Nervous Flashcards
Abbreviated mental test
Age Time to nearest hour Address they remember Year Name Recognise two people Date of birth Year of ww1 Name of monarch Count down from 20
What is a speech disturbance called and types in it
Dysphasia
Receptive - can’t understand
Expressive - can’t express self
Nominal - can’t name it
Conduction - repititon is poor but can follow command
Cranial nerve 1
Olfactory
Responsible for smell
Test - smell
Loss = basal skull fracture
Come from forebrain =olfactory bulb
Cranial nerve 2
Optic
Controls pupil = visual acuity, visual fields
Tests - read something, move finger in from 4 areas,
Comes from forebrain
Cranial nerve 3,4,6
Oculomotor controls 4/6 muscles
Trochlear controls superior oblique
Abducens controls lateral rectus
Do H test
If nystagmus - neuro issue
Swinging light test
Originate from brain stem
Where does cranial nerve 3 and 4 originate from
Oculomotor and trochelar
Brain stem
Specifically the mid brain
Where does cranial nerve 6 originate from
Abducens
Pontine- medulla junction
Cranial nerve 5
Trigeminal
Sensation in face
3 branches - ophthalmic
Maxillary.
Mandibular - sensory and motor
Feel areas of face
Feel jaw when clenched any weakness
Originated from pons
Cranial nerve 7
Facial
Sensory and motor
Different facial expressions
What is Bell’s palsy
When facial nerve is paralysed
8th cranial nerve
Vestibulocochlear
Whispering / making sound
Vestibular tested in cerebellum tests
Originates from pontine medulla junction
9 and 10 cranial nerve
Glossopharyngeal
Vagus
Soft palate and pharynx
Involved in swallowing
Check uvula is central
Get to swallow
Orginates from medulla oblongata
Cranial nerve 11
Accessory
Internal branches join the vagus
Ask patient to shrug turn head against distance
Originate from medulla oblongata
Cranial nerve 12
Hypoglossal
Tongue into 4 corners
And
Into cheek
Orginate from medulla oblongata
Cerebellum tests
Gait - walking ability Rapid alternating movement Arm coordination - finger to nose Leg coordination - heel up to leg Pronator drift - arms out in front see if they move
Pronator drift go up cause go down cause
Up
Motor neurone weakness
Down
Cerebellum disease
Peripheral nervous system tests
Assess dermatomes =feeling
Assess myotonia = tone and strength in leg
Myoclonus muscle twitching different types
Monoplegia - one arm or leg
Hemiplegia - arm leg on same side of body
Paraplegia - both legs
Quadriplegia - both arms and legs
What is ischemic stroke
Where they is a embolism means oxygen can’t get to brain
What is haemorrhagic stroke
Is where there is a bleed on the brain
What is TIA
Transient they resolve before full infarct but then u are more likely to have a stroke
What is cauda equina
Occurs when the nerves are compressed and disrupt motor and sensory function to the lower extremities and bladder
Can lead to incontinence and paralysis
Red flags symptoms for cauda equina
Severe lower back pain Motor weakness and sensory loss in legs Saddle anaesthesia Bladder dysfunction Bowel in continence A loss of reflexes in extremities
What is meningitis
The inflammation of the membranes that cover the brain and spinal cord = the meninges
Specific to meningitis
Neck stiffness
Photophobia
Non- blanching rash
Signs used for meningitis
Brundzinkis sign -
Lift patients head towards chest and they will involuntary lift their legs
Kernigs sign
When hip flexed try to turn the knee will cause pain and feel resistance
Management for meningitis
Oxygen
Fluids
Benzylpencillin
Cushing triad is and what it indicates
Bradycardia, bradpneoa, widened pulse pressure
=increased ICP
Signs of increased icp
Cushing triad Non reactive pupils Posturing Vomiting Convulsions
Cheynes stokes breathing
Paresis means
Weakness of voluntary movement
Chorea means
Involuntary movements that flow along muscle groups
Athetosis means
Involuntary slow movements
Myoclonus means
Brief voluntary contraction
Dysarthria means
Can’t make words
Slurred speech
GCS each part
Eye opening
1-4
Verbal response
1-5
Best motor response
1-6
What bone does olfactory nerve pass through
Relevant ?
Ethmoid bone
A basal skull fracture may present with a loss of smell
What is optic nerve path
Retina
Optic canal
Sphenoid bone
Nerves then cross over
How many muscles does oculomotor control
What does trochlear control
4
Superior oblique
Abducens control lateral rectus
3 branches of trigeminal nerve
Ophthalmic
Maxillary
Mandibular
What nerve does labyrinthitis and Ménière’s disease involve
Vestibulocochlear
8th cranial nerve
Which muscles controlled by accessory nerve
Trapezius
Sternocleidomastoid
3 layers of meninges
Pia mater
Dura mater
Arachnoid mater
Neurone made up of
Axon, dendrites, cell body
Difference between myelinated and non-myelinated neurones
Myelinated have Schwann cells which make the impulse faster
Where do motor nerves originate
Brain
Spinal cord
Basal ganglia
Name 2 types of motor neurone
Somatic and autonomic
What is corpus callosum
Mass of nerve fibres
White matter
Connects the two hemispheres
How many spinal nerves are there
31 8 cervical 12 thoracic 5 lumbar 5 sacral 1 coccygeal
How long for the Romberg test
20- 30 seconds
Tests to assess cerebellum
Romberg Gait Ram Finger to nose Pronator drift
What would assess for in peripheral nervous system
Tone, power, sensation
Brudizinkis sign is
Involuntary lifting of legs when lift patients head
=meningitis
Kernigs sign is
Knee flexed to 90
Hip flexed to 99
Extension of knee causes pain
Meningitis
