Neuro

Question 1

When do you use old carts?

Answer 1

Subjective data from patient

Question 2

Examples of subjective neuro data from patient

Answer 2

-headache, syncope, head injury, dizziness/vertigo, seizures, tremors, weakness, coordination, numbness/tingling, difficulty swallowing, difficulty speaking, significant past history, enviro/job hazard

Question 3

vertigo vs dizziness

Answer 3

vertigo = things spinning around you
dizziness= you feel like you are spinning

Question 4

ataxia

Answer 4

muscular dis-coordination manifested with attempted voluntary movements

• can be attributed to:
• • external causes like alcoholism
• • internal causes like cerebellar disease

Question 5

decerebrate posturing

Answer 5

• more serious, less likely to see someone come out of this
• lost cerebral control
• arms = stiff , extended
• forearms = pronated
• hands = turned out out/down
• hyperreflexive

Question 6

decorticate posturing

Answer 6

• lesion at or above the upper brainstem
• arms = flexed in on chest
• hands = fists clenched
• legs= extended and inverted
• *to CORE

Question 7

3 kinds of memory

Answer 7

-immediate, recent, and remote

Question 8

immediate memory

Answer 8

remembers events or information from a few minutes before

Question 9

recent memory

Answer 9

remembers events or information from earlier in the day

Question 10

remote memory

Answer 10

remembers events or information from months or years ago

Question 11

which kind of memory do you usually lose last?

Answer 11

remote memory

Question 12

paresis

Answer 12

• partial or incomplete paralysis
• reduced ability
• can be reversed or not- usually caused by injury

Question 13

paresthesia

Answer 13

abnormal or unpleasant sensation that results from injury to one or more nerves
-burning/ tingling

Question 14

proprioreception

Answer 14

awareness of posture, movement, and changes in equilibrium

Question 15

clonus

Answer 15

alternate involuntary muscular contraction and relaxation in rapid successive

• jerky looking
• progressive deterioration

Question 16

what does neuro assessment tell us?

Answer 16

brain/spinal cord/nervous system issues

-conditions directly or indirectly related to nervous system

Question 17

tools needed to collective objective data for neuro assessment

Answer 17

penlight, tongue blade or something else sharp for pain assessment, cotton swab, tuning fork (or something else for temp sensitivity), percussion hammer (reflexes), aromatic substance possibly

Question 18

LOC x4

Answer 18

level of consciousness

-person, place, time, situation

Question 19

4 things to assess cerebral fxn

Answer 19

1. LOC
2. Orientation
3. Verbal responsiveness
4. Mental Status exam

Question 20

5 levels of consciousness

Answer 20

1. fully
2. lethargy
3. obtunded
4. stupor
5. Coma

Question 21

Fully conscious

Answer 21

patient is alert, attentive, follows commands

• responses promptly to external stimulation
• once awake, remains awake and attentive

Question 22

lethargy

Answer 22

• patient is drowsy but slightly awakens w/o painful stimulation
• answers questions and follows commands slowly and inattentively
• sluggish

Question 23

obtunded

Answer 23

• difficult to rouse
• needs constant stimulation in order to follow a simple command
• limited verbal response
• fall back asleep b/w stimulation
• confused when awake

Question 24

stupor

Answer 24

• arouses to vigorous and continuous stimulation (painful)
• moan briefly
• does NOT follow commands
• only response is to withdraw from painful stimulus

Question 25

comatose

Answer 25

does not respond to continuous or painful stimuli does not move except reflexively no verbal sounds

Question 26

4 things to consider with mental status exam

Answer 26

- appearance - behavior - cognition - though processes

Question 27

deep tendons

Answer 27

triceps, biceps, brachioradialis, patellar, achilles

Question 28

superficial tendons, when assess?

Answer 28

plantar reflex and brain stem | -comatose patients

Question 29

dolls reflex

Answer 29

turn head side to side and eyes do not move to the opposite side (eyes stay on same side)

Question 30

oculovestibular reflex

Answer 30

when put ice water in ear, eyes turn toward ear if intact

Question 31

Reflex response grading

Answer 31

0-4+

Question 32

0 reflex response

Answer 32

no resposce

Question 33

1+ reflex response

Answer 33

diminished, low normal, or occurs only with reinforcement

Question 34

2+ reflex response

Answer 34

average

Question 35

3+ reflex response

Answer 35

brisker than average, may indicate disease, possibly normal

Question 36

4+ reflex response

Answer 36

very brisk, hyperactive with clonus, always abnormal

Question 37

Plantar reflex

Answer 37

normal response when sharp stimulus on foot is for toes to curl in

Question 38

babinski's sign

Answer 38

babinski positive = toes hyperextend instead of curling in

Question 39

what age group is normal for positive babinski sign?

Answer 39

up to age 2

Question 40

4 things to assess when looking at motor and cerebrellar fxn

Answer 40

muscle: | size, strength, tone, involuntary movement

Question 41

drift or pronation test

Answer 41

- hold arms in front with palms facing ceiling | - if observe pronation or arm drifts downward = limb weakness

Question 42

Cerebellar fxn tests

Answer 42

1. balance test 2. gait 3. Coordination and skilled movements (rapid alternative movement, finger to nose, heel to toe or shin)

Question 43

Romberg Test

Answer 43

feet together, arms at sise, close eyes | positive = loss of balance- sways, falls, widens, stance to avoid falling

Question 44

Positive romberg is a sign of....

Answer 44

- neurological deficit | - alcohol intoxication

Question 45

Spinothalmic tract , what order lose?

Answer 45

- pain, temp, light touch | - in that order (if can feel pain can usually feel temp and touch)

Question 46

stereogenesis

Answer 46

ability to recognize forms by touch

Question 47

graphesthesia

Answer 47

ability to recognize letters, words, numbers, outlines when drawn/traced on skin

Question 48

what exam do you do for diabetic feet?

Answer 48

monofilament exam

Question 49

provides easily reproducible and somewhat predictive neurological exam checking for baseline neurological status and tracking changes over time

Answer 49

glasgow coma scale

Question 50

3 scored categories in glasgow coma scale and what it means

Answer 50

-eye opening (4 max) -verbal response (5 max) best motor response (6 max) higher the number the better the score (15 best score) <8 indicates coma