Exam1 Neuro

Question 1

What is part of the central nervous system?

Answer 1

Brain and spinal cord

Question 2

What is part of the peripheral nervous system

Answer 2

Nerve fibers outside brain and spinal cord

Question 3

What is the cerebellum responsible for

Answer 3

Coordination of volunteer movement.
Equilibrium, balance.
Muscle tone, postural.

VOLUNTARY MOVEMENT, BALANCE, POSTURE.

Question 4

What is the definition of reflex? What are the four types of reflexes?

Answer 4

Reflexes are involuntary, defense mechanisms.

The four reflexes are:

Deep tendon reflexes. Muscle stretch, deep tissue

Somatic. Superficial/skin feeling, other superficial feeling. Example burn on hand and jerk back, knee jerk with percussion hammer.

Visceral. Organs in the body, digestion, vomiting, pupil dilation.

Pathologic. These are the tests usually done on children, the plantar rub toe flex, hand grasp test etc.

Question 5

What are the parts of a neurological exam?

Answer 5

Mental status.
Cranial nerves.
Cerebellum function.
Motor system.
Sensory system. 
Deep tendon reflexes.

Question 6

What are subjective data questions?

Answer 6

Headache.
Recent head injury.
Dizziness.
Vertigo.
Tremors.
Syncope.
Numbness or tingling.
Incoordination
Weakness.
Difficulty swallowing.
Difficulty sleeping.
Memory loss.
Behavior change.
A significant history.

Question 7

What are the 12 cranial nerves? What are the nerves responsible for? And how do you test each one?

Answer 7

1. Ofactory, sense of smell. Tested by having patient close eyes and presenting them with smells.
2. Optic nerve, vision. Tested using melon chart or confrontation test; crossarm across body cover same eyes patient move hand into field of vision.
3. Oculomotor nerve, movement top and pupil movement. PERRLA- pupils, round, reactive to light, look at size, accommodation for things approaching. EOM: extra ocular movement. Have patient follow finger in all directions six fields, touch face.
4. Trochlear nerve, obleque eye movement. Same test used in third nerve.
5. Trigeminal nerve, jaw movement. Tested by having patient clench jaw and feel muscles on the side tighten up.
6. Absucens nerve, eye movement lateral. Tested in the same way as nerve three.
7. Facial nerve, muscles for facial expressions. Tested by asking patient to smile frown lift eyebrows close eyes and resist from having them opened, puff cheeks and resist trying to have them pushed out.
8. Veatibulocochlear nerve, hearing and balance. Whisper test.
9. Glossopharyngeal nerve, swallow. Tested by checking uvula.
10. Vegas nerve, taste and sensation to epiglottis. Taste test.
11. Spinal nerve, motor control to trapezius muscles. Mama test by having patient lift and resist.
12. Hypoglassel nerve, tongue muscle. Tested by having patients stick tongue out and then have them say light tight dynamite.

Question 8

What are the five testable reflexes?

What are the four child reflexes?

Answer 8

Bicep reflex.
Tricep reflex.
Brachioradialis reflex.
Quadricep reflex
Achilles reflex

Rooting - cheek touch.
Palmer - grab something in hand.
Moro- extend arm when alarmed or scared.
Plantar- tickle feet or rub up foot and toe curls.

Question 9

What is mental status?

Answer 9

Emotional feeling and cognitive knowing function.

Question 10

What behaviors are looked for in mental status?

Answer 10

Consciousness, language, mood, orientation, attention, memory, abstract reasoning, thought process, perceptions

Question 11

What are the ABCT of mental status

Answer 11

Appearance. Posture, body movement, dress, hygiene

Behavior. Level of consciousness, speech, mood, facial expression.

Cognition. Orientation, attention span, recent memory, remote memory, executive function ( calculations, clock reading )

Thought process. Logic in problem solving.

Question 12

What is a way to determine mental status of a child?

Answer 12

ABCT test administered with discretion to child’s developmental stage.

The Denver 2 test -0 to 6 years old and addresses developmental milestones a child should meet.

Question 13

What are the levels of consciousness?

Answer 13

Alert.
Lethargic. Aroused when name called
Abtundant. Need loud noise vigorously
Stupor. Persistent shaking or pain administration
Coma. Not responsive to pain or stimuli.

Question 14

What is the coma scale called, and the levels in?

Answer 14

The Glasgow coma scale.
4- spontaneous eye movement
3-patient opens eyes in responds to speech
2 - patient opens eyes and response to pain
1 -No response

Question 15

What is mini mental state exam?

Answer 15

11 questions with scores between 24 and 30 average being 27. Tests cognitive function only.

Question 16

What do you screen for cognitive test?

Answer 16

Clock drawing test.
Three item recall test.
Executive function test.