NUR 505 Module 2 Neurologic System Study Guide 2026 | Cranial Nerves, Reflexes, Sensory Assessment &
Exam Prep PDF | University of Alabama
The University of Alabama
Capstone College of Nursing
NUR 505 Advanced Health Assessment
Module 2 Neurologic System Study Guide
1. Review the anatomy and pathophysiology of the neurological system.
The neurological system is a complex network responsible for coordinating and controlling the
body's voluntary and autonomic responses, and its assessment is one of the most intricate
parts of a physical examination.
Anatomy and Pathophysiology of the Neurological System
The neurological system is broadly divided into three main components: the Central Nervous
System (CNS), the Peripheral Nervous System (PNS), and the Autonomic Nervous System.
1. Central Nervous System (CNS):
◦ Brain: This includes the cerebrum, cerebellum, and brainstem.
▪ Cerebrum: Consists of two cerebral hemispheres, which form the outer gray layer
(cerebral cortex). It is responsible for higher mental functions, general movement, visceral
functions, perception, behavior, and the integration of these functions. The frontal lobe
contains the motor cortex for voluntary skeletal and fine repetitive motor movements, as well
as eye movement control. The cerebrum is primarily responsible for a person's mental status.
▪ Cerebellum: Aids the cerebrum's motor cortex in integrating voluntary movement. It
processes sensory information from the eyes, ears, touch receptors, and musculoskeletal
system. In conjunction with the vestibular system, it uses this sensory data for reflexive control
of muscle tone, balance, and posture, leading to steady and precise movements.
▪ Brainstem: Acts as a pathway between the cerebral cortex and the spinal cord,
controlling many involuntary functions. It contains the medulla oblongata, pons, midbrain, and
diencephalon, from which the nuclei of the 12 cranial nerves arise. The reticular activating
system (RAS), located in the brainstem, regulates wakefulness and arousal.
◦ Spinal Cord: Extends from the medulla oblongata at the foramen magnum down to L1 or L2
of the vertebral column. It contains fibers grouped into tracts that carry sensory, motor, and
autonomic impulses between the brain and the body. Spinal tracts include ascending tracts
(e.g., spinothalamic for light touch, pressure, temperature, pain; posterior column for vibration,
deep pressure, position sense, two-point discrimination) and descending tracts (e.g.,
corticospinal for skilled movements, vestibulospinal for extensor muscle contraction during
falls).
2. Peripheral Nervous System (PNS): Comprises cranial and spinal nerves, carrying information
to and from the CNS. Cranial nerves are peripheral nerves originating from the brain, each
having motor or sensory functions, and four of them also have parasympathetic functions.
,3. Autonomic Nervous System: Coordinates and regulates the body's internal organs, such as
cardiac and smooth muscle. It has sympathetic and parasympathetic divisions that balance each
other to manage stress responses and conserve body resources.
2. Review how to take a history on a patient with a neurological problem. What specific
questions should you ask?
History Taking for a Patient with a Neurological Problem
Building a patient's history is a joint effort between the healthcare provider and the patient,
aiming to capture the patient's story. This process should be flexible and adapted to the
individual patient's circumstances, age, gender, and cultural background.
General Principles for Building a History:
• Relationship Building: Develop trust through honesty, candor, and explaining boundaries and
roles. Personal interactions and physical examination are integral.
• Effective Communication: Use open-ended questions initially to give the patient free rein,
allowing them to provide a complete history without prompting. Direct questions focus on
specific answers, while leading questions can sometimes influence the patient's response and
should be avoided at first.
• Active Listening: Listen attentively and avoid interrupting.
• Clarification: Clarify responses using "where, when, what, how, and why" questions.
• Review: Review what you have heard with the patient to ensure understanding and allow for
corrections.
• Patient-Centered Approach: Address the patient properly, introduce yourself, make eye
contact, and proceed at a reasonable pace. Ask about their expectations for the visit and their
understanding of their symptoms and diagnosis. Be aware of your own cultural biases and
preconceptions.
• Documentation: Record findings as objectively as possible, using direct quotes when a
description is vivid, especially for the chief concern.
