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Health Assessment final > Neurological > Flashcards

Neurological Flashcards

(101 cards)

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1
Q

What does the CNS consist of?

A

Brain and spinal cord

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2
Q

What does the PNS consist of?

A

12 pairs of cranial nerves
31 pairs of spinal nerves
ANS (parasympathetic and sympathetic)

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3
Q

What is the sympathetic nervous system responsible for?

A

Fight or flight

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4
Q

What is the parasympathetic nervous system responsible for?

A 
Rest and digest
Salivation
Lacrimation
Urination
Defecation
Digestion
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5
Q

What are the layers of the spinal cord?

A 
Epidural space
Dura mater
Subdural space 
Arachnoid mater
Subarachnoid mater
Pia mater
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6
Q

What is dura mater?

A

Protective covering for brain tissue

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7
Q

What makes up brain matter?

A

Gray and white matter

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8
Q

Do we have more gray or white matter?

A

Gray (demyelinated)

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9
Q

What does arachnoid mater do?

A

Like a spiderweb, holds white mater in place

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10
Q

What is pia mater?

A

Mater full of nerves and blood supply to brain

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11
Q

Where is CSF found?

A

Subarachnoid space

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12
Q

What does CSF do?

A

Provides cushion
Removes metabolic waste
Provides nutrition
Maintains normal ICP

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13
Q

What factors increase ICP?

A 
BP sometimes
Hypotonic solutions
Lots of Na
Lying down flat
Rectal temps/suppositories (usually)
Constipation/anything that increases strain (coughing)
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14
Q

What are the parts of the brain?

A

Cerebrum (cerebral cortex)
Cerebellum
Brainstem
Diencephalon

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15
Q

What makes up the diencephalon?

A

Hypo and thalamus

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16
Q

What vessels supply the brain?

A

2 internal carotid arteries

2 vertebral arteries

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17
Q

What is the largest part of the brain?

A

Cerebrum

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18
Q

Into what 4 parts is the cerebrum divided?

A

Frontal
Parietal
Temporal
Occipital

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19
Q

What is the frontal lobe responsible for?

A 
Personality
Speech
Memory
Behavior
Emotion
Intellectual function
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20
Q

What is the parietal lobe responsible for?

A

Sensation

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21
Q

What is the temporal lobe responsible for?

A

Hearing
Taste
Smell

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22
Q

What is the occipital lobe responsible for?

A

Visual reception

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23
Q

What is the hypothalamus responsible for?

A 
Homeostasis
Body temp
Hunger
Thirst
Storage and secretion of hormones
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24
Q

What is the thalamus responsible for?

