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NURS 202 > Neuro > Flashcards

Neuro Flashcards

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1
Q

What is the leading cause of disability worldwide?

A

depression

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2
Q

Most common physical comorbidities with mental health disorders (4)

A

1) CVD
2) hypertension
3) respiratory disease
4) diabetes

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3
Q

Concurrent disorder: mental health disorder & _________

A

problematic substance use/substance use

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4
Q

T or F: Those with a mental health disorder are more likely than members of the general public to engage in violent behaviour.

A

FALSE

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5
Q

What is essential when doing a mental health assessment with a patient?

A

build rapport

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6
Q

Elements of a mental health history (4)

A

1) Interview
2) Observation
3) Examination
4) Collaboration

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7
Q

What is the primary source of information in a mental health assessment?

A

patient

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8
Q

What are secondary sources of information in a mental health assessment?

A

family, other HCP, patient records

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9
Q

T or F: For most patients, conducting an interview is sufficient enough for a mental health assessment.

A

TRUE

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10
Q

Interview

A

complete health history

what’s normal for the patient

identification/biographical info

reason for seeking care (verbatim or DSM5 diagnoses)

past health

family health history

developmental considerations

present health

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11
Q

What should you assess first during observation?

A

most basic functions (consciousness, language)

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12
Q

Main Components of Observation (4)

A

1) Appearance
2) Behaviour
3) Cognition
4) Thinking

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13
Q

Orientation x 4

A

1) Person
2) Place
3) Time
4) Self

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14
Q

What is the first sense/orientation to go?

A

time

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15
Q

What is the last sense/orientation to go?

A

self

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16
Q

Order in which the senses go

A

time –> place –> self

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17
Q

Questions to assess orientation to person

A

who examiner is, type of worker

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18
Q

Questions to assess orientation to place

A

where person lives, present location, type of building, names of city and province

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19
Q

Questions to assess orientation to time

A

day of week, date, year, season

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20
Q

Questions to assess orientation to self

A

person’s own name, age

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21
Q

Questions to assess immediate memory

A

on spot recall

ask to recall a statement you just made

affected by: head injury, fatigue, anxiety, strong emotions

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22
Q

Questions to assess recent memory

A

day-to-day events

“What did you think of the meal yesterday?”

affected by: organic disorders - delirium, dementia, amnesia, chronic alcoholism

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23
Q

Questions to assess long-term memory

A

years worth of experiences

“Where did you grow up?”

