Neuro Flashcards
1
Q
CN I
A
Olfactory
2
Q
CN II
A
Optic (vision)
3
Q
CN III
A
Oculomotor (pupil constriction)
4
Q
CN IV
A
Trochlear (downward movement of eyes)
5
Q
CN V
A
Trigeminal (jaw movement, sensation of face and neck)
6
Q
CN VI
A
Abducens (lateral movement of eyes)
7
Q
CN VII
A
Facial (facial movement, taste on anterior 2/3 of tongue)
8
Q
CN VIII
A
Acoustic or Vestibulochlear (hearing and balance)
9
Q
CN IX
A
Glossopharyngeal (swallowing, taste on posterior 1/3 of tongue)
10
Q
CN X
A
Vagus (swallowing, speaking)
11
Q
CN XI
A
Spinal/Accessory (flexion and rotation of head)
12
Q
CN XII
A
Hypoglossal (tongue movements)
13
Q
CN NERVE MNEMONIC
A
One of our toughest teachers asked for a good valued artificial hip
14
Q
Morning Headaches that subside after rising
A
may be an early sign of increased intracranial pressure such as brain tumor-vomit and it goes away you relieve the pressure
15
Q
Seizures
A
occur with epilepsy, metabolic disorders, head injuries and high fever
aura is an auditory, visual or motor sensation that forewarns a person that a seizure is about to occur
patients with generalized seizures often experience bladder incontinence during a seizure
16
Q
Dizziness or lightheadness
A
Related to CAD, cerebellar abscess or an inner ear infection
17
Q
Imbalance and difficulty coordinating or controlling movements
A
are seen in neurologic diseases involving the cerebellum, basal ganglia, or cranial nerve VIII (Acoustic)
diminished cerebral blood flow and vestibular response may increase the risk for falls
18
Q
Numbness or tingling
A
loss of sensation, tingling or burning (paraesthesia) may occur to damage to the brain, spinal cord or peripheral nerves
19
Q
Decrease in your ability to smell
A
A decrease in the ability to smell may be related to a dysfunction of cranial nerve I (olfactory) or a brain tumor
20
Q
Decrease ability to taste
A
related to dysfunction of cranial nerves VII (facial) or IX (glossopharyngeal)
21
Q
Ringing or hearing loss
A
ringing in the ears and decreased ability to hear may occur with dysfunction of cranial nerve VIII (acoustic)
22
Q
Change in your vision
A
Changes in vision may occur with dysfunction of cranial nerve II (optic), increased cranial pressure or brain tumors
23
Q
Double or blurred vision
A
damage to cranial nerves III (oculomotor), cranial nerves IV (trochlear), or VI. (abduces) may cause double or blurred vision
24
Q
Transient blind spots
A
early sign of cebreovascular accident (stroke)
25
Understanding or speaking verbal language
Injury to the cerebral cortex can impair the ability to speak or understand verbal langage
26
Dysphagia
May be related to CVA, Parkinson's, myasthenia gravis, gulliain barre syndrome, or dysfunction of cranial nerves IX (glossopharyngeal), X (vagus) or XII (hypoglossal)
27
Muscle weakness
unilateral weakness or paralysis may result from CVA, compression of the spinal cord or nerve injury
progressive weakness is a symptom of several nervous system diseases
28
Fasicultaitons
continuous, rapid twitching of a resting muscle
seen in lower motor neuron disease
29
Tremors
involuntary contraction of opposing groups of muscle
see in degenerative neurologic disorders such as Parkinson
seen in cerebellar disease and multiple sclerosis
30
Tics
involuntary repetitive twitching movements
seen in Tourette syndrome or tar dive dyskinesia
31
Myoclonus
sudden jerks of arms and legs
may occur normal when falling asleep as a single jerk
severe jerking is seen with grand Mal seizures
32
Chorea
sudden rapid jerky voluntary and involuntary movements of limbs, trunk, or face
seen in Huntington disease and Sydenham chorea
33
Athetosis
twisting, writhing, slow continuous movments
seen in cerebral palsy
34
intentional tremors
tremors that occur with intentional movements
Seen in extending hands, head nodding for yes or no extending one tongue which may protrude back and forth
35
Recent Memory loss
24 hours
seen with amnesic disorders, Korsakoff syndrome, delirium and dementia
36
Remote memory
(the past)
seen with impaired cerebral cortex disorders
37
head injury
minor head injuries can produce long term neurological defects and affect the patient's level of functioning
38
Meningitis, encephalitis, injury to the spinal cord or a stroke
these disorders can affect the long term physical and mental status of a patient
