T3 - Assessment of Nervous System (Josh) Flashcards
1
Q
How many layers are in the scalp?
A
3
middle layer is where blood vessels are
2
Q
What volume can the avg skull hold?
A
1400-1500 mL
3
Q
Fossae:
Which lobes are within the Anterior Fossae?
A
Frontal
4
Q
Fossae:
Which lobes are within the Middle Fossae?
A
Temporal
Parietal
Occipital
5
Q
Fossae:
Which areas of brain are found in Posterior Fossae?
A
Brainstem
Cerebellum
6
Q
What are the 3 major divisions of the brain?
A
Cerebrum
Brainstem
Cerebellum
7
Q
What are the lobes of the Brain?
A
Frontal Parietal Temporal Occipitol Limbic
8
Q
Where is the respiratory center located?
A
Brainstem
- Midbrain
- Pons
- Medulla
9
Q
Which area of the brain takes over learned, repetitive tasks like riding a bicycle?
A
Cerebellum
- provides smooth, coordinated body mvmt
10
Q
Which lobe?
- Voluntary eye mvmt
- Access to sensory data
- Affective response to judgement
- Regulated behavior based upon judgment
- Judgment
- Long-term goals
- Reasoning, concentration, abstraction
A
Frontal Lobe
11
Q
Where is the Motor Strip for the opposite side of body located?
A
Frontal lobe
12
Q
Where is Broca’s Area?
A
Frontal lobe
- inferior frontal gyrus
- responsible for MOTOR aspects of speech
13
Q
What will damage to Broca’s Area cause?
What will damage to auditory center in Temporal lobe cause?
A
Expressive Aphasia
Receptive Aphasia
14
Q
Which lobe receives data from skin: pain, heat, cold, pressure?
A
Parietal
15
Q
Which lobe processes sensory of spacial awarenes and is used in hand-eye coordination?
A
Parietal
16
Q
Which lobe contains the sensory strip for the opposite side of the body?
A
Parietal
17
Q
Where is the Auditory center located?
A
Temporal Lobe
18
Q
Which lobe has the special senses of taste and smell?
A
Temporal Lobe
19
Q
Which lobe?
- Memory
- Understanding Music
- Aggressiveness
- Sexual Behavior
A
Temporal Lobe
20
Q
Which lobe is most likely the site of seizure activity?
A
Temporal Lobe
21
Q
Which lobe regulates emotion and memory?
A
Limbic
- involved in formation of long-term memories
- closely associated with olfactory structures
22
Q
What is the Diencephalon?
A
posterior part of forebrain that connects the midbrain with the cerebral hemispheres
***encloses the third venticle
23
Q
What is housed inthe Diencephalon?
A
Thalamus Hypothalamus Epithalamus Pineal Gland Pituitary Gland
24
Q
What is referred to as the ‘gateway’ to cerebral cortex and serves as a relay station from sensory inputs to higher levels of brain?
A
Thalamus
25
Which area of brain has controls for the following:
- Temp
- Food and Water intake
- Behavior
- Autonomic Responses
- Hormonal Secretion of Pituitary Gland
- Visible Physical Expressions (Limbic System)
Hypothalamus
26
How many ventricles and what do they contain?
4 total: 2 lateral, 1 central, 1 at bottom of brain
contain CSF
27
If the longitudinal fissure is not midline, we should suspect what?
increased pressure in one hemisphere shifting it the other way
28
If the Lateral or Central Fissures look smooth, we should suspect what?
increased pressure
- they should be wrinkled
29
What are the 12 Cranial Nerves?
```
I: Olfactory
II: Optic
III: Occulomotor
IV: Trochlear
V: Trigeminal
VI: Abducens
VII: Facial
VIII: Vestibulocochlear
IX: Glossopharyngeal
X: Vagus
XI: Accessory
XII: Hypoglossal
```
30
In the neuro status exam, what is the order of severity?
```
Alert
Confused
Delirious
Lethargic
Obtunded
Stuporous
Comatose
```
31
If pupils have an irregular shape, such as oval-shaped, what should we suspect?
increased pressure on that cranial nerve
32
What is the Best Score for GCS?
What is worst score?
15
3 (even if braindead)
33
What is the order for GCS?
E4 - Eye Opening
V5 - Verbal Response
M6 - Motor Response
34
GCS:
What is the scores for Eye Movment?
Spontaneous eye opening = 4
Eye open to speech = 3
Eye open to pain (stimulus) = 2
No eye opening = 1
35
GCS:
What are the scores for Verbal Response?
Oriented = 5
Confused over conversation = 4
Inappropriate conversation = 3
Incomprehensible speech = 2
No speech = 1
36
GCS:
What are the scores for Motor Response?
Obeys commands = 6
Localizes response to pain = 5
Generalized withdrawal to pain = 4
Flexor posturing to pain = 3
Extensor posturing to pain = 2
No response to pain = 1
37
GCS:
What is localization?
attempt to remove or stop the painful stimuli
38
GCS:
What is withdrawal?
attempt to avoid the painful stimuli
39
Patient teaching for Cerebral Angiogram?
