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NSC 332 Exam 2 > Neuro > Flashcards

Neuro Flashcards

1
Q

Neuro-System Health History

A

-Any changes in your ability to move around or ADLS?
-Any history of head or spinal cord injury?
-History of stroke?
-Medications
-Family history of neurological problems?
-Social history? Alcohol use?
-Previous neurological surgeries/procedures
-Proprioception chages?: Awareness of the body’s position and movement

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2
Q

Problem-Based History
Types of complaints

A

-Headache
-Seizure
-Altered LOC (level of consciousness)
-Change in mobility
-Change in sensation
-Dysphagia: difficulty swallowing
-Red flag “worst headache of my life” - Emergency get CT scan

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3
Q

Health Promotion

A

-Stroke prevention: Smoking
-TBI prevention: Helmets, safe driving, seatbelts
-Meningitis prevention: Vaccine

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4
Q

Neurological Anatomy

A
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5
Q

Anatomy Review - Central Nervous System (CNS)

A

-Brain
-Cerebrum
-Brainstem
-Cerebellum Spinal Cord

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6
Q

Peripheral Nervous System (PNS)

A

-Cranial Nerves: 12 pairs
-Spinal Nerves: 31 pairs

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7
Q

Autonomic Nervous System (ANS)

A

-Sympathetic Nervous System
Speed up, fight or flight
-Parasympathetic Nervous System
Slow down, breed and feed

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8
Q

What are the brain’s 3 major intracranial components?

A

Cerebrum, Brainstem, Cerebellum

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9
Q

Cerebrum

A

Right, and left cerebral hemispheres. If the stroke is on the right side, the left side of the brain is affected.

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10
Q

Brainstem

A

Connects brain to spinal cord

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11
Q

Cerebellum

A

Muscle movement, posture, equilibrium, and muscle tone

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12
Q

Dermatone Map

A

The map that indicates where spinal nerves innervate regions of the skin

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13
Q

Neurological Physiology

A
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14
Q

3 main functions

A

Sensory input
Integration of data
Motor output

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15
Q

Neurological Physical Assessment

A
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16
Q

Elements of Neurological Exam

A

-Mental status: mood, affect, LOC, A&O
-Cranial nerves
-Motor
-Sensory
-Reflexes
-Gait, balance, and coordination

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17
Q

Cranial Nerve 1

A

Olfactory (S)

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18
Q

Cranial Nerve 2

A

Optic (S)

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19
Q

Cranial Nerve 3

A

Oculomotor (M)

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20
Q

Cranial Nerve 4

A

Trochlear (M)

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21
Q

Cranial Nerve 5

A

Trigeminal (B)

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22
Q

Cranial Nerve 6

A

Abducens (M)

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23
Q

Cranial Nerve 7

A

Facial (B)

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24
Q

Cranial Nerve 8

A

Acoustic (S)

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25
Q

Cranial Nerve 9

A

Glossopharyngeal (B)

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26
Q

Cranial Nerve 10

A

Vagus (B)

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27
Q

Cranial Nerve 11

A

Spinal accessory (M)

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28
Q

Cranial Nerve 12

A

Hypoglossal (M)

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29
Q

Neurologic Assessment - Cranial Nerves

A

-Start with the patient seated and assess

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30
Q

Motor

A

Makes something move

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31
Q

Sensory

A

Perceives a sense

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32
Q

Parasympathetic

A

Response

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33
Q

CN I

A

-Olfactory
-Sensory Function: Smell
Occlude nostril one at a time and sniff

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34
Q

CN II

A

-Optic
-Sensory Function: Visual activity (Snellen chart), and visual fields

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35
Q

CN III

A

-Oculomotor
-Motor Function: Eye-opening (raising lid)
Extraocular Movements (H-Test)
-Parasympathetic: Pupillary constriction (PERLL, convergence, and accomodation)

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36
Q

CN IV

A

-Trochlear
-Motor Function: Downward, inner eye movements (EOM’s)

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37
Q

CN V

A

-Trigeminal
-Motor Functions: temporal and masseter muscles
-Sensory Functions: facial (ophthalmic, maxillary, mandibular), sharp and dull test
-Parasympathetic: saliva and tears

38
Q

CN VI

A

-Abducens
-Motor Function: Lateral eye movement (EOM’s)
Also called 6 cardinal fields of gaze

39
Q

CN VII

A

-Facial
-Motor Function: facial movement (ask the patient to smile, frown, puff cheeks)
-Sensory Function: Taste anterior 2/3 tongue
-Parasympathetic: Saliva and tears

40
Q

CN VIII

A

-Acoustic
-Sensory Function: Hearing

Balance & Hearing: To check hearing perform Whisper Test. If abnormal, the goal is to distinguish the type of hearing loss using Weber and Rhinne testing

Rhinne: strike tunning fork, place on mastoid bone. Time until no longer heard. Move fork next to ear, time.
Normal= AC > BC

Weber: strike tunning fork, place in center of head. Can they hear it equally in both ears?
Normal= Heard equal in both ears

41
Q

CN IX

A

-Glossopharyngeal
-Motor Function: Swallowing. Say “ah” also swallowing, both cause the soft palate rises to block nasal passages
-Sensory Function: Gag reflex
-Parasympathetic: Salivary glands

42
Q

CN X

A

-Vagus
-Motor Function: Say “ah”
-Sensory Function: Gag reflex
-Parasympathetic: Heart, lung, and GI “vagal down” Vasovagal response

43
Q

CN XI

A

-Spinal Accessory
-Motor Function: Sternomastoid (SCM) and Trapezius

44
Q

CN XII

A

-Hypoglossal
-Motor Function: Tongue Movement

45
Q

Motor

A

Observe and test muscle bulk, strength, and tone

46
Q

0- Zero

A

No muscle contractoin is seen

47
Q

1- Trace

A

Flicker or trace of contraction is seen

48
Q

2- Poor

A

Active movement only with gravity eliminated

49
Q

3- Fair

A

Active movement against gravity but no resistance

50
Q

4- Good

A

Active movement against gravity with some resistance

51
Q

5- Normal

A

Active movement against gravity with full resistance

52
Q

Sensory- Tests that are done to make sure we can “feel” sensation

A

-Light touch
-Sharp v Dull
-Vibratory

53
Q

Proprioception

A

Romberg test

54
Q

Stereognosis

A

tests the individual’s ability to perceive and integrate a variety of sensory modalities and to interpret the stimuli to identify small objects placed in the hand

55
Q

Two Point Discrimination

A

The ability to discern that two nearby objects touching the skin are truly two distinct points, not one

56
Q

Graphesthesia

A

The ability to recognize symbols when they’re traced on the skin

57
Q

Reflexes

A

The contraction of a muscle when a tendon is percussed

58
Q

Tricep

A

hold arm, strike above elbow

59
Q

Bicep

A

thumb on tendon, hold arm, strike your thumb with pointed end

60
Q

Brachioradialis

A

hold arm strike 2 inches above wrist, either side of hammer

61
Q

Patellar

A

sit, relax leg, strike below patella

62
Q

Achilles

A

Knee 90 deg, dorsiflex foot, tap with flat end behind ankle, feel for “tap” of foot

63
Q

Babinski

A

end of hammer, stroke lateral side of foot, toes dorsiflex adult

64
Q

Deep Tendon Reflexes

A

-Issues with this are usually related to the spinal cord
-Asses with patient seated using a reflex hammer
-Pt may need a distraction
-Response to stimulation of tendon that communicates with the spinal cord (Peripheral Nervous System)

65
Q

Deep Tendon Reflexes - Neurological Assessment
Scoring DTR

A

0= no response
1+ = sluggish or diminished
2+ = active or expected response
3+ = slightly hyperactive
4+ = brisk; hyperactive

66
Q

Triceps Reflex

A

Cervical 6, 7

67
Q

Biceps Reflex

A

Cervical 5, 6

68
Q

Brachioradialis

A

Cervical 5, 6

69
Q

Patellar Reflex

A

Cervical 2, 3, 4

70
Q

Achilles Reflex

A

Sacral 1

71
Q

Reflexes - Pediatric

A
72
Q

Moro Reflex

A

-startle
-Birth to 1-4 months

73
Q

Palmar Grasp

A

Birth to 3-4 months

74
Q

Rooting Reflex

A
75
Q

Tonic Neck

A

Birth to 6 weeks up to 4-6 months

76
Q

Babinski Reflex

A
  • Toes flare (opposite than adults)
    -Birth-18 months
77
Q

Step Reflex

A

Birth-3 months

78
Q

Motor and Cerebellar Function

A
79
Q

Motor Function

A
  • Gait: Heel to toes walking and tandem walking
    -Balance and Cerebellar Function: Cerebellum - coordination, balance, equilibrium, posture
    -Muscle strength and Tone
80
Q

Gait, Balance and Coordination

A

Multiple systems working together
- Heel strike, and tandem walking

81
Q

Balance

A

-Rhomberg Test: stand feet together, arms to side, eyes open then close, then open = observes
-Positive Rhomberg: foot moved with eyes open and closed to keep balance. Suggests a cerebellar or vestibular issue
-Negative Rhomberg: no movement, sway, or fall

82
Q

Rhomberg

A

Assesses balance
-Vestibular, proprioception, and cerebellar function
-Vision: eyes open first, close eyes, 30 seconds, provide support

83
Q

Coordination - Cerebellar Testing

A

-Finger to nose
-Heel to shin
-Rapid alternating movements
-Gait

84
Q

Sensory Function

A
85
Q

Sensory Function- Peripheral Nerve Assessment

A

-Pain
-Temperature
-Light sensation
-Vibration: 1st lost in peripheral neuropathy

86
Q

Additional Neuro Tests

A

-Stereognosis: Tactile recognition
-Two point discrimination: distinguish two points of stimuli

87
Q

Common Neurological Disorders

A
88
Q

Meningitis

A

Inflammation of the meninges that surround the brain and spinal cord
-Headache
-Fever
-Malaise
-Nuchal rigidity: very stiff neck
-Decreased LOC

89
Q

Parkinson’s Disease

A

Chronic and Progressive: movement disorder resulting in decreased dopamine in the brain
-Resting tremors
-Bradykinesia: slow movement
-Rigidity
-Shuffling gait
-Finger pill rolling

90
Q

Cerebral Vascular Accident (CVA)

A

-Stroke (CVA):
Mental status changes
Impaired orientation
Inability to follow commands
Slurred speech
Weakness
Numbness
-Transient Ischemic Attack (TIA)- mimics a stroke
Symptoms lasting less than an hour
No neurological impairment

91
Q

Signs and Symptoms that could represent neurological issues

A

-Change in sensation
Numbness or tingling
Possibly chronic disease
-Dysphagia: difficulty swallowing
-Speech or communication: Aphasia
Receptive- Wernicke’s area
Expressive- Broca’s area

NSC 332 Exam 2 (1 decks)

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