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AHA Final > Module 11 - Neurological Assessment > Flashcards

Module 11 - Neurological Assessment Flashcards

1
Q

Structure of the Neurological System

A
  • CNS
  • PNS
  • Meninges
  • Cerebrospinal Fluid
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2
Q

Central Nervous system Structure

A
  • Cerebral Cortex
  • Frontal lobe
  • Parietal lobe
  • Occipital lobe
  • Temporal lobe
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3
Q

Function of Neurological System

A
  • Sensory
  • Motor
  • Integration
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4
Q

Function of Thalamus

A

Main relay station for the nervous system

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5
Q

Hypothalamus

A
  • Major control centre
  • Controls temperature, heart rate and blood pressure
  • Regulates sleep
  • Endocrine function from anterior/posterior pituitary
  • Co-ordination of autonomic activity and emotions
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6
Q

Cerebellum

A
  • Balance
  • Equilibrium
  • Coordination
  • Muscle tone
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7
Q

Midbrain

A

Motor neurons

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8
Q

Pons

A

Relay station containing ascending and descending tracts

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9
Q

Medulla Oblongata

A
  • Respiratory
  • Cardiac
  • GI
  • Nuclei for cranial nerves VIII through XII
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10
Q

What is a dermatome?

A

A circumscribed skin area that is supplied mainly from one spinal cord segment through a spinal nerve
- Overlap if one nerve is severed most sensations will continue

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11
Q

Dermatome Landmarks

A
  • Thumb, middle finger and fifth finger are connected to C6, C7 and C8
  • The axilla is at level T1
  • The nipple is at T4
  • The umbilicus is at T10
  • The groin is at L1
  • The knee is at L4
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12
Q

Health History Questions

A

1) Headaches
2) Head Injury
3) Dizziness/Injury
4) Seizures
5) Tremors
6) Weakness
7) In-coordination
8) Numbness
9) Dysphagia
10) Difficulty speaking
11) Significant past history
12) Environmental and Occupational hazards

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13
Q

Components of the Glasgow coma scale

A
  • Assessment of comatose patients and is important in critical care
  • Used to assess functional state of the brain
  • Standard assessment that defines LOC
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14
Q

Scoring areas of Glasgow Coma Scale

A

1) Best Eye opening response
2) Best Verbal responses
3) Best Motor responses
- 15 points is best response
- 8 or less is comatose
- 3 is totally unresponsive

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15
Q

Assessment of Gait

A
  • Observe the client walking 3-6 m and then turn and return to starting point
  • Smooth gait
  • Rhythmic
  • Effortless
  • Equal arm coordination
  • Turns are smooth
  • Client should be walking in a straight line
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16
Q

Gait - Abormalities

A
  • Stiff immobile posture
  • Lack of arm swing or rigid arms
  • Unequal rhythm of steps
  • Crooked line
  • Widening base
  • Staggering balance
  • Muscle weakness
  • Swaying, falling
  • Positive Romberg
  • Loss of proprioception
  • Loss of vestibular function
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17
Q

Romberg Assessement

A
  • Test for balance/equilibrium
  • A positive test is loss of balance
    1) Ask patient to stand up with feet together and arms at the sides and to close their eyes and hold the position
    2) Wait 20 seconds
    3) Some swaying will occur - normal
    4) Perform a shallow knee bend or hop in place - both legs
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18
Q

What are the neuro vital signs?

A 
- All vitals (BP, HR, Temp)
Co-ordination/Skilled Movements:
- Grip strength
- Finger to Finger 
- Finger to nose
- Heel to shin
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19
Q

Cranial 1 – Olfactory Nerve

A
  • Normal sense of smell

- Test one nostril at a time

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20
Q

Cranial 1 – Olfactory Nerve - Abnormalities

A
  • Blocked passages
  • Anosmia
  • Neurogenic Anosmia (nasal disease)
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21
Q

Cranial Nerve II – Optic

A
  • Test vision and visual fields
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22
Q

Cranial Nerve II – Optic

A

Vision lost

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23
Q

Cranial III, IV and VI – Oculomotor, Trochlear and Abducens

A

PERRLA:

  • Pupils’ size
  • Regulatory
  • Equality
  • Direct and consensual light reactions
  • Accommodation
  • Position of gaze
  • Movement
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24
Q

Cranial III, IV and VI – Oculomotor, Trochlear and Abducens - Abnormal

A
  • Myasthenia gravis
  • Dysfunction of the nerves
  • Intracranial pressure causes unilateral dilation and non-reactivity of the pupil
  • Limited movement
  • Disease
  • Poor accomodation
  • Stigma
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25
Q

Cranial Nerve V – Trigeminal Nerve - Motor

A
  • Equally strong bilaterally

- Clenching teeth

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26
Q

Cranial Nerve V – Trigeminal Nerve - Motor Abnormal

A
  • Decreased strength on one or both sides
  • Asymmetry
  • Pain
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27
Q

