Ch 23 Neurologic System Flashcards
Loss of ability to recognize importance of sensory impressions
Agnosia
Loss of ability to express thoughts in writing
Agraphia
Loss of memory
Amnesia
Loss of pain sensation
Analgesia
Loss of power of expression by speech, writing, or signs or loss of comprehension of spoken or written language
Aphasia
Loss of ability to perform purposeful movements in the absence of sensory or motor damage (inability to use objects correctly
Apraxia
Inability to perform coordinated movements
Ataxia
Bizarre, slow, twisting, writing movement, resembling a snake or worm
Athetosis
Sudden, rapid, jerky purposeless movements involving limbs, trunk, or face
Chorea
Rapid alternating involuntary contraction and relaxation of a muscle in response to sudden stretch
Occurs with hyper-reflexia, hyper contraction of the muscle, more exaggerated response, kicks leg way up in the air
Clonus
State of profound unconsciousness from which person cannot be aroused
Coma
Imperfect articulation of speech due to problems of muscular control resulting from central of peripheral nervous system damage
Dysarthria
Impairment in speech consisting of lack of coordination and inability to arrange words in their proper order
Dysphasia
Disappearance of conditioned response
touch both sides of the body at the same time, can patient tell how many sensations were felt and where it was
Extinction
Rapid continuous twitching of resting muscle without movement of limb
Fasciculation
Loss of muscle tone, limp
Unable to do foot pushes or hand grips
Flaccidity
Ability to read a number by having it drawn on the skin
Graphesthesia
Loss of motor power (paralysis) on one side of the body, usually caused by a stroke, paralysis occurs on the side opposite the lesion
Hemiplegia
Motor neuron in the peripheral nervous system with its nerve fiber extending out to the muscle and only its cell body in the central nervous system
Lower motor neuron
Rapid sudden jerk of a muscle
Myoclonus
Stiffness in cervical neck area
Nuchal rigidity
Back and forth oscillation of the eyes
Nystagmus
Prolonged arching of back, with head and heels bent backward, and meningeal irritation
Opisthotonos
Decreased or loss of motor function due to problem with motor nerve or muscle fibers
NEUROLESIONS
Paralysis
Impairment or loss of motor and/or sensory function in the lower half of the body
Paraplegia
Abnormal sensation: burning, numbness, tingling, prickling, crawling skin sensation
Paresthesia
Ability of the person to discriminate exactly where on the body the skin has been touched
Point localization
Sensory information concerning body movements and position of the body in space
Proprioception
Continuous resistance to stretching by a muscle due to abnormally increased tension, with increased deep tendon reflexes
INCREASE IN MUSCLE TONE
Spasticity
Ability to recognize objects by feeling their forms, sizes, and weights, while eyes are closed
Stereognosis
Repetitive twitching of a muscle group at inappropriate times (wink, grimace)
Tic
Involuntary contraction of opposing muscle groups resulting in rhythmic movement of one or more joints
Tremor
Ability to distinguish the separation of 2 simultaneous pinpricks on the skin
2 point discrimination
Nerve located entirely within the central nervous system
Upper motor neuron
The central nervous system (CNS) is made up of the..
Brain and spinal cord
The peripheral nervous system (PNS) is made up of..
