FREE NIHSS Group A Patient Questions and Answers
Keep your head straight and keep your eyes on my finger.Horizontal eye movement
Keeping the head straight and following a finger with horizontal eye movement assesses motor control, specifically the function of the eye muscles and cranial nerves responsible for eye movement.
4-Facial Palsy: "Raise eyebrows and show me your teeth." Look for droopiness in face or mouth5-"Lift your left arm/Lift your right arm/Lift your left or right leg) 10 sec vs 5 sec.
Both instructions—checking for facial droopiness and asking the patient to lift their arms or legs—assess motor function, focusing on muscle control and strength.
Visual and sensory integration- Hold fingers in upper and lower quadrants-Ask pt which is wiggling (L,R,&Both)
he task of holding fingers in upper and lower quadrants and asking the patient which is wiggling (left, right, or both) assesses sensory integration. T
his evaluation examines the patient's ability to perceive and differentiate sensory stimuli in different areas of their visual field. It does not primarily focus on extinction/inattention, wakefulness, or motor coordination, but rather on the sensory aspect of their neurological function.
1a-are they immediately awake or otherwise engage them. (responsiveness)1b-correctly state age and current month (questions)1c-open/close eyes AND squeeze hand (commands)
These instructions assess the patient's level of wakefulness and responsiveness, which is an important aspect of neurological assessment.
Asking them to engage or respond to commands helps determine their level of consciousness.
Cover your left eye? How many fingers can you see?
Assess accuracy of vision. If they can't perform it, then use visual threat and check if they blink.
The instruction to cover one eye and count fingers tests the accuracy of vision in different areas of the visual field.
If the patient cannot perform this, using a visual threat to check for blinking is another way to assess the visual field.
Read list of words
read list of word in the context of speech (Dysarthria) refers to a task where a patient reads a predetermined list of words aloud.
This helps assess and diagnose speech and language issues, such as Dysarthria, which is characterized by poor articulation.
What is happening in picture with kids and woman in sink (comprehension and expression)
Assessing what is happening in a picture involving kids and a woman at a sink involves comprehension and expression, which are components of language skills.
This activity helps evaluate the ability to understand and describe the scene.
"Touch your nose and touch my finger. Can you slide your heel up and down your opposite leg? Weakness versus ataxia. Heel to shin test.
The instruction to touch the nose and then the examiner's finger, as well as sliding the heel up and down the opposite leg, tests motor coordination.
These tasks help differentiate between weakness (muscle strength issue) and ataxia (coordination issue).
Close your. Can you feel this? Does it feel the same or different on each side?"Test sense of pinprick (ability to withdraw from noxious stimuli if pt is obtunded or aphasic).
This instruction tests the sensory function by assessing the patient's ability to feel a pinprick and compare sensations on both sides of their body.
Wakefulness (Q1ABC)Vision (Q3)Motor (Q2,4567)Sensory (Q8,11)Language and Speech (9,10)
The NIHSS (National Institutes of Health Stroke Scale) assesses various aspects of neurological function to evaluate stroke severity and guide treatment.
In the assessment, Wakefulness (Q1ABC) measures the patient's level of consciousness and responsiveness, while Vision (Q3) evaluates their visual fields and acuity. Motor (Q2, 4, 5, 6, 7) assesses muscle strength and coordination through tasks like arm and leg movement. Sensory (Q8, 11) tests sensation and touch perception. Lastly, Language and Speech (9, 10)
evaluate the patient's ability to comprehend and express language through tasks like naming objects and repeating phrases. These components help clinicians make informed decisions regarding stroke management and treatment plans.
"1a- 0
1b- 0
1c- 0
2- 0
3- 0
4- 1
5a- 0
5b- 0
6a- 2
6b- 2
7- 0
8- 1
9- 0
10- 1
11- 0
"
The numerical values represent the scores obtained by patients on different components of a neurological assessment, possibly using a standardized scale such as the NIHSS (National Institutes of Health Stroke Scale). Each score corresponds to a specific aspect of neurological function, such as wakefulness, motor coordination, sensory perception, and language comprehension