neuro

Question 1

Neuro system:

Answer 1

central and peripheral

Question 2

Damage to cortex can produce:

Answer 2

Loss of function (dependent on area affected
Motor weakness
Paralysis
Loss of sensation (paresthesia)
Impaired ability to understand and process language

Question 3

Cerebellum:

Answer 3

motor coordination of voluntary movements

Question 4

Brain functions you want to assess:

Answer 4

Sensation
Vision, hearing
Language comprehension

Question 5

Left cerebral cortex:

Answer 5

receives sensory information and controls motor function to the right side of the body

Question 6

Right cerebral cortex

Answer 6

receives sensory information and controls motor function to the left side of the body

Question 7

Sensory pathways:

Answer 7

—sensory fibers transmit/conduct sensations of: pain, temperature, crude or light touch (not precisely located), position, vibration, finely localized touch (e.g. can ID familiar object by touch—feeling and identifying a key in your hand with your eyes closed)

Question 8

Motor pathways:

Answer 8

pyramidal tract: skilled and purposeful movement;

extrapyramidal tract: more primitive motor system—maintains muscle tone, controls body movement such as walking

Question 9

Cerebellar system—

Answer 9

coordinates movement; maintains equilibrium; helps maintain posture; all done subconsciously

Question 10

UMNs (upper motor neurons):

Answer 10

within CNS; diseases associated with—stroke, CP, MS

Question 11

LMNs (lower motor neurons):

Answer 11

located in peripheral nervous system; final direct contact with the muscles; movement translated into action by LMNs; examples—cranial nerves, spinal nerves; diseases associated with—spinal cord lesions, poliomyelitis, amyotrophic lateral sclerosis (ALS)

Question 12

Reflexes are mediated by:

Answer 12

spinal nerve fibers—tapping a tendon stimulates he sensory (afferent) nerve at a synapse in the spinal cord with the motor neuron—efferent fibers then travel to the muscle, stimulating a contraction

Question 13

Deep tendon reflexes—5 components:

Answer 13

Intact sensory nerve (afferent)
A functional synapse at the cord
An intact motor nerve (efferent)
The neuromuscular junction
A competent muscle

Question 14

Peripheral nervous system: cranial nerves and spinal nerves

Answer 14

Function—somatic and autonomic
Somatic: innervate the skeletal (voluntary) muscles
Autonomic: innervate smooth (involuntary) muscles, cardiac, and glands; mediates unconscious
activity

Question 15

Spinal nerves:

Answer 15

31 pairs arise from spinal cord; 8 cervical, 12 thoracic, 5 lumbar, 2 sacral, 1 coccygeal

Question 16

Spinal nerves Contain both;

Answer 16

sensory and motor fibers
Nerves exit through roots
Sensory through posterior (dorsal) roots
Motor through anterior (ventral) roots

Question 17

Dermatomes:

Answer 17

circumscribed skin area supplied from the spinal cord segment through particular spinal nerve

Question 18

Infants:

Answer 18

movement directed primarily by primitive reflexes; these disappear with age
Increased process of myelination results in increased motor control
Sensation rudimentary at birth—need strong stimulation to create response in an infant

Question 19

Aging Adult:

Answer 19

steady loss of neuron structure in brain and spinal cord
General loss of muscle bulk; loss of muscle tone in face, neck, around spine
	Decreased muscle strength
	Impaired fine coordination and agility
	Loss of sensation
	Pupillary changes
	Reaction time slows
	Touch, pain, taste, smell may diminish

Question 20

Decreased cerebral blood flow and oxygen consumption may cause

Answer 20

dizziness, loss of balance with position changes

Question 21

U.S. Southeast—stroke belt

Buckle region—coastal plain of N.C., S.C., and Georgia—stroke mortality is:

Answer 21

20% higher than that in the stroke belt and 40% higher than the rest of the U.S.

Question 22

Seizures—ask about:

Answer 22

Aura: can be auditory, visual, or motor
Motor activity
Associated signs others noted you have
Post-ictal period: sleepy, confused, weakness, headache
Precipitating factors
Medications
Effect on daily life/quality of life

Question 23

Subjective Data

Answer 23

Headache—worry about ‘the worse headache of my life’—immediate screening for stroke
Head injury
Dizziness/vertigo—vertigo indicates neurologic disease
Seizures—
Medications
Effect on daily life/quality of life
Tremors—precipitating and palliative factors
Weakness—large and small muscles; understand paresis, paralysis, paresthesia
Incoordination
Numbness or tingling
Difficulty swallowing—with solids and liquids; ask about drooling and excessive saliva
Difficulty speaking—dysarthria (difficulty forming words); dysphagia (difficulty with language comprehension or expression)
Past neuro history—stroke, meningitis, spinal cord injury, congenital defect, alcohol use
Environmental hazards—insecticides, organic solvents, lead, mercury
Medications—pain meds, anticonvulsants; mood-altering drugs or ETOH
Aging Adult: assess fall risk—increased with diagnosis of stroke or dementia, gait and balance disorders, use of assistive devices, history of recent falls
What is micturition syncope?
Assess for change in memory, decrease in cognitive function
Stroke symptoms: what are they?

Question 24

Test for sensation:

Answer 24

Pain
   Light touch
   Vibration
   Position
   Tactile discrimination (fine touch)
   Stereognosis
   Graphesthesia
   Two-point discrimination
   Extinction
   Point location

Question 25

Glasgow Coma Scale (GCS):

Answer 25

Rating in 3 areas—eye opening, verbal response, motor response

Question 26

Neuro Recheck:

Answer 26

Level of consciousness
Motor coordination
Pupillary response
Vital signs