12 cranial nerves
31 spinal nerves and their branches
Carries messages back and forth from CNS
The cerebral cortex is part of the central nervous system: what is the frontal lobe responsible for
Personality
Behavior
Emotions
Talking/thoughts
The cerebral cortex is part of the central nervous system: what is the parietal lobe responsible for
Sensations
The cerebral cortex is part of the central nervous system: what is the occipital lobe responsible for
Visual reception (seeing)
The cerebral cortex is part of the central nervous system: what is the temporal lobe responsible for
Hearing
Taste
Smell
The cerebral cortex is part of the central nervous system: what is the Wernicke’s area for
Language comprehension
The cerebral cortex is part of the central nervous system: what is the Broca’s area for
Motor speech
The hypothalamus is part of the central nervous system, what is it responsible for
Temperature
Sleep cycles
Gland control
Controls HR and B/P
The cerebellum is part of the central nervous system, what is it responsible for
Equilibrium/balance
Muscle tone
Coordination
Movements
The brain stem is part of the central nervous system, what is it responsible for
Respiratory
Heart rate
Blood pressure
The spinal cord is part of the CNS and responsible for
Posture control
Urination
Pain response
Defense mechanism to protect the body
Reflex arc
Pulling your hand off a hot stove is what type of reflex
Deep
Closing your eye when something touches it is what type of reflex
Superficial
PERRLA reflexes are what type of reflex
Visceral
Abnormal reflexes such as stroke or babinski is what type of reflex
Pathologic
What subjective data should you collect with the neurologic system
Headaches Head injuries (Strokes and mini strokes/TIA) Dizziness/vertigo Seizure and ora (feeling) before a seizure Tremors Weakness/paralysis Numbness or tingling Past history Environment/occupational hazards
Partial or incomplete paralysis
Paresis
Aging adults will have issues with..
Mobility or dizziness
What objective data/physical exam should you find
LOC A&O times 3 Hand grips Foot pushes Identify new problems
Corticospinal/pyramidal tract is responsible for
skilled and purposeful movements
Extrapyramidal tract is responsible for
muscle tone and controlling movements made by the pyramidal tract
Test for muscle..
Strength and tone bilaterally
Cerebellar movements are most concerned with balance, what are the ways to test balance
Tandem walking: walking with one foot in front of the other
Romberg test: have them stand with their eyes closed and test for swaying
Shallow knee bend or hop in place
Cerebellar is also concerned with coordination and movements, what are ways to test this
Rapid alternating movements: flipping hands back and forth on lap/knees
Finger to finger: pt touches your finger then their own nose
Finger to nose: pt closes eyes, puts both hands out, then alternates touching their own nose
Heel to shin: pt in supine position, runs their heel along their shin in a straight line
How do you test the intact peripheral nerve fibers along the spinothalamic tract
- Test for pain by poking with a dull and sharp end
- Test temperature with something warm and cold
- Test light touch with a cotton ball
- Test vibration with a tuning fork
- Kinesthesia: move their body parts and see if they can tell where they are pointing
- Tactile discrimination
- Some organs are absent from the brain map so use referred pain which is pt’s liver might hurt but it feels like shoulder pain
How do you test tactile discrimination (things you can feel or sense on the skin)
Stereognosia Graphesthesia 2 point discrimination Extinction Point localization
How do you rate deep tendon reflexes
0, no response, flaccid 1+, diminished 2+, normal 3+, brisker than normal 4+, very brisk/hyperactive
What are the areas of assessment on the Glasgow Coma Scale
(E) Eye opening when you walk in, rate 1-4
(V) Verbal response with normal conversation, rate 1-5
(M) Motor response with following commands, rate 1-6
*Coma is a score of 7 or less
What should you look for in an aging adult
Decreased muscle tone, muscle weakness
Occasional tremors, fine handshakes, and tongue protrusions
Dyskinesia: abnormality/impairment of movements, protrude the jaw, open/close the jaw
Gait slower
Hard to perform rapid alternating movements
Deep tendon reflexes sluggish
For the achilles reflex you hit..
back of the ankle
For the quad reflex you hit..
the front of the knee
For the brachioradialis reflex you hit..
the radius while holding the thumb
For the triceps reflex you hit..
the back of the elbow
For the biceps reflex you hit..
your them on their inner elbow
What are you looking for when you test the oculomotor, trochlear, and abducens nerves
Drooping
Strabismus (deviated gaze)
Nystagmus
What are you looking for when you test the trigeminal nerve
Mastication and sensing light touch on the skin and cornea
What are you looking for when you test the facial nerve
Facial expressions and taste
What are you looking for when you test the spinal accessory nerve
Sternomastoid and trapezius muscle strength
What are you looking for when you test the hypoglossal nerve
A still tongue and clear speech
