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Care Of Adults 2 > Chapter 43 Assessment Of The Nervous System > Flashcards

Chapter 43 Assessment Of The Nervous System Flashcards

0
Q

Peripheral nervous system consists of

A

12 cranial nerves
31 pairs of spinal nerves
Sympathetic
Parasympathetic

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1
Q

Central nervous system consists of

A

Brain and spinal cord

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2
Q

Role of neurons

A

Motor (efferent): carry impulses away from CNS
Sensory (afferent): carry impulses towards CNS
Process information
Retain information

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3
Q

Myelin sheath

A

White lipid covering
Speeds transmission of impulses
White matter

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4
Q

Non-myelinated

A

Gray matter

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5
Q

Synaptic knob

A

Distal end of each axon

Manufacture, store, and release neurotransmitter

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6
Q

Neuroglial cells provide:

A 
Protection
Structure
Nutrition 
Part of blood brain barrier
Help regulate CSF
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7
Q

Meninges

A

Cover brain and spinal cord

Three layers all made of connective tissue

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8
Q

Dura mater

A

Outermost meninges

Very tough

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9
Q

Arachnoid

A

Middle meninges

Cobweb in appearance

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10
Q

Pia mater

A

Innermost meninges
Very thin and delicate
Tightly bound to brain and spinal cord

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11
Q

Subarachnoid space

A

Layer between arachnoid and pia mater

Contains CSF and blood vessels

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12
Q

Cerebrospinal Fluid (CSF)

A

Clear fluid derived from blood stream
Adds additional protection and lubricates the spinal cord and brain
Contains nutrients needed by the brain and spinal cord
Also contains waste products that will be brought to the blood stream and excreted by the body

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13
Q

Cerebrum

A

Outer other part of the brain
Left and right hemispheres
Hemispheres divided by longitudinal fissure
*LARGEST PART OF THE BRAIN
*Controls intelligence, creativity, and memory

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14
Q

Frontal lobe

A

Anterior most lobe
Primary motor area for muscular contraction
Personality, behavior, emotion, intellectual function, *judgement

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15
Q

Parietal lobes

A

Sensation

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16
Q

Occipital lobes

A

Vision

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17
Q

Temporal lobe

A

Hearing (does not cross sides: right side=right ear)

Smell

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18
Q

Gustatory area

A

Located in these parietal lobes where it is overlapped by the temporal lobes
Usually located on left side

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19
Q

Broca’s area

A

Motor speech: the act of physically talking

If a pt is damaged, they may know what they want to say but different words will come out

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20
Q

Gnostic area

A

Stores complex memory patterns

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21
Q

Wernicke’s area

A

Language COMPREHENSION

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22
Q

Which part of the brain makes us human?

A

Central cortex

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23
Q

Thalamus

A

Receives all sensory information and sends it to the appropriate lobe

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24
Q

Brain stem contains:

A

~Midbrain-voluntary motor nerve cells, visual and auditory reflex centers, narrow channel for CSF
~Pons-helps to regulate breathing movements
~Medulla oblongata-cardiac center, vasomotor center, respiratory center

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25
Q

Cerebellum

A

~Another motor area of the brain
~Subconscious contractions of skeletal muscles to maintain: coordination, posture, balance
~Impulses from inner ear sent here: equilibrium

26
Q

Spinal cord nerves have 2 main functions

A

Conduction of impulses going to and from brain

Reflex center

27
Q

Spinal cord location

A

Begins at foramen magnum and ends at the first lumbar vertebrae

28
Q

Voluntary nervous system

A

Goes to skin and muscles

Involved in conscious activities

29
Q

Autonomic nervous system

A

~Automatically takes care of body functions
~Sympathetic nervous system (fight for flight)
~Parasympathetic nervous system (active under ordinary relaxed conditions)

30
Q

Nerve impulse: conduction

A

Sending a message

It all works with potassium and sodium

31
Q

The resting membrane of a nerve cell

A

DOES NOT allow potassium or sodium to diffuse across it

32
Q

Minimum threshold

A

The minimum amount of stimulus to cause an action potential

33
Q

Refractory period

A

Is small amount of time necessary to restore the cell back to its resting membrane
Cannot respond to the second stimuli until this is done

