Neurological status. Study of neurological status

The human nervous system ensures the regulation of the work of organs and tissues, and also helps to adapt the organism to certain conditions. It depends on it the work of the organism as a whole, as well as the interaction of man with the environment. It is very important for each doctor to be able to determine the neurological status The patient. What it is, and how its research is going on, we'll talk about this later.

Why it is important to determine the status

First of all, when dealing with a patient, a doctor should pay attention to his behavior, reaction and general mental state. Especially if the patient has acted with any kind of trauma or immediate help was caused by relatives. The doctor determines, in the first place, the state of the brain, since the therapy prescribed in the future largely depends on it. It is by examining the patient's neurological status that the doctor allows himself to prescribe a treatment that will improve the functionality of the brain and increase the chances of a positive outcome of treatment.

The pupil's response to light is not enough to establish a neurological status. Currently, a scheme has been developed that assesses brain function, based on certain neurological symptoms. You can set the status by contacting a specialized diagnostic center. Let's consider further how to establish the status.

Primary patient interview

The main condition for a proper study of the neurological status is the doctor's ability to compare symptoms and signs with certain parts of the nervous system.

At general examination the doctor should show an active position and find out the following:

  • To establish the patient's data: the full name of the position;
  • Listen to the patient's complaints;
  • To establish whether there have been syncope or epileptic seizures;
  • Complaints of frequent headaches and of what character they are, where they are localized, find out what triggered the pain, what were the accompanying symptoms;
  • It is necessary to know in what sequence the pain or attack develops, which is a stimulant;
  • To find out what treatment was carried out earlier, what drugs were used and how they acted on the patient.

Also, the writing of a neurological status will include sexual identity, transferred infectious diseases, peculiarities of the perinatal period, and also what are the hereditary diseases of the nervous system.

General examination of the patient

To establish the neurological status, it is necessary not only to interview the patient, but also carefully examine it. For this, the patient must be undressed to the underwear.

Then assess the condition of the skin, their color. Measure body temperature. Mark the presence of scarring, traces of injections. It is necessary to determine to which type the patient belongs: asthenic, hypersthenic, normasthenic. Is there obesity or excessive leanness.

Further, a visual and palpatory examination of the head is performed. Mark its shape, symmetry, as well as the presence of abrasions. Pay attention to seals, painful foci. Feel the temporal arteries, assess their condition. Give an assessment of eyeballs and secretions from the nose and ears, if any.

Inspection of the cervical and spine

When examining the neck, attention is paid to the position and mobility of the head and neck. Thyroid, carotid arteries, lymph nodes are examined by palpating. Sleepy arteries and subclavian animals are examined by conducting auscultation. Determine the tone of the occipital muscles, whether there is a symptom of Lermitt. Further, the thorax and the abdominal cavity are examined.

A thorough examination of the spine is very important. Pay attention to various kinds of deformations of the spine, assess the mobility of the vertebrae, tilt the patient in different directions, determine the degree of tension of the back muscles and their soreness, as well as the condition of the lumbar vertebrae.

Brain function and examination of the cranial nerves

It is very important to evaluate the brain functions in the study of the neurological status. It is necessary to distinguish the violation from pathologies in the work. To do this, evaluate the following criteria:

  • Consciousness;
  • Ability to navigate;
  • To find out how much attention, memory is developed;
  • To determine how a person goes into contact, what kind of speech he has;
  • Whether the patient is able to follow consistency;
  • Check if there are signs of agnosia.

The description of the neurological status can not bypass the analysis of the cranial nerves. There are only 12 pairs.

Each of them is responsible for this or that function. Sensitive nerves (1, 2, 8 pairs) are responsible for the sensitivity of the skin of the face, eyes, mouth, nasopharynx. Motor 3, 4, 6, 7, 11, 12 pairs are responsible for the movement of eyeballs, facial muscles, tongue, palate, and larynx. Mixed 5, 9, 10 pairs of nerves are responsible for motor and sensory function. These are the trigeminal nerve, the glossopharyngeal and the vagus nerves.

There are special tests that check how the cranial nerves function.

Evaluation of motor functions and reflexes

It is important to evaluate the work of muscles. It is necessary to examine the muscles of the lower leg and shoulder girdle, determine the tone and symmetry of muscle contractions, how well musculature is developed.

In this case, several tests are performed to evaluate the motor reaction in order to examine the neurological status. Example: in the supine position on the back, the patient raises the knee, while observing the movement of the foot. The muscular weakness of the lower limbs is determined by bending the leg in the knee and flexing the thumb. In the standing position with tightly closed eyes, the patient is asked to raise his hands palms up. Muscular strength can be checked by asking the patient to walk on his heels and fingers.

The study of the neurological status can not do without an evaluation of the patient's coordination. According to the gait of the patient, its coordination, motor functions is estimated. A good test is used: the patient must touch the tip of the nose and fingertips with the greatest accuracy.

All actions need to be done quickly. If the hand trembles or does not hit the target, this is an anomaly.

Assess reflexes are also necessary. They are divided into deep tendon and regressive.

The asymmetry of reflex reactions or their inhibition suggests damage to the nerve roots or peripheral nerves. Further, having visited the center of diagnostics, it can be confirmed, having spent instrumental inspection.

Assessment of sensitivity and evaluation of the autonomic nervous system

Sensory perception is assessed by finding out the following facts:

  • Whether there are painful sensations;
  • Nature of pain;
  • Localization and duration;
  • What symptoms accompany pain and what actions it weakens;
  • Actions that gave rise to bouts of pain.

Also tests are performed to determine sensitivity. The sensitivity is checked at symmetrical points on the right and on the left. For a deeper examination, the state of deep and surface receptors is assessed.

Evaluation of autonomic functions is partially carried out during the interview of the patient, based on his complaints. In order to do a deeper analysis of the vegetative system, the following actions are carried out:

  • Measure blood pressure when lying down, after 3 minutes standing;
  • Measure the heart rate;
  • Conduct tests with deep breathing;
  • Conduct a sample for reactivity with pressure on the eyeballs;
  • Touch the skin, determining sweating, you can use iodine if necessary;
  • When urination is abnormal, the stomach is felt, if necessary, an instrumental examination is performed.

Study of a patient in a coma

It is much more difficult to assess the patient's neurological status if he is in a coma. In this case, it is necessary to pay attention to the following factors: assess the performance of the respiratory system and blood circulation, determine the depth of the coma and the reason for getting into this state, examine the patient for injuries, check the reflexes.

All actions of the doctor should be aimed at saving the life of the patient, therefore, when assessing the neurological status, actions are jointly carried out, which are aimed at eliminating life-threatening conditions. In such cases it is better to send the patient to the center of neurology. They will conduct a full examination.

Neurological status of the child

The peculiarity of assessing the child's neurological status is that he is not able to perform certain tests and answer questions. But the doctor will be able to give the correct evaluation, observing the behavior of the baby, from the words of the mother and through appropriate tests for movement and reflexes.

Pay attention to the symmetry of the limbs, the shape and size of the skull, the color of the skin. It is important to evaluate the congenital reflex reactions. When they appeared and as expressed, since these reactions characterize the development and condition of the child. In the case of abnormalities in the establishment of a neurological status in a child, it can be sent for further examination to the center of neurology.

The nervous system is the main command post in the body, the human condition depends on its functioning, therefore it is necessary to take all necessary measures to maintain its normal functioning.

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