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Comprehensive Health Assessments > Chapter 15: Neurological > Flashcards

Chapter 15: Neurological Flashcards

1
Q

Achilles

A

reflexive action that jerks the ankle when the achilles tendon is tapped with the foot dorsiflexed

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2
Q

Babinski

A

reflexive action of the big toe when the foot’s sole is stimulated

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3
Q

Brachioradialis Reflex

A

caused by striking the brachioradialis tendon at the base of the wrist into the radial styloid process

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4
Q

Biceps Reflex

A

reflex contraction of the biceps brachii used to assess the C5 and C6 reflex arcs

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5
Q

Clonus

A

neurological condition causing involuntary muscle contractions

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6
Q

Cranial Nerves I-XII

A

twelve nerves assessed in a neurological exam to ensure appropriate sensory and motor issues

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7
Q

Dermatome

A

skin area that is mainly supplied by a single spinal nerve

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8
Q

Dysphagia

A

difficulty in the oral or pharyngeal phases of swallowing

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9
Q

Dysphasia

A

partial or complete inability to communication, resulting from a brain injury

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10
Q

Gait

A

coordinated action of the neuromuscular system and musculoskeletal systems that allow walking

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11
Q

Gag Reflex

A

reflexive action causing a cough or gag when each side of the back of the throat is touched

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12
Q

Graphesthesia

A

ability to recognize writing on the skin by onlu touch

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13
Q

Moro

A

protective response to a quick disruption of body balance; tested in infants by pulling up on the arms of an infant in the supine position

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14
Q

Palmar Grasp

A

grasp pattern in infants when pronated hand on an object causes the fingers to curl around the object

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15
Q

Patellar Reflex

A

kicking reflex caused when the knee joint is stimulated

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16
Q

Plantar Grasp

A

reflex action in some newborns; a stroke beneath the toe bed and pressured applied causing a curling reflex

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17
Q

Reflexes

A

automatic muscle reaction when stimulus is applied

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18
Q

Rooting

A

involuntary reflex where infant turns head when the corner of the mouth is stimulated

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19
Q

Romberg Test

A

test of balance and ability to maintain upright posture

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20
Q

Stereognosis

A

ability to identify the shape of a 3D object by only tactile manipulation

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21
Q

Sucking

A

reflexive action when a finger or nipple is placed near an infant’s mouth

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22
Q

Triceps Reflex

A

automatic contraction of the triceps brachii muscle when stimulated

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23
Q

Cranial Nerve I

A

Olfactory nerve (sensory)
- sense of smell

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24
Q

Cranial Nerve II

A

Optic nerve (sensory)
- ability to see

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25
Q

Cranial Nerve III

A

Oculomotor Nerve (motor)
- ability to move and blink your eyes

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26
Q

Cranial Nerve IV

A

Trochlear Nerve (motor)
- controls superior oblique muscle
- moves eye down, or back and forth (side to side)

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27
Q

Cranial Nerve V

A

Trigeminal Nerve (sensory and motor)
- Ophthalmic: sends sensory info to upper face (forehead, scalp)
- Maxillary: sends sensory info to middle of face (cheeks, upper lip, nasal cavity)
- Mandibular: (both motor and sensory) sends sensory info to lower face and moves jaw and ear
- Sensations in your face and cheeks, taste and jaw movements

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28
Q

Cranial Nerve VI

A

Abducens Nerve (motor nerve)
- controls the lateral rectus muscle
- ability to move your eyes

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29
Q

Cranial Nerve VII

A

Facial nerve (sensory and motor)
- facial expressions and sense of taste

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30
Q

Cranial Nerve VIII

A

Auditory/Vestibular Nerve (sensory)
- sense of hearing and balance and coordination

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31
Q

Cranial Nerve IX

A

Glossopharyngeal nerve (sensory and motor)
- ability to taste and swallow

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32
Q

Cranial Nerve X

A

Vagus Nerve (sensory and motor)
- Digestion and heart rate

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33
Q

Cranial Nerve XI

A

Accessory Nerve (motor)
- shoulder and neck muscle movement

34
Q

Cranial Nerve XII

A

Hypoglossal Nerve (motor)
- Ability to move your tongue

35
Q

What is mental status ?

A

the degree of competence that a person shows in intellectual, emotional, psychological and personality functioning

36
Q

What questions do we ask to ensure the patient is alert and oriented ?

A
  • For client’s name (last orientation to be lost)
  • Where he or she is (second orientation to be lost)
  • Ask the date (first orientation to be lost)
  • what is happening (situation)
37
Q

Lethargic

A

aroused by saying their name and touching them
- once aroused they respond appropriately but return to “sleep” once stimuli cease

38
Q

Obtunded

A

require louder verbal stimuli and vigorous shaking to prompt a response
- they carry out requests while awake but return to “sleep” when stimuli ceases

39
Q

Stuporous

A

require painful stimuli to respond
- response is usually withdrawal from pain

40
Q

Semicomatose

A

require painful stimuli and respond with abnormal flexion or extention

41
Q

Comatose

A

does not respond to any stimuli, even central pain

42
Q

What is the test we perform for balance ?

A

Romberg test

43
Q

What determines consciousness ?

A

awareness, arousal, and cognition

44
Q

What is the scale of the Deep Tendon Reflexes ?

A

0: no response
1+: sluggish or diminished
2+: active or expected response (normal)
3+: more brisk than expected, slightly hyperactive
4+: brisk, hyperactive, with intermittent or transient clonus

45
Q

What is clonus ?

