Neurological Assessment & Monitoring Flashcards
7 cards from real ASC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Neurological Assessment & Monitoring flashcards as text
A patient with pontine stroke demonstrates pinpoint pupils (1mm bilateral). This finding results from disruption of:
Answer: Sympathetic fibers descending through the pons with intact parasympathetics
Pontine hemorrhage destroys sympathetic pathways while sparing parasympathetic outflow, causing bilateral miosis (pinpoint pupils).
The Full Outline of UnResponsiveness (FOUR) score differs from the GCS by including assessment of:
Answer: Brainstem reflexes and respiratory patterns
The FOUR score replaces the verbal component with brainstem reflexes (pupil, corneal, cough) and respiratory patterns, making it applicable to intubated patients.
In a patient with acute cerebellar stroke, which clinical finding warrants immediate neurosurgical consultation for possible decompression?
Answer: Obstructive hydrocephalus with deteriorating consciousness
Cerebellar edema causing obstructive hydrocephalus and altered consciousness is a neurosurgical emergency requiring suboccipital decompression or ventriculostomy.
During neurological monitoring, a patient develops a Cushing's triad. The correct sequence of components is:
Answer: Hypertension, bradycardia, irregular respirations
Cushing's triad (hypertension, bradycardia, irregular respirations) is a late sign of severely elevated ICP and impending brainstem herniation.
Which assessment best differentiates a patient in a minimally conscious state (MCS) from a vegetative state (VS)?
Answer: Reproducible purposeful command-following or emotional responses
MCS is defined by reproducible but inconsistent command-following, object recognition, or intelligible verbalization — behaviors absent in VS.
The motor examination component of the NIHSS assesses drift by holding the patient's arm elevated for how many seconds before scoring?
Answer: 10 seconds
NIHSS motor arm testing requires the patient to hold the limb at 90° (sitting) or 45° (supine) for 10 seconds while the examiner observes for drift.
A patient with acute ischemic stroke in the posterior circulation presents with dysphagia, ipsilateral facial numbness, and contralateral body numbness. This is consistent with:
Answer: Wallenberg (lateral medullary) syndrome
Wallenberg syndrome from PICA or vertebral artery occlusion causes ipsilateral facial and contralateral body sensory loss due to the crossing of pain/temperature pathways.