Lesson 10 Neurological Flashcards
What are the two regions of the Nervous System?
- Central Nervous System (CNS)
- Peripheral Nervous System (PNS)
*Control center of body
- Covered and protected by scalp, skull, and meninges
- Blood brain barrier
CNS - Brain
right and left hemispheres, frontal, parietal, occipital & temporal lobes
Cerebrum
What part of the brain regulates body temperature and sleep
Diencephalon
What are the organs containing the Diencephalon?
thalamus and hypothalamus
What part of the brain regulates position sense, posture & equilibrium/balance?
Cerebellum
What part of the brain regulates resp. & cardiac regulation, sneezing?
Brain Stem
What organs contain the brain stem?
medulla oblongata, pons & midbrain
What are the lobes of the Cerebrum?
Parietal, Temporal, Frontal and Occipital
What lobe contains the somatic sensory center?
Parietal
What lobe contains higher intellect, speech production, personality, behavior, emotions, voluntary movement
Frontal
What lobe contains hearing, memory, speech perception and translation?
Temporal
What lobe contains vision?
Occipital
- Extends from medulla to the level of the first lumbar vertebra
- Cord protected by vertebra, meninges and cerebral spinal fluid
- Gray matter is on the inside and white matter on the outside
- Mediates deep tendon reflexes
CNS - Spinal cord
What consists of the insides of the spinal cord?
Gray matter
What consists of the outside of the spinal cord?
White matter
Mediates deep tendon reflexes
CNS - Spinal cord
What nerves consists of the spinal roots?
Cervical, thoracic, lumbar nerves
What type of roots is the posterior root?
Sensory
What type of roots is the anterior root?
Motor
What is the implication of a damage to the anterior spine?
flaccid paralysis
What is the implication of a damage to the posterior spine?
Loss of sensation
What links CNS with the rest of the body?
PNS (Peripheral Nervous System)
How many pairs in the cervical nerve?
8 pairs ( C1-C8 )
How many pairs in the Thoracic nerve?
12 pairs ( T1-T12 )
How many pairs in the Lumbar nerve?
5 pairs ( L1-L5 )
How many pairs in the Sacral nerve?
5 pairs ( S1-S5 )
How many pair in the Coccygeal nerve?
1 pair ( Coccyx )
Rapid involuntary predictable motor response to a stimulus
Reflex
Is the reflex arc a dependent part of the brain?
No
What type of reflex exists in the Somatic reflex?
Skeletal muscle contraction
What type of reflex exists in the Autonomic reflex?
Cardiac, smooth muscle and glands
Three basic types of neurologic examination?
a) Screening neurologic exam
b) Complete neurologic exam
c) Neurologic recheck exam
What do you measure in the Glasgow Coma Scale?
Eye opening (E)
Verbal response (V)
Motor response (M)
What do you evaluate in the Glasgow Coma Scale?
a) Traumatic brain injury
b) altered mental status
What is the Normal GCS score?
15
What does a score of 13-15 in the GCS suggest?
Mild head injury
What does a score of 9-12 in the GCS suggest?
Moderate head injury
What does a score of 8 or less in the GCS suggest?
Severe head injury
What are the abnormal patterns in fluency?
a) Aphonia/dysphonia
b) Cerebellar dysarthria
What type of abnormal pattern consists of distorted speech sounds, may sound unintelligible, basic language intact?
Cerebellar dysarthria
What type of abnormal pattern consists of distorted speech?
Aphonia/dysphonia
Is a language disorder that makes it hard to read, write, and say what you mean?
Aphasia
What type of Aphasia that understands, but cannot speak?
Broca’s (expressive)
What type of Aphasia that is severe, absent/reduced speech, absent/reduced understanding?
Global
What type of Aphasia that has the ability to express self, but cannot understand others?
Wernicke’s (receptive)
What are the types of comatose posturing?
a) Decorticate Rigidity
b) Decerebrate Rigidity
c) Flaccid Quadriplegia
d) Opisthotonos
What type of abnormality present in Decorticate Rigidity?
abnormal flexion
What type of abnormality present in Decerebrate Rigidity?
abnormal extension
What type of issue is related in Flaccid Quadriplegia?
nonfunctional brain stem
What type of issue is related in Opisthotonos?
meningeal irritation
is a term fora group of disorders that affect coordination, balance and speech.
Ataxia
What type of test do you use for balance and coordination?
Romberg’s test
What type of test do you use for gait and balance?
Heel-toe walk (Tandem test)
Assess the patient’s ability to stand with the feet parallel and together with the eyes open and then close for 30 s ?
Romberg Test
is agait(method of walking or running) where the toes of the first foot touch the heel of the next one at each step.
Tandem gait
What type of Gait abnormality that has stroke, immobile arm against body, stiff/extended leg, toe drag?
Spastic hemiparesis
What type of Gait abnormality that is the sudden, uncoordinated muscle movement due to disease or injury to the cerebellum?
Cerebellar Ataxia
What type of Gait abnormality that is a brain disorder that causes unintended or uncontrolled movement, such as shaking, stiffness, and difficulty with balance and coordination?
Parkinsonian
What type of Gait abnormality that is characterized by hypertonia and flexion in the legs, hips and pelvis accompanied by extreme adduction?
Scissors
What type of Gait abnormality that is the inability to lift foot while walking?
Steppage/footdrop
What type of Gait abnormality that is weakness in the hip girdle and upper thigh muscles?
Waddling
In sensory assessment, what is (also termed superficial sensation): receptors in skin and mucous membranes?
Exteroceptive sensation
In sensory assessment, what is (also termed deep sensation): receptors located in muscles, tendons, ligaments and joints?
Proprioceptive sensation
In sensory assessment, what is the interpretative sensory functions that require analysis of individual sensory modalities by the parietal lobes to provide discrimination. Individual sensory modalities must be intact to measure cortical sensation?
Cortical sensation
- Client sitting
- Eyes closed
- “Say where you are touched.”
Compare bilaterally, and distally to
proximally.
Light Touch
- Close eyes
- Strike fork & start on most distal bony prominence & work medially with neuropathy
- Ask when do you feel the vibration start and when do you feel the vibration stop.
Vibratory Sensation
- Close eyes
- Place object in hand
- “Identify object.”
- Test bilaterally with different objects.
Note speed and accuracy
Stereognosis
In stereognosis, what is the inability to identify object?
Astereognosis
- Close eyes
- Draw letter or number on hand
- “Identify figure.”
- Test bilaterally
- Note speed and accuracy
Graphesthesia
What type of lobe is related to Graphesthesia?
Parietal lobe
In Graphesthesia, what is the inability to identify figure?
Agraphesthesia
What does having a 4+ in Reflex chart?
Hyperactive, commonly with clonus
In reflex charting, what is the continued movement after stimulations removed?
Clonus
In Meningeal Irritation, what is related to severe pain, spasms and resistance with gentle neck flexion?
Nuchal rigidity
In Meningeal Irritation, what is related to thigh on abdomen, knee flexed to 90 degrees, resistance with pain?
Kernig’s sign
In Meningeal Irritation, what is related to Chin to chest – involuntary hip flexion and pain?
Brudzinski’s sign
What do you assess for increased intracranial pressure (ICP)?
a) Level of consciousness (LOC)
b) Motor function
c) Pupillary response
d) Vital signs