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Adult Health I final > Exam 3 Neuro: Assessment of the nervous system (8 questions) > Flashcards

Exam 3 Neuro: Assessment of the nervous system (8 questions) Flashcards

1
Q

Meninges: Dura Mater

A

Directly beneath the skull, consists of two layers. The outermost adheres to the skull. The inner layer extends into the cranial space.

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2
Q

Meninges: Arachnoid membrane

A

Delicate, fragile membrane that surrounds the brain. Below this is the subarachnoid space which consists of a fine web-like structure that connects to the pia mater. CSF and cerebral arteries and veins are located here.

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3
Q

Meninges: Pia mater

A

The innermost portion of the meninges, it follows all of the folds and convolutions of the brain’s surface

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4
Q

Cerebrum

A

The largest portion of the brain. It has two hemispheres which are linked by the corpus callosum which provides for the communication between the two hemispheres

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5
Q

Frontal lobe

A

Responsible for higher cognitive functions. These include:
- Voluntary eye movement
- Access to current sensory data
- Access to past information or experience
- Affective response to a situation
- Regulates behavior based on judgment and foresight
Judgment
- Ability to develop long term goals
- Reasoning, concentration, abstraction
- Motor strip for opposite side of body

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6
Q

Broca’s area

A

located in the inferior frontal gyrus is responsible for the motor aspects of speech.

Damage here will cause expressive aphasia (can’t say right words)

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7
Q

Parietal lobe

A

Understands sensation, texture, size, shape and spatial relationships

  • Receives data from the skin
  • Pain, heat, cold, pressure.

Sensory strip for the opposite of the body.

  • Awareness of position in space.
  • Processes sensory and spatial awareness
  • Key component in eye-hand coordination and arm movement.
  • Plays a role in our sensations of touch, smell, and taste.
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8
Q

Temporal lobe

A
  • Auditory center for sound interpretation
  • Vestibular sense
  • Interpretative area…integrates sounds, thoughts and emotions
  • memory, understanding music, aggressiveness, and sexual behavior.
    Seizures
  • Auditory, visual and sensory hallucinations
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9
Q

Wernicke’s area

A
  • Located in the temporal lobe. For speech Special senses of taste and smell.
  • Damage can cause receptive aphasia (not able to receive words)
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10
Q

Occipital lobe

A
  • Vision
  • Visual recognition of objects
  • Reading comprehension.
  • Damage here will cause blindness
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11
Q

Limbic lobe

A
  • regulates emotion and memory

- Is involved in the formation of long-term memory

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12
Q

Thalamus

A

called the gateway to the cerebral cortex, as nearly all sensory inputs pass through it to the higher levels of the brain

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13
Q

Hypothalamus

A
  • Temperature
  • Food & water intake
  • Behavior
  • Limbic system
  • Aggressive & sexual behavior
  • Sleep-wakefulness cycle
  • Autonomic responses
  • Parasympathetic responses
  • Sympathetic responses
  • Hormonal secretion of the pituitary gland
    ADH
  • Visible physical expressions (limbic system)
    Blushing, dry mouth, clammy hands
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14
Q

Cerebellum

A
  • It influences muscle tone associated with equilibrium, orientation in space, locomotion, and posture.
  • Takes over the learned, repetitive tasks (riding a bike), while voluntary motor activity is located in the motor cortex.
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15
Q

Cranial nerve I

A

Olfactory (smell)

Test: wave a substance under nose

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16
Q

Cranial nerve II

A

Optic (sight)

Test: Confrontation test

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17
Q

Cranial nerve III

A

Oculomotor (Moves eyelid and eyeball and adjusts the pupil and lens of the eye)

Test: PERRL, Accommodation, and Whisker test

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18
Q

Cranial nerve IV

A

Tronchlear (moves eyeballs)

Test: PERRL, Accommodation, and Whisker test

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19
Q

Cranial nerve V

A

Trigeminal (Facial muscles including chewing; Facial sensations)

Test: Palpate temporal and mandibular muscles while client clinches teeth. Have client close eyes and lightly touch them with a cotton ball on both sides of their forehead, cheeks, and chin.

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20
Q

Cranial nerve VI

A

Abducens (Moves eyeballs)

Test: PERRL, Accommodation, and Whisker test

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21
Q

Cranial nerve VII

A

Facial (Taste, tears, saliva, facial expressions)

Test: Grin, frown, show teeth, close eyes tightly and don’t allow me to open them, and raise eyebrows

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22
Q

Cranial nerve VIII

A

Vestibulocochlear (Acoustic)

Test: Whisper test

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23
Q

Cranial nerve IX

A

Glossopharyngeal (Swallowing, saliva, taste)

Test: Uvula and soft palate rise simultaneously when client says “ahhh.” Check gag reflex

24
Q

Cranial nerve X

A

Vagus (Control of PNS e.g. smooth muscles of GI tract)

Test:Uvula and soft palate rise simultaneously when client says “ahhh.” Check gag reflex

25
Q

Cranial nerve XI

A

Accessory (Moving head & shoulders, swallowing)

Test: Rotate head to both sides against my hand. Raise shoulders against my pressure pushing on them.

