neuro

Question 1

Major units of nervous system

Answer 1

spinal cord: Lowest functional level

Controls automatic motor responses (reflexes)

brain stem: Controls BP, Respiration, equilibrium, & primitive emotions

cortical level: Responsible for cognition

Question 2

nervous system 2 parts

Answer 2

Central Nervous System: (brain, spinal cord)

the network of coordination and control of the body.

Peripheral Nervous System: motor and sensory nerves and ganglia outside the central nervous system carries information to and from the central nervous system

12 pairs of cranial nerves
31 pairs of spinal nerves

Autonomic Nervous System
Sympathetic
Parasympathetic

Question 3

Brain blood usage

Answer 3

Receives blood supply from the 2 internal carotid arteries and 2 vertebral arteries that join to form the basilar artery

Blood supply- 15% to 20% of total cardiac output goes to the brain.

Question 4

3 Major units of the central nervous system

Answer 4

Three major units Cerebrum, Cerebellum, Brainstem

Question 5

Cerebrum

Answer 5

Two cerebral hemispheres – divided into lobes.

Outer layer- Gray matter of the cerebral cortex:

Higher mental function, General movement, Visceral functions, Perception, Behavior

Integrates the functions

White matter of the cerebral cortex:

Nerve fibers and myelin

Disorders:
Multiple Sclerosis
CMV
Encephalitis
Folate or Vit-B12 deficiency
Vasculitis
PKU

Question 6

Lobes of the cerebrum: frontal

Answer 6

FRONTAL LOBE- motor cortex, voluntary skeletal movement and fine repetitive motor movements, eye movements.

Question 7

parietal lobe

Answer 7

PARIETAL LOBE- processing received sensory data. Assists in interpretation of tactile, visual, gustatory, olfactory, auditory sensations, recognition of body parts and body position. Communication between sensory and motor areas of the brain

Question 8

occipital lobe

Answer 8

OCCIPITAL LOBE- primary vision center, provides interpretation of visual data

Question 9

temporal lobe

Answer 9

perception and interpretation of sounds and determination of the source, integration of taste, smell, balance, reception and interpretation of speech (Wernicke area)

Question 10

cerebrum lobes locations

Answer 10

Question 11

cerebellum function

Answer 11

Aids the motor cortex of the cerebrum in the integration of voluntary movement.

Processes sensory information from eyes, ears, touch receptors.

Works with the vestibular system for reflexive control of muscle tone, equilibrium, and posture to produce steady and precise movements

Disorders have numerous causes: congenital malformations, hereditary ataxias, and acquired conditions. Symptoms vary with the cause but typically include ataxia (impaired muscle coordination).

Question 12

Brainstem function general function

Answer 12

Pathway between cerebral cortex and the spinal cord

Controls many involuntary movements

Medulla oblongata, Pons, midbrain, diencephalon.

Nuclei contains the 12 cranial nerves

Reticular formation contains a network of fibers for muscle stimulation:

Counteract gravitational forces

Regulates cardiac and respiratory systems

Maintains consciousness.

Question 13

Medulla oblongata

Answer 13

Medulla oblongata (CN IX-XII)- respiratory, circulation, vasomotor activities; houses respiratory center. Reflexes- swallowing, coughing, vomiting, sneezing, hiccupping

Question 14

pons

Answer 14

Pons (CN V-VIII)- regulates respiration, houses portion of respiratory center, controls voluntary muscle action

Question 15

midbrain

Answer 15

Midbrain (CN III-IV)- reflex center for eye and head movement, auditory relay pathway

Question 16

Diencephalon

Answer 16

(CN I-II)- relays information between cerebrum, cerebellum, pons and medulla. All sensory impulses EXCEPT Olfactory. Consciousness, perceptions of sensations, abstract feelings

Question 17

thalamus

Answer 17

perception of pain and temperature control

Question 18

Epithalamus-

Answer 18

pineal body. Sexual development and behavior

Question 19

Hypothalamus-

Answer 19

major processing center of stimuli for autonomic nervous system. Maintains temperature control, H2O metabolism, body flds. osmolarity, feeding behavior, neuroendocrine activity

Question 20

Pituitary Gland-

Answer 20

hormonal growth control, lactation, vasoconstriction, and metabolism

Question 21

brainstem injury and posture

Answer 21

Decerebrate posture- arms and legs extended, the toes being pointed downward, and the head and neck being arched backwards. Muscles are rigid. Usually means severe damage to the brain (brainstem)

Decorticate posture- arms flexed, clenched fists, and extended legs (held out straight). Arms are bent inward toward the body with the wrists and fingers bent and held on the chest. Muscles are rigid.

Question 22

spinal cord and tracts

Answer 22

Spinal cord- 40 to 50 cm in length.

Fibers grouped into 2 tracts that run through the spinal cord carrying sensory, motor, and autonomic impulses between higher centers of the brain and body.

31 pairs of spinal nerves. Myelin-

coated white matter contains the ascending and descending tracts. Gray matter contains nerve cell bodies, arranged in a butterfly shape with anterior and posterior horns

Question 23

Ascending spinal cord tract

Answer 23

Ascending Tract- carries SENSORY data to the brain. Mediates various sensations, facilitates sensory signals for complex discrimination for touch, pressure, vibration and position of joints, two-point discrimination

Descending Tract- carries MOTOR impulses from the brain. Conveys impulses to various muscle groups by inhibiting or exciting spinal activity

Question 24

Sympathetic nervous sytem

Answer 24

responds to physiological and psychological stress to the body. Fight or flight.

