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NURS 202 > Neuro > Flashcards

Neuro Flashcards

1
Q

What is the leading cause of disability worldwide?

A

depression

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2
Q

Most common physical comorbidities with mental health disorders (4)

A

1) CVD
2) hypertension
3) respiratory disease
4) diabetes

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3
Q

Concurrent disorder: mental health disorder & _________

A

problematic substance use/substance use

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4
Q

T or F: Those with a mental health disorder are more likely than members of the general public to engage in violent behaviour.

A

FALSE

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5
Q

What is essential when doing a mental health assessment with a patient?

A

build rapport

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6
Q

Elements of a mental health history (4)

A

1) Interview
2) Observation
3) Examination
4) Collaboration

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7
Q

What is the primary source of information in a mental health assessment?

A

patient

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8
Q

What are secondary sources of information in a mental health assessment?

A

family, other HCP, patient records

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9
Q

T or F: For most patients, conducting an interview is sufficient enough for a mental health assessment.

A

TRUE

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10
Q

Interview

A

complete health history

what’s normal for the patient

identification/biographical info

reason for seeking care (verbatim or DSM5 diagnoses)

past health

family health history

developmental considerations

present health

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11
Q

What should you assess first during observation?

A

most basic functions (consciousness, language)

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12
Q

Main Components of Observation (4)

A

1) Appearance
2) Behaviour
3) Cognition
4) Thinking

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13
Q

Orientation x 4

A

1) Person
2) Place
3) Time
4) Self

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14
Q

What is the first sense/orientation to go?

A

time

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15
Q

What is the last sense/orientation to go?

A

self

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16
Q

Order in which the senses go

A

time –> place –> self

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17
Q

Questions to assess orientation to person

A

who examiner is, type of worker

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18
Q

Questions to assess orientation to place

A

where person lives, present location, type of building, names of city and province

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19
Q

Questions to assess orientation to time

A

day of week, date, year, season

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20
Q

Questions to assess orientation to self

A

person’s own name, age

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21
Q

Questions to assess immediate memory

A

on spot recall

ask to recall a statement you just made

affected by: head injury, fatigue, anxiety, strong emotions

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22
Q

Questions to assess recent memory

A

day-to-day events

“What did you think of the meal yesterday?”

affected by: organic disorders - delirium, dementia, amnesia, chronic alcoholism

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23
Q

Questions to assess long-term memory

A

years worth of experiences

“Where did you grow up?”

affected by: Alzheimer’s

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24
Q

How to assess new learning

A

Give them 4 unrelated words and ask them to recall a few minutes later

e.g. fun, carrot, ankle, loyalty

Alzheimer’s: 0 or 1 words recalled

also affected by anxiety, depression

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25
Q

Tool to assess risk factors for suicide

A

SADPERSONS

Score out of 10
-Score 3-6 = consider very close follow-up or hospitalization
-Score 7+ = consider hospitalization, contact MRP

higher score=higher risk

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26
Q

A patient scores an 8 on the SADPERSONS scale. What should your next course of action be?
a) consider this as normal and document
b) contact the most responsible provider
c) monitor the patient
d) call the patient first thing tomorrow morning and ask them how they’re feeling

A

b) contact the most responsible provider

and consider hospitalization

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27
Q

Tool to assess patient’s functioning

A

Global Assessment of Functioning

psychiatrist or other qualified physician

estimate of overall psychological, social, and occupational functiong

score: 0 to 100 (higher=better functioning, under 50=serious, severe)

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28
Q

When to perform mental health assessment (5)

A

1) Abnormality in mood or behaviour
2) Symptoms of mental illness, especially ACUTE onset
3) Family concerned
4) Brain lesions - trauma, tumour, stroke
5) Aphasia

29
Q

For a depression diagnosis, the patient must experience sadness and loss of interest in activities for at least _____ weeks

A

2 weeks

30
Q

Additional symptoms for depression diagnosis (7)

A

1) Disruption in sleep
2) Disruption in appetite
3) Poor concentration
4) Low energy
5) Psychomotor agitation or retardation
6) Excessive guilt
7) Feelings of worthlessness

need at least 4/7

31
Q

T or F: In children and adolescents, emotional and cognitive functioning are independent of one another

A

FALSE

interdependent

ask about educational and developmental milestones

32
Q

T or F: The majority of mental health disorders have onset during childhood and adolescence.

A

TRUE

70%

33
Q

Which age group is more likely to experience mental illness and/or substance use disorders than any other age group?

A

Young adults 15 to 24

34
Q

Screening tools for perinatal period

A

Edinburgh Postnatal Depression Scale (EPDS)

35
Q

T or F: There is universal consensus on the value of universal perinatal depression screening.

