 Welcome to Nursing School Explained and this assessment video demonstration of the focus neurologic assessment. Remember that as always with the assessment we follow in a methodical head-to-toe approach but this time we'll specifically focus on the neurologic system. And that consists of two parts really which is number one the cranial nerves and number two the peripheral neurologic assessment. Now you can incorporate the neurologic assessment as you're working your way in the head-to-toe fashion or you can just complete the neural assessment first and then go back and assess the patient's heart, lungs, belly and all those other things that we always assess for. Just keep in mind that always stick with one way of doing it so that you don't miss anything when you're actually performing the assessment. And then for the neurologic assessment we need a little bit more tools than usual so we will always need our set of scope. In addition we'll need something that the patient can smell in this case here I have some toothpaste and then we'll also need a reflex hammer but if you don't have one of those you can always take the side of your stethoscope as a reflex hammer that's another option. And then something that'll allow you to have the patient tell you if they're feeling sharp or dull and in this case I'm going to use a q-tip a cotton tipped applicator that has a sharp edge which is the wooden end and then a the other end the soft edge which is the cotton tipped applicator. So let's go ahead and take a look at this focused neurologic assessment right here. Hi my name is Petra how are you today? I'm all right. I'm going to be doing your assessment but first let me ask you a few questions. What's your name please? Steve Jones. Okay what year is it? 2022. Excellent and where are we at right now? What facility is this? The hospital. Okay and what brings you in? I'm having headaches. Okay so let's take a look at you here. Let me wash my hands and put on some gloves. So first we're going to assess your sense of smell. Can you please close your eyes and look occlude your right nostril with one of your fingers and let me know what you smell. To the face. Okay keep the eyes closed occlude the left nostril and what do you smell here? To the face. Okay excellent. So then next I'm going to check your eyes. Please look straight at the top of my nose right here bright light come in and then the other side. Okay good and now please look at the pen right here and then focus on the corner of the room and the wall right there. One more time look at the pen look at the corner and one more time at the pen and at the corner. Okay great now just look straight ahead and I'm going to move the pen come in at you from the side tell me when you see the pen. Okay okay great and now keep looking straight ahead and I'm going to put the pen right here with just your eyes follow the pen please. Okay very good and then I'm going to touch your face now with this cotton tipped applicator so it's just a q-tip and one end of it is going to be soft just so you know what that feels like and the other one is going to be sharp do you feel the difference? Okay so close your eyes please and I'm going to be touching your face in different parts let me know if you feel sharp or dull. Okay very good okay and so then next smile for me raise your eyebrows make your eyes close shut your eyes real tight and don't let me open them okay puff out your cheeks and don't let me push them in okay let go of that okay next I'm going to whisper some words in your ear and please let me know what you hear one two three a b c okay very good and then next I'm going to take a look inside your mouth so just look straight ahead please open up stick out your tongue and say ah okay excellent and then shrug your shoulders on both sides against my hand good turn your hand to your head towards your left and towards the right good and now stick out your tongue again and move it left and right okay very good so we are done with the cranial nerve part and now we're going to move to other to your extremities I'm going to ask you to hold your arms out like this in front of you close your eyes and count out loud to ten one two three okay excellent don't let me press them down very good okay relax your arms now with your the index finger of your right hand touch my finger touch your nose touch my finger again touch your nose and my finger again good other side index finger of the left hand my finger your nose my finger your nose and you can keep looking at the finger and there you go very good one more time okay squeeze my finger as hard as you can okay great do a bicep curl turn the palms upside down push against me okay very good now let me check your pulses good and your circulation here good and the same thing that we just did on the face I'm going to have use the q-tip and ask you if you feel sharp or dull so close your eyes please sharp or dull sharp sharp or dull sharp sharp or dull dull sharp or dull dull sharp or dull sharp sharp or dull okay excellent now place the palms of your hands up with the palms facing up on your thighs and turn them up and down as fast as you can keep going okay very good so that is the rapid alternating movement and then we're going to move on to the lower extremities but before I do that I'm going to listen to your heart and lungs here while you're sitting up so I'm just going to lower your gown here for a moment and listen just breathe nice and normally okay good next I'm going to be listening to your lungs so every time I touch my stethoscope to your skin take a nice deep breath in and out nice deep breath in and out please and actually let me lower this down here okay deep breath again okay now the same thing on the back I'll just sit beside here for a moment nice deep breath okay very good next we'll put this back up and we'll take a look at your stomach here actually are you able to just hold it up here good I'm going to just be listening here for a moment when was the last time you had a bowel movement this morning okay any pain when I press no good I'm gonna press a little harder any pain there no okay good you can let go of the gown so next we're going to move on to your lower extremities and I'm going to check your strength first please kick your legs out against me and then pull back good push down like on a gas pedal and pull your toes to your nose excellent let me check your circulation okay and then the same thing we did before with the sharpened doll on the upper extremities we're going to do this on the lower extremities now so close your eyes please and let me know if you feel sharp or dull okay very good and then next for your coordination I'd like for you to run the heel of the right foot up and down the shin on the left side and from all the way down to up to the knee very good and do that three times nice and slow and now switch sides please okay very good you can relax your legs I'm going to take your reflexes here with your patella reflexes close your eyes please there we are good other side okay excellent so those are nice and equal and now we'll do a couple of specialized tests here close your eyes please I'm going to place an object in your hand and I'd like for you to tell me what that is okay very good now keep your eyes closed please I'm going to be writing a letter or a number in your hand and the palm of your hand and let me know what what that is okay and now let's check the other side okay excellent so this concludes our neurologic focus neurologic assessment please also check out the other videos about the specifics for cranial nerves as well as a peripheral neural assessment where I go into more options of how to assess certain things of the periphery thanks for watching nursing school explains see you soon