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Care Of Adults 2 > Chapter 43 Assessment Of The Nervous System > Flashcards

Chapter 43 Assessment Of The Nervous System Flashcards

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0
Q

Peripheral nervous system consists of

A

12 cranial nerves
31 pairs of spinal nerves
Sympathetic
Parasympathetic

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1
Q

Central nervous system consists of

A

Brain and spinal cord

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2
Q

Role of neurons

A

Motor (efferent): carry impulses away from CNS
Sensory (afferent): carry impulses towards CNS
Process information
Retain information

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3
Q

Myelin sheath

A

White lipid covering
Speeds transmission of impulses
White matter

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4
Q

Non-myelinated

A

Gray matter

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5
Q

Synaptic knob

A

Distal end of each axon

Manufacture, store, and release neurotransmitter

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6
Q

Neuroglial cells provide:

A 
Protection
Structure
Nutrition 
Part of blood brain barrier
Help regulate CSF
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7
Q

Meninges

A

Cover brain and spinal cord

Three layers all made of connective tissue

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8
Q

Dura mater

A

Outermost meninges

Very tough

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9
Q

Arachnoid

A

Middle meninges

Cobweb in appearance

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10
Q

Pia mater

A

Innermost meninges
Very thin and delicate
Tightly bound to brain and spinal cord

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11
Q

Subarachnoid space

A

Layer between arachnoid and pia mater

Contains CSF and blood vessels

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12
Q

Cerebrospinal Fluid (CSF)

A

Clear fluid derived from blood stream
Adds additional protection and lubricates the spinal cord and brain
Contains nutrients needed by the brain and spinal cord
Also contains waste products that will be brought to the blood stream and excreted by the body

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13
Q

Cerebrum

A

Outer other part of the brain
Left and right hemispheres
Hemispheres divided by longitudinal fissure
*LARGEST PART OF THE BRAIN
*Controls intelligence, creativity, and memory

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14
Q

Frontal lobe

A

Anterior most lobe
Primary motor area for muscular contraction
Personality, behavior, emotion, intellectual function, *judgement

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15
Q

Parietal lobes

A

Sensation

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16
Q

Occipital lobes

A

Vision

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17
Q

Temporal lobe

A

Hearing (does not cross sides: right side=right ear)

Smell

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18
Q

Gustatory area

A

Located in these parietal lobes where it is overlapped by the temporal lobes
Usually located on left side

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19
Q

Broca’s area

A

Motor speech: the act of physically talking

If a pt is damaged, they may know what they want to say but different words will come out

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20
Q

Gnostic area

A

Stores complex memory patterns

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21
Q

Wernicke’s area

A

Language COMPREHENSION

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22
Q

Which part of the brain makes us human?

A

Central cortex

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23
Q

Thalamus

A

Receives all sensory information and sends it to the appropriate lobe

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24
Brain stem contains:
~Midbrain-voluntary motor nerve cells, visual and auditory reflex centers, narrow channel for CSF ~Pons-helps to regulate breathing movements ~Medulla oblongata-cardiac center, vasomotor center, respiratory center
25
Cerebellum
~Another motor area of the brain ~Subconscious contractions of skeletal muscles to maintain: coordination, posture, balance ~Impulses from inner ear sent here: equilibrium
26
Spinal cord nerves have 2 main functions
Conduction of impulses going to and from brain | Reflex center
27
Spinal cord location
Begins at foramen magnum and ends at the first lumbar vertebrae
28
Voluntary nervous system
Goes to skin and muscles | Involved in conscious activities
29
Autonomic nervous system
~Automatically takes care of body functions ~Sympathetic nervous system (fight for flight) ~Parasympathetic nervous system (active under ordinary relaxed conditions)
30
Nerve impulse: conduction
Sending a message | It all works with potassium and sodium
31
The resting membrane of a nerve cell
DOES NOT allow potassium or sodium to diffuse across it
32
Minimum threshold
The minimum amount of stimulus to cause an action potential
33
Refractory period
Is small amount of time necessary to restore the cell back to its resting membrane Cannot respond to the second stimuli until this is done
34
All or none principle
If the stimulus is strong enough to cause an action potential: - The action potential will go out one speed - A stronger stimuli cannot speed up the process
35
Saltatory conduction
Deals with nerve cells that have myelin | Greatly speeds up the process
36
Acetylcholine
Work on skeletal muscles
37
Norepinephrine
Smooth and cardiac muscle
38
Epinephrine
Behavior and mood
39
Dopamine
Emotional responses and has an effect on the cardiac and circulatory system
40
Serotonin
Regulates temperature, sensory perception, mood, and onset of sleep
41
GABA
Slows everything down | ~inhibits the excessive discharge of neurons
42
Endorphins
Inhibits the release of sensory pain neurotransmitters
43
Hypoactive deep tendon reflexes and loss of vibration sense
Can impair balance: need to look at their feet placement as they walk A change that happens with age
44
Some changes with aging
- Changes in pain perception - Changes in sleep patterns: require less sleep, but more frequent rest periods - Increased risk for infection
45
A change in the LOC is usually the first indication of
A decline in central neurological function
46
A complete neurological assessment is done three times:
Laying, sitting, standing
47
One issue with glaucoma medication:
It may dilate the eye and slow the pupil response
48
When testing the patient's memory function
Ask questions regarding their date of birth, city of birth, or anything that can be verified
49
Higher levels of cognition
Favorite hobbies, current events, name of last few presidents Abstract reasoning: meaning of Proverbs Judgment: rational decisions in dealing with symptoms
50
Romberg's test
Patient stands with eyes closed | Loss of balance is positive Romberg's sign (difficulty with proprioception)
51
Patients with decreased sensation are instructed to
Look at their feet when they walk
52
Hyperactive reflexes
Upper motor neuron disease, tetanus, hypocalcemia
53
Hypoactive reflexes
Lower motor neuron disease, DM with nerve damage, hypothyroidism, hypokalemia
54
Decortication
Arms wrists and fingers are flexed Internal rotation and plantar flexion of feet Corticospinal pathways are interrupted (lesions on the spinal cord)
55
Decerebration
Extension of arms and legs Pronation of arms and plantar flexion Obsithotonos (body spasm in which body is bowed forward) Seen with disfunction of brainstem
56
Glasgow coma scale
The higher the score the better
57
Cerebral angiography: post procedure:
Circulation of extremity: both at site, and downstream from site
58
PET scan
No alcohol, caffeine, and tobacco 24 hours prior to test NPO 4 to 12 hours before test No glucose solution 4 to 12 hours before the test Follow up: increase fluid intake Contraindicated in women who are breast-feeding
59
What is important to have before getting a lumbar puncture?
Signed informed consent
60
Normal total proteins
15-45 mg/dL (up to 70 mg/dL in older adults)
61
Immune gamma globulin (IgG)
- The most important protein - Normal: 3% to 12% of total protein - More than 12% of total protein: multiple sclerosis, neurosyphilis, or viral infection
62
Normal glucose
50-75 mg/dL or 60% to 70% of blood glucose level | Less than 50 mg/dL : usually accompanied by the presence of pathologic organisms
63
Electroencephalography (EEG)
Graphically records electrical activity of cerebral hemispheres Patient must be sleep deprived before procedure Anticonvulsants may be withheld Hyperventilation during the test: cerebral vasoconstriction and can induce seizure activity

Care Of Adults 2 (4 decks)

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