A

involuntary, rhythmic muscular contractions and relaxations

46
Q

What are some reasons for hyperactive reflexes ?

A
  • spinal cord injuries
  • calcium and magnesium deficits
  • hyperthyroidism
47
Q

What are some reasons for diminished reflexes ?

A
  • calcium or magnesium excesses
  • hypothyroidism
  • spina bifida
  • guillain barre syndrome
48
Q

What does a positive babinski look like ?

A

the big toes bends up and the other toes fan out
- normal in kids younger than 2 yrs old

49
Q

Aphasia

A

defective, or absent, language function

50
Q

Dysphagia

A

difficulty swallowing

51
Q

Receptive/Fluent Aphasia

A

inability to comprehend the speech of others, spoken words are logical
- Wernicke’s Asphasia: temporal lobe

52
Q

Expressive/Non-Fluent Aphasia

A

inability to communicate or express ideas as meaningful speech

53
Q

Dysphasia

A

speech impairment

54
Q

What does a normal/negative babinski look like ?

A

toes curl down (flex)
- normal in kids older than 2 yrs old

55
Q

What is the expected age range for the Moro Reflex ?

A
  • birth to 1-4 months
56
Q

Tonic Neck Reflex

A
  • birth/6 wks to 4-6 months
  • move head to side with arm/leg extended
  • they will extend on the side where their head is turned and the opposite side is flexed
57
Q

What are abnormal findings in toddlers and children ?

A
  • spasticity
  • paralysis
  • impaired vision, speech or hearing
  • inattention, motor restlessness and easy distractibility may indicate ADHD
58
Q

What are expected findings in older adults ?

A
  • slowed responses
  • move more slowly
  • decline in function
  • deviation of gait from midline
  • difficulty with rapidly alternating movements
  • some loss of reflexes and sensation
59
Q

What are abnormal findings in older adults ?

A
  • resting tremor of the hands that is reduced with purposeful movement
  • dizziness or vertigo
  • hemiparesis of upper or lower extremities (weakness/mild loss of strength)
60
Q

What is Multiple Sclerosis ?

A

progressive demyelination of nerve fibers of brain and spinal cord
- typical onset between 20-50 yrs; higher risk among women
- clinical findings depend on the area of affected CNS
Symptoms:
- fatigue
- depression
- paresthesia
- ocular changes
- gait instability
- bowel/bladder dysfunction

61
Q

What are Spinal Cord Injuries (SCI) ?

A

caused by traumatic disruption of spinal cord
- Cervical SCI: quadriplegia, tetraplegia
- Thoracic and Lumbar SCI: paraplegia
- Clinical Findings: complete SCI vs incomplete SCI

62
Q

What are Head Injuries ?

A

in injury or trauma to the scalp, skull, or brain
- Open Head Injury: d/t fractures or penetrating wounds
- Closed Head Injury: d/t blunt trauma (concussion or confusion)
- Clinical Findings: depend on severity of the trauma and areas of brain involved

63
Q

What is Parkinson Disease ?

A

a chronic, progressive movement disorder
- results from degeneration of dopamine-producing neurons

64
Q

What is a Cerebrovascular Accident (Stroke) ?

A

occurs when brain cells die from ischemia
- results from thrombus, embolus, or hemorrhage
- clinical findings vary depending on area of the brain involved and extend of ischemic area
Symptoms:
- motor impairments
- bowel and bladder dysfunction
- speech and swallowing difficulties

65
Q

What is the acronym for Cerebrovascular Accident (stroke) ?

A

ACT FAST
- facial drooping
- arm weakness
- speech difficulty
- time to call 911

66
Q

What is one of the earliest and most sensitive indictors in alternations in cerebral function ?

A

change in LOC

67
Q

What is 2-point discrimination ?

A

touch with 2 points; patient states if 1 or two pokes felt at the same time

68
Q

What is extinction ?

A

impairs ability to percieve multiple stimuli at the same type simultaneously
- touch both sides of the boy with paperclip at same time
- patient states how many touches were felt

69
Q

What can a compression of the nerve cause ?

A

absence of sensation

70
Q

What is consciousness ?

A

awareness, arousal and cognition

71
Q

Which people are at most risk for skin breakage like pressure ulcers ?

A

people with diminished/loss of sensation
- like older adults

72
Q

When is the expected age for the Palmar Grasp ?

A

birth to 3-4 months
- can reemerge after a brain injury and sometimes it can cause the family of the patient to think they are doing it voluntarily and that means they’ll be okay but instead it’s a reflexive action

73
Q

What does the frontal lobe do ?

A
  • motor decision making (impulse control)
  • personality
74
Q

What does the temporal lobe do ?

A
  • hearing
75
Q

What does the parietal lobe do ?

A

sensory
- touch, shape, and taste

76
Q

What does the cerebellum do ?

A

balance and coordination

77
Q

What is Wernicke’s area and in which lobe is it in ?

A

concerned with comprehension of language
- in temporal lobe
- damage to this area causes you to speech fluently but can’t understand or use basic nouns

78
Q

What is Broca’s area and in which lobe is it in ?

A

concerned with speech and language production
- frontal lobe

79
Q

What assessment test can we perform to assess for peripheral nervous sensory function ?

A

light touch sensation

80
Q

What is the function of the occipital lobe ?

A

vision

Comprehensive Health Assessments (13 decks)

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