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ACVN - SURGICAL NURSING > Advanced Nursing of Spinal Patient 1 > Flashcards

Advanced Nursing of Spinal Patient 1 Flashcards

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1
Q

Why do we do a neurlogical exam?

A
  • clinical signs can be spectacular, distressing and confusing
  • breaks down complex presentations downs into manageable steps
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2
Q

What are the aims for a neurological exam?

A
  • whether it is neurological
  • where it is localised
  • what is causing it
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3
Q

Where can neurlogical problems be localised?

A

brain, spinal cord, peripheralnerves, neuromuscular

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4
Q

What is the brain broken down into?

A

forebrain, cerebellum and brain stem

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5
Q

What is within the spinal cord?

A

c1-c5, c6-t2, t3-l3, l4-s2/3

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6
Q

What is the five finger rule?

A

signalment
onset
progression
symmetry
pain

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7
Q

What are you asking yourself when observaing mentation of a neurological patient?

A

are they alert?
are they obtunded?
are they stuporous?
are they comatosed?
are they reacting to their environment?
are they just old and relaxing or young and investigating?

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8
Q

What are you looking at when observing their gait and posutre?

A

head tilt or flexion of the spine

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9
Q

What is important to take into account when doing a neurological exam?

A

signalment, what is normal for the patient and what isn’t, breed predispositions

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10
Q

What are you looking for when observing postural reactions?

A

proprioception
can the patient place their feet appropriately when moved around the room
can they feel

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11
Q

What cranial nerve reflexes can you perform?

A

menace
pupillary light reflex
gag reflex
palpebral reflex

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12
Q

What are you looking at when doing a sensory evaluation?

A

panniculus and deep pain perception

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13
Q

What is one of the most common neurlogical presentations?

A

gait abnormalities

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14
Q

What is a head tilt?

A

one ear is below the other

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15
Q

What is a head turn?

A

nose is turned towards the body

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16
Q

What is ventrofelxion of the neck?

A

a low head carriage

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17
Q

What are the 3 types of cruvature of the spine?

A

scoliosis
lordosis
kyphotic

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18
Q

What is decerebrate rigidity?

A

extension of all limbs, head and neck

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19
Q

What is decerebellate rigidity?

A

extension of the thoracic limbs, head and neck

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20
Q

What is lordosis?

A

arching upward of the spine

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21
Q

What is scoliosis?

A

curving of the spine

22
Q

What is kyphotic?

A

arching downward ofthe spine

23
Q

What are postural reactions?

A

proprioceptive positioning
hopping
visual placing
tactile placing
hemi-walking
wheelbarrowing

24
Q

What is visual placing?

A

when picking patient up and moving them towards a table would expect them to place their paws down on the table as they can see where this is

25
Q

What is tactile placing?

A

similar to visual placing but patients eyes are covered, when front of paws touch the table expecting them to place their paws down

26
Q

What is hemi-walking?

A

lifting thoracic and pelvic limbs on one side either left or right and getting patient to walk one way then the other

27
Q

What is wheelbarrowing?

A

lifting up both legs and getting them to walk forward or backward

28
Q

Where are upper motor neurons located?

A

between the cerebral cortdex and spinal cord

29
Q

What do lower motor neurons do?

A

connect to the CNS to the effector organand send a signal to make them connect

30
Q

What would happen if the lower motor neurons were effected?

A

any existing reflexes that the patient still has will be weaker or absent, msucle tone reduced, decreased muscle mass and severe muscle atrophy

31
Q

What does flaccid paresis or paralysis mean?

A

limbs are completely flaccids, no muscle tones, reduced reflexes

32
Q

What would happen if upper motor neurons were effected?

A

reflexes will be stronger than normal,more exaggerated and easier to elict, some normally inhibited reflexes may become apparent, increase in muscle tone, chronic muscle atrophy

33
Q

What does chronic muscle atrophy mean?

A

muscle atrophy that occurs over a longer period

34
Q

What is a panniculus reflex?

A

testing skin reaction when pinched, going along the back as well

35
Q

What are the spinal reflexes of the thoracic limbs?

A
  • withdrawal reflex
  • extensor carpi radialis reflex
  • biceps brachii and triceps reflex
36
Q

What are the pelvic limb reflexes?

A
  • patella reflex
  • cranial tibial and gastrocnemius
37
Q

What other spinal reflexes are there that don’t affect the limbs?

A
  • perineal
  • panniculus
38
Q

What is the cutaneous trunci reflex?

A

panniculus relfex, testing segmental nerves, spinal cord up to T1 and the lateral thoracic nerve

39
Q

What is the cutaneous trunci reflex for?

A

localisation of a spinal lesion

40
Q

What is deep pain?

A

when a aptient can feela noxious stimuli on their toes

41
Q

What is deep pain negative?

A

patient cannot feel any pain at all within their toes (no reaction or withdrawal reflex with no additional reaction)

42
Q

What are we looking for when performing a pain assessment?

A

reaction from the patient e.g turning, vocalising and trying to bite

43
Q

What is occulcephalic reflex?

A

when you move the patients head and they track the correct way

44
Q

What is miosis/miotic?

A

constricted pupils

45
Q

What is mydriasis/mydratic?

A

dilated pupils

46
Q

What is anasocoria?

A

asymmetric pupils

47
Q

What does it mean if a patients pupil goes from miotic to mydriatic?

A

they are neurologically deteriorating

48
Q

What does a mid-size fixed pupil that is unresponsive to light indicate?

A

grave prognsosis

49
Q

What is paraparetic?

A

weak with some movement

50
Q

What is non-ambulatory paraparesis?

A

cannot use their legs much but has good movement when supported

ACVN - SURGICAL NURSING (17 decks)

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