neuro

Question 1

what are the four parts of the brain?

Answer 1

cerebrum, dienchepalon, brainstem, cerebellum

Question 2

that brainstem includes?

Answer 2

midbrain, medulle, pons

Question 3

the medulla and pons are responsible for what?

Answer 3

controlling the respiratory center

Question 4

the spinal cord extends from the

Answer 4

medulla of the brainstem to L1 or L2

Question 5

the spinal cord contains

Answer 5

motor and sensory pathways that enter and exit the cord

Question 6

the nervous system consists of

Answer 6

central nervous system and peripheral nervous system

Question 7

central nervous system includes

Answer 7

the brain and spinal cord

Question 8

peripheral nervous system includes

Answer 8

cranial nerves, peripheral nerves, motor and sensory pathways

Question 9

brain structures of the brain include

Answer 9

basal ganglia, thalamus, hypothalamus, cerebellum

Question 10

the hypothalamus maintains

Answer 10

homeostasis, regulates temperature, heart rate, BP, endocrine system, hormonal secretion, and emotional behavior

Question 11

the cerebellum coordinates

Answer 11

body movement and maintains body in an upright position

Question 12

the basal ganglia affects

Answer 12

movement

Question 13

what are the 5 spinal segments of the spinal cord

Answer 13

cervical, thoracic, lumbar, sacral, coccygeal

Question 14

the cervical spine consists of

Answer 14

C1-C8

Question 15

Thoracic spine is from

Answer 15

T1-T12

Question 16

Lumbar spine is from

Answer 16

L1-L5

Question 17

Sacral spine consists of

Answer 17

S1-S5

Question 18

spinal and peripheral nerves control the

Answer 18

somatic nervous system and autonomic nervous system

Question 19

the somatic nervous system regulates

Answer 19

muscle movement and response to touch and pain

Question 20

the autonomic nervous system consists of

Answer 20

sympathetic and parasympathetic nervous system

Question 21

CN I is located in

Answer 21

the nose and controls sense of smell; it can be assessed using soap, coffee, cloves or vanilla. Have pt close both eyes, close one nostril, and gently inhale.

Question 22

CN II is located

Answer 22

in and behind the eyes and controls central and peripheral vision; test acuity with Snellen eye chart or hand’held card; inspect fundi, screen visual fields by confrontation (test of peripheral vision)

Question 23

CN III is located

Answer 23

in and behind the eye and controls pupillary constriction; to test dim lights and shine a penlight to measure shape and size of pupil

Question 24

CN IV acts as a pulley for the

Answer 24

eyes; acts as a pulley to move the eyes down toward the nose; to assess ask patient to follow finger while you move it down

Question 25

CN V covers most of the

Answer 25

face; if patient has a problem c this nerve it typically involves the forehead, cheek, or jaw; to assess check sensation in all three areas using a soft and dull object, also test motor fxn of temporal and masseter muscles by assessing jaw strength; test corneal reflex by touching the cornea with the tip of a cotton ball

Question 26

CN VI controls

Answer 26

eye movement to the sides; test extraocular movements in six cardinal directions of gaze, check convergence --> twitching of the eyeball

Question 27

CN VII controls

Answer 27

facial movements and expressions; assess pt for facial symmetry, ask pt to raise eyebrows, frown, close eyes tightly, show teeth, smile, puff both cheeks

Question 28

CN VIII located in the

Answer 28

ear and controls hearing; test hearing, lateralization, and air/bone conduction

Question 29

CN IX & X innervate the

Answer 29

tongue and throat (pharynx & larynx) and are assessed together; assess if voice is hoarse and swallowing, inspect movement of palate as pt says "ah", test gag reflex

Question 30

CN XI controls

Answer 30

neck & shoulder movement; assess strength as pt shrugs shoulders against downward pressure (note trapezius and sternocleigomastoid muscle) and force as pt turns head against hands

Question 31

CN XII innervates the

Answer 31

tongue; ask pt to protrude tongue and move it side to side --> assess for symmetry and atrophy