34
Q

All or none principle

A

If the stimulus is strong enough to cause an action potential:

  • The action potential will go out one speed
  • A stronger stimuli cannot speed up the process
35
Q

Saltatory conduction

A

Deals with nerve cells that have myelin

Greatly speeds up the process

36
Q

Acetylcholine

A

Work on skeletal muscles

37
Q

Norepinephrine

A

Smooth and cardiac muscle

38
Q

Epinephrine

A

Behavior and mood

39
Q

Dopamine

A

Emotional responses and has an effect on the cardiac and circulatory system

40
Q

Serotonin

A

Regulates temperature, sensory perception, mood, and onset of sleep

41
Q

GABA

A

Slows everything down

~inhibits the excessive discharge of neurons

42
Q

Endorphins

A

Inhibits the release of sensory pain neurotransmitters

43
Q

Hypoactive deep tendon reflexes and loss of vibration sense

A

Can impair balance: need to look at their feet placement as they walk
A change that happens with age

44
Q

Some changes with aging

A
  • Changes in pain perception
  • Changes in sleep patterns: require less sleep, but more frequent rest periods
  • Increased risk for infection
45
Q

A change in the LOC is usually the first indication of

A

A decline in central neurological function

46
Q

A complete neurological assessment is done three times:

A

Laying, sitting, standing

47
Q

One issue with glaucoma medication:

A

It may dilate the eye and slow the pupil response

48
Q

When testing the patient’s memory function

A

Ask questions regarding their date of birth, city of birth, or anything that can be verified

49
Q

Higher levels of cognition

A

Favorite hobbies, current events, name of last few presidents
Abstract reasoning: meaning of Proverbs
Judgment: rational decisions in dealing with symptoms

50
Q

Romberg’s test

A

Patient stands with eyes closed

Loss of balance is positive Romberg’s sign (difficulty with proprioception)

51
Q

Patients with decreased sensation are instructed to

A

Look at their feet when they walk

52
Q

Hyperactive reflexes

A

Upper motor neuron disease, tetanus, hypocalcemia

53
Q

Hypoactive reflexes

A

Lower motor neuron disease, DM with nerve damage, hypothyroidism, hypokalemia

54
Q

Decortication

A

Arms wrists and fingers are flexed
Internal rotation and plantar flexion of feet
Corticospinal pathways are interrupted (lesions on the spinal cord)

55
Q

Decerebration

A

Extension of arms and legs
Pronation of arms and plantar flexion
Obsithotonos (body spasm in which body is bowed forward)
Seen with disfunction of brainstem

56
Q

Glasgow coma scale

A

The higher the score the better

57
Q

Cerebral angiography: post procedure:

A

Circulation of extremity: both at site, and downstream from site

58
Q

PET scan

A

No alcohol, caffeine, and tobacco 24 hours prior to test
NPO 4 to 12 hours before test
No glucose solution 4 to 12 hours before the test
Follow up: increase fluid intake
Contraindicated in women who are breast-feeding

59
Q

What is important to have before getting a lumbar puncture?

A

Signed informed consent

60
Q

Normal total proteins

A

15-45 mg/dL (up to 70 mg/dL in older adults)

61
Q

Immune gamma globulin (IgG)

A
  • The most important protein
  • Normal: 3% to 12% of total protein
  • More than 12% of total protein: multiple sclerosis, neurosyphilis, or viral infection
62
Q

Normal glucose

A

50-75 mg/dL or 60% to 70% of blood glucose level

Less than 50 mg/dL : usually accompanied by the presence of pathologic organisms

63
Q

Electroencephalography (EEG)

A

Graphically records electrical activity of cerebral hemispheres
Patient must be sleep deprived before procedure
Anticonvulsants may be withheld
Hyperventilation during the test: cerebral vasoconstriction and can induce seizure activity

Care Of Adults 2 (4 decks)

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