Neurologic System

Question 1

The PNS carries what to the CNS from sensory receptors?
Carries what from the CNS out to muscles and glands, and autonomic messages that govern the internal organs and blood vessels?

Answer 1

Sensory/afferent

Motor/efferent

Question 2

What makes up the PNS?

What makes up the CNS?

Answer 2

12 pairs of cranial nerves, 31 pairs of spinal nerves.

Brain, spinal cord

Question 3

Areas connected with personality, behavior, emotions, and intellectual function. Its precentral gyrus initiates voluntary movement.

Answer 3

Frontal lobe

Question 4

This lobe’s postcentral gyrus is the primary center for sensation.

Answer 4

Parietal lobe

Question 5

The primary visual receptor center.

Answer 5

Occipital lobe

Question 6

Lobe behind the ear that has the primary auditory reception center, with functions of hearing, taste, and smell.

Answer 6

Temporal lobe

Question 7

Area in the temporal lobe that is associated with language comprehension. What results when damaged in the dominant hemisphere?

Answer 7

Wernicke’s area. Receptive aphasia results, the person hears sound but it has no meaning, like hearing a foreign language.

Question 8

Area in the frontal lobe that mediates motor speech. When injured in the dominant hemisphere, what occurs?

Answer 8

Broca’s area. Expressive aphasia results, the person cannot talk. They can understand language and knows what they want to say but can only produce garbled sound.

Question 9

Large bands of gray matter located deep within the two hemispheres that form the subcortical-assoaicted nervous system (the extrapyramidal system)

Answer 9

Basal ganglia.

Helps to initiate and coordinate movement and control automatic associated movements of the body.

Question 10

The main relay station where the sensory pathways of the spinal cord, cerebellum, basal ganglia, and brainstem form synapses on their way to the cerebral cortex.

Answer 10

Thalamus. Integrating center with connections that are crucial to human emotion and creativity.

Question 11

Major respiratory center with basic vital functions: appetite, sex drive, HR, BP, sleep, anterior and posterior pituitary gland regulator, and coordinator of ANS activity and stress response.

Answer 11

Hypothalamus

Question 12

Concerned with motor coordination of voluntary moments, equilibrium, muscle tone, “auto pilot”.

Answer 12

Cerebellum

It does not initiate movement but coordinates and smooths it.

Question 13

Central core of the brain consisting mostly of nerve fibers. Which cranial nerves originate from nuclei in here?

Answer 13

Brainstem. Nerves III through XII.

Question 14

The most anterior part of the brainstem that merges into the thalamus and hypothalamus. Contains many motor neurons and tracts.

Answer 14

Midbrain

Question 15

The enlarged area of the brainstem that containing ascending sensory and descending motor tracts.

Answer 15

Pons

Has two respiratory centers (Pneumotaxic and apneustic) that coordinate with the main respiratory center in the medulla.

Question 16

The continuation of the spinal cord in the brain that contains all ascending and descending fiber tracts. It has vital ANS centers (respiration, heart, GI function) and nuclei for cranial nerves what?

Answer 16

Medulla
Nerves VIII through XII
Pyramidal decussation occurs here

Question 17

Ascending and descending fiber tracts that connect the brain to the spinal nerves. Mediates reflexes of postural control, urination, and pain response. Where does it occupy?

Answer 17

Spinal cord. Occupies upper two thirds of vertebral canal form the medulla to the lumbar vertebrae L1-L2.

Question 18

Visceral and involuntary PNS? Parasympathetic vs sympathetic?

Answer 18

Autonomic.

Para is rest and digest. Sympathetic is fight or flight.

Question 19

Voluntary muscle movement of the PNS?

Answer 19

Somatic

Question 20

Left cerebral cortex receives sensory information from and controls motor function to right side of body and vice versa.

Answer 20

Crossed representation of nerve tracts

Question 21

Contains sensory fibers that transmit sensations of pain and temp (ascend the lateral), and crude or light touch (form anterior)

Answer 21

Spinothalamic tract.
Fibers enter the dorsal root of spinal cord and synapse with a second sensory neuron. At thalamus, fibers synapse with this sensory neuron, carrying message to sensory cortex for full interpretation.

Question 22

These fibers conduct sensations of position, vibration, and finely localized touch.

Answer 22

Posterior/dorsal columns

Question 23

An area of skin that is supplied by a single nerve. Corresponds with spinal cord. Anterior and posterior.

Answer 23

Dermatomes.

Can determine nerve related pathologies. C1 has no dermatome.

Question 24

Basic, involuntary defense mechanism of the nervous system. Help the body maintain balance and appropriate muscle tone. Four types?

Answer 24

Reflexes.

Deep tendon, superficial, visceral, pathologic.

Question 25

Neuro system for infants?

Answer 25

System is not completely developed at birth. Movements primarily directed by primitive reflexes. As myelination develops, motor response develops, reflexes diminish. Persistence of primitive reflexes is an indication of CNS dysfunction.

Question 26

Newborn reflexes?

Answer 26

Tonic neck, stop, grasp, crawl, suckling, plantar, startle

Question 27

What neurological changes occur in the aging adult?

Answer 27

Atrophy with steady loss of neuron structure in the brain and spinal cord. Loss of muscle bulk/tone, decreased muscle strength, impaired fine coordination and agility, dizziness and loss of balance, walk more slowly and deliberately, diminished touch, smell, taste

Question 28

Subjective data for the nervous system?