26
Q

Cranial nerve XII

A

Hypoglossal (Tongue muscles - speech & swallowing)

Test: Stick tongue out and look for wasting or tremors. Say light, tight, dynamite and the L, T, N, and D should be clear and distinct

27
Q

Neuro assessment: Level of consciousness

A
  • Arousal
  • Awareness
  • Glascow coma scale
28
Q

Neuro assessment: Motor function

A
  • Spontaneous movement
  • Movement response to stimulus
    Verbal, tactile, noxious
    Central or peripheral stimulation
  • Arm drift (pronator drift)
  • Lateralizing
  • Decorticate (up)
  • Decerebrate (down/out)
  • Reflexes
    Normal: cough, blink, gag, swallow
    Pathological
  • Grasp w/o release, babinski, sucking
29
Q

Neuro assessment: Pupillary function & eye movement

A
  • Pupil size & reaction to light (intracranial pressure)
  • Shape (round, irregular shape, oval)
  • Consensual response
  • EOMs, gaze
30
Q

Neuro assessment: Respiratory patterns

A
  • Cheynes-Stokes
  • Central neurogenic hyperventilation
  • Apneustic
  • Cluster
  • Ataxic
31
Q

Cheynes-stokes respiratory pattern

A
  • Rhythmic crescendo and decrescendo of rate and depth of respiration; includes brief periods of apnea
  • Usually seen with bilateral deep cerebral lesions or some cerebellar lesions
32
Q

Central neurogenic hyperventilation

A
  • Very deep, very rapid respirations with no apneic periods

- Usually seen with lesions of the midbrain and upper pons

33
Q

Apneustic respiratory pattern

A
  • Prolonged inspiratory and/or expiratory pause of 2-3 sec

- Usually seen in lesions of the lower pons or upper medulla

34
Q

Cluster respiratory pattern

A
  • Clusters of irregular, gasping respirations separated by long periods of apnea
  • Usually seen in lesions of the lower pons or upper medulla
35
Q

Ataxic respiratory pattern

A
  • Irregular, random pattern of deep and shallow respirations with irregular apneic periods
  • Usually seen in lesions of the medulla
36
Q

Glascow coma scale (score 3-15): Eye opening

A
  • Spontaneous eye opening: 4
  • Eye opening to speech: 3
  • Eye opening to pain: 2
  • No eye opening: 1
37
Q

Glascow coma scale (score 3-15): Verbal responses

A
  • Oriented: 5
  • Confused conversation: 4
  • Inappropriate conversation: 3
  • Incomprehensible speech: 2
  • No speech: 1
38
Q

Glascow coma scale (score 3-15): Motor responses

A
  • Obeys commands: 6
  • Localizing responses to pain: 5
  • Generalizing withdrawal to pain: 4
  • Flexor posturing to pain: 3
  • Extensor posturing to pain: 2
  • No motor response to pain: 1
39
Q

Electroencephalography (EEG)

A
  • Graphically records electrical activity of cerebral hemispheres
  • Patient must be sleep-deprived before procedure
  • Anticonvulsants may be withheld
40
Q

Evoked Potentials

A
  • Measure electrical signals to brain generated by hearing, touch, sight
    Auditory
    Visual
    Somatosensory
41
Q

Cerebral Blood Flow Evaluation

A

Particularly useful in evaluating cerebral vasospasms

42
Q

Dermatome Map

A

Indicate level of injury by knowing where sensation is felt (T4 nipple line)

43
Q

Spinal cord: Central gray matter

A
  • Anterior horn
  • Lateral horn
  • Posterior horn
44
Q

Spinal cord: White matter

A

Myelinated ascending & descending tracts

45
Q

Spinal nerves: Dorsal root

A
  • Afferent pathway in which impulses enter the cord

- Convey sensory input from specific areas of the body known as dermatomes

46
Q

Spinal nerves: Ventral root

A
  • Efferent pathway in which impulses leave

- Convey efferent impulses from the spinal cord to the body

47
Q

Ascending tracts

A
  • Sensory
  • Carries information to the brain
  • Three major sensory tracts
    Spinothalamic
    Spinocerebellar
    Posterior column tract
48
Q

Spinothalamic tracts

A
  • Transmits to the thalamus and then to the cerebrum
  • Opposite side of stimulus
  • Anterior
    crude touch, pressure
  • Lateral
    Pain, temperature
49
Q

Spinocerebellar tracts

A
  • Transmits to the cerebellum
  • Same side as stimulus
  • Proprioception
50
Q

Posterior column tracts

A
  • Transmits to primary sensory cortex
  • Opposite side of stimulus
  • Proprioception, fine touch, pressure, vibration
51
Q

Descending voluntary motor tracts

A
  • Corticospinal

- Subconscious Motor tracts

52
Q

Corticospinal tracts

A
  • Originates in motor cortex of the frontal lobe & portions of the parietal lobe
  • Conscious control of skeletal muscle
    Lateral tract
    Ventral tract
53
Q

Subconscious Motor tracts

A
  • Vestibularspinal tracts
  • Tectospinal tracts
  • Reticulospinal tracts
  • Rubrospinal tract:
  • Originates in the nucleus of the midbrain
  • receives fibers from cerebellum and descends in the lateral and anterior funiculi
  • conveys impulses to control muscle synergy and tone
54
Q

Upper motor neuron syndrome

A
  • Weakness, paralysis
  • Spasticity
  • Increased tendon reflexes
  • Positive Babinski sign
  • Loss of abdominal reflexes
  • Little or no muscle atrophy
  • Facilitates and inhibits descending supraspinal pathways
  • Located entirely in the CNS
55
Q

Lower motor neuron syndrome

A
  • Motor weakness
  • Wasting and fasciculations of muscles
  • Hypotonia
  • Loss of tendon reflexes
  • Located in the CNS and the PNS
  • Linkage between CNS and voluntary muscles

Adult Health I final (16 decks)

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