Neuro Flashcards
Explain Receptive vs Expressive Aphasia
Receptive: Wernicke’s Area damaged- can’t understand language
Expressive: Broca’s Area damaged- can’t speak
Explain Basal Ganglia
Initiate/coordinate movement
Control automatic associated movements
Thalamus
Main relay station where sensory pathways of spinal cord, cerebellum, brain stem form synapses
CNS component
Explain the Hypothalamus
Major respiratory center
Temperature
Heart rate
Blood pressure
Sleep
Appetite
Sex drive
Explain the cerebellum
Coordination of voluntary movements
Equilibrium
Muscle tone
Doesn’t initiate, but coordinates and smooths movements
What mediates reflexes?
Spinal cord
List some upper motor neuron diseases
(entirely in CNS)
Cerebrovascular accident (stroke)
Cerebral palsy
Multiple sclerosis
List lower motor neuron diseases
(Cranial nerves and spinal nerves of PNS)
Spinal cord lesions
Poliomyelitis
Amyotrophic lateral sclerosis
What are the 4 types of reflexes?
Deep tendon
Superficial
Visceral
Pathologic (abnormal)
Explain dermatomes
Area of skin mainly supplied by 1 spinal nerve.
Causes referred pain
Causes shingles pattern
How are the following affected in aging adults?
Neuron structure in brain/spinal cord
Reaction time
Senses of pain, touch, taste, smell
Balance
Strength/agility/movement speed
Atrophy of neurons
slower reaction time
Diminished senses
decreased strength/agility, slower movement
What are 3 neurologic examinations for objective data collection?
Screening Neurologic Examination
Complete Neurologic Examination
Neurologic Recheck Examination
How would one assess CN I?
Can they identify/describe the smell of toothpaste?
How are CN II, III, IV, VI assessed?
PERRLA, visual acuity/visual fields, confrontation
direct/consensual responses
pupil size
Cardinal positions of gaze for EOMs
How is CN VII assessed?
Smile, frown, lift eyebrows, show teeth
How is CN VIII assessed?
Intact if the patient can converse throughout assessment
Whispered voice test
How are CN IX and X assessed?
Uvula rising midline
Gag reflex w/ tongue blade
How is CN V assessed?
palpating TMJ and seeing if the jaw can protract/retract against resistance, and if the mouth can open and close
How is CN XI assessed?
Asking patient to shrug shoulders upward against resistance
How is CN XII assessed?
Asking patient to stick out tongue, see if it is midline, has tremors, or bends
How is cerebellar functioning assessed?
GAIT: person walks 10-20 feet and returns
Walks in straight line in heel-to-toe fashion
Walking on toes for a few steps, then heels
Romberg test: closing eyes and standing still
How are RAM assessed?
Rapid Alternating Movements
-Hands on knees test
-touching thumbs to fingers test
-Finger to finger test
-Finger to nose test (closed eyes)
What 4 things are routinely screened for to assess the sensory system?
Superficial pain
light touch
vibration
steognosis
What are some characteristics of Deep tendon reflex testing?
Limb must be relaxed
Short, snappy blow of hammer onto muscle’s insertion tendon
Compare right/left sides
Explain the following fine touch tests:
Sterognosis
Graphesthesia
Two-point discrimination
Extinction
Point location
Stereognosis: ability to recognize objects by feeling their forms, sizes, weights
Graphesthesia: ability to “Read” a number by having it traced on skin
Two-point Discrimination: ability to distinguish separation of 2 simultaneous pin points on skin
Extinction: simultaneously touch both sides of body at same point
Point location: touch skin and have patient put finger where you briefly touched
Explain the Reflex grading scale
4= very brisk, hyperactive with clonus, indicative of disease
3=brisker than average, may indicate disease
2=average, normal
1=diminished, low-normal, occurs with reinforcement
0= nonresponsive
What is the normal response:
Biceps reflex
Triceps reflex
Brachioradialis reflex
Quadriceps reflex
Achilles
Biceps: contraction of biceps muscle and flexion on forearm
Triceps: extension of forearm
Brachioradialis: flexion/supination of forearm
Quadriceps: extension of lower leg
Achilles: foot plantar flexes against your hand
What is the normal response of the plantar reflex for adults?
Toes flex inwards
How should reflexes be assessed in aging adults?
Same examinations as younger adults
senile tremors occasionally occur
always use reinforcement when eliciting DTRS
What is the FAST acronym for stroke awareness?
F: Face dropping
A: arm weakness
S: speech difficulty
T: time to call 911
What are some risk factors for strokes?
HTN
Cigarette smoking
heart disorders
What are some warning signs of Alzheimer disease?
Memory loss
losing track
forgetting words
getting lost
poor judgement
losing things
mood swings
personality change
growing passive
abstract failing
How is a neurologic recheck done?
Level of Consciousness: most important
Motor function
Pupillary response
Vital signs
Explain the Glascow Coma Scale
Assesses:
Eye-opening response
Best verbal response
Best motor response
Best response: 15
Comatose client: 8 or less
Totally unresponsive: 3
Explain:
Decorticate
Decerebrate
Decorticate: abnormal flexion inward
Decerebrate: abnormal extension outward
Explain the following abnormalities in muscle tone:
Flaccidity
Spasticity
Rigidity
Cogwheel Rigidity
Flaccidity: soft, limp, hypotonia
Spasticity: increased tone, hypertonia
Rigidity: constant resistance to motion- stiffness
Cogwheel Rigidity: increased tone that releases with small jerks
List some abnormal gaits
Cerebellar ataxia: inability to coordinate movements from cerebellum injury
Parkinsonian (festinating): shuffling
Footdrop: inability to lift front of foot off the ground
List the LOC
COMA: unconsciousness, unresponsiveness to all external and internal stimuli
STUPOR: general unresponsiveness with arousal following repeated stimuli
OBTUNDITY: sleepy, reduced alertness to arousal, delayed stimuli responses
DELIRIUM: disorientation, confusion, agitation, loudness
CONSCIOUSNESS: alertness, awareness, orientation, memory
What is the summary checklist for a neurologic examination?
Mental status
Cranial nerves
Motor function
Sensory function
Reflexes