Answer 28

Headache, head injury, dizziness/vertigo, seizures, rumors, weakness, incoordination, numbness, tingling, difficulty swallowing or speaking, history, environmental/occupational hazards.

Question 29

What to ask about infants during a neuro assessment?

Answer 29

Mother had any health problems during pregnancy, infant premature or full term, birth trauma to the infant

Question 30

When to do a screening vs complete examination? | Neurologic recheck?

Answer 30

Screening for well persons with no significant findings from history. Complete on persons with neurological concerns. Recheck for those with neurologic deficits who require periodic assessments

Question 31

Sequence for complete neurologic examination?

Answer 31

Mental status, cranial nerves, motor system, sensory system, reflexes

Question 32

Involuntary eye movement that can be congenital, idiopathic, or secondary to a preexisting neurologic condition.

Answer 32

Nystagmus. Causes are drugs, alcohol, roller coasters, Down's syndrome, optic nerve disease. Severe is almost always consistent with disease of the cerebellum or brainstem.

Question 33

A sudden loss of strength, a temporary loss of consciousness (a faint) caused by lack of cerebral blood flow, low BP

Answer 33

Syncope

Question 34

A partial or incomplete paralysis. | A loss of motor function caused by a lesion in the neurologic or muscular system or loss of sensory innervation.

Answer 34

Paresis | Paralysis

Question 35

The inability to control the distance, power, and speed of a muscular action. An abnormal sensation like burning or tingling.

Answer 35

Dysmetria | Paresthesia

Question 36

Why are teens more susceptible to concussion?

Answer 36

Thinner cranial bones, larger head-to-bdoy ratio, immature CNS, larger subarachnoid space in which the brain can rattle.

Question 37

What to assess for children?

Answer 37

Seizures, motor or developmental milestones, environmental exposure to lead, reflexes/gait/balance issues, family history

Question 38

What to assess for motor as far as muscles?

Answer 38

Size, strength, one, involuntary movements

Question 39

What to assess for motor as far as cerebellar function?

Answer 39

Balance tests, gait, tandem walking, Romberg's test, shallow knee bend

Question 40

What to assess for motor as fares coordination and skilled movements?

Answer 40

Rapid alternating movements, finger-to-finger test, finger-to-nose test, heel-to-shin test

Question 41

What does a screening neurologic examination consist of?

Answer 41

Mental status, cranial nerves, motor function, sensation, reflexes

Question 42

When is CN I, olfactory, tested?

Answer 42

Those who report loss of smell, head trauma, and those with abnormal mental status and when the presence of an intracranial lesion is suspected

Question 43

Romberg's sign?

Answer 43

Observe balance as patient stands with eyes open, feet together, arms at sides. Ask patient to close eyes. Positive sign is loss of balance that occurs when closing the eyes.

Question 44

Sensory assessment spinothalamic tract? Posterior column tract?

Answer 44

Pain, temp, light touch Vibration, position, tactile discrimination: sterognosis, graphesthesia, extinction and unilateral extinction, point location

Question 45

Testing the stretch or deep tendon reflexes?

Answer 45

Technique, grading, reinforcement, biceps, triceps, brachioradialis, quadriceps, achilles

Question 46

Testing the superficial reflexes?

Answer 46

Abdominal, cremasteric, plantar

Question 47

4-pont reflex response scale?

Answer 47

4: very brisk, hyperactive with clonus (twitching), indicative of disease 3: brisker than average, may indicate disease 2: average, expected finding 1: diminished, low normal, or occurs with reinforcement 0: no response

Question 48

Ability to perceive passive movements of the extremities. Ability to recognize objects by feeling their forms, sizes, and weights. Ability to read a number by having it traced on the skin

Answer 48

Kinesthesia Stereognsis Graphesthesia

Question 49

What's involved in a neurologic recheck?

Answer 49

LOC, motor function, vitals, pupillary response, Glasgow coma scale

Question 50

What do stretch reflex and deep tendon reflexes (DTRs) test for?

Answer 50

Reveals the intactness of the reflex arc at specific spinal levels and the normal override on the reflex of the higher cortical levels

Question 51

Decrease or loss of smell that occurs bilaterally with tobacco smoking, allergic rhinitis, and coke use. Loss of smell in the absence of nasal disease.

Answer 51

Anosmia | Neurogenic anosmia

Question 52

Decreased resistance, hypotonia of muscles that occurs with peripheral weakness. Types of increased resistance that occurs with central weakness.

Answer 52

Flaccidity | Spasticity and rigidity

Question 53

Hypoalgesia Analgesia Hyperalgesia

Answer 53

Decreased pain sensation None Increased

Question 54

Hypoesthesia Anesthesia Hyperesthesia

Answer 54

Decreased touch sensation None Increased

Question 55

Peripheral neuropathy is? As opposed to?

Answer 55

It's worse at the feet and gradually improves as you move up the leg. As opposed to a specific nerve lesion, which has a clear zone of deficit for its dermatome.

Question 56

A good measure of sensory loss if the person cannot make the hand movements needed for what?

Answer 56

Graphesthesia is a good measure Stereognosis Can occur with arthritis

Question 57

Seen when the monosynaptic reflex arc is released from the usually inhibiting influence of higher cortical levels.

Answer 57

Hyperreflexia

Question 58

Occurs with the interruption of sensory afferents or destruction of motor efferents and anterior horn cells

Answer 58

Hyporeflexia