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Health Assessment > neuro > Flashcards

neuro Flashcards

1
Q

what are the four parts of the brain?

A

cerebrum, dienchepalon, brainstem, cerebellum

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2
Q

that brainstem includes?

A

midbrain, medulle, pons

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3
Q

the medulla and pons are responsible for what?

A

controlling the respiratory center

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4
Q

the spinal cord extends from the

A

medulla of the brainstem to L1 or L2

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5
Q

the spinal cord contains

A

motor and sensory pathways that enter and exit the cord

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6
Q

the nervous system consists of

A

central nervous system and peripheral nervous system

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7
Q

central nervous system includes

A

the brain and spinal cord

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8
Q

peripheral nervous system includes

A

cranial nerves, peripheral nerves, motor and sensory pathways

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9
Q

brain structures of the brain include

A

basal ganglia, thalamus, hypothalamus, cerebellum

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10
Q

the hypothalamus maintains

A

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

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11
Q

the cerebellum coordinates

A

body movement and maintains body in an upright position

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12
Q

the basal ganglia affects

A

movement

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13
Q

what are the 5 spinal segments of the spinal cord

A

cervical, thoracic, lumbar, sacral, coccygeal

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14
Q

the cervical spine consists of

A

C1-C8

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15
Q

Thoracic spine is from

A

T1-T12

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16
Q

Lumbar spine is from

A

L1-L5

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17
Q

Sacral spine consists of

A

S1-S5

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18
Q

spinal and peripheral nerves control the

A

somatic nervous system and autonomic nervous system

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19
Q

the somatic nervous system regulates

A

muscle movement and response to touch and pain

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20
Q

the autonomic nervous system consists of

A

sympathetic and parasympathetic nervous system

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21
Q

CN I (olifactory is located in

A

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.

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22
Q

CN II (optic) is located

A

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)

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23
Q

CN III (optic, occulomotor) is located

A

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

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24
Q

CN IV (oculomotor, trochlear, abducens) acts as a pulley for the

A

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

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25
Q

CN V (trigeminal) covers most of the

A

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

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26
Q

CN VI (abducens) controls

A

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

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27
Q

CN VII (facial) controls

A

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

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28
Q

CN VIII (acoustic) located in the

A

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

29
Q

CN IX & X (glossopharyngeal, vagus) innervate the

A

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

30
Q

CN XI (spinal accessory) controls

A

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

31
Q

CN XII (hypoglossal) innervates the

A

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

32
Q

motor fibers are part of what in peripheral nerves

A

the anterior (ventral) root

33
Q

sensory fibers are part of what in peripheral nerves

A

the posterior (dorsal) root

34
Q

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

A

FALSE! It will affect them

35
Q

basal ganglia controls

A

gross body movements - walking

36
Q

cerebellar sys maintains

A

equillibrium and posture

37
Q

pyramidal tract mediates

A

voluntary movements - keyboarding

38
Q

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

A

TRUE! There will be motor impairment on the contralateral side

39
Q

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

A

FALSE! It will affect the contralateral side

40
Q

upper motor neuron lesions result in

A

increased muscle tone and DTR’s are exaggerated

41
Q

lower motor neuron damage results in

A

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

42
Q

sensory pathways participate in

A

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

43
Q

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

A

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

44
Q

what are DTR’s

A

muscle stretch reflex that involves sensory and motor pathways

45
Q

DTR of ankle =

A

sacral

46
Q

DTR of knee =

A

L2-L4

47
Q

DTR of brachioradialis =

A

C5-C6

48
Q

DTR of biceps =

A

C5-C6

49
Q

DTR of triceps =

A

C6-C7

50
Q

neuro health hx includes

A

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

51
Q

neuro exam includes

A

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

52
Q

what is involved in motor sys assess

A

romberg test and pronator drift

53
Q

what is the romberg test

A

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

54
Q

what is test for pronator drift

A

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

55
Q

DTR grading scale is from

A

0-4+

56
Q

DTR 0=

A

no response

57
Q

DTR 1+ =

A

somewhate diminished, low normal

58
Q

DTR 2+ =

A

average, normal

59
Q

DTR 3+ =

A

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

60
Q

DTR 4+ =

A

hyper-reflexive –> abnormal, pt may have clonus

61
Q

what is clonus

A

“foot beats” to normal position after dorsiflexion –> the more beats the higher the risk of seizure

62
Q

what is the most common DTR assessment site is

A

patellar

63
Q

range of the glasgow scale is

A

3 to 15

64
Q

score for a moderate brain injury is

A

9 to 12

65
Q

score for a severe brain injury is

A

3 to 8

66
Q

score for a mild brain injury

A

13 to 15

67
Q

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

A

OR or PACU

68
Q

for acutely injured or ill patients LOC is assess in

A

ER or ICU

Health Assessment (8 decks)

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