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Neurological Assessment Flashcards

1
Q

the brain

A

frontal, parietal, temporal, occipital lobes

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2
Q

What does the frontal lobe control?

A

voluntary, personality, behavior, emotions, intellectual function, speech

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3
Q

What does the parietal lobe control?

A

sensation

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4
Q

What does the temporal lobe control?

A

hearing and smell

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5
Q

What does the occipital lobe control?

A

sight, reading

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6
Q

Other parts of the brain

A

pons, medulla oblongata, cerebellum, spinal cord connects to brain

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7
Q

What does pons control?

A

breathing

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8
Q

What does the medulla oblongata control?

A

breathing, blood pressure, heart rate

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9
Q

What does the cerebellum control?

A

balance and coordination

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10
Q

spinal cord

A

connects to brain, sends messages to other parts of body/body sends back. four sections - 8 cervical, 12 thoracic, 5 lumbar, 1 sacral

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11
Q

cranial nerves

A

labeled 1-12, from brain or brainstem

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12
Q

Cranial nerve I

A

olfactory - sensory, test by smelling

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13
Q

Cranial nerve II

A

optic - sensory. vision - test snellen, near vision, confrontation, red reflex

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14
Q

Cranial nerve III

A

oculomotor - motor. eye movements, pupils, eyelids - test extraocular movement, pupillary reaction to light

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15
Q

Cranial nerve IV

A

trochlear - motor. inferomedial eye movement - test extraocular movement, pupillary reaction to light

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16
Q

Cranial nerve V

A

trigeminal - both. pain, touch, temp of face, biting/chewing - test touch face, clench teeth

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17
Q

Cranial nerve VI

A

abducens - motor. lateral eye movement. test extraocular movement, pupillary reaction to light

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18
Q

Cranial nerve VIII

A

vestibulocochlear - sensory. hearing, balance. test whisper test (weber, rinne)

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19
Q

Cranial nerve VII

A

facial - taste in front, facial expressions

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20
Q

Cranial nerve IX

A

glossopharyngeal - both. taste in back, gag reflex, swallowing. uvula rises midline, gag reflex, swallowing

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21
Q

Cranial nerve X

A

vagus - both. lot of things, swallowing, speaking. test swallowing, speaking

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22
Q

Cranial nerve XI

A

spinal accessory - motor. shrug shoulders, turn head

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23
Q

Cranial nerve XII

A

hypoglossal - motor. tongue movement/strength

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24
Q

If a patient cannot swallow correctly, which nerve is affected?

