ASSESSING
THE SENSORYNEUROLOGICAL
SYSTEM
Outcomes
 Identify pertinent neuro/sensory
history questions.
 Obtain a neuro/sensory history.
 Perform a neuro/sensory physical
assessment.
(Continued)
Outcomes
 Document pertinent neuro/
sensory assessment findings.
 Identify actual/potential health
problems stated as nursing
diagnosis.
 Differentiate between normal
and abnormal findings.
Structures
 Cerebrum
 Frontal lobe
 Limbic system
 Occipital lobe
 Thalamus
 Cerebellum
 Midbrain
 Meninges
 Cortex
 Temporal lobe
 Parietal lobe
 RAS
 Hypothalamus
 Brainstem
 Medulla
 Ventricles
Functions
What are the functions of…
Cerebrum:
Largest part of brain
Cortex:
Outer layer of cerebrum; controls
most conscious processes
Frontal Lobe:
Emotional expression, Broca’s area
(expressive language)
(Continued)
Functions
What are the functions of…
Temporal lobe:
Hearing, taste, smell, memory,
Wernike’s (language
comprehension)
Limbic system:
Emotions, sexual arousal, behavioral
expression, recent memory
(Continued)
Functions
What are the functions of…
Parietal:
Sensory input
Occipital lobe:
Vision and spatial relationships
RAS:
Wakefulness
(Continued)
Functions
What are the functions of…
Thalamus:
Clusters multiple sensory stimuli
Hypothalamus:
Controls autonomic nervous system
and pituitary gland
Cerebellum:
Coordination, equilibrium
(Continued)
Functions
What are the functions of…
Brainstem:
Involuntary survival behaviors;
includes midbrain, medulla and
pons
Midbrain:
Visual, auditory, pupils, and eye
movements
(Continued)
Functions
What are the functions of…
Medulla:
Regulates heart, respiratory rates,
B/P, and protective reflexes
Pons:
Helps with respiratory function,
facial sensation and movement
(Continued)
Functions
What are the functions of…
Meninges:
3 layers (pia, arachnoid, dura);
protect brain and spinal cord
Ventricles:
4 cavities; capillaries produce and
reabsorb CSF
(Continued)
Relationship to
Other Systems
What is the relationship of the neurologic/
sensory system to other systems?
 Integumentary  Respiratory
 HEENT
 Musculoskeletal
 Lymphatic
 Genitourinary
 Cardiovascular  Endocrine
 Hematological
 Gastrointestinal
Developmental
Variations
What developmental variations of the
neurologic/sensory system might you
seen with:
Children
Pregnant clients
Older adults
Cultural Variations
What cultural variations of the
neurologic/sensory system might be
seen with:
 African Americans
 Irish
 Native Americans
History
What can the history tell you about
the neurologic/sensory system?
Biographical data
Current health status
Past health history
Family history
Review of systems
Psychosocial history
Symptoms
What symptoms would signal a
problem with the neurologic/sensory
system?
Headache
Mental status change
Dizziness, vertigo, syncope
Numbness or loss of sensation
Deficits of the 5 senses
Physical
Assessment
Approach: inspection, palpation, and
auscultation
Position: sitting
Tools: stethoscope, B/P cuff, penlight,
gloves, cotton, sharp object, coin,
fragrance, sweet and sour substance,
tongue blade, test tubes, reflex hammer,
ophthalmoscope
General Survey and head-to-toe scan
Cerebral Function
 Behavior
 Level of consciousness: time, place,
person
 Glasgow Coma Scale
 Memory: immediate, recent, remote
 Mathematical ability
 Thought process
 Judgement
 General knowledge  Communication
Sensory Function
Superficial sensations:
Light touch
Pain
Temperature
Deep sensations:
Vibratory sensations
Kinesthetics
(Continued)
Sensory Function
Discriminatory sensations:
Stereognosis
Graphesthesia
2 point discrimination
Point localization
Extinction
Deep Tendon
Reflexes
Biceps
Triceps
Brachioradialis
Patellar
Achilles
Superficial
Reflexes
Plantar
Abdominal
Anal
Cremasteric
Bulbocavernosus
Protective
Reflexes
Gag
Cough
Swallow
Blink
Corneal
Primitive Reflexes
Babinski
Sucking
Grasp
Rooting
Snout
Glabellar
Meningeal Signs
Nuchal rigidity
Kernig’s Sign
Brudzinski’s Sign
Motor Function
Finger-to-nose
Heel-to-shin
Rapid alternating movements
Romberg
Gait: heel-to-toe