Cranial Nerve V – Trigeminal Nerve - Sensory

A
  • Sensation is felt using cotton bud

- Test 3 division: ophthalmic, maxillary and mandibular

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28
Q

Cranial Nerve V – Trigeminal Nerve - Sensory Abnormalities

A

Decreased sensation

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29
Q

Cranial Nerve V – Trigeminal Nerve - Corneal Reflex

A

Test blinking reflex

30
Q

Cranial Nerve V – Trigeminal Nerve - Corneal Reflex Abnormalities

A

No blinking occurs

31
Q

Cranial Nerve VII: Facial Nerve

A
  • Smiling
  • Frown
  • Lift eyebrows
  • Shows teeth
  • Puffs cheek
32
Q

Cranial Nerve VII: Facial Nerve Abnormalities

A
  • Muscle weakness
  • Loss of movement
  • Asymmetry
33
Q

Cranial Nerve VIII: Acoustic Nerve

A
  • Hearing

- Identifying sounds

34
Q

Cranial Nerve IX and X: Glossopharyngeal and Vagus Nerve

A

Phalageal movement

35
Q

Cranial Nerve IX and X: Glossopharyngeal and Vagus Nerve - Abnormalities

A
  • Absence or asymmetry
  • Deviation
  • Asymmetry of tonsillar pillar
  • Hoarseness or brassy voice
36
Q

Cranial Nerve XI: Spinal Accessory

A
  • Resistance is equal
  • Equal movement
  • Shrug against resistance
  • Side to side resistance
37
Q

Cranial Nerve XI: Spinal Accessory Abnormalities

A
  • Atrophy
  • Muscle weakness
  • Paralysis
38
Q

Cranial Nerve XII: Hypoglossal Nerve

A
  • Speech

- Smooth/even tone tongue

39
Q

Cranial Nerve XII: Hypoglossal Nerve Abnormalities

A
  • Atrophy
  • Tongue deviation
  • Paralysis
40
Q

Hypoalgesia

A

Decreased pain sensation

41
Q

Analgesia

A

Absence of pain sensation

42
Q

Hyperglesia

A

Increased pain sensation

43
Q

Assessment of Sensory System

A
  • Testing intactness of the spinal nerve, sensory tracts and higher cortical discrimination
  • Do not need to test entire skin surface
  • Detect localized pain, numbness and tingling
  • Note decreases sensation areas
44
Q

Hypoesthesia

A

Decreased touch sensation

45
Q

Anaesthesia

A

Absent of touch sensation

46
Q

Hyperasthesia

A

Increased touch sensation

47
Q

Clonus

A

Rapid rhythmic contractions

48
Q

Hyper-reflexes

A

Exaggerated reflexes

- Motor lesions

49
Q

Hyporeflexia

A

Reduced function of reflex

50
Q

Paralysis

A

Decrease in motor power caused by a problem with motor nerve or motor fibre

  • Trauma
  • Spinal Cord injury
  • CVA
  • MS
  • Muscular Dystrophy
51
Q

Fasciculation

A

Rapid continuous twitching of resting muscle

  • Atrophy
  • Fatigue
52
Q

Tic

A

Involuntary compulsive repetitive twitching of muscle group

- Neurological issue (Tourettes)

53
Q

Myoclonus

A

Rapid sudden jerk or short series of jerks at regular intervals
- Tonic Clonic Seizures

54
Q

Rest Tremor

A
  • Coarse and slow

- Disappearing voluntary movement

55
Q

Intention tremor

A

Rate varies but worsens with voluntary movement

-Seen in MS and alcoholism

56
Q

Chorea

A
  • Sudden rapid jerky and purposeful movement involving the limbs, trunk or face
  • Accentuated voluntary acts
  • No rhythm or repetitive movement
  • Disappears with sleep
57
Q

Athetosis

A

Slow, twisting, writhing continuous movement resembling a snake or a worm
- Cerebral palsy

58
Q

Spastic Hemiparesis

A

Arm is immobile against the body

  • CVA
  • Trauma
59
Q

Cerebellar Ataxia

A

Patient is staggering, wide based gait

- Alcoholism

60
Q

Parkinsonian (Festinating)

A
  • Posture is stooped, trunk forward
  • Elbow, hips and knees are flexed
  • Hesitant to start walking
61
Q

Scissors

A

Knees cross or are in contact

62
Q

Steppage or Foot drop

A

Appears if patient is walking up stairs where there are no stairs

63
Q

Waddling

A
  • Weak hip muscles

- Opposite hip drop

64
Q

Short Leg

A

Leg length discrepancy

65
Q

Diseases of Motor System

A

1) Cerebral Palsy - Damage to cerebral cortex - developmental defect
2) Muscular Dystrophy - Wasting of skeletal muscle structures
3) Hemiplegia - Lower muscle paralysis
4) Parkinson Disease - Destruction of neurons producing dopamine
5) Cerebellar - A lesion in one hemisphere (will affect opposite side)
6) Paraplegia - Spinal injury - no movement below the lesion
7) Multiple Sclerosis - Destruction of Myelin of the neurons - both sensory/motor dysfunction

66
Q

Sensory - Peripheral Neuropathy

A

Loss of sensation involves all modalities

- Diabetes

67
Q

Sensory - Individual Nerves or Roots

A

Decrease in or loss of all sensory

68
Q

Sensory - Spinal cord Hemisection

A

Loss of pain and temperature sensation starting one to two segments below the level of the lesion

69
Q

Sensory - Complete Transection of the Spinal Cord

A

Complete loss of ALL sensory modalities below the level of the lesion

70
Q

Sensory Loss - Thalamus

A

Loss of ALL sensory modalities

71
Q

Sensory Loss - Cortex

A

Loss of discrimination of sensation

- Lesions

AHA Final (6 decks)

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