A

vagus

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25
spinal nerves
31, innervate dermatomes, attached to spinal cord by 2 nerve roots
26
Autonomic nervous system
sympathetic, parasympathetic
27
Sympathetic nervous system
fight or flight, activated during stress - decreased gastric secretions, bronchial dilation, increased pulse, pupil dilation. can't stay forever
28
Parasympathetic nervous system
nervous system restores/maintains body functions, decreases heart rate, slows things down after sympathetic
28
A patient recalls a time when they were running to grab the last PS5 in the store, and got it before 3 others could get it off the shelf. Which response during this phase would be a normal bodily response? a. heart rate of 112 bpm b. respirations at 12 c. hyperactive bowel sounds d. slow response in dodging customers and the competition
a
29
What type of conditions are pertinent to a neurological assessment?
CVAs, seizures, headaches, dizzy, paresthesia, loss of senses, speaking deficits, dysphasia, loss of muscle control
30
A patient is discussing her neurological health history with the nurse. Which statement(s) below indicate a type of neuro history? (select all that apply) a. I have been diagnosed with gingivitis and need to brush with a soft toothbrush because my gums are so sensitive now b. I passed out last year because my blood pressure was very low c. After my car accident, my left fingers are in a constant state of numbness d. I had a stroke 6 years ago e. I was so dizzy two years ago when I had a massive ear infection
c, d, e
31
Preparing the client
provide privacy/explain the procedure, check mental status, cranial nerves, motor/cerebellar systems, sensory systems, reflexes. geriatric patients may need breaks
32
General routine screening
loc, behavior/affect, hygiene, facial expressions, speech, mood/expressions, cranial nerve II, posture/gait/balance/involuntary movements, light touch/pain
33
Focused specialty assessment
thought processes/perceptions, orientation/concentration/memory/reasoning, all cranial nerves, Romberg, coordination, rapid alternating movements, light touch/pain/temp, vibratory sensations/position/point localization, reflexes, meningeal irritation
34
Motor and cerebellar systems with older adults
older adults may have reduced muscle mass, careful w/ old people, may have slow/uncertain gait - could be neurological, muscle/skeletal/aging process
35
Motor and cerebellar systems
note unusual involuntary movements, evaluate gait/balance - tandem walking, Romberg test
36
Romberg test
stand erect w/ arms at sides/feet together, note swaying, eyes closed 20 sec
37
Which of the following would be an indication of a positive Romberg test? a. patient able to touch their toes with little difficulty b. patient sways after standing for 20 minutes and eyes closed c. patient backs up after closing their eyes to catch their balance d. patient complains of leg pain after closing their eyes
c
38
Neuro assessment
assess coordination - finger to nose test, assess rapid alternating movements, shin to heel test, posture unconscious
39
Assess rapid alternating movements
sit down - finger to thumb/increase speed. palms down/up
40
Shin to heel test
supine, slide heel down opposite shin/other side
41
Unconscious posture
primitive posture due to loss of motor control - decorticate (flexed, adducted), decerebrate (extended arms, back hyperextended, teeth clenched)
42
More sensory testing
vibratory sensation testing, sensitivity to position, tactile discrimination, point localization, graphesthesia
43
Vibratory sensation
tuning fork, base on distal radius, tip of forefinger, big toe, medial malleolus. normal = correct identification of sensation
44
Sensitivity to position
hold finger or toes laterally and move up or down. ask pt to tell you which way you moved.
45
Tactile discrimination (stereognosis)
familiar object in hand, id w/o looking
46
Point localization test
can pt tell you where you lightly touched them (eyes closed)
47
Graphesthesia testing
use blunt object to write number or letter in palm. can id?
48
Two point discrimination
on fingertips, forearm, dorsal hands, back, or thighs. ask client to id number of points felt when touched w/ calipers, measure distance between when can no longer distinguish as separate
49
Testing extinction
simultaneously touch same area on both sides of the body. if CVA might just feel good side
50
What would be an abnormal finding when testing extinction? a. patient can identify both spots touched correctly b. patient cannot identify the areas simultaneously touched c. pain at the site touched d. increased heart rate and breathing after the test
b
51
Areas to test reflexes
deep tendon, biceps, brachioradialis, triceps, patellar, achilles, ankle clonus, superficial, plantar, abdominal, cremasteric (males)
52
Reflex grades
4 - hyperactive, very brisk rhythmic oscillations, abnormal and indicative of disorder. 3 - more active than normal but not indicative of disorder. 2 - normal, usual response. 1 - decreased, less active than normal. 0 - no response
53
Reflexes in older adults
may be difficult/absent - difficulty relaxing, no achilles reflex/flexion of the toes
54
Tests for meningeal irritation or inflammation
brudzinski sign, kernig sign
55
Brudzinski sign
flex neck and watch hips/knees - normal remain relaxed, abnormal = pain/flexion of hips and knees (meningeal inflammation)
56
Kernig sign
flex leg at hip and knee then straighten knee - normal no pain but may have discomfort behind knee during full extension. abnormal = pain/increased resistance when extending knee (meningeal irritation)
57
Abnormal muscle movements
eye tics, chorea choreiform movements, tremors, cerebellar ataxia, scissors gait, static hemiparesis, foot drop, parkinsonian
58
Eye tics
brief repetitive stereotyped coordinated movements occurring at irregular intervals. meds or Tourettes - ex: repetitive winking, grimacing, shoulder shrugging
59
Chorea choreiform movements
brief rapid jerky irregular unpredictable movements. seldom repeat, can involve the face head lower arms, and hands
60
tremors
resting, postural, intention
61
Resting (static) temors
at rest, decrease/disappear w/ voluntary movement
62
Postural tremor
appear when affected part is actively maintaining a posture nm
63
Intention tremor
absent at rest, appear with activity and often get worse as target is neared
64
Cerebellar ataxia
wide based, staggering, unsteady gait. positive romberg
65
Scissors gait
stiff, short gait, thighs overlap with each step
66
Spastic hemiparesis
flexed arm held close to body while client drags toe of leg or circles it stiffly outward/forward
67
Footdrop
client lifts foot and knee high w/ each step then slaps foot down hard on ground. can't walk on heels
68
Parkinsonian gait
shuffling gait, turns very stiff. stooped posture w/ flexed hips/knees

Health Assessment (32 decks)

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