan
hypothalamus
JAYESH
what are epithelial tissues
Sachibu Reply
epithelial tissue that cover overall parts of the body and it's free from blood and nerves
Bhanu
Epithelial tissues are composed of cells laid out in sheets with strong cell-to-cell attachments.
Duah
Epithelial tissues perform a variety of functions that include; protection, secretion, filtration, diffusion, absorption, etc.
Duah
what control the flow of the blood ?
Donkor Reply
the pumping action of the heart
Holly
what is bony promises on the human body
Kelly Reply
what is the bony promises on human body
Kelly
what are bony prominences on human body
Kelly
support of the body
Bhanu
what are the characteristics of blood
yeboah Reply
they are red in colour
Tawoi
why blood is red in color?
Sudhakar
blood is red because it contains hemoglobin
Abena

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Source:  OpenStax, Anatomy & Physiology. OpenStax CNX. Feb 04, 2016 Download for free at http://legacy.cnx.org/content/col11496/1.8
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