Neuro specific

Question 1

possible further assessment

Answer 1

cerebellar, proprioception, deep tendon reflexes

Question 2

cerebellar

Answer 2

finger to nose
heel to shin
gait evaluation (ataxia?)

Question 3

ataxia

Answer 3

indicates loss of muscle coordination, affects:
balance
speech
eye movement

Question 4

proprioception

Answer 4

being able to know where your body parts are in space without having to see them
Romberg test (balance) – CN VII

Question 5

bad deep tendon reflexes

Answer 5

hyperactive: problem w upper motor neurons
clonus: dorsiflexion and count oscillations

Question 6

CVA

Answer 6

cerebrovascular accident (stroke)

Question 7

hemorrhagic stroke

Answer 7

caused by bleeding in the brain

Question 8

ischemic stroke

Answer 8

caused by blood clot in the brain

Question 9

thrombolytic t-PA

Answer 9

alteplase– breaks down clot in ischemic stroke

Question 10

chronic deficits caused by stroke

Answer 10

hemiplegia
hemianopsia
aphasia
dysarthria
dysphagia

Question 11

hemiplegia

Answer 11

paralysis on one side of the body

Question 12

hemiparesis

Answer 12

weakness in half of the body

Question 13

hemianopsia

Answer 13

loss of 1/2 vision in each eye

Question 14

aphasia

Answer 14

language difficulty

Question 15

expressive aphasia

Answer 15

Broca’s: word finding

Question 16

receptive aphasia

Answer 16

Wernicke’s: understanding

Question 17

global

Answer 17

total= both

Question 18

dysarthria

Answer 18

loss of speech articulation

Question 19

dysphasia

Answer 19

loss of ability to swallow (no gag reflex)

Question 20

cincinnati prehospital stoke scale components

Answer 20

droop, drift, speech

Question 21

cincinnati prehospital stroke scale assesses…

Answer 21

balance, eyes, face, arms, speech, tongue/time

Question 22

NIH stroke scale

Answer 22

done daily on all stroke pt’s, not memorized

Question 23

transient ischemic attack (TIA)

Answer 23

temporary neuro deficits d/t impaired circulation to the brain (mini stroke)

Question 24

TIA S/S

Answer 24

same as acute CVA

Question 25

length of TIA

Answer 25

resolves in less than 24 hours

Question 26

TIA indicates...

Answer 26

impending major CVA

Question 27

meningitis

Answer 27

an infection of the meninges caused by bacteria, virus, or fungus (less common)

Question 28

7 PA findings indicating meningitis (due to ⬆ ICP)

Answer 28

1. HA and fever 2. altered metal status (AMS) 3. photophobia 4. dizziness 5. projectile vomiting 6. nuchal rigidity and pain 7. petechiae

Question 29

kernigs's sign

Answer 29

laying flat on back, bent leg and hip 90 degrees, resisting and in a lot of pain

Question 30

Brudzinski's sign

Answer 30

forcefully bend head own to chest, checking for rigidity and pain. pt will bend knees to relieve pain

Question 31

cerebral palsy

Answer 31

disorder of movement, muscle tone, or posture caused by injury to or abnormal development of the brain (anoxia or motor brain area-- not progressive)

Question 32

classifications of CP

Answer 32

spastic dyskinetic ataxic

Question 33

spastic

Answer 33

hyeprtonicity, stiffness, rigidity, contractures

Question 34

dyskinetic CP

Answer 34

involuntary writhing movements of extremities

Question 35

ataxic CP

Answer 35

abnormalities of balance and coordination of trunk/extremities (least common)

Question 35

parkinsons disease (PD)

Answer 35

lack of domapine in the brain = movement disorder

Question 36

S/S of Parkinsons Disease (PD)

Answer 36

tremors at rest and fatigue pin rolling of fingers interia when starting movement shuffling, hunched gait mask like facies w/ drooling

Question 37

2 classifications of spinal cord injury

Answer 37

cerivical and thoracic

Question 38

spinal cord injury (SCI) PA findings

Answer 38

impaired sensation and movement quadriplegia (cervical spine) - above C2-3, ventilator dependent paraplegia (thoracic spine)

Question 39

acute care for SCI

Answer 39

immobilize neck, assess for respiratory compromise

Question 40

head injury with internal bleeding or swelling can cause

Answer 40

intracranial pressure (ICP)

Question 41

cerebral herniation

Answer 41

ICP pushes brainstem downward thru opening in skull where spinal cord exits

Question 42

abnormal levels of consciousness

Answer 42

lethargic obtunded stuporous coma

Question 43

obtunded

Answer 43

falling asleep if not continually kept awake, when awakened typically confused

Question 44

stuporous

Answer 44

significantly out of it, difficult to keep awake

Question 45

coma (comatose)

Answer 45

will not wakeup even if inflicting pain (finger pressed underneath fingernail, or press knuckles against sternum)

Question 46

glasgow coma scale (GCS) tests what three things

Answer 46

eye opening response verbal response motor response

Question 47

GCS score

Answer 47

from 3-15 anything less than 8 is a coma and requires intubation

Question 48

TBI

Answer 48

traumatic brain injury

Question 49

signs of TBI

Answer 49

projectile vomiting altered CN 6 pupils posturing

Question 50

TBI pupils

Answer 50

pinpoint (commonly seen in drug abuse) oval shape (ICP affecting CN3) dilated and fixed if unconscious -> dolls eyes

Question 51

decorticate

Answer 51

arms flexed and fists clenched legs extended and internally rotated toes pointed

Question 52

decerebrate

Answer 52

arms stiffly extended with pronated forearms and flexed wrists head and neck extended legs and toes extended, internally rotated (indicates increased severity)

Question 53

flaccid

Answer 53

limp without movement worst sign indicates damage to lower brain stem

Question 54

neuro specific assessment

Answer 54

5 upper 7 lower * weakness numbness or tingling? * recent severe unexplained HA * recent falls/altered balance * look for facial droop or slurred speech