Neuro Flashcards
cerebellum
coordination of movement and balance and muscle tone
hypothalamus
temperature control, sleep, emotions, pituitary gland, autonomic avctivity
medulla
respiration, hear, GI function
What is the function of CN I?
olfactory
What is the function of CN II?
oculomotor
What is the function of CN IV?
trochlear
What is the function of CN V?
trigeminal
What is the function of CN VI?
abducens
What is the functions CN VII
facial
What is the function of CN VIII?
acoustic
What is the function of CN IX?
glossopharyngeal
What is the function of CN X?
vagus
What is the function of CN XI?
spinal
What is the function of CN XII?
hypoglossal
How do you test for CN II?
visual acuity with confrontation
How do you test CN III?
PERRLA
How do you test CN IV?
EOM test
How do you test CN V?
palpate facial muscle/ separate jaw attempts, cotton whisp test
How do you test CN VI?
EOM test
How do you test CN VII?
facial symmetry
How do you test CN VIII?
normal convo and whisper test
How do you test CN IX?
depress tongue and check uvula retraction when saying “ahhh”
How do you test CN X?
depress tongue and check uvula retraction when saying “ahhh”
How do you test CN XI?
turn head against resistance
How do you test CN XII?
stick out tongue and say light, tight, dynamite
What is the romberg test?
person hold standing position with eyes closed for 20 seconds
What does a positive Romberg test mean?
swaying signals cerebellar ataxia (MS), lowered proprioception and lowered vestibular function
How do you perform the superficial pain test?
- use a pointed tongue blade and alternate sharp and dull to see fi patient is able to detect the changes
- patient says sharp or dull
How do you assess light touch?
- use a cotton whip and brush on skin
- person says yes and now when sensed
What is stereo genesis?
person’s ability to recognize objects by feeling their forms, sizes and wights with eyes closed
What is the primary function of the stereogenesis?
- assess parietal lobe discrepancies
How do you assess deep tendon reflexes?
- direct a short and snappy blow to insertion of tendon with hammer
- smaller tendons use pointed end
- large tendons use fat end
What is the normal finding of deep tendon reflexes?
Equal
What are three abnormal findings of deep tendon reflexes?
- hyporeflexia
- clonus
- hyperreflexia
clonus
short jerking contraction
hyporeflexia
absence of reflex with lower motor neuron problems leading to spinal cord injury
hyperreflexia
exaggerated with upper CNS neuron lesions (stroke)
What are the 5 grades of the reflexes?
4+ very brisk, hyperactive with clonus
3+ brisker than average, may indicate disease
2+ average, normal
1+ diminished, low normal
0 no response
What is the normal plantar reflex?
- should initiate plantar flexion of toes and sometimes the whole foot with the J motion
What is the Babinski reflex?
in infancy when big toe dorsiflects and other toes fan
What signals an upper motor neuron disease of pyramidal tract?
babinski relfex
what is the glasgow coma scale?
defines level of consciousness with numeric value
What is the scaling for eye opening?
4- spontaneous
3- to speech
2- to pain
1- no response
What is the scaling for motor?
6- obeys verbal command
5- localizes pain
4- flexion (w/ drawl)
3- flexion (abnormal)
2- extension (abnormal)
1- no response
What is the scaling for verbal?
5- oriented x3
4- conversation confused
3- speech inappropriate
2- speech incomprehensible
1- no response
What is a normal score on the glasgow coma scale?
adds up to 15
What is a score signaling coma on the glasgow coma scale?
7
PNS
12 cranial nerves and 31 spinal nerves
CNS
Brain and spinal cord
What is the function of the cerebral cortex?
thought, memory, reasoning, sensation, voluntary movement
What is the function of the thalamus?
main place for incoming information
what are the sections of the spinal nerves?
- 8 cervical
- 12 thoracic
- 5 lumbar
- 5 sacral
-1 coccygeal
CN IV, XI, XII are:
a. motor
b. sensory
c. mixed
A
CN I, II, VIII are:
a. motor
b. sensory
c. mixed
B
CN III, V, VII, IX, X are:
a. motor
b. sensory
c. mixed
C
What are the 5 parts of the reflex arc?
- intact sensory nerve afferent
- functional synapse in the cord
- intact motor nerve
- the NM junction
- the competent muscle
How do you obtain objective data?
- perform neurologic screening on well people
- perform neurologic recheck on people with deficits
Papilledema? Which nerve does it affect?
- increased cranial pressure leading to optic atrophy
- CN II
ptosis
drooping with myasthenia grevis
Which CN does Horner Syndrome affect?
CN III
Nystagmus
Back and forth quiver of eyes
What is the motor function of the trigeminal?
- palpate chewing muscle with patient clenching teeth
- push down on chin in attempt to separate the jaw
What is the sensory function of the trigeminal?
- touch cotton whip to forehead, cheeks and chin
What is the motor function of CN VII?
motility and facial movement
What is fasciculation? Which nerve does it affect?
- tongue deviation to one side
- hypoglossal (CN XII)
What are you testing for with the muscle strength test?
- size
- strength
Atrophy
wasted away small muscle with injury or disease
If there is a difference in muscle measure what is a non significant measure?
1cm
hypertrophy
increase size and strength with isometric exercise
What do you observe for with cerebellar function?
- gait
- romberg test
ataxia
uncoordinated or unsteady gait
hypoaglasia
decreased pain sensation
hyoaglasia
increased pain sensation
analgesia
absent pain sensation
hypoesthesia
decreased touch sensation
anesthesia
absent touch sensation
hyperpaestheisa
increased touch sensation
What is the first sensation lost with a diabetic patient?
vibration
How do you test the biceps reflex?
support forearm and put thumb on tendon and strike
How do you test the triceps reflex?
arm goes dead and strike tendon above the elbow, should see extension
What is the purpose of the Denver screening?
to check for fine motor
How do you test the infants head control muscle tone?
- pull up infant to sitting position
- 4 months the head shouldn’t flop
How do you test the rooting reflex?
brush cheek and head will turn with open mouth
What is the palmar grasp?
- when the baby grasps the finger and it’s strongest at 2 months
What is the tonic neck reflex?
- baby puts chin to the side
- appears 2 to 3 months and disappears at 4 to 6 months
What is the Moro reflex?
- jarr the crib to see if the baby hugs the tree
senile tremors
intention of hands, head, nodding, tongue protrusion
tremors of parkinson?
rigidity, slowness
What is the abbreviated neurologic check?
- level of consciousness
- motor function
- pupillary response
- vital signs