Neuro (PPT) Flashcards
(52 cards)
Problem-Based History
- Headache
- Dizziness
- Seizures
- Tremors
- Weakness
- Loss of consciousness
- Changes in movement
- Changes in sensations
- Difficulty swallowing
- Difficulty communicating
A complete neurologic examination consists of evaluating the following five areas:
✓Mental status
✓Cranial nerves
✓Motor and Cerebellar System
✓Sensory system
✓ Reflexes
Purpose of Neurologic Assessment
- In emergency settings, rapid assessment of the severity of an injury and neurologic involvement is crucial and leads to fast decision-making in patient management, as well as improvement of patient survival rates.
- Early neurologic assessment may serve as baseline data for later comparison
the neurologic examination follows a logical sequence and progresses from higher levels of cortical function such as abstract thinking to lower levels of function such as the determination of the integrity of peripheral nerves.
_____ examinations provide information about cerebral cortex function.
It is often performed at the beginning of the head-to-toe examination because it provides clues regarding the validity of the subjective information provided by the client.
Mental status
Cranial Nerves
- 12 pairs
- Emerge directly from the brain and brainstem.
Functions:
* _____
* _____
* _____ – both sensory and motor
- Sensory
- Motor
- Mixed – both sensory and motor
type of impulse of cranial nerves
Sen
Sen
Mo
Mo
Mi
Mo
Mi
Sen
Mi
Mi
Mo
Mo
_____
Sensory – Carries smell impulses from nasal mucous membrane to brain
_____
Sensory – Carries visual impulses from eye to brain
_____
Motor – Contracts eye muscles to control eye movements (interior lateral, medial, and superior), constricts pupils, and elevates eyelids
_____
Motor – Contracts one eye muscle to control inferomedial eye movement
_____
Sensory – Carries sensory impulses of pain, touch, and temperature from the face to the brain
Motor – Influences clenching and lateral jaw movements (biting, chewing)
_____
Motor – Controls lateral eye movements
I (olfactory)
II (optic)
III (oculomotor)
IV (trochlear)
V (trigeminal)
VI (abducens)
_____
Sensory – Contains sensory fibers for taste on anterior two thirds of tongue and stimulates secretions from salivary glands (submaxillary and sublingual) and tears from lacrimal glands
Motor – Supplies the facial muscles and affects facial expressions (smiling, frowning, closing eyes)
_____
Sensory – Contains sensory fibers for hearing and balance
_____
Sensory – Contains sensory fibers for taste on posterior third of tongue and sensory fibers of the pharynx that result in the “gag reflex” when stimulated
Motor – Provides secretory fibers to the parotid salivary glands; promotes swallowing movements
_____
Sensory – Carries sensations from throat, larynx, heart, lungs, bronchi, gastrointestinal tract, and abdominal viscera
Motor – Promotes swallowing, talking, and production of digestive juices
______
Motor – Innervates neck muscles (sternomastoid and trapezius) that promote movement of the shoulders and head rotation. Also promotes some movement of the larynx
_____
Motor – Innervates tongue muscles that promote the movement of food and talking
VII (facial)
VIII (acoustic, vestibulocochlear)
IX (glossopharyngeal)
X (vagus)
XI (spinal accessory)
XII (hypoglossal)
EVALUATION OF CN I:
- Head trauma
- Lesions
- Patients report abnormal smell
_____ - Loss of the sense of smell that may result from:
a. infections of the nasal mucosa,
b. head injuries in which the cribriform plate of the ethmoid bone is fractured,
c. lesions along the olfactory pathway or in the brain, d. meningitis,
e. smoking, or
f. cocaine use.
NEUROGENIC ANOSMIA
Visual acuity is usually expressed in a fraction (i.e. 20/20, 20/40):
(𝑑𝑖𝑠𝑡𝑎𝑛𝑐𝑒 𝑜𝑓 𝑡h𝑒 𝑝𝑎𝑡𝑖𝑒𝑛𝑡𝑓𝑟𝑜𝑚 𝑐h𝑎𝑟𝑡)
__________________________
(𝑑𝑖𝑠𝑡𝑎𝑛𝑐𝑒 𝑎𝑡 𝑤h𝑖𝑐h 𝑎 𝑛𝑜𝑟𝑚𝑎𝑙 𝑒𝑦𝑒 𝑐𝑎𝑛 𝑟𝑒𝑎𝑑 𝑡h𝑒 𝑙𝑖𝑛𝑒 𝑜𝑓 𝑙𝑒𝑡𝑡𝑒𝑟𝑠)
a physiological insufficiency of optical accommodation associated with the aging of the eye.
Presbyopia
Blindness due to a defect in or loss of one or both eyes. May be due to:
a. fractures in the orbit,
b. brain lesions,
c. damage along the visual pathway,
d. diseases of the nervous system,
e. pituitary gland tumors, or
f. cerebral aneurysms
Anopia
_____ (swelling of the optic nerve) due to increased ICP
Papilledema
a condition of involuntary (or voluntary, in some cases) eye movement.
Nystagmus
The _____, _____, AND _____ nerves are the cranial nerves that control the muscles that move the eyeballs. They are all motor nerves that contain only motor axons as they exit the brain stem.
OCULOMOTOR, TROCHLEAR, AND ABDUCENS
Largest cranial nerve
CN V Trigeminal
3 Branches or sensory divisions of CN V Trigeminal
- Opthalmic
- Maxillary
- Mandibular
- a sharp cutting or tearing pain that lasts for a few seconds to a minute and is caused by anything that presses on the trigeminal nerve or its branches.
- caused by conditions such as inflammation or lesions.
- occurs almost exclusively in people over 60 and can be the first sign of a disease
Trigeminal Neuralgia (Tic Douloureux)
CN VII Vestibulocochlear
Acoustic/Auditory nerve
* SENSORY nerve
1._____ – equilibrium/balance
2. _____ - hearing
VESTIBULAR BRANCH
COCHLEAR BRANCH
CN VII Vestibulocochlear
NORMAL FINDINGS:
The patient should hear the tone equally in both ears.
- Lateralization of sound to the affected ear suggests conductive hearing loss.
- With _____, the client reports lateralization of sound to the poor ear – that is, the client “hears” the sounds in the poor ear.
Lateralization of sound to the unaffected ear suggests _____.
conductive hearing loss
sensorineural hearing loss
Air conduction sound is normally heard longer than bone conduction sound (AC > BC).
- With _____, bone conduction (BC) sound is heard longer than or equally as long as air conduction (AC) sound.
- With ____, air conduction sound is heard longer than bone conduction sound (AC > BC) is anything is heard at all.
conductive hearing loss
sensorineural hearing loss
