Chapter 23: Neurologic System Flashcards
(41 cards)
The autonomic nervous system coordinates which of the following?
a. High-level cognitive function
b. Balance and affect
c. Internal organs of the body
d. Balance and equilibrium
ANS: C
The autonomic nervous system coordinates the internal environment of the body by the
sympathetic and parasympathetic nervous systems. The other options are associated with the
cerebral cortex; its function consists of determining intelligence, personality, and motor
function
The major function of the sympathetic nervous system is to
a. orchestrate the stress response.
b. coordinate fine motor movement.
c. determine proprioception.
d. perceive stereognosis.
ANS: A
Stimulation of the sympathetic branch of the autonomic nervous system prepares the body for
emergencies for fight or flight (stress response). The cerebellum plays a key role in the
coordination of fine motor movements. Recognition of body parts and awareness of body
position (proprioception) are dependent on the parietal lobe. Stereognosis is the ability to
perceive the weight and form of solid objects by touch and is not under sympathetic control.
The parasympathetic nervous system maintains the day-to-day function of
a. digestion.
b. response to stress.
c. lymphatic supply to the brain.
d. lymphatic drainage of the brain.
ANS: A
The parasympathetic division functions in a complementary and counterbalancing manner to
conserve body resources and maintain day-to-day body functions, such as digestion and
elimination.
Cerebrospinal fluid serves as a
a. nerve impulse transmitter.
b. red blood cell conveyer.
c. shock absorber.
d. mediator of voluntary skeletal movement.
ANS: C
Cerebrospinal fluid circulates between an interconnecting system of ventricles in the brain and around the brain and spinal cord, serving as a shock absorber.
Diabetic peripheral neuropathy will likely produce
a. hyperactive ankle reflexes.
b. diminished pain sensation.
c. exaggerated vibratory sense.
d. hypersensitive temperature perception.
ANS: B
Peripheral neuropathy is a disorder of the peripheral nervous system that results in motor and
sensory loss in the distribution of one or more nerves, usually in the hands and feet. Patients
may have sensations of numbness, tingling, burning, and cramping. In moderate to severe
diabetic neuropathy, there is wasting of the foot muscles, absent ankle and knee reflexes,
decreased or no vibratory sensation below the knees, and/or loss of pain or sharp touch
sensation to the midcalf level.
The thalamus is the major integration center for the perception of
a. speech.
b. olfaction.
c. pain.
d. thoughts.
ANS: C
The thalamus is the major integrating center for the perception of various sensations such as
pain and temperature, serving as the relay center between the basal ganglia and cerebellum.
The reception of speech and interpretation of speech are located in the Wernicke area. The
olfactory sense is processed in the parietal lobe. The cerebrum holds memories, allows you to
plan, and enables you to imagine and think.
The awareness of body position is known as
a. proprioception.
b. graphesthesia.
c. stereognosis.
d. two-point discrimination.
ANS: A
Recognition of body parts and awareness of body position are known as proprioception. This
is dependent on the parietal lobe. The other options are assessment techniques that test for
sensory impairment.
Which area of the brain maintains temperature control?
a. Epithalamus
b. Thalamus
c. Abducens
d. Hypothalamus
ANS: D
The hypothalamus is the major processing center of internal stimuli for the autonomic nervous
system. It maintains temperature control, water metabolism, body fluid osmolarity, feeding
behavior, and neuroendocrine activity. The epithalamus houses the pineal body and is
responsible for sexual development and behavior. The thalamus conveys all sensory impulses,
except olfaction, to and from the cerebrum before their distribution to appropriate associative
sensory areas. The abducens is the sixth cranial nerve with motor function responsible for
lateral eye movement.
If a patient cannot shrug his or her shoulders against resistance, which cranial nerve (CN)
requires further evaluation?
a. CN I, olfactory
b. CN V, trigeminal
c. CN IX, glossopharyngeal
d. CN XI, spinal accessory
ANS: D
CN XI is responsible for the motor ability to shrug the shoulders. CN I is associated with
smell reception and interpretation. CN V is associated with opening of the jaw, chewing, and
sensation of the cornea, iris, conjunctiva, eyelids, forehead, nose, teeth, tongue, ear, and facial
skin. CN IX is associated with swallowing function, sensation of the nasopharynx, gag reflex,
taste, secretion of salivary glands, carotid reflex, and swallowing.
Motor maturation proceeds in an orderly progression from
a. peripheral to central.
b. head to toe.
c. lateral to medial.
d. pedal to cephalic.
ANS: B
Motor maturation proceeds in a cephalocaudal direction. Motor control of the head and neck
develops first, followed by the trunk and extremities. The other choices are incorrect because
they relate the maturation sequence inappropriately, from outward to central.
Normal changes of the aging brain include
a. increased velocity of nerve conduction.
b. diminished perception of touch.
c. increased total number of neurons.
d. diminished intelligence quotient.
ANS: B
Sensory perceptions of touch and pain are diminished by aging. The velocity of nerve impulse
conduction declines, so responses to stimuli take longer. The number of cerebral neurons is
thought to decrease by 1% a year, beginning at 50 years of age; however, the vast number of
reserve cells inhibits the appearance of clinical signs.
The area of body surface innervated by a particular spinal nerve is called a
a. dermatome.
b. nerve pathway.
c. spinal accessory area.
d. cutaneous zone.
ANS: A
The sensory and motor fibers of each spinal nerve supply and receive information to a
segment of skin known as a dermatome. Nerve pathway and spinal accessory area refer to
nerve routes. Cutaneous zone refers to a skin area that transmits fine mechanical information
and normal exogenous thermal information at the same time.