NPO 4-6 hrs
Assess for shellfish or iodine allergy
Assess BUN and kidney function due to dye
No jewelry
Mild sedative used
Closely monitor puncture site post-procedure
40
Patient teaching for CT Scan?
NPO 4 hrs
Shellfish or iodine allergy
BUN, Crit, and kidney function
No jewelry
Small pillow for back since in supine position
painless (no follow-up care needed, though sedation available of anxious)
41
Patient teaching for EKG?
Takes about an hour
Hold anticonvulsants
Wash hair prior to procedure
Be SLEEP DEPRIVED
May be exposed to bright flashing lights or asked to hyperventilate for 3-4 mins
Normal activities can be resumed post-procedure
42
Which clients are candidates for ICP Monitoring?
comatose of GCS of 8
43
What is normal ICP?
10-15 mmHg
44
Nursing care for ICP Monitoring?
Inspect insertion site q day
Neuro checks q hr
Keep drainage system closed
Irrigate only as needed
Limit to 3-5 days max
45
Nursing care for MRI Scan?
NPO 4-8 hrs
Pillows in small of back
No follow-up care needed, unless sedation was used for claustrophobia or contrast media was used
46
---- uses a glucose based tracer so we must monitor for hyper-hypoglcemia and assess history of DM.
PET Scan
***painless and sedation rarely necessary
47
How many spinal nerves?
31
- 7 Cervical
- 12 Thoracic
- 5 Lumbar
- 5 Sacral
- 1 Coccyx
48
Which part of Spinal Cord is myelinated and contains the ascending and descending tracts?
White Matter
49
Which part of Spinal Cord is unmyelinated and contains Anterior, Lateral, and Posterior Horns?
Grey Matter
- central part of SC
50
The Dorsal Root is on the --- side of body and is an --- pathway.
Posterior
Afferent (enters the cord = adds)
51
The Ventral Root is on the --- side of body and is an --- pathway.
Anterior
Efferent (exits)
52
--- --- conveys sensory input from specific areas of body (dermatomes) into the spinal cord and up to brain.
Dorsal Root
53
--- --- conveys impulses from spinal cord to different parts of body.
Ventral Root
54
Which tract?
Carries sensory info to the brain.
Ascending tract
55
Which tract?
Carries impulses from brain.
Descending tract
56
What are the Three Major Ascending Tracts?
Spinothalamic
Spinocerebellar
Posterior Column Tract
57
Which Ascending Tracts convey impulses from OPPOSITE side?
Which ones from SAME side?
Opposite:
- Spinothalmic
- Posterior Column Tract
Same:
- Spinocerebellar
58
Ascending Tracts:
Which tract carries sensations for CRUDE TOUCH and PRESSURE from opposite side of body?
Anterior Spinothalamic
59
Ascending Tracts:
Which tract carries sensations for PAIN and TEMP from opposite side of body?
Lateral Spinothalamic
60
Ascending Tracts:
Which tract carries info for PROPRIOCEPTION?
Spinocerebellar
61
Ascending Tracts:
Which tract carries info for PROPRIOCEPTION, as well as FINE TOUCH, PRESSURE, and VIBRATION for opposite side of body?
Posterior Column Tract
62
Descending Tracts:
Where does the Corticospinal Tract originate?
motor cortex of FRONTAL LOBE and portions of PARIETAL LOBE
63
Which tract has conscious control of skeletal muscle?
Corticospinal Tract
***a descending tract
64
Which tract doesn't need to ascend up spinal cord to illicit a response?
Reflex Arc
65
Which neurons are located entirely in CNS and facilitate/inhibit descending supraspinal pathways?
UMN (Upper Motor Neurons)
66
Which neurons are located in CNS and PNS and serve as a linkage b/t CNS and voluntary muscles?
LMN (Lower Motor Neurons)
67
Which Motor Neuron syndrome has SPASTIC paralysis?
Which Motor Neuron syndrome has FLACCID paralysis?
UMN Syndrome
LMN Syndrome
68
S/S of UMN Syndrome:
Weakness, paralysis
Spasticity
Increased tendon reflexes
Positive Babinski
Loss of Abdominal reflexes
Little of no muscle astrophy
69
S/S of LMN Syndrome:
Motor weakness
Wasting and Fasciculations of muscles
Hypotonia (flaccid paralysis)
Loss of tendon reflexes
70
Where would a Lumbar Puncture be done?
L4-L5
71
What is the Glucose value of CSF?
50-75 mg/dL
***two-thirds of blood sugar value
72
What is volume of CSF:
135-150 mL
73
An injury in the --- Fossae is very serious.
Posterior
**where brainstem and cerebellum is
74
Where are CSF and Cerebral arteries located?
Subarachnoid Space
75
Which lobe may have auditory, visual, and sensory hallucinations?
Temporal
76
The --- --- is responsible for blushing, dry mouth, clammy hands and other visible expressions of anxiety.
Limbic System
77
Client with traumatic brain injury with a temp of 104 F and no signs of infection likely has an injury where?
Limbic System
78
Dermatomes:
--- is the nipple line.
T4
79
What is the most common cause of changes in an older adult's mental status?
insufficient O2
