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RN Summer 2021 Test 1 > Ch. 35 Neurological Fxn > Flashcards

Ch. 35 Neurological Fxn Flashcards

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1
Q

What does the Central Nervous system consist of?

A

Brain and spinal cord

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2
Q

What does the Peripheral Nervous system consist of?

A

12 pairs of cranial nerves that originate in the brain and 31 pairs of spinal nerves that originate to the spinal cord
and the Autonomic nervous system

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3
Q

Autonomic nervous system divided into?

A

Sympathetic and parasympathetic systems

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4
Q

Sympathetic

A

Flight or fight

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5
Q

Parasympathetic

A

Rest and digest

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6
Q

What are neurons?

A

Impulse conducting cells that facilitate communication within the nervous system

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7
Q

what are the 3 parts of the brain?

A

Cerebrum
Cerebellum
Brainstem

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8
Q

What are neurotransmitters?

A

Chemical messengers that transmit impulses from one cell to another

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9
Q

What protects the brain and spinal cord?

A

Brain = skull

Spinal Cord = vertebral column

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10
Q

4 lobes of the cerebrum?

A

Frontal
Parietal
Temporal
Occipital

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11
Q

Frontal Lobe fxn

A

Motor movement and personality

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12
Q

Parietal Lobe fxn

A

Control sensation and perception

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13
Q

Temporal Lobe fxn

A

Control sound recognition and language

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14
Q

Occipital Lobe fxn

A

Vision

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15
Q

Cerebrum: thalamus

A

relay center for sensory impulses to the cerebral cortex

includes: pain, temp, taste, smell, hearing, equilibrium, vision, and touch

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16
Q

Cerebrum: Basal Ganglia

What type of signals?

A

Regulate movement by sending information back and forth through the thalamus to cerebral cortex

Signals are inhibitory

Regulates movement

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17
Q

Problems in the basal ganglia can lead to what type of disorders?

A

Movement disorders

ex: Parkinson’s

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18
Q

Cerebrum: Hypothalamus

examples of what it regulates?

A

Main regulator of ANS

BP, HR, metabolism, reproduction, growth, stress responses by secreting hormones, thermoregulation, regulation of food and water intake, sleep, memory, and emotional behavior

*Anything we do automatically

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19
Q

Cerebrum: Limbic System

A

Primary role is memory and emotions and center of gratification

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20
Q

Brainstem consists of what areas?

A

Medulla
Pons
Midbrain

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21
Q

Brainstem: Reticular Formation

A

network of neural cells and with the following fxns:

  • Motor control, coordination, maintaining balance, and posture
  • Respiratory and cardiac control
  • Pain modulation by providing a route of passage for pain signals from the periphery
  • Alertness and sleep by controlling some of the sensory stimuli that reach the cerebral cortex
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22
Q

Where is the reticular formation located?

A

Medulla Oblongata

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23
Q

Brainstem: Medulla Oblongata

A

The reticular formation in the medulla contain the respiratory and cardiac centers
Vomiting, sneezing, and swallowing controlled here

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24
Q

Cranial nerves within the medulla

A

9 - glossopharyngeal
10 - vagus
11 - spinal accessory
12 - hypoglossal

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25
Q

Brainstem: Pons

What cranial nerves live here?

A

relays impulses between the brain and spinal cord

5- trigeminal
6 - abducens
7- facial
8 - acoustic

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26
Q

Brainstem: Midbrain

A

Contains nerve pathway between cerebrum and medulla

3 - oculomotor
4 - trochlear
both control eye movement

27
Q

Cerebellum fxn

A

coordination, fine motor, balance, and equilibrium, speech, senses, and emotion

28
Q

Spinal cord fxn

A

carries information to and from the brain and the rest of the body through the spinal nerves of the PNS

29
Q

Spinal Cord: Upper motor neurons

A

Carry motor information down a common pathway and terminate on a lower motor neuron in the spinal cord

30
Q

Spinal Cord: Lower motor neurons

A

Carry information directly to the muscle

31
Q

The skull

A

encases and protects the brain from injury and is made up of 8 cranial bones

32
Q

Vertebrae

A

Protects and covers the spinal cord

33
Q

Meninges

A

Barrier on brain and spinal cord

-Through meningeal layer of the dura layer helps CSF reabsorption

34
Q

Blood Brain Barrier

A

Prevents passage of harmful substances to the brain (antibodies, toxins, or macrophages)
-Tight junctions require substances to pass through the cell rather than in between b/c the cells are more selective of what they allow through

35
Q

PNS consists of

A

Spinal and cranial nerves and the autonomic nervous system

Contain sensory and more nerves

36
Q

Sensory nerve vs motor nerves fxn in PNS

A

Sensory - transport signals from organs and cells in the body to the CNS
Motor- transport signals back to the target organs

both divided into somatic and visceral

37
Q

Somatic sensory division vs somatic motor division

A

Sensory - transmits signals from the receptors in the muscles, bones, joints, and skin
Motor - transports signals back to the skeletal muscles to produce a contraction

38
Q

Visceral sensory vs Visceral motor

A

Sensory - transmits signals from the heart, lungs, GI tract, and bladder
Motor - transports signals back to the smooth muscle, cardiac muscle, and glands at an unconscious level

39
Q

Spinal Nerves

A

Transmits information to and from the spinal cord and receptors throughout the body
-Mixed nerves (have sensory or motor nerves)

40
Q

Cranial Nerves

A

12 CN, some are sensory or motor or both, arise in the brain and travel down spinal cord

41
Q

What is the best indicator of neurological deterioration?