Question 32

motor fibers are part of what in peripheral nerves

Answer 32

the anterior (ventral) root

Question 33

sensory fibers are part of what in peripheral nerves

Answer 33

the posterior (dorsal) root

Question 34

T/F a lesion in motor or sensory pathway will not affect movement or reflex activity

Answer 34

FALSE! It will affect them

Question 35

basal ganglia controls

Answer 35

gross body movements - walking

Question 36

cerebellar sys maintains

Answer 36

equillibrium and posture

Question 37

pyramidal tract mediates

Answer 37

voluntary movements - keyboarding

Question 38

T/F upper motor systems damaged above crossover impairs motor movement on contralateral side

Answer 38

TRUE! There will be motor impairment on the contralateral side

Question 39

T/F CVA injury affects the ipsilateral side of the body

Answer 39

FALSE! It will affect the contralateral side

Question 40

upper motor neuron lesions result in

Answer 40

increased muscle tone and DTR's are exaggerated

Question 41

lower motor neuron damage results in

Answer 41

ipsilateral wakness & paralysis; musle tone and reflexes are decreased or absent

Question 42

sensory pathways participate in

Answer 42

reflex activity, conscious sedation (important for RN to know), body position, regulate autonomic nervous sys - BP, HR, respiration

Question 43

T/F damage to sensory pathways can result in peripherial neuropathy

Answer 43

TRUE! Person can experience a loss of sensation in hands and feet

Question 44

what are DTR's

Answer 44

muscle stretch reflex that involves sensory and motor pathways

Question 45

DTR of ankle =

Answer 45

sacral

Question 46

DTR of knee =

Answer 46

L2-L4

Question 47

DTR of brachioradialis =

Answer 47

C5-C6

Question 48

DTR of biceps =

Answer 48

C5-C6

Question 49

DTR of triceps =

Answer 49

C6-C7

Question 50

neuro health hx includes

Answer 50

HA, viz disturances, dizziness or vertigo, gen prox or distal weakness, numbness or tingling, abnormal or loss of sensations, LOC/syncope/near syncopal episode, seizures, tremors/involuntary movemts, memory/cognative/affective changes

Question 51

neuro exam includes

Answer 51

mental status, affective status, speech and language, cranial nerves, motor sys, sensory sys, reflexes

Question 52

what is involved in motor sys assess

Answer 52

romberg test and pronator drift

Question 53

what is the romberg test

Answer 53

pt should stand c feet together, then close eyes for 30-60 seconds w/o support; observe for inability to stand still w/o support or swaying --> minimal swaying is normal

Question 54

what is test for pronator drift

Answer 54

pt should stand for 20-30 seconds c both arms straight forward, plams up and eyes closed; gently tap arms downward--> arms and hands should remain in a horizontal position; abnormal=one arms falls/drifts to side

Question 55

DTR grading scale is from

Answer 55

0-4+

Question 56

DTR 0=

Answer 56

no response

Question 57

DTR 1+ =

Answer 57

somewhate diminished, low normal

Question 58

DTR 2+ =

Answer 58

average, normal

Question 59

DTR 3+ =

Answer 59

brisk --> may be normal for some individuals - hypersensitive pts

Question 60

DTR 4+ =

Answer 60

hyper-reflexive --> abnormal, pt may have clonus

Question 61

what is clonus

Answer 61

"foot beats" to normal position after dorsiflexion --> the more beats the higher the risk of seizure

Question 62

what is the most common DTR assessment site is

Answer 62

patellar

Question 63

range of the glasgow scale is

Answer 63

3 to 15

Question 64

score for a moderate brain injury is

Answer 64

9 to 12

Question 65

score for a severe brain injury is

Answer 65

3 to 8

Question 66

score for a mild brain injury

Answer 66

13 to 15

Question 67

if a pt is receiving anesthesia or recovering from anesthesia they are assess for LOC in the

Answer 67

OR or PACU

Question 68

for acutely injured or ill patients LOC is assess in

Answer 68

ER or ICU