Finals_Assessing Neurological System and Mental Status Examination Flashcards
Its Components of Nervous System
- Central Nervous System (CNS)
- Peripheral Nervous System
Component of CNS
Brain and Spinal Cord
It connects the brain and peripheral nervous system
Spinal Cord
It carries messages to and from the CNS
Peripheral Nervous System
Components of Peripheral Nervous System
- Somatic Nervous System
- Autonomic Nervous System
Controls voluntary muscles and transmits sensory information to the CNS
Somatic Nervous System
Controls involuntary body functions
Autonomic Nervous System
Arouses body to expend energy
Sympathetic Nervous System
Calms body to conserve and maintain energy
Parasympathetic Nervous System
Components of Cerebrum
- Frontal
- Parietal
- Temporal
- Occipital
It has right and left hemispheres joined by the corpus callosum
Cerebrum
- aggregation of neuronal cell bodies
- mediates higher level function like memory, perception, communication, initiation of voluntary movements
Gray Matter
Identify which of the four lobes is being described:
- regulates emotional, expression, behavior, intellect
- influence personality
- control voluntary movement
Frontal Lobe
Identify which of the four lobes is being described:
- Perceives and interpret sensory inputs like pain, temp, touch, texture, and proprioception
Parietal Lobe
Identify which of the four lobes is being described:
- Influence hearing, smell, taste, and memory
Temporal Lobe
Identify which of the four lobes is being described:
- perceive and interpret visual stimuli like spatial relationships
- influence the ability to read with understanding
Occipital Lobe
Parts of the Diencephalon
- Thalamus
- Hypothalamus
Clusters multiple stimuli into a coherent whole
Thalamus
It regulates production of several hormones. Stimulates visceral responses such as heart rate in response to emotions. Regulates temp by prompting shivering and sweating
Hypothalamus
Parts of the Brainstem
- midbrain
- Pons
- Medulla Oblongata
Identify which part of the brainstem is being described:
- regulates visual, auditory, and other reflexes
- controls eye movements, focusing, and pupil dilation
Midbrain
Identify which part of the brainstem is being described:
- helps control respiration function, facial movement and sensation, and eye movement
Pons
Identify which part of the brainstem is being described:
- Regulates heart and respiratory rate and BP
- Regulates protective reflexes like swallowing, vomiting, sneezing, and coughing
Medulla Oblongata
- Responsible for the coordination and smoothing of voluntary movements
- maintain equilibrium
- maintains muscle tone
Cerebellum
Where is the spinal cord located
vertebral canal
- It extends from the medulla oblongata to the first lumbar vertebra
- Conducts sensory impulses up the ascending tracts of brain
- conducts motor impulses down descending tracts to neurons that stimulate glans and muscles
- responsible for simple reflex activity
Spinal Cord
2 ways impulses travel
- afferent - towards brain
- efferent - away from brain
Identify the Sensory Ascending Neural Pathways:
- Sensations of pain, temperature, and crude light touch travel here
Spinothalamic tract
Identify the Ascending Neural Pathways:
- Sensations of positions, vibration and fine touch travel here
Posterior columns
Pyramidal Tracts
- Corticospinal Tracts
- Corticobulbar tracts
Identify which pyramidal tract is being described:
- control voluntary skilled movement of the extremities and fine movement of fingers
Corticospinal Tract
Identify which pyramidal tract is being described:
responsible of voluntary control of face, head, and neck
This tract crosses over to the opposite side then travels down the spinal cord. It then carries it to the muscles and produce voluntary movement
Pyramidal tract
This tract is responsible for involuntary control and modulation like tone and balance. It originates from the brain stem.
