Introduction
Welcome to the Testing the Nervous System Assignment. This assignment will cover the brain and spinal cord. For this assignment, you will investigate a case and answer the corresponding questions.
Remember to view the assignment rubric (see below) before completing the assignment.
Assignment Instructions
Read the Testing the Nervous System case study.
Answer each question and create a report for the case study.
Which of the test results indicated a central nervous system injury and why?
Which of the test results indicated a peripheral nervous system injury and why?
Are there any cranial nerves involved? Describe which cranial nerves could be involved.
Explain why the reflexes were hyperactive and the Babinski reflex was present.
Your report must be a minimum of 300 words.
All answers should be in your own words and typed neatly using appropriate grammar, spelling, punctuation, and APA style.
Include APA citations when necessary.
Must be submitted as a Word file.
Submit to your instructor by 11:59 PM on the date listed in the course schedule.
Notes
Do not include/rewrite the questions in the assignment.
Your submission must have a Turnitin similarity score of less than 20%. Remember you have 3 submissions before the due date to check your score.
Submissions greater than 20% will risk point deductions, and you may be reported to Administration for academic discipline.
Case Study
The case is based on a case from the National Center for Case Study Teaching in Science and modified/rewritten by Dr. Bruce Forciea.
Dr. Mary Smith and Dr. Ashley Peters were beginning their ER residency at ACME Memorial Hospital. They had been close friends throughout medical school and were looking forward to helping each other through the challenges of clinical work. They had just completed a 16-hour shift and were sitting down to enjoy a cup of bitter vending machine coffee when Nurse Cassidy burst into the break room.
“I wouldn’t get too comfortable,” said nurse Cassidy. “A call just came in; paramedics are bringing in a 19-year-old male with neuro injuries. Better drink up and get back to the ER.”
The young doctors intercepted the paramedics wheeling in the teen. His eyes were wide open, and he struggled to speak with the neck brace anchoring his head.
“19-year-old male, BP 100/70, pulse 102 bpm, respirations elevated, conscious and alert. A head wound with significant loss of blood. Motorcycle versus car accident. Friends called 911. Loss of consciousness at the scene, loss of sensation and movement in right upper and lower extremities. We immobilized and stabilized him at the scene.”
“So, what do you think?” said Dr. Smith. “I think we should rule out central nervous system/brain injury first?” said Dr. Peters.
“Actually, I disagree,” said Dr. Peters. “I think we should evaluate the spinal cord and peripheral nervous system first.”
“We’ll do both,” said Dr. Smith. “Let’s get going.”
The following table summarizes the findings of the evaluation, which included a physical exam, x-rays, magnetic resonance imaging (MRI), and neurological tests.
Table 1. Summary of Diagnostic Testing for ER Patient
Sensory Testing
Decreased sensation to touch, pressure, and vibration in the right upper/lower extremities
Decreased temperature discrimination (cold vs. warm) in the left upper/lower extremities
Numbness on the right cheek
Motor Testing
Decreased strength and movement of the right upper/lower extremities during muscle testing
Absence of triceps and biceps reflexes in the right upper extremity
Numbness on the medial portion of the right hand and forearm
Abnormal response of patellar, Achilles (hyper) reflexes in the right lower extremity
Positive Babinski sign on the right foot
Inability of patient to turn head to the right along with weak right trapezius muscle
Weakness of right masseter muscle
Mild blurred vision
General Examination
Abnormal pupil response of right eye (constriction)
Other vital signs within normal limits
Cognitive testing normal (counts backward from 100 by 7s; knows name, date, place)
X-ray and MRI Examination
No fractures were present in the skull
Fracture in the 7th cervical vertebra
Significant swelling present in the spinal canal in the C7-T2 region
Spinal cord appears to be intact