Question 25

Parasympathetic system:

Answer 25

responds to the balancing and conservation of body resources and to maintain the day to day functioning of the body such as digestion and elimination. Feed, breed, rest.

Question 26

parasympathetic vs sympathetic

Answer 26

Question 27

Cranial nerves 12

Answer 27

I Olfactory II Optic- not PNS III Oculomotor IV Trochlear V Trigeminal VI Adbucens VII Facial VIII Acoustic IX Glosso-pharyngeal X Vagus XI Accessory XII Hypoglossal

Question 28

functions of cranial nerves: 1-6

Answer 28

I Olfactory: Smell (S) II Optic: Vision (S) III Oculomotor: Upward, downward, medial eye movement, lid elevation, pupil constriction (M) IV Trochlear: Downward, medial, eye movement (M) V Trigeminal: Face, scalp nasal mucosa, buccal mucosa, jaw muscle(S), masseter muscle, temporal, digastric muscle (M) VI Abducens- lateral eye movement (M)

Question 29

function's of cranial nerves 7-12

Answer 29

VII Facial- external ear, taste anterior sides 2/3 tongue (S) facial movement, scalp, salivation, lacrimation (M) VIII Acoustic- cochlear hearing (S) IX Glossopharyngeal- external ear, taste posterior 1/3 carotid reflexes, sinus, baro & chemoreceptors (S) Gag swallow, salivation (M) X Vagus- external ear, pharynx (S), swallow, pronation bronchoconstriction, gastric secretion, peristalsis (M) XI Accessory- swallow, pharyngeal muscles, head turn, shoulders rise (M) XII Hypoglossal- tongue muscle, hypoglossus (M)

Question 30

symptom analysis: of cranial nerves

Answer 30

The 5 Senses: Cranial Nerve I – (olfactory) Cranial Nerve II- (optic) Cranial Nerve III- (oculomotor) Cranial Nerve IV- (trochlear) Cranial Nerve VI (abducens) All responsible for smell, visual acuity, pupillary constriction, extraocular movement. Cranial Nerve VII- (facial) and CN IX–(glossopharyngeal) Control Taste: Cranial Nerve VIII (acoustic) Controls Hearing and Cranial Nerve V (trigeminal) Controls sensory innervation to face/teeth/tongue/eye

Question 31

neurological assessment

Answer 31

health history and present health status signs and symptoms

Question 32

neuro assessment approach and general survey

Answer 32

General Appearance- grooming, manner of dress. Appropriate for lifestyle, hygiene, posture, gait, awareness Patient’s perception as well as objective data. Make sure the patient is comfortable Allow the older patient longer time for responses Safety: be close to the patient Tools: stethoscope, BP cuff, penlight, nonsterile gloves, cotton, sharp object, coin or button, key, something fragrant, tasteable products, tongue blade, reflex hammer, ophthalmoscope, tuning fork(s)

Question 34

abnormal gait patterns

Answer 34

Spastic hemiparesis- affected leg stiff and extended. Foot dragged, scraping of toes, affected arm flexed, adducted. No swing Ataxia- Uncoordinated Uncontrolled falling occurs Ataxic Gait Parkinsonian- stooped, rigid, short shuffling steps starting, difficulty stopping

Question 35

Mental status

Answer 35

LOC- Glasgow coma scale Awake/Alert (follows commands) Lethargic (drowsy-tap awake) Stuporous (Shake or shout to wake) Comatose (Does not respond to verbal cues or painful stimuli)

Question 36

Mental status

Answer 36

behavior, mood, emotional state, nonverbal ques, speech, cognitive function

Question 37

orientation status, memory, intellectual function

Answer 37

awareness of: person place time situation memory: recollection of the past memorization of numbers intellectual: learning ability read judgment

Question 38

change in mental status and possible causes

Answer 38

mental status: forgetfulness, memory loss, inability concentrate or process info rapidly, unconsciousness causes: neurological issues, fluid or electrolyte imbalance, hypoxia, poor perfusion, nutrition, infection, renal or liver disease, hyper/hypothermia, trauma, medications/toxins

Question 39

testing cerebellar function

Answer 39

Finger to nose Finger nose finger movements Rapid alternating movements: thumb to 4 fingers as rapidly as possible, or slapping thighs with palms alternating with back of hands. Note speed/accuracy. Heel to shin Romberg test- 20 sec Tandem/Tip Toe Walking

Question 40

testing somatic sensation function

Answer 40

Sensation: Dermatones & major peripheral nerves Forehead, cheek, hand, foot Light touch: Wisp of cotton on different areas of body Pain & Temp: Sharp/dull & hot/cold Vibration: Tuning fork on bony prominence Ask localization stop & start

Question 41

sensory function

Answer 41

position Sensitivity Tactile Discrimination: Stereognosis Graphesthesia Two point Discrimination Extinction

Question 42

Dermatomes

Answer 42

relationship between the spinal nerves and skin sensation each of the spinal nerves root. provides sensation to a predicatble area of the skin there is a great deal of overlapping however

Question 43

Deep tendon reflex and scale

Answer 43