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NURS125 > Neuro > Flashcards

Neuro Flashcards

1
Q

what attributes do we use to assess patterns of progression of neuro symptoms?

A
  • rapid vs slow
  • same vs dynamic
  • progressively worse vs getting better
  • remitting vs relapsing
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2
Q

define tone

A

resistance of a muscle to passive stretch while at rest

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3
Q

define atony

A

complete loss of muscle tone

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4
Q

define hypotonic

A

decreased muscle tone

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5
Q

define hypertonic

A

increased muscle tone

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6
Q

define alert

in terms of LOC

A

knows person, place, time

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7
Q

define confused

in terms of LOC

A

slow thinking, perhaps memory loss, does not respond correctly/quickly to person, place or time

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8
Q

define delirious

in terms of LOC

A

restless or agitated and marked loss of attention

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9
Q

define lethargic

A

drifts off frequently, must be aroused

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10
Q

define obtunded

A

frequent sleep, difficult to arouse, incoherent speech

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11
Q

define stupor

in terms of LOC

A

responds only to pain, groans and mumbles

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12
Q

define coma

in terms of LOC

A

unconscious with little or not response to stimuli

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13
Q

how do we test pronator drift?

A
  • Palms up
  • Hold the position
  • Observe eyes open then closed
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14
Q

what is the expected response of pronator drift?

A

arms remain steady and symmetric, no drifting, pronation or searching movements

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15
Q

what is the cause of forearm pronation (+/- downward movement)?

A

Subtle muscle weakness from lesion in contralateral pyramidal tract

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16
Q

what is the cause of slow pronation with upward movement?

A

Suggests ipsilateral cerebellar lesion

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17
Q

what is the cause of a searching movement during pronator drift?

A

lesion in ipsilateral dorsal column

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18
Q

how do we test tremor?

A

ask pt to draw a spiral

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19
Q

how do we perform the Romberg test?

A
  • Ask patient to stand with feet together, arms at the side
  • Observe for sway and loss of balance with eyes open and then closed
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20
Q

what is the expected response of Romberg test?

i.e. negative romberg

A

patient remains stable with eyes open and closed

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21
Q

what does an unexpected romberg response look like?

i.e. positive romberh

A

Patient starts to sway, stagger or fall when eyes are closed but was steady with eyes open

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22
Q

why is the Romberg test not considered a cerebellar test?

A

Romberg isolates proprioception by removing vision which cerebellar balance doesn’t depend on as much

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23
Q

what systems are required for balance?

A

vision, vestibular sense, proprioception

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24
Q

define dysarthria

A

difficulty producing sounds

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25
what is the mini mental state examination (MMSE)?
assessment tool that scores orientation, registration, attention, recall and language to assess cognitive function
26
define dysphasia
disorder in language use
27
define hemineglect
neuropsychological condition in which, after damage to one hemisphere of the brain, a deficit in attention and awareness towards the side of space opposite brain damage is observed
28
what components does the ABSCATT assess?
* appearance * behaviour * speech * cognition * affect * thought pereption/process * though content
29
what muscles are especially important to assess for muscle strength?
* triceps * wrist extensors * hamstrings * tibialis anterior * extensor halluces longis
30
how do we test for dysmetria?
touch your finger then their nose, repeatedly and quickly or run heel to opposite shin
31
how do we test for dysdiadochokinesia?
test rapid alternating movements by rapidly flipping hands back and forth on thighs (supination, pronation)
32
how do we test for dysarthria?
assess scanning speech (irregular speech rhythm, fluctuating volume or tone)
33
define spasm
sudden, involuntary muscle contraction
34
define fasciculations
brief, fine, involuntary muscle twitches seen under the skin
35
define tremor
rhythmic, oscillating movement of a body part, caused by alternating muscle contractions
36
what reflexes do we test?
* Brachioradialis * Biceps * Triceps * Patellar * Ankle
37
what spinal nerve does the brachioradialis reflex test?
C5&C6
38
what spinal nerve does the biceps reflex test?
C5 and C6
39
what spinal nerve does the triceps reflex test?
C6 and C7 (mostly C7)
40
what spinal nerve does the patellar reflex test?
L2-L4
41
what spinal nerve does the ankle reflex test?
S1 and S2
42
how do we test abdominal reflexes?
Use a blunt object to lightly stroke the skin in a diagonal direction toward the umbilicus
43
what is the normal response of the abdominal reflex?
contraction of abdominal muscles
44
what spinal nerve does abdominal reflex above umbilicus test?
T8-T10
45
what spinal nerve does abdominal reflex at middle abdomen test?
T9-T11
46
what spinal nerve does abdominal reflex below umbilicus test?
T10-T12
47
what is the expected response of the babinski test?
toes flex downwards
48
what is an unexpected response of the babinski test? | i.e. positive babinski
fanning of the toes
49
what vertebral level does the spinal cord reach in an adult?
L1
50
what vertebral level does the spinal cord reach in a child?
L2
51
what sensations is the lateral spinothalamic pathway responsible for?
pain and temperature
52
what sensations is the anterior spinothalamic pathway responsible for?
crude touch
53
where does the neuron decussate in the spinothalamic pathway?
right away in the spinal cord
54
where does the neuron decussate in the posterior column pathway?
in the medulla oblongata
55
what sensations is the posterior column pathway responsible for?
fine touch, pressure, vibration, proprioception
56
how do we test proprioception?
move pt’s fingers and toes up and down while eyes closed and ask to identify whether moving up or down
57
how do we test light touch?
using a cotton wisp to lightly touch skin in various dermatomes
58
how do we test vibration sense?
place low pitched tuning fork (128 Hz) on bony prominences while eyes closed
59
how do we test stereognosis?
place a familiar object in their palm and ask them to identify while eyes closed
60
how do we test grapthesia?
draw a letter or number on pt’s palm and ask them to identify while eyes closed
61
what motor movements is the corticospinal pathway responsible for?
voluntary control of skeletal muscles
62
how do we test extinction?
With patients eyes closed lightly touch one side at a time, then both simultaneously and ask where they feel the touch
63
what is the function of dermatome maps?
estimate sensation arriving at the dorsal horn cells through single level spinal nerve roots and correlate to areas of skin
64
define myotome
the group of muscles which is innervated by a spinal nerve root
65
we use dermatomes to assess issues where in the NS?
Spinal cord, dorsal horn or nerve root issues
66
what are some advantages of the GCS?
* Fast * Good for monitoring progress * Good predictor of prognosis and outcome acutely
67
what are some disadvantages of the GCS?
* Results can be confounded by things like sedation, intubation, or alcohol intoxication * Large inter-rater variability * Not great for long-term predictability
68
what is considered a "mild" GCS?
13-15
69
what is considered a "moderate" GCS?
9-12
70
what is considered a "severe" GCS?
<8
71
what components does the GCS use to assess function?
* eye opening * best motor response * best verbal response

NURS125 (12 decks)

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