Extrapyramidal Tracts
Extrapyamidal Tracts
- Rubrospinal Tract
- Reticulospinal Tract
- Vestibuospinal Tract
- Tectospinal (Colliculospinal) Tract
Identify which Extrapyramidal tract is being described:
- responsible for motor control
Rubrospinal tract (midbrain)
Identify which Extrapyramidal tract is being described:
- Has Pons: facilitates contraction and increases tone
- has Medulla: inhibits contraction, decreases tone, and automatic breathing
Reticulospinal Tract
Identify which Extrapyramidal tract is being described:
- involved in balance and posture
Vestibulospinal tract
Identify which Extrapyramidal tract is being described:
- Involved in coordination of head and eyes
Tecotospinal (Colliculospinal) Tract
What are the 12 Cranial Nerves
1.Olfactory
2. Optic
3. Oculomotor
4. Trochlear
5. Trigeminal
6. Abducens
7. Facial
8. Vestibulochochlear
9. glossopharyngeal
10. vagus
11. spinal accessory
12. hypoglossal
Identify which cranial nerve is being described:
- Carries Smell impulses from nasal mucous membrane to the brain
Olfactory Nerve (I)
Identify which cranial nerve is being described:
- Carries visual impulses from eye to brain
Optic Nerve (II)
Identify which cranial nerve is being described:
- contracts eye muscles to control eye movement
Oculomotor Nerve (III)
Identify which cranial nerve is being described:
- Contracts superior oblique muscle to control inferomedial eye movement
Trochlear Nerve (IV)
Identify which cranial nerve is being described:
- has 3 divisions: Ophthalmic, Maxillary, and Mandibular
- Motor: chewing and jaw opening and clenching
- Sensory: conveying sensory data from eyes, nose, mouth, teeth, jaw, forehead, scalp, and facial skin
Trigeminal Nerve (V)
Identify which cranial nerve is being described:
- Control Lateral Eye Movement
Abducens (VI)
Identify which cranial nerve is being described:
- Motor: Closing Eyes, closing mouth, moving lips, and other facial expression, salivation, and lacrimation
- Sensory: Tasting on anterior tongue
- Branches: Temporal, Zygomatic, Buccal, Mandibular, Cervical
Facial Nerve (VII)
Identify which cranial nerve is being described:
- Contains sensory fibers for hearing and balance
Acoustic/ Vestibulocochlear Nerve (VIII)
2 phases of hearing
Conductive and Sensorineural Phase
Identify which phase of hearing is being described:
- from the external ear through middle ear
Conductive Phase
Identify which phase of hearing is being described:
- involves the cochlea and cochlear nerve
Sensorineural Phase
Identify which cranial nerve is being described:
- Sensory: Contains sensory fibers for taste and posterior third of tongue and sensory fibers of pharynx (results in the gag reflex when stimulated)
- Motor: Provides Secretory Fibers to the parotid salivary glands; promotes swallowing movements
Glossopharyngeal Nerve (IX)
Identify which cranial nerve is being described:
- Carries sensation from throat, larynx, heart, lungs, bronchi, gastrointestinal tract, and abdominal viscera
- Promotes swallowing, talking, and production of digestive juices
Vagus Nerve (X)
Identify which cranial nerve is being described:
- Innervates neck muscles that promote movement of the shoulders and head rotation
- promotes movement of larynx
Spinal Accessory Nerve (XI)
Identify which cranial nerve is being described:
- innervates tongue muscles that promote the movement of food and talking
Hypoglossal Nerve (XII)
How many pairs of spinal nerves do we have
38 pairs
- 8 cervical
- 12 thoracic
- 5 sacral
- 1 coccygeal
What does the sensory root of each spinal nerve innervate
Dermatome
Pathway in spinal cord
Each nerve attached to spinal cord by two nerve roots. Sensory (afferent) fiber that enters through the dorsal (posterior) root and the motor (efferent) fiber that exits through the ventral (anterior) roots of the cord
Components of the Autonomic Nervous System
Sympathetic and Parasympathetic Nervous system
Its activated during stress sand elicits responses such as decreased gastric secretions, bronchiole dilation, increased pulse rate, and pupil dilation. It arises from thoracolumbar level T1 to L2
Sympathetic Nervous System
It restores and maintains normal body functions like decreasing heart rate; arise
from craniosacral regions (S1 to S4 and CN III, VI, IX, and X
Parasympathetic Nervous System
What to consider for patient’s biographical data
- age and education level
- age related neurological disorders
- Job history and possible exposure to neurotoxins
- head and/or back injury
- marital status
- spiritual beliefs
What to consider for patients Current Health Status
- chief complaint
- common neurologic symptoms are headache, memory loss, confusion, dizziness, loss of consciousness, numbness, sensory loss, and problems with any of five senses
What methods can u use to collect patient’s current health status
- PQRST
- COLDSPA
- OLDCAART
- Most common pain.
- Can be mild or severe,
- acute or chronic,
- localized generalized
- 90% benign
- 10% have underlying pathology
Headache
What to ask with patient experiencing seizures
- altered or loss of consciousness
- what happens before it occurs and which part of the body does it start
- loss of bladder control
- medications taken for seizure
- what aura does the patient observe
An auditory, visual, or motor sensation that forewarns the client that a seizure will occur
Aura
Its the early indication of change in neurological status. may begin as forgetfulness, memory loss, or inability to concentrate, or rapidly proceeds to unconsciousness.
Mental changes
It may be caused by neurologic problems, fluid and electrolyte
imbalance, hypoxia, low perfusion states, nutritional deficiencies,
infections, renal and liver disease, hyper- or hypothermia, trauma,
medications, and drug and alcohol abuse
Mental changes
fainting” sensation
Dizziness
sensation that the
surroundings are spinning around or that the person is spinning around; often accompanied by nausea and vomiting, nystagmus,
and tinnitus
Vertigo
temporary loss of consciousness
Syncope
numbness or tingling. caused by diabetes and neurologic, metabolic,
cardiovascular, renal, and inflammatory diseases
Paresthesia
Identify which CN is affected when these fail:
- sense of smell
CN I
Identify which CN is affected when these fail:
- visual acuity, pupillary constriction, and extraocular movement
CN II, III, IV, and VI