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Health Assessment > neurological > Flashcards

neurological Flashcards

1
Q

CNS brain

A
  • Located in cranial cavity
  • 4 Major Divisions
    1. Cerebrum
    2. Diencephalon
    3. Brain stem (breathing, heart rate)
    4. Cerebellum (think coordination)
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2
Q

true or false: whatever affects the left side of the brain affects the right side of the body

A

true

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3
Q

cerebrum

A
  • Divided into left and right hemispheres
    • hemispheres joined by corpus callosum
      • each hemisphere sends and receives impulses from opposite sides of body
  • Consists of 4 Lobes: frontal, parietal, temporal, occipital
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4
Q

diencephalon

A
  • Lies beneath cerebral hemispheres
  • Consists of:
    • thalamus
    • hypothalamus: controls temp
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5
Q

brain stem

A
  • control center
  • Located between the cerebral cortex and spinal cord
  • Consists of:
    • Midbrain
    • Pons
    • Medulla oblongata
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6
Q

cerebellum

A
  • Located behind brain stem and under cerebrum
  • Has two hemispheres
  • Functions
    • coordination and smoothing of voluntary movements
    • maintenance of equilibrium (balance)
    • maintenance of muscle tone
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7
Q

spinal cord

A
  • Located in vertebral canal
  • Extends from medulla oblongata to L1 (first lumbar vertebra)
  • Spinal cord is NOT as long as spinal canal
  • Conducts sensory impulses up ascending tracts to the brain
  • Conducts motor impulses down descending tracts to neurons that stimulate glands and muscles throughout the body
  • Is responsible for simple reflex activity
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8
Q

PNS

A
  • Carries information to and from CNS
  • Consists of:
    • 12 Pairs of Cranial Nerve
    • 31 Pairs of Spinal Nerves
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9
Q

12 cranial nerves

A
  1. olfactory
  2. optic
  3. oculomotor
  4. trochlear
  5. trigeminal
  6. abducens
  7. facial
  8. acoustic (vestibulocochlear)
  9. Glossopharyngeal
  10. vagus
  11. spinal accessory
  12. hypoglossal
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10
Q

subjective data

A
  • Headache
  • Head Injury
  • Dizziness/Vertigo
  • Seizures
  • Tremors
  • Weakness
  • Incoordination
  • Numbness/tingling
  • Difficulty Swallowing
  • Difficulty Speaking
  • Patient-centered care
  • Environmental/occupational hazards
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11
Q

objective data

A
  • Preparation
    • Perform a screening neurologic exam on seemingly well people who have no significant subjective findings in the history
    • Sequence
      • Mental status (alert, appropriate, orientation)
      • Cranial nerves (II, III,IV, VI, VII, VIII)
      • Motor function(strength, coordination, gait)
      • Sensation(light touch, pain, temp)
      • Reflexes (biceps, patellar, Achilles, plantar responses)
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12
Q

neuro exam

A
  • If neurological deficits, perform a complete neurologic exam that includes cognitive & intellectual processes
    • Sequence
      • Mental status
      • Cranial nerves
      • Motor system
      • Sensory system
      • Reflexes
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13
Q

Cognitive & intellectual processes (can assess using the mini-mental examination)

A
  • Memory
  • Level of knowledge
  • Ability for calculation (by 7s)
  • Abstract thinking (abstract ideas)
  • Insight (give scenarios)
  • Judgement (give scenarios)
  • Thought processes
  • Thought content
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14
Q

equipment used

A
  • penlight
  • tongue blade
  • cotton swab
  • tuning fork
  • percussion hammer
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15
Q

cranial nerve 1: olfactory

A
  • not tested routinely
  • test in those who report loss of smell
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16
Q

cranial nerve 2: optive

A
  • Test visual acuity (Snellen chart)
  • Test visual fields by confrontation
17
Q

cranial nerve 3 (oculomotor), 4 (trochlear), and 6 (abducens)

A
  • Test all three together
  • PEERLA
  • Direct & consensual light reflexes
  • Accommodation
  • Cardinal positions of gaze
18
Q

cranial nerve 5: trigeminal

A
  • Motor function: Clench teeth, attempt to separate clenched jaw
  • Sensory function: test light touch sensation to forehead, cheeks, & chin (have them close their eyes and touch them with a cotton swab and ask where they felt it)
19
Q

cranial nerve 7: facial

A
  • Motor function: Smile, frown, close eyes tightly. Lift eyebrows, show teeth, & puff cheeks
  • Sensory function: Do not test routinely. Test sense of taste
20
Q

cranial nerve 8: acoustic (vestibulocochlear)

A
  • Test hearing acuity with hearing normal conversation & whispered voice test
21
Q

cranial nerve 9 (glossopharyngeal) and 10 (vagus)

A
  • Motor function: Depress tongue with tongue blade, have person say “ahhh”.
  • Sensory: Test taste on posterior 1/3 of tongue
22
Q

cranial nerve 11: spinal accessory

A
  • Test sternomastoid & trapezius muscle for equal size
  • Rotate head against resistance applied to side of chin
  • Shrug shoulders against resistance
23
Q

cranial nerve 12: hypoglossal

A
  • Inspect tongue
  • Ask person to “stick out tongue”
  • Check lingual speech (l,t,d)
    • say these letters
24
Q

inspect and palpate motor system

A
  • muscles
    • size, strength, tone, involuntary movements
  • cerebellar fxn
    • balance tests
      • gait/tandem walking
        • tandem: putting one foot in front of the other
      • Romberg test: stand and put arms straight out (sway = neuro or inner ear)
25
Q

cerebral fxn

A
  • Coordination & skilled movements
    • Rapid alternating movements – supination and pronation
    • Finger-to-finger test
    • Finger-to-nose test –> close eyes, arms out, bring fingers to nose
    • Heel-to-shin test
  • Balance tests
    • Gait
    • The Romberg Test
26
Q

spinothalamic tract

A
  • Pain
  • Light touch
  • use paperclip
  • have pt close eyes and touch paperclip on them
27
Q

posterior column tract

A
  • Vibration: take tuning fork and put on fingertip
  • Position (Kinesthesia): close eyes and move finger up and down. should be able to perceive if it is going up and down
    • Ability to perceive passive
      motion
  • Tactile Discrimination (fine touch)
  • Stereognosis
    • Able to recognize objects by feel
  • Graphesthesia
    • Able to ‘read’ a number by having it traced on the skin
28
Q

two point discrimination test

A
  • Able to distinguish separation of two simultaneous pin points on the skin
  • taking a paperclip, taking it apart and poke them w/ two pointy sides @ the same time. should be able to say where you touched them
29
Q

extinction

A
  • Simultaneously touch both sides of the body at the same point
30
Q

point location

A
  • Touch skin & withdraw stimulus promptly
  • Is able to point where touched
31
Q

deep tendon reflexes (stretch reflexes)

A
  • Strike with percussion
    hammer
  • Grade on 4-point scale
    • 4+ Very Brisk
    • 3+ Brisker than
      average
    • 2+ Average, expected
    • 1+ Diminished
    • 0 No response
32
Q

superficial reflexes

A
  • Plantar
    • Normal response
      (except infancy)
      • Plantar flexion of
        toes
      • Inversion & flexion
        of forefoot

Health Assessment (9 decks)

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