Week 10: Neurological Assessment Flashcards

Question

Nerve 12

Answer 1

hypoglossal

Answer 2

by testing dermatomes

Answer 3

an area or zone of skin

Answer 4

is associated with a single spinal nerve

Answer 5

31 pairs of spinal nerves, but only 30 dermatomes

Answer 6

prevent the transmission of nerve fibres entering the spinal cord

Answer 7

use a cotton swab and the stick to test pain or light sensation, pt closes eyes and tells what sensation they feel test bilaterally

Answer 8

no dermatomes

Answer 9

back of head

Answer 10

Lower head and upper neck

Answer 11

Lower neck and upper shoulders

Answer 12

Upper shoulders and collar bones

Answer 13

Lateral forearm and thumb

Answer 14

upper back, back of arms, index/middle fingers

Answer 15

Lower back, inner arms, ring/little fingers

Answer 16

Upper chest/back, inner arms

Answer 17

upper chest/back

Answer 18

mid chest/back

Answer 19

upper abdomen/mid back

Answer 20

Abdomen and mid back

Answer 21

lower abdomen and mid back

Answer 22

Lower back, hips and groin

Answer 23

lower back, front and inside of thigh

Answer 24

lower back, front of thigh, calf, knee, inner ankle

Answer 25

lower back, front and outside of calf, top and bottom of foot and toes 1-3

Answer 26

lower back, back of thigh, and calf toes 4/5, and outer ankle bone

Answer 27

butt, back of thigh/calf, heel bone, genitals

Answer 28

mid butt, genitals

Answer 29

perianal region/skin

Answer 30

perianal region/skin immediately next to anus

Answer 31

Balance - gait smooth? coordinated arm movement? effortless - sensory ataxia: Romberg test coordination finger to fingr heel to shin RAM Muscles strength symmetry

Answer 32

an instantaneous and involuntary response to stimulus

Answer 33

the stimulus/sensory neuron/interneuron/motor neuron/muscle

Answer 34

percussion hammer

Answer 35

L2, L3, L4

Answer 36

spinal cord S1 and S2

Answer 37

L2, L3, L4

Answer 38

0 absent 1 diminished 2 brisk; normal 3 very brisk 4 clonus or repetitive contraction

Answer 39

peripheral neuropathy nerve compression trauma or lesions medications hormone/electrolyte imbalances nutrient deficiencies disease

Answer 40

When blood flow stops to any part of the brain, ischemia occurs, and brain cells are damaged

Answer 41

Blockage (ischemic) or spontaneous bleeding (hemorrhagic)

Answer 42

Tumor, infection, brain swelling, congenital abnormalities

Answer 43

Blood clot stops the flow of blood to an area of the brain

Answer 44

weakened/diseased blood vessels rupture

Answer 45

paralyzed L side ledt sided neglect spatial perceptual deficits tends to deny or minimize problems rapid performance/short attention span impulsive, safety problems impaired judgement

Answer 46

paralyzed right side impaired speech language slow performance aware of deficits (depression, anxiety) impaired comprehension related to language, math

Answer 47

GCS National institute of health stroke scale canadian neurological scale Toronto bedside swallowing Screen IH adult swallowing screen IH stroke PPO

Answer 48

a sudden onset of uncontrolled electrical activity in one or more areas of the brain

Answer 49

LOC changes emotion changes loss of muscle control sensory changes loss of bladder/bowel respiratory changes staring or rapid blinking

Answer 50

1. where begins in brain 2. level of awareness during a seizure 3. describing the other features of the seizure

Answer 51

onset is one area on one side of the brain

Answer 52

involves both sides of the brain at the onset

Answer 53

not known may be determined later

Answer 54

starts in one side or part of the brain an spreads to both sides

Answer 55

awareness remains intact, even if the person is unable to talk or respond during a seizure

Answer 56

awareness is impaired or affected at any time during the seizure

Answer 57

not always possible to know if a person is aware or not (eg occurs at night, lives alone)

Answer 58

presumed to affects a person's awareness or consciousness

Answer 59

Body movement occurs (twitch, jerk) or automatisms (chewing, lip licking)

Answer 60

changes in sensation, emotions, thinking, or experiences

Answer 61

generalized tonic clonic describes seizures with stiffening (tonic) and jerking (clonic)

Answer 62

primarily absence seizures involve brief changes in awareness, staring, and may present with automatisms

Answer 63

Precedes seizure with signs (headache, confusion, mood/behaviour changes) can occur several days or minutes prior to seizure

Answer 64

sensory warning (vision changes, smells, auditory sensations, fear, panic, nausea, de je vu) prior to seizure an aura is a focal seizure

Answer 65

seizure activity, loss of awareness, repeated movements, convulsions, tachycardia, trouble breathing