A

Relays info to parts of cerebral cortex

Regulates states of sleep and wakefulness

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25
What can damage of the thalamus lead to?
Coma state
26
What two systems does the hypothalamus connect and how?
Hypothalamus connects the CNS with the endocrine system through the pituitary gland
27
Where is the diencephalon located?
On top of the brainstem
28
What does the brainstem consist of?
Midbrain Pons Medulla oblongata
29
What is the midbrain responsible for?
Processing visual and auditory info Initiating involuntary motor responses Maintaining consciousness.
30
What is the pons responsible for?
[physically] Connecting cerebellum to brainstem | Motor control
31
What is the medulla responsible for?
[physically] Connects brain and spinal cord Involuntary functions Primitive life maintenance Heart function Breathing Sneezing Coughing Vomiting
32
What happens if the brainstem herniates?
One is clinically dead by law
33
What is the cerebellum responsible for?
Coordination of voluntary movement Equilibrium/balance Muscle tone Proprioception
34
What does a cerebellar injury lead to?
Uncoordinated movement
35
What is ataxia?
Uncoordinated movement
36
What is the spinal cord?
Continuation of the medulla | "Central highway" for sensory and motor impulses
37
Where does the spinal cord begin?
The base of the skull (foramen magnum)
38
What is the cauda equina?
Where L1 and L2 branch into lumbar and sacral nerve roots
39
What are the pairs of spinal nerves?
``` 8 cervical 12 thoracic 5 lumbar 1 coccygeal 5 sacral ```
40
What do motor (efferent) roots do?
Carry impulses from brain to the spinal cord to the muscles & glands
41
What do sensory (afferent)
Carry impulses from sensory receptors of the body through the spinal cord to the brain
42
What is a dermatome?
Band of skin innervated by the sensory nerve root of a single spinal segment
43
When testing sensation, what area should be tested first?
Distal point
44
What is hypoesthesia?
Decreased sensation
45
What is hyperesthesia?
Excessive sensation
46
What is anesthesia?
Loss of sensation
47
What is paresthesia?
Numbness, tingling, burning
48
What is the reflex arc?
Tapping the tendon of a partially stretched muscle, activating sensory fibers within the muscle
49
What abnormal sensation can be present in diabetes?
Paresthesia, which turns into hypoesthesia
50
When is hyperesthesia seen?
Shingles - touching hand and feeling like there's something there CNS defect
51
How does a reflex arc work?
Impulses travel to the spinal cord via peripheral nerves where they cross the NMJ and the muscle contracts
52
When is hypoesthesia seen?
Old age - reflexes decrease
53
What is CN I?
Olfactory Sensory Smelling odors with eyes closed
54
What is CN II?
Optic Sensory Snellen/confrontation
55
What is CN III?
``` Oculomotor Motor H test Levetator palpebral muscle Pupil constriction - direct and indirect (consensual) ```
56
What is CN IV?
Trochlear Motor H test
57
What is CN V?
``` Trigeminal Sensory Regions of face sensation on both sides: temporal, maxillary, mandibular feeling Corneal reflex Motor Movement of jaw ```
58
What is CN VI?
Abducens Motor H test
59
What is CN VII?
``` Facial Sensory Anterior ⅔ of tongue taste Motor Smile, frown, puff cheeks, move eyebrows ```
60
What is CN VIII?
Vestibulocochlear Sensory Hearing Whisper, weber (lateralization), rinne
61
What is CN IX?
``` Glossopharyngeal Sensory Posterior ⅓ of tongue taste Motor Gag reflex/AHHHH ```
62
What is CN X?
``` Vagus Sensory Relay information to organs/glands of body (did not study) Motor Gag reflex/AHHHH ```
63
What is CN XI?
Accessory Motor Shrugging shoulders, turning of head
64
What is CN XII?
Hypoglossal Motor Tongue movement - up, down, side to side
65
How do you check cerebral function?
``` Brief (mini) Mental Status LOC Remote memory (LTN) Recent memory Orientation (person, place, time, situation - A&Ox4) Mood Thought content Test balance & coordination Point to Point - Upper Extremities - Lower Extremities. Alternating Movements: - Upper Extremities - Lower Extremities. Gait Tandem Gait Romberg ```
66
How do you test proprioception?
Touch eye and touch nurse's finger, then close eyes and continue to test
67
What is the alternating movement test?
Take body part and flip back and forth
68
What is tandem gait walking?
Walking heel to toe
69
What is the Romberg test?
Pt must be standing Should be able to stand feet together hands to sides with eyes closed for 20-30 seconds Cerebellar lesion will force someone to step out when they close their eyes + Romberg - sign of cerebellar dysfunction
70
How is sensory interpreted?
By the cerebral cortex
71
How do you assess sensory?
``` Upper and lower extremities Sharp and soft objects Distal parts first Tuning fork on joint Position sense Two point discrimination Stereognosis Extinction Point location ```
72
How does paresthesia affect sensory assessment?
May prevent pt from feeling the touch
73
How do you test position sense?
Have pts put hands in correct anatomical position Move their finger up, down, left, right to demonstrate Have pt close eyes and ask in what direction you’re moving their finger
74
How do you test two point discrimination?
Only do pads of fingers and thighs Tell pt you’ll touch area with object Say you’re touching at two points Have pt close eyes and ask them to say when they don't feel 2 points anymore Body cannot discriminate between feeling 1 point and 2 points once the points are close enough together You can usually feel 2 points for up to 5 mm
75
How do you test stereognosis?
Ask pt to identify familiar object in hard with eyes closed
76
How do you test graphesthesia?
Drawing numbers on the pt’s hand with their eyes closed
77
How do you test extinction?
Touch either one or both sides have pt close eyes and say if you touched one or both sides
78
How do you test point location?
Close pt’s eyes and touch a point in their body. Have pt open eyes and touch where you touched
79
What is spasticity?
Muscle in constant contraction Stiff Harder to do passive ROM
80
What is rigidity?
Increased muscle tone leads to rigidity | Harder to do passive ROM
81
What is flaccidity?
Decreased muscle tone | Easier to do passive ROM
82
What is a resting tremor?
Tremor at rest
83
What is an intention tremor?
Tremor during movement/use of muscle
84
What is a fasciculation?
Spasm of muscle during tired; pulsating Not related to a disorder Overuse/tired muscle
85
What is a seizure?
Abnormal electrical conduction of the brain
86
When do seizures occur?
``` Epilepsy High fever Hitting head Swelling of brain Too much alcohol Amphetamines Any brain injury can increase risk (Turn pt on side) ```
87
What is a tic?
Brain imbalance Can be verbal/motor Ex: tourette’s
88
How do you test muscle strength?
ROM against resistance
89
How do you elicit a DTR?
Briskly tap the tendon of a partially stretched muscle
90
What spinal cord segment is related to the triceps?
Cervical 6, 7
91
What spinal cord segment is related to the patellar?
Lumbar 2, 3, 4
92
What spinal cord segment is related to the achilles?
Sacral 1
93
What spinal cord segment is related to the biceps?
Cervical 5, 6
94
What spinal cord segment is related to the brachioradialis?
Cervical 5, 6
95
What movement occurs in bicep DTR?
Elbow flexion
96
What movement occurs in tricep DTR?
Elbow extension
97
What movement occurs in patellar DTR?
Extension of leg (usually runs +3)
98
What movement occurs in achilles DTR?
Plantar flexion
99
What movement occurs in superficial plantar DTR?
Flexion of toes
100
How do you look for superficial plantar DTR?
Start on outer portion of foot and scrape up and across toes
101
What does it mean when the big toe dorsiflexes and other toes fan out?
It’s positive Babinski sign | Normal in babies, not normal in adults

Health Assessment final (6 decks)

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