Lecture 8: Neurological Assessment Flashcards
What does the CNS consist of? What is it important for?
Brain and spinal cord
- control and coordination of the body
Brain - what does the cerebrum consist of? What does the cerebral cortex consist of (all lobes/areas)?
Cerebrum - Left and Right hemispheres
Cerebral cortex:
- frontal lobe
- parietal lobe
- temporal lobes
- occipital lobe
- Wernicke’s are (temporal)
- Broca’s area (frontal)
Name the other areas of the brain? BTHCAFMB
- basal ganglia
- thalamus
- hypothalamus
- cerebellum
- amygdala
- forebrain
- midbrain
- brainstem (pons and medulla)
What does the peripheral nervous system consist of (PNS)
- cranial, spinal, and peripheral nerves
they connect the CNS to the rest of the body
How many pairs of nerves enter/exit the brain? Where do these nerve pairs come from?
- 12 pairs enter and exit the brain
CN 1 & 2 come from the cerebral cortex
The remaining 10 pairs come from the brainstem, the cerebellum has no CNs associated to it
What is the function of CNs?
CNs relay info from the brain to the body, mostly the head and neck
What function does each CN have (sensory, motor, both)
say both the acronyms for CN function and names of CNs
CN 1: S
CN 2: S
CN 3: M
CN 4: M
CN 5: B
CN 6: M
CN 7: B
CN 8: S
CN 9: B
CN 10: B
CN 11: M
CN 12: M
some say marry money but my brother says big brains matter more
on old Olympus’ towering top a fin and German viewed some hops
How many spinal nerves are there? How many are cervical, thoracic, lumbar, sacrum, coccygeal?
There are 31 spinal nerves:
- 8 cervical
- 12 thoracic
- 5 lumbar
- 5 sacrum
- 1 coccygeal
What does the autonomic nervous system (ANS) do? What are the two parts that make it up and their functions?
It maintains involuntary functions of cardiac and smooth muscle
1. Sympathetic:
- “fight or flight” produces body-to-action during periods of physiologic and psychologic stress (adrenaline)
2. Parasympathetic:
- “rest & digest” to conserve body resources and day-to-day functions (acetylcholine)
What are the components of the neurological assessment?
- Vital signs
- Level of consciousness (LOC) using GCS (Glasgow coma scale)
- Cranial nerves 1-12 (concentrate on 2, 3, 7, 9, 10)
- Speech
- Strength testing
- Cerebellar function
- Sensation testing
- Reflexes (advanced)
What is the Glasgow Coma Scale (GCS) purpose? What are its three components? What is the score range? What does a score of less than 8 mean?
- system for assessing extent of consciousness impairment (numeral score, low bad high good)
3 components:
- eye opening, verbal response, and motor response
Score range: lowest score you can get is 3, highest is 15.
less than 8 - profound impairment and cannot protect own airway
How does the GCS work (max points per component, what is the min amount of points)
- Eye opening
- none = 1 point
- max 4 - Verbal response
- none = 1 point
- max 5 - Motor response
- none = 1 point
- max = 6
What does verbal response consist of?
Orientation is made of the person, place, and time
- all 3 must be intact for the patient to be considered oriented
- usually documented as A & O x 3
What does motor response consist of?
Patient’s ability to receive the simple command and produce the action
- ex. “wiggle your thumb”
ability reflects LOC not motor impairment
Severely impaired LOC - decorticate & decerebrate postures
Decorticate posture is flexion (arms adducted/flexed to chest, legs fully extended)
Decerebrate posture is extension (arms adducted/extended, legs fully extended)