A neurologic past medical history should include data about
a. allergies.
b. circulatory problems.
c. educational level.
d. immunizations.
ANS: B
The neurologic past medical history should include data concerning neurovascular problems
such as stroke, aneurysm, and brain surgery. The other answers are not pertinent medical
information for the neurologic past medical history.
Which is the technique most often used for evaluating the neurologic system?
a. Auscultation
b. Inspection
c. Palpation
d. Percussion
ANS: B
The evaluation tool of inspection is used most often. Inspection of gait and response to
questions can provide data concerning neurologic system function.
When assessing superficial pain, touch, vibration, and position perceptions, you are testing
a. cerebellar function.
b. emotional status.
c. sensory function.
d. tendon reflexes.
ANS: C
Superficial pain, touch, vibration, and position perceptions are sensory functions.
You are initially evaluating the equilibrium of Ms. Q. You ask her to stand, with her feet
together and arms at her sides. She loses her balance. Ms. Q has a positive
a. Kernig sign.
b. Homan sign.
c. McMurray test.
d. Romberg sign.
ANS: D
The Romberg test has the patient stand with the eyes closed, feet together, and arms at the
sides. A slight swaying movement of the body is expected, but not to the extent of falling.
Loss of balance results in a positive Romberg test. The Kernig sign indicates meningeal
irritation, the Homan sign indicates venous thrombosis, and the McMurray test is a rotation
test for demonstrating a torn meniscus.
The finger to nose test allows assessment of
a. coordination and fine motor function.
b. point location.
c. sensory function.
d. stereognosis.
ANS: A
To perform the finger to nose test, the patient closes both eyes and touches his or her nose
with the index finger, alternating hands while gradually increasing the speed. This tests
coordination and fine motor skills. All the other choices test sensory function without motor
function.
You are performing a two-point discrimination test as part of a well physical examination.
The area with the ability to discern two points in the shortest distance is the
a. back.
b. palms
c. fingertips.
d. upper arms.
ANS: C
The fingertips can discern two points with a minimal distance of 2 to 8 mm, the back, 40 to 70
mm, the palms, 8 to 12 mm, and the upper arms, 75 mm.
As Mr. B enters the room, you observe that his gait is wide-based and he staggers from side to
side while swaying his trunk. You would document Mr. B’s pattern as
a. dystonic ataxia.
b. cerebellar ataxia.
c. steppage gait.
d. tabetic stamping.
ANS: B
A cerebellar gait (cerebellar ataxia) occurs when the patient’s feet are wide-based, with a staggering gait, lurching from side to side, often accompanied by swaying of the trunk.
Dystonic ataxia is jerky dancing movements that appear nondirectional. Steppage gait is noted when the hip and knee are elevated excessively high to lift the plantar-flexed foot off the
ground. The foot is brought down with a slap and the patient is unable to walk on the heels.
Tabetic stamping occurs when the legs are positioned far apart, lifted high, and forcibly brought down with each step; in this case, the heel stamps on the ground.
Deep pressure tests are used mostly for patients who are experiencing
a. absent superficial pain sensation.
b. gait and stepping disturbances.
c. lordosis, osteoporosis, or arthritis.
d. tonic neck or torso spasms.
ANS: A
Deep pressure sensation is tested by squeezing the trapezius, calf, or biceps muscle, thus
causing discomfort. When superficial pain sensation is not intact, further assessments of
temperature and deep pressure sensation are performed
Vibratory sensory testing should be routinely done for the patient with
a. Parkinson disease.
b. diabetes.
c. cerebral palsy.
d. Guillain-Barré syndrome.
ANS: B
Diabetic neuropathy must be routinely assessed in all diabetic patients. In moderate to severe
cases, decreased or absent vibratory sensation occurs below the knees, which should be
assessed with a tuning fork. The other choices do not result in sensation deficits
To assess a cremasteric reflex, the nurse strokes the
a. sole of the foot and observes whether the toes fan down and out.
b. abdomen and observes whether the umbilicus moves away from the stimulus.
c. inner thigh and observes whether the testicle and scrotum rise on the stroked side.
d. palm and observes whether the fingers attempt to grasp.
ANS: C
Stroking the inner thigh of a male patient (proximal to distal) will elicit the cremasteric reflex.
The testicle and scrotum rise on the stroked side. Stroking the sole of the foot elicits a
Babinski sign. Stroking the abdomen elicits an abdominal reflex. Stroking the palm elicits a
palmar grasp.
When you ask a patient to close his or her eyes and identify an object placed in the hand, you
are evaluating
a. stereognosis.
b. graphesthesia.
c. vibratory sensation.
d. extinction phenomenon.
ANS: A
Stereognosis is the ability to recognize an object through touch and manipulation. Tactile
agnosia, an inability to recognize objects by touch, suggests a parietal lobe lesion.
Graphesthesia tests the patient’s ability to identify the figure being drawn on the palm. The
vibratory sense uses a tuning fork placed on a bony prominence, and the extinction
phenomenon tests sensation by simultaneously touching bilateral sides of the body with a
sterile needle.
The ability to recognize a number traced on the skin is called
a. stereognosis.
b. graphesthesia.
c. an extinction phenomenon.
d. two-point discrimination.
ANS: B
The ability to recognize a number traced on the skin is called graphesthesia. Stereognosis is
the ability to recognize an object through touch and manipulation. The extinction phenomenon
test and two-point discrimination assess a person’s ability to discern the number of pinpoints
and their location.