Answer 66

rest and recovery (N, muscle weakness, exhaustion, fear, fatigue, decreased LOC)

Answer 67

A state of constant seizure or when seizures recur in rapid succession without return to consciousness between seizures neuro emegency can involve any type of seizure

Answer 68

Causes the brain to use more energy than is supplied - neurone become exhausted and cease to function - permanent brain damage can result

Answer 69

most dangerous as it can cause ventilatory insufficiency, hypoxemia, cardiac arrhythmias, hyperthermia, and systemic acidosis

Answer 70

Client Hx and physical examination seizure history EEG, blood work, CT, MRI, lumbar puncture medications vagal nerve stimulation (thought to interrupt the synchronization of epileptic brain wave activity) surgery counselling special diet

Answer 71

Stress excessive excitement/stimulation excessive fluid intake extremely low BS in DM's Sunlight, heat, humidity flickering lights skipping meals, poor nutrition illness, fever, allergies lack of sleep withdrawal from meds, drugs, alcohol missed medication

Answer 72

padding lining the bed bedside safety check (functioning, O2)

Answer 73

ensure patient is safe ensure airwau stay w pt DO NOT restrain turn on side apply O2 as needed DO NOT insert anything into mouth establish IV and administer medication as ordered] suction PRN assist with ventilation if patient does not breath after seizure call a code BLUE if patient status is warranted

Answer 74

VS LOC, GCS

Answer 75

abnormal RR, rhythm, sounds, apnea airway occlusion HTN, tachycardia, or bradycardia excessive salivation

Answer 76

any precipitating factors bitten tongue, soft tissue damage cyanosis bowel/urinary incontinence diaphoresis weakness, paralysis, ataxia neuro vitals

Answer 77

remove obstructing secretions facilitate ventialtion obtain secretions for diagnosis purposes prevent infection that may result from accumulated secretions

Answer 78

a medical condition characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational or health consequences

Answer 79

neurotransmitters in the CNS are heavily suppressed by alcohol consumption, it inhibits excitatory receptors (glutamate) of the CNS and enhances inhibitory receptors (GABA)

Answer 80

initial relaxation decreased inhibition lack of coordination impaired judgement slurred speech anxiety or agitation hypotension bradycardia bradypnea

Answer 81

Wernicke's encephalopathy Korsakoff's syndrome impaired cognition decreased psychomotor skills impaired abstract thinking and memory sleep disturbances depression/labile mood attention deficit seizures

Answer 82

1. Have you ever felt you ought to Cut down on your drinking 2. Have people Annoyed you by criticizing your drinking 3. Have you ever felt bad or Guilty about your drinking? 4. Have you every had a drink in the morning (Eye opener) to steady your nerves or get rid of a hangover?

Answer 83

tremors anxiety N/V headahce tachycardia diaphoresis irritability confusion insomnia nightmares HTN

Answer 84

Profound confusion agitation aggression fever seizures tactile disturbances auditory and/or visual hallucinations excessive diaphoresis tachycardia, tachypnea tremors HTN

Answer 85

standardized assessment tool used to assess and monitor symptoms caused by alcohol withdrawall

Answer 86

N/V tremor tactile disturbances auditory disturbances paroxysmal sweats visual disturbances anxiety headache agitation orientation/clouding od sensorium

Answer 87

6-12 minor symptoms 12-24 hallucinations (visual, tactile, auditory) 24-48 withdrawal seizures, generalized tonic-clonic seizures 48-72 delirium, hallucinations, agitation, disorientation, diaphoresis

Answer 88

24 hours after last drink though different for everyone, can occur as soon as 2 hrs or 48 hours after

Answer 89

long Hx of use aged >40

Answer 90

heavy prolonged use Hx of seizures or DT age >30 concurrent illness and more medical comorbidities prior detox occur 48-72 hours after last drink

Answer 91

with each episode of alcohol use and alcohol withdrawal (even if mild) the brain becomes more excitable and sensitive to the effects of alcohol withdrawal

Answer 92

clinical manifestations become more severe people become increasingly likely to experience seizures and DT

Answer 93

alcohol is a diuretic N/V poor appetite due to gastritis not drinking adequate water diaphoresis

Answer 94

energy metabolism converting carbs to glucose

Answer 95

a diseases caused thiamine deficiency

Answer 96

affects the CNS and PNS

Answer 97

affects the heart and circulatory system

Answer 98

wernicke's encephalopathy korsakoffs syndrome

Answer 99

acute/sudden syndrome requiring urgent tmt swelling causes damages to nerves and blood vessels in brain ataxia confusion, nystagmus

Answer 100

irreversible significant short term memory impairment inability to learn new things or retain new info some loss of long term memory