A

FALSE

but HCP needs to be aware and alert to this

36
Q

4 Lobes of the Cerebral Cortex

A

1) Frontal
2) Parietal
3) Occipital
4) Temporal

37
Q

Frontal Lobe

A

personality, behaviour, emotions, intellectual function

precentral gyrus: initiates voluntary movement

Broca’s area: mediates motor speech, damaged=expressive aphasia: person can understand language and knows what they would like to say, but can produce only a garbled sound

38
Q

Parietal Lobe

A

postcentral gyrus: primary centre for SENSATION

39
Q

Occipital Lobe

A

primary VISUAL receptor centre

(think of the O like an eye)

40
Q

Temporal Lobe

A

primary AUDITORY receptor centre

Wernicke’s area: language comprehension
damaged=receptive aphasia: person hears sound, but it has no meaning, like hearing a foreign language

41
Q

Aphasia

A

impairment of language ability secondary to brain damage

42
Q

Broca’s/Expressive Aphasia

A

can understand language but cannot express self with language

nonfluent, dysarthric, and effortful speech

motor speech cortex

43
Q

Wernicke’s/Receptive Aphasia

A

can hear sounds and words but cannot relate them to previous experiences

speech is fluent, effortless, and well-articulated but nonsensical

association auditory cortex

44
Q

You ask a patient to tell you where they live and they respond, “Two of them. And up and down.” What type of aphasia do they have?
a) Broca’s
b) Wernicke’s

A

b) Wernicke’s

45
Q

Basal Ganglia

A

controls autonomic associated movements of the body

“Be Good at movements”

46
Q

Thalamus

A

main relay station

think T for “train station”

47
Q

Hypothalamus

A

major control centre

controls temp, HR, BP

regulating sleep and pituitary

coordinating ANS activity and emotional stress

48
Q

Cerebellum

A

motor coordination of:
-voluntary movements
-equilibrium
-muscle tone

does NOT initiate movements

49
Q

Components of the brain stem (3)

A

1) midbrain
2) pons
3) medulla

50
Q

Where in the brain are the vital autonomic centres located?

A

medulla

e.g. resp, cardiac, GI

51
Q

Which structure in the CNS mediates reflexes?

A

spinal cord

52
Q

KEEP GOING YOU CAN DO THIS

A

SLAY UR EXAM

53
Q

Reflex Arc

A

basic defense mechanism of the nervous system

involuntary

enabling quick reaction to potentially painful or damaging stimulus

maintain balance and muscle tone

54
Q

4 Types of Reflexes

A

1) deep tendon
2) superficial
3) visceral
4) pathological

“don’t stop vibing, people”

55
Q

Deep Tendon Reflex Example

A

e.g. patellar (knee jerk)

56
Q

Superficial Reflex Example

A

e.g. corneal reflex, abdominal reflex

57
Q

Visceral Reflex Example

A

e.g. pupillary response to light and accomodation

58
Q

Pathological Reflex Example

A

e.g. positive Babinski (extensor plantar) reflex

ABNORMAL

59
Q

What order does myelination in infants follow?
a) distal to proximal
b) proximal to distal

A

b) proximal to distal

head → neck → trunk → extremities

60
Q

What is the most important piece of information in the initial assessment for stroke?

A

time of onset

61
Q

Stroke - FAST acronym meaning

A

F - FACE - drooping?
A - ARMS - raise both?
S - SPEECH - slurred or jumbled?
T - TIME - to call 911 right away

62
Q

Balance Tests (3)

A

1) Gait
-get patient to walk

2) Tandem walking
-heal-to-toe walking

3) Romberg
-get them to stand for 20 seconds with eyes closed

63
Q

Coordination and Skilled Movement Testing (4)

A

1) RAM
-slapping palm and back of hand back and forth across thighs, thumb and fingers

2) Finger-to-finger
-patient touches nose and examiners finger

3) Finger-to-nose
-patient closes eyes and alternates touching nose

4) Heel-to-shin test

64
Q

Spinothalamic Tract Sensations (3)

A

1) Pain - pinprick, something sharp

2) Temperature - cool metal, tuning fork

3) Light touch - cotton whisp

65
Q

Posterior Column Tract Sensations (3)

A

1) Vibration
-tuning fork

2) Position (Kinaesthesia)
-move their finger up or down and ask which direction you moved it

3) Tactile Discrimination (Fine Touch)
-Stereognosis: recognizing familiar object in hand
-Graphaesthesia: reading number or letter on skin
-2 Point Discrimination - paperclip
-Extinction - touch both sides of body at same time, ask how many sensations are felt and where
-Point location - point to location of touch

66
Q

Testing Deep Tendon Reflex

A

e.g. knee jerk reflex

reflex hammer

hit tendon insertion on both sides, should be symmetrical

67
Q

Grading Deep Tendon Reflex

A

4+: Very brisk, hyperactive with clonus (rapid, rhythmic contraction), indicative of disease
3+: Brisker than average, may indicate disease (upper motor lesions e.g. MS)
2+: Average, normal
1+: Diminished, low normal (lower motor lesions)
0: No response

68
Q

Testing Clonus

A

move the foot up and down a few times to relax the muscle

stretch the muscle by briskly dorsiflexing the foot and hold stretch

Normal: no further movement

Abnormal: clonus

69
Q

Testing Superficial Reflex

A

e.g. plantar reflex/Babinski

edge of reflex hammer on bottom of foot

normal: plantar flexion of the toes and inversion and flexion of the forefoot

abnormal: dorsiflexion of toes and fanning out of toes
NORMAL IN INFANTS THOUGH
(Babinski - think babi, normal in babies)

NURS 202 (6 decks)

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