Final answer:
When assessing a patient with suspected spinal injury, it's important to evaluate motor and sensory functions without causing movement that could worsen the injury. Ambulatory status or absence of neck pain does not exclude the possibility of a spinal injury. Sensory and motor tests help in assessing and localizing the injury.
Step-by-step explanation:
When assessing a conscious patient with a mechanism of injury that suggests spinal injury, it is crucial to perform a detailed and careful assessment without causing any further damage to the spine. One should not ask the patient to move his or her head to assess for pain, as this could aggravate an existing spinal injury. Instead, check for equal strength in all extremities without requiring any movement that could compromise spinal integrity. Ambulatory patients can still have a spinal injury, and lack of neck pain does not rule out a spinal injury.
To assist in diagnosing a potential injury to the spinal cord or peripheral nerves, a neurologist might conduct tests such as examining resistance to muscle movement or checking for sensory discrimination with a simple tool like a cotton-tipped applicator. Sensory changes, especially if they are asymmetrical or follow a specific pattern, can help localize the injury level. Additionally, any observed deficits such as difficulty with tongue movement or facial expressions may indicate damage to cranial nerves. In the event of suspected sensory impairment, tests like a tuning fork assessment to observe bone conduction or asking a patient to identify when a light touch is felt can be used.