affected by: Alzheimer’s

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24
Q

How to assess new learning

A

Give them 4 unrelated words and ask them to recall a few minutes later

e.g. fun, carrot, ankle, loyalty

Alzheimer’s: 0 or 1 words recalled

also affected by anxiety, depression

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25
Tool to assess risk factors for suicide
SADPERSONS Score out of 10 -Score 3-6 = consider very close follow-up or hospitalization -Score 7+ = consider hospitalization, contact MRP higher score=higher risk
26
A patient scores an 8 on the SADPERSONS scale. What should your next course of action be? a) consider this as normal and document b) contact the most responsible provider c) monitor the patient d) call the patient first thing tomorrow morning and ask them how they're feeling
b) contact the most responsible provider and consider hospitalization
27
Tool to assess patient's functioning
Global Assessment of Functioning psychiatrist or other qualified physician estimate of overall psychological, social, and occupational functiong score: 0 to 100 (higher=better functioning, under 50=serious, severe)
28
When to perform mental health assessment (5)
1) Abnormality in mood or behaviour 2) Symptoms of mental illness, especially ACUTE onset 3) Family concerned 4) Brain lesions - trauma, tumour, stroke 5) Aphasia
29
For a depression diagnosis, the patient must experience sadness and loss of interest in activities for at least _____ weeks
2 weeks
30
Additional symptoms for depression diagnosis (7)
1) Disruption in sleep 2) Disruption in appetite 3) Poor concentration 4) Low energy 5) Psychomotor agitation or retardation 6) Excessive guilt 7) Feelings of worthlessness need at least 4/7
31
T or F: In children and adolescents, emotional and cognitive functioning are independent of one another
FALSE interdependent ask about educational and developmental milestones
32
T or F: The majority of mental health disorders have onset during childhood and adolescence.
TRUE 70%
33
Which age group is more likely to experience mental illness and/or substance use disorders than any other age group?
Young adults 15 to 24
34
Screening tools for perinatal period
Edinburgh Postnatal Depression Scale (EPDS)
35
T or F: There is universal consensus on the value of universal perinatal depression screening.
FALSE but HCP needs to be aware and alert to this
36
4 Lobes of the Cerebral Cortex
1) Frontal 2) Parietal 3) Occipital 4) Temporal
37
Frontal Lobe
personality, behaviour, emotions, intellectual function precentral gyrus: initiates voluntary movement Broca's area: mediates motor speech, damaged=expressive aphasia: person can understand language and knows what they would like to say, but can produce only a garbled sound
38
Parietal Lobe
postcentral gyrus: primary centre for SENSATION
39
Occipital Lobe
primary VISUAL receptor centre (think of the O like an eye)
40
Temporal Lobe
primary AUDITORY receptor centre Wernicke's area: language comprehension damaged=receptive aphasia: person hears sound, but it has no meaning, like hearing a foreign language
41
Aphasia
impairment of language ability secondary to brain damage
42
Broca's/Expressive Aphasia
can understand language but cannot express self with language nonfluent, dysarthric, and effortful speech motor speech cortex
43
Wernicke's/Receptive Aphasia
can hear sounds and words but cannot relate them to previous experiences speech is fluent, effortless, and well-articulated but nonsensical association auditory cortex
44
You ask a patient to tell you where they live and they respond, "Two of them. And up and down." What type of aphasia do they have? a) Broca's b) Wernicke's
b) Wernicke's
45
Basal Ganglia
controls autonomic associated movements of the body "Be Good at movements"
46
Thalamus
main relay station think T for "train station"
47
Hypothalamus
major control centre controls temp, HR, BP regulating sleep and pituitary coordinating ANS activity and emotional stress
48
Cerebellum
motor coordination of: -voluntary movements -equilibrium -muscle tone does NOT initiate movements
49
Components of the brain stem (3)
1) midbrain 2) pons 3) medulla
50
Where in the brain are the vital autonomic centres located?
medulla e.g. resp, cardiac, GI
51
Which structure in the CNS mediates reflexes?
spinal cord
52
KEEP GOING YOU CAN DO THIS
SLAY UR EXAM
53
Reflex Arc
basic defense mechanism of the nervous system involuntary enabling quick reaction to potentially painful or damaging stimulus maintain balance and muscle tone
54
4 Types of Reflexes
1) deep tendon 2) superficial 3) visceral 4) pathological "don't stop vibing, people"
55
Deep Tendon Reflex Example
e.g. patellar (knee jerk)
56
Superficial Reflex Example
e.g. corneal reflex, abdominal reflex
57
Visceral Reflex Example
e.g. pupillary response to light and accomodation
58
Pathological Reflex Example
e.g. positive Babinski (extensor plantar) reflex ABNORMAL
59
What order does myelination in infants follow? a) distal to proximal b) proximal to distal
b) proximal to distal head → neck → trunk → extremities
60
What is the most important piece of information in the initial assessment for stroke?
time of onset
61
Stroke - FAST acronym meaning
F - FACE - drooping? A - ARMS - raise both? S - SPEECH - slurred or jumbled? T - TIME - to call 911 right away
62
Balance Tests (3)
1) Gait -get patient to walk 2) Tandem walking -heal-to-toe walking 3) Romberg -get them to stand for 20 seconds with eyes closed
63
Coordination and Skilled Movement Testing (4)
1) RAM -slapping palm and back of hand back and forth across thighs, thumb and fingers 2) Finger-to-finger -patient touches nose and examiners finger 3) Finger-to-nose -patient closes eyes and alternates touching nose 4) Heel-to-shin test
64
Spinothalamic Tract Sensations (3)
1) Pain - pinprick, something sharp 2) Temperature - cool metal, tuning fork 3) Light touch - cotton whisp
65
Posterior Column Tract Sensations (3)
1) Vibration -tuning fork 2) Position (Kinaesthesia) -move their finger up or down and ask which direction you moved it 3) Tactile Discrimination (Fine Touch) -Stereognosis: recognizing familiar object in hand -Graphaesthesia: reading number or letter on skin -2 Point Discrimination - paperclip -Extinction - touch both sides of body at same time, ask how many sensations are felt and where -Point location - point to location of touch
66
Testing Deep Tendon Reflex
e.g. knee jerk reflex reflex hammer hit tendon insertion on both sides, should be symmetrical
67
Grading Deep Tendon Reflex
4+: Very brisk, hyperactive with clonus (rapid, rhythmic contraction), indicative of disease 3+: Brisker than average, may indicate disease (upper motor lesions e.g. MS) 2+: Average, normal 1+: Diminished, low normal (lower motor lesions) 0: No response
68
Testing Clonus
move the foot up and down a few times to relax the muscle stretch the muscle by briskly dorsiflexing the foot and hold stretch Normal: no further movement Abnormal: clonus
69
Testing Superficial Reflex
e.g. plantar reflex/Babinski edge of reflex hammer on bottom of foot normal: plantar flexion of the toes and inversion and flexion of the forefoot abnormal: dorsiflexion of toes and fanning out of toes NORMAL IN INFANTS THOUGH (Babinski - think babi, normal in babies)

NURS 202 (6 decks)

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