A

Change in LOC

-Orientation to person, place, and time

42
Q

How to describe/categories of LOC?

A 
conscious 
confused 
lethargic 
stuporous 
obtunded 
comatose
43
Q

What test is used to assess LOC?
Name of categories?
Best score?

A

Glascow Coma Scale

  • Eye opening
  • Best motor response
  • Verbal response

Best- 15
<8 = neurological issues

44
Q

How to get an accurate response to a stimulus?

A

the command needs to be clear and definitive such as:

  • Hold two fingers up with your left hand
  • Wiggle your toes on your right foot

Avoid: “squeeze my fingers” b/c grasps may be reflexive

45
Q

How to test for cognitive function?

A

Mini-Mental Status Exam (MMSE)
-tool that assesses for patient’s orientation, attention, calculation, memory, and language abilities

-Score below 20 = cognitive impairment

46
Q

Cranial Nerve assessment

A

identifying neurological impairment due to disease or trauma to the brain

47
Q

Motor Assessment

A

Performed to inspect and assess muscle mass and tone as well as strength and equality between the left and right and to note abnormalities

  • Grasps and squeeze hand bilaterally
  • Pull and push away from me
  • step on gas
  • toes to nose
48
Q

Sensory System is tested

A

to determine if the patient can feel or identify specific sensations such as temp, vibration, superficial or deep pain

  • pt asked to close eyes when performing
  • compares findings right to left and proximal to distal
  • important when performing a spinal cord assessment
49
Q

Cerebellar Assessment tests for?

A

balance, gait, coordination, and posture

50
Q

Romberg Test

A

performed to assess balance

  • Stand with feet together, arms at side, eyes open (if they can stay without swaying then close eyes)
  • If they sway with eyes open = positive rombergs test
51
Q

How to assess for coordiation?

A
  • walking
  • getting up from chair
  • reach for objects
  • Run the heel of foot down other legs
52
Q

How to assess for gait and posture?

A
  • pt should be able to stand and walk erect with steady gait

- assess for length of stride, arm movement, base of gait, and ability to turn steadily

53
Q

What are reflexes?

A

involuntary and automatic responses to stimuli that provide the body with protection and help adjust to the changing environment

54
Q

Babinski Sign

- and + signs

A
  • also called planter reflex
  • takes sharp object and stimulates outside the sole of the foot
- = toes curl downward 
\+ = toes curl up
55
Q

Meaning of - and + babinski sign?

A
  • = normal response in adult

+ = upper motor neuron lesion = damage to corticospinal tract of the spinal cord (happens with MS and TBI)

**Want a + in infants

56
Q

HR, BP, and respirations are regulated in the

A

Brain and brainstem

57
Q

Monro-Kellie hypothesis

A

sum of the volumes of the brain (brain tissue, CSF, anf blood) is constant. A change or increase in one should cause a compensatory decrease in one or both of the other two.

58
Q

If Monro-Kellie has failed =

A

Increased ICP

59
Q

Normal ICP

IICP?

A

Normal = 0 - 15 mm Hg

Increased = 20 mm Hg for more than 20 minutes

60
Q

Early s/s of IICP

A
  • changes in LOC
  • vomiting
  • headaches
  • seizures
61
Q

Late s/s of IICP

A

Cushings triad

  • elevated BP with widening pulse pressure
  • bradycardia
  • irregular respirations
62
Q 
Assess for in: (noninvasive)
CT
PET
MRI
MRA
A

CT - shows cuts and slices that allow brain, spine, and orbits to be seen; assess for bleeding, edema, or masses; done before MRI

PET - detects areas of increased metabolic activity (cancer or acute infections)

MRI - offers clear visualization and detail of small structures; assess for injuries of the brain and spinal column, as well as diagnose tumors, infections, and bleeding

MRA - shows presence of clots, aneurysms, dissections, or vessel stenosis

63
Q 
Assess for in: 
Cerebral angiography
CT angiography
Electroencepalography 
Evoked Potentials 
Lumbar Puncture 
Myelography 
Biopsy
A

CA - test for cerebral and ocular vessel occlusion, carotid disease, aneurysms, arteriovenous malformations; invasive b/c dye inserted into femoral artery

CTA - evaluate cerebral vasculature (Dye injected into vein)

E - for seizure activity

EP - noninvasive; measures speed and size of neuron conduction in response to stimuli

LP - obtain sample of CSF for analysis and to measure intracranial pressure; lie flat for 4-6 hours

M - invasive; lumbar puncture and injection of contrast to evaluate for lesions, cysts, injury, herniated discs, and masses/tumors

B- invasive; done to rule out or identify infections or abscesses or or identify tumor tissue

64
Q

UTI is older adults

A

Can cause changes in mental status

RN Summer 2021 Test 1 (9 decks)

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