39
Neuro check
useful in an emergency situation and frequent assessments as needed during an acute phase of illness
quick assessment to see neurological status
includes: level of consciousness, pupillary checks, movement and strength of extremities, and vital signs
40
Glasgow Coma scale
Minor brain injury 13-15 points
moderate brain injury 9-12
Severe brain injury 3-8
41
CN I test
test of smell for those who report loss of smell, head trauma and abnormal mental status, and when presence of intracranial lesion suspected
smell is decreased with aging and asymmetry in sense of smell is important
42
Anomia with smell
can be congenital, chronic nasal and sinus problem
43
Smoking and cocaine with smell
will alter sense of smell
44
Snellen Eye Chart
most accurate
higher the denominator the poor the vision
20/200
means you can read at 20 feet a letter that normal vision can read at 200feet
45
Myopia
Nearsightedness
if patient is unable to see objects in the distance
46
Hyperopia
farsightedness
if the patient is unable to see near objects
47
Presbyopia
not being able to accommodate or focus
48
Confrontation test
screen for loss of peripheral vision
abnormal: glaucoma, retinal disease, stroke
49
CN III, IV, and VI
oculomotor, trochlear, and abducens nerve
palpebral fissures usually equal in width
check pupils for size regularity, equality, direct and consensual light reaction and accommodation (PERRLA)
assess extra ocular movements by cardinal positions of gaze
50
Ptosis
drooping of the eyelid
defect in the oculomotor (III) nerve
51
Pupilary Reflex
direct light reflex
consensual light reflex
52
Direct light reflex
constriction of pupil when exposed to bright light
53
consensual light reflex
the simultaneous contraction of the other pupil
54
Accommodation
adaptation of the eye for near vision
eyes will converge and the pupil will constrict
55
Testing for Accommodation
Ask the patient to focus on a distant object
this dilate pupils than have the shift gaze to near object
normal responses include pupillary constriction and convergence of axes of eyes
56
Abnormalites in Pupil
CN III, IV, VI
anisocoria
miosis
mydriasis
57
Anisocoria
unequal pupil size
58
Miosis
constricted and fixed pupils
brain stem damage
59
Mydriasis
dilated and fixed pupils
CNS injury, deep anesthesia, circulatory arrest
60
One large pupil
ICP can cause a sudden unilateral dilated and nonreactive pupil
any changes in the pupil needs to be reported to provider
61
Extraocular Movement
lead the eyes through Asterix
normal response is parallel tracking of object with both eyes
62
Corneal light reflex
Hirschberg Test
assess the parallel alignment of the eye
abnormal: asymmetry of light reflex is indicative of eye muscle weakness or paralysis
63
Nystagmus
Damage to the brain stem or cerebellum
the eyes drift slowly in one direction and then jerk back to the other
64
Strabismus
deviated gaze or limited movement (lazy eye)
65
Cranial Nerve V motor
motor function: assess muscles of mastication by palpating as person clenches teeth
muscle should feel equally strong on both sides, try to separate Jaws by pushing down on the chin; normally you can't
note them making faces
66
Cranial Nerve V sensory
with persons eyes closed test light touch sensation by touching cotton wisp to their face
test all division of CN V: ophthalmic (forehead), maxillary (cheek) and mandibular (jaw)
67
Abnormalities of CN V
any decreases or unequal sensation
with brain lesions sensation of face and body is lost on the opposite side of the lesion
68
Cranial Nerve VII
loss of movement or asymmetry as in stroke or bells palsy
69
bells palsy
most common facial paralysis
may be associated with herpes simplex infection
may develop several days or months and often recovers spontaneously
usually treated with corticosteroid
70
Cranial nerve VIII
acoustic nerve (vestibulochlear)
measures air conduction by bone in which sound vibrates through cranial bones to inner ear
rinne test
weber test
71
Weber test
# choose this test if they complain that they hear better in one ear than the other
place a tuning fork in the middle of person's skull and ask if they hear the tones equally in both ears
the person should hear the tone by conduction through the skull equal in both ears
if they only hear it in one ear they lateralized to the affected ear
72
RINNE TEST
COMPARES AIR CONDUCTION AND bone conduction sounds
place the tuning for on the person's mastoid process and ask them to signal when the sound goes away
put it back and they should hear the sound
normal: patients hears AC tone twice as long and louder as they hear the BC tone. So ac>bc is normal
conductive loss:patient hears BC tone as long as or long than they hear AC tone (BC>AC)
73
Conductive hearing loss
an infection
build up of ear wax
a punctured eardrum
fluid in the middle ear
damage to the small bones within the middle ear
74
Sensorineural hearing loss
Occurs when there's damage to any part of the specialized nervous system of the ear
includes the auditory nerve, hair cells in the inner ear, and other parts of the cochlea
ongoing exposure to loud noises and aging are common reasons for this type of heating loss
75
Cranial nerve IX and X
glossopharyngeal and vagus nerves
motor function: depress tongue with tongue blade
uvula and soft plate should rise in midline and tonsillar pillars should move medially
touch posterior pharyngeal wall with tongue blade and not gag reflex voice should sounds smooth not strained
76
Cranial nerve XI
spinal accessory nerve
check equal strength by asking person to rotate head against resistance applied to side of chin
ask person to shrug shoulders against resistance and it should be equal on both sides
77
Cranial nerve XII
Hypoglossal nerve
ask patient to stick out tongue movie it side and then return it to mouth
fasciculations and atrophy maybe seen with peripheral nerve disease
deviation to the affected side is seen with unilateral lesions
78
Assess condition and movement of muscles
asses the size and symmetry of all muscle groups
atrophy may be seen in diseases of low motor neurons or muscle disorders
79
Gait and balance
look for posture, freedom of movement, symmetry, rhythm and balance
ask them to walk heel to toe
80
Gait and balance disorders
motor, sensory, vestibular and cerebellar systems
an uncoordinated or unsteady gait that was not apparent with normal walking may be more obvious with tandem walking
81
Spastic gait
stiff, foot dragging walk caused by unilateral leg muscle hypertonicity
upper motor neuron lesion-CVA and trauma
82
Scissors Gait
adduction of thighs with each step
causing knees to hit or cross in a scissor like movement
cerebral palsy, multiple sclerosis
83
Propulsive Gait
stooped rigid posture
cardinal sign of advanced Parkinson's disease
84
Steppage Gait (slap Gait)
results from foot drop (lower motor neuron disease) which causes outward rotation of hip and exaggerated flexion of knee
toes hit ground first, producing an audible step
85
The Romberg test
ask person to stand up feet together and arms at side
when in stable position ask person to close eyes and to hold position for about 20 seconds
positive test is swaying and moving feet apart to prevent falling(vestibular dysfunction or cerebellar disorders)
86
DECORTICATE POSTURING
Mummy
arms, wrists, and fingers flexed
arms adducted
lower extremities extended, internal rotated with plantar flexion of feet
occurs with lesions of the cerebral cortex
87
Decerebrate posturing
(RIGID EXTENSION AND PRONATION OF THE ARMS)
arms extended adducted, internally rotated
wrist pronated and fingers flex
back hyperextended
teeth clenched legs extended in plantar flexion
occurs with lesions of brain steam at midbrain or upper pons
worse than decorticate posting
88
Assess light touch, pain and temperature
many disorders alter a person's ability to perceive sensation correctly
89
Anesthesia
absence of touch sensation
90
hypesthesia
decreased sensitive to touch
91
hyperesthesia
decreased sensitivity to touch
92
Analgesia
absence of pain
93
Hypalgesia
decreased sensitivity to apin
94
Hyperalgesia
increased sensitivity to pain
95
Vibratory sensation
low pitched tuning fork on a bony prominence
sensation at the ankles decreases after age 70
inability to sense vibrations may be seen in peripheral neuropathy with diabetes or chronic alcohol abuse
96
Kinesthesia
test person's ability to perceive passive movements of extremities
97
Tactile discrimination
evaluate sternognois by having patient identify an object placed in their hand with their eyes closed
asses for graphethesia to evaluate patient ability to perceive writing on the skin
98
Clonