Ch 25. Neurological Flashcards
Nervous system 2 parts
Central nervous system (CNS)
Peripheral nervous system (PNS)
Cerebral cortex lobes
Frontal lobe
Parietal lobe
Occipital lobe
Temporal lobe
Ex of Sensory receptors:
Skin Mucous membranes Muscles Tendons Viscera
sensory receptors monitor
Conscious sensations
Internal organ functions
Body positions
Reflexes
4 types of reflexes
deep tendon
superficial
visceral
pathological
Cranial Nerve #
Spinal nerves #
12 pairs of cranial nerves
31 pairs of spinal nerves: 8 cervical, 12 thoracis 5 lumbal, 5 sacral, 1 coccyx
Developmental Considerations: Older Adults
- General atrophy and loss of neurons in brain and spinal cord
- Decrease in weight and volume of brain
- Decreased muscle strength and impaired fine coordination – sensations may be diminished.
- Slowed reaction time
- Dizziness and loss of balance
- Decrease in muscle bulk seen in hand
- Benign tremors (senile tremors)
- Dyskinesias
- Difference in gait
- Loss of ankle jerk
- DTRs less brisk
Subjective Data: Health History
Headache Head injury Dizziness or vertigo Seizures Tremors Weakness Incoordination Numbness or tingling Difficulty swallowing Difficulty speaking Significant past history
Older adults Risk for falls Cognitive function Tremor Vision
Stroke Prevention: common symptoms
Most common symptoms
- Sudden weakness or numbness in face, arms, or legs, especially on one side of the body
- Sudden confusion, trouble speaking or understanding speech
- Sudden changes in vision
- Sudden trouble walking, dizziness, or loss of balance or coordination
- Sudden severe headache with no reason or explanation
Less common symptoms
- Sudden nausea or vomiting
- Brief loss of consciousness, including fainting
Modifiable risk factors for stroke
Cardiovascular disease (CHD, HF, PAD) Hypertension Smoking/second-hand exposure Diabetes Atrial fibrillation Other cardiac conditions Dyslipidemia Asymptomatic carotid stenosis Sickle cell disease Postmenopausal hormone therapy Diet and nutrition Inactivity Obesity (fat distribution) History of TIA
Stroke Prevention
Diet Limit sodium intake Moderate exercise Maintain healthy weight Smoking cessation Limit alcohol intake Manage underlying medical conditions
Objective: Test Cranial Nerve II (optic)
Visual acuity
Visual fields (confrontation, cover one eye they cover the other)
Examine ocular fundus, determine the colour, size, shape of the optic disc
Objective: Test Cranial Nerve III, IV, VI (oculomotor, trochlear, abducens)
Pupils (PERRLA) – Pupis, equal, round, reactive, light and accommodation
Assess extraocular movements (diagnostic positions test)
Are they equal strong in each side against resistance?
Objective: Test Cranial Nerve V (trigeminal)
MOTOR FUNCTION
Assess muscles of mastication with teeth clenched
Try to separate jaw by pushing down on chin
Clenth teeth and palpate the tempral and masseter muscles
SENSORY FUNCTION
Light touch
Corneal Reflex – touch coreal area with bit of cotton and it should automatically close.
Only do this if persons unconscious/make sure no contacts in eye
Distinigish between sharp and dull (on all areas of face) (sensory)
Soft touch: piece of cotton
3 points of touch: ophthalmic, maxillary, mandibular
Objective: Test Cranial Nerve VII (facial)
MOTOR FUNCTION
Mobility and symmetry
Frown, close eyes tightly (against your attempt to open them), lift eyebrows, show teeth, puff cheeks- then press puffed cheeks in… note whether air escapes equally from both sides, smilling
SENSORY FUNCTION
Test Taste (not routinely tested)
Sugar, salt, lemon