Structure of the History (Problem-Oriented Health Record - POHR):
1. Identifiers: Name, date, time, age, sex assigned at birth, sexual orientation, gender identity,
preferred language, race, source of information, and referral source.
2. Chief Concern (CC) / Presenting Problem / Reason for Seeking Care: A brief statement, often
in the patient's own words, describing why they are seeking care. Always include the duration
of the concern.
, 3. History of Present Illness (HPI): A detailed, chronological description of all symptoms related
to the chief concern. This section requires symptom analysis, including:
◦ Location: Where are the symptoms precisely? Do they move or radiate?
◦ Timing and Duration: When did it begin? Does it come and go? How often and for how
long? What time of day or week?
◦ Quality/Character: What does it feel like? (e.g., sharp, dull, burning, aching, cramping,
shock-like)
◦ Context: What were the circumstances surrounding the primary reason for the visit? What
else happened that might be related?
◦ Severity/Intensity: How bad is it? Use a pain scale (e.g., 0-10) and describe its impact on
daily activities.
◦ Modifying/Aggravating Factors: What makes it better or worse (e.g., specific activities,
positions, diet, medications)?
◦ Associated Signs and Symptoms: Are there any other related symptoms (e.g., nausea,
fatigue, disturbed sleep)?.
◦ Patient Perception: What does the patient think is causing the problem? What are their
expectations for treatment?.
◦ Effect on ADLs and Psyche: How does it affect daily living activities, leisure, ability to
perform tasks, or cope with stress?.
◦ Medications: Current and recent prescriptions, home remedies, and non-prescription
medications, including dosages. Ask why each is taken.
◦ Review of Systems (ROS): Inquire about health-related issues in each body system, looking
for complementary or seemingly unrelated symptoms. For a neurological problem, specific ROS
questions would include:
▪ Syncope
▪ Seizures
▪ Weakness or paralysis
▪ Abnormalities of sensation or coordination
▪ Tremors
▪ Loss of memory
4. Past Medical History (PMH): The baseline for assessing the present concern. Relevant
neurological elements include:
Exam Prep PDF | University of Alabama
The University of Alabama
Capstone College of Nursing
NUR 505 Advanced Health Assessment
Module 2 Neurologic System Study Guide
1. Review the anatomy and pathophysiology of the neurological system.
The neurological system is a complex network responsible for coordinating and controlling the
body's voluntary and autonomic responses, and its assessment is one of the most intricate
parts of a physical examination.
Anatomy and Pathophysiology of the Neurological System
The neurological system is broadly divided into three main components: the Central Nervous
System (CNS), the Peripheral Nervous System (PNS), and the Autonomic Nervous System.
1. Central Nervous System (CNS):
◦ Brain: This includes the cerebrum, cerebellum, and brainstem.
▪ Cerebrum: Consists of two cerebral hemispheres, which form the outer gray layer
(cerebral cortex). It is responsible for higher mental functions, general movement, visceral
functions, perception, behavior, and the integration of these functions. The frontal lobe
contains the motor cortex for voluntary skeletal and fine repetitive motor movements, as well
as eye movement control. The cerebrum is primarily responsible for a person's mental status.
▪ Cerebellum: Aids the cerebrum's motor cortex in integrating voluntary movement. It
processes sensory information from the eyes, ears, touch receptors, and musculoskeletal
system. In conjunction with the vestibular system, it uses this sensory data for reflexive control
of muscle tone, balance, and posture, leading to steady and precise movements.
▪ Brainstem: Acts as a pathway between the cerebral cortex and the spinal cord,
controlling many involuntary functions. It contains the medulla oblongata, pons, midbrain, and
diencephalon, from which the nuclei of the 12 cranial nerves arise. The reticular activating
system (RAS), located in the brainstem, regulates wakefulness and arousal.
◦ Spinal Cord: Extends from the medulla oblongata at the foramen magnum down to L1 or L2
of the vertebral column. It contains fibers grouped into tracts that carry sensory, motor, and
autonomic impulses between the brain and the body. Spinal tracts include ascending tracts
(e.g., spinothalamic for light touch, pressure, temperature, pain; posterior column for vibration,
deep pressure, position sense, two-point discrimination) and descending tracts (e.g.,
corticospinal for skilled movements, vestibulospinal for extensor muscle contraction during
falls).
2. Peripheral Nervous System (PNS): Comprises cranial and spinal nerves, carrying information
to and from the CNS. Cranial nerves are peripheral nerves originating from the brain, each
having motor or sensory functions, and four of them also have parasympathetic functions.
,3. Autonomic Nervous System: Coordinates and regulates the body's internal organs, such as
cardiac and smooth muscle. It has sympathetic and parasympathetic divisions that balance each
other to manage stress responses and conserve body resources.
2. Review how to take a history on a patient with a neurological problem. What specific
questions should you ask?
History Taking for a Patient with a Neurological Problem
Building a patient's history is a joint effort between the healthcare provider and the patient,
aiming to capture the patient's story. This process should be flexible and adapted to the
individual patient's circumstances, age, gender, and cultural background.
General Principles for Building a History:
• Relationship Building: Develop trust through honesty, candor, and explaining boundaries and
roles. Personal interactions and physical examination are integral.
• Effective Communication: Use open-ended questions initially to give the patient free rein,
allowing them to provide a complete history without prompting. Direct questions focus on
specific answers, while leading questions can sometimes influence the patient's response and
should be avoided at first.
• Active Listening: Listen attentively and avoid interrupting.
• Clarification: Clarify responses using "where, when, what, how, and why" questions.
• Review: Review what you have heard with the patient to ensure understanding and allow for
corrections.
• Patient-Centered Approach: Address the patient properly, introduce yourself, make eye
contact, and proceed at a reasonable pace. Ask about their expectations for the visit and their
understanding of their symptoms and diagnosis. Be aware of your own cultural biases and
preconceptions.
• Documentation: Record findings as objectively as possible, using direct quotes when a
description is vivid, especially for the chief concern.
Structure of the History (Problem-Oriented Health Record - POHR):
1. Identifiers: Name, date, time, age, sex assigned at birth, sexual orientation, gender identity,
preferred language, race, source of information, and referral source.
2. Chief Concern (CC) / Presenting Problem / Reason for Seeking Care: A brief statement, often
in the patient's own words, describing why they are seeking care. Always include the duration
of the concern.
, 3. History of Present Illness (HPI): A detailed, chronological description of all symptoms related
to the chief concern. This section requires symptom analysis, including:
◦ Location: Where are the symptoms precisely? Do they move or radiate?
◦ Timing and Duration: When did it begin? Does it come and go? How often and for how
long? What time of day or week?
◦ Quality/Character: What does it feel like? (e.g., sharp, dull, burning, aching, cramping,
shock-like)
◦ Context: What were the circumstances surrounding the primary reason for the visit? What
else happened that might be related?
◦ Severity/Intensity: How bad is it? Use a pain scale (e.g., 0-10) and describe its impact on
daily activities.
◦ Modifying/Aggravating Factors: What makes it better or worse (e.g., specific activities,
positions, diet, medications)?
◦ Associated Signs and Symptoms: Are there any other related symptoms (e.g., nausea,
fatigue, disturbed sleep)?.
◦ Patient Perception: What does the patient think is causing the problem? What are their
expectations for treatment?.
◦ Effect on ADLs and Psyche: How does it affect daily living activities, leisure, ability to
perform tasks, or cope with stress?.
◦ Medications: Current and recent prescriptions, home remedies, and non-prescription
medications, including dosages. Ask why each is taken.
◦ Review of Systems (ROS): Inquire about health-related issues in each body system, looking
for complementary or seemingly unrelated symptoms. For a neurological problem, specific ROS
questions would include:
▪ Syncope
▪ Seizures
▪ Weakness or paralysis
▪ Abnormalities of sensation or coordination
▪ Tremors
▪ Loss of memory
4. Past Medical History (PMH): The baseline for assessing the present concern. Relevant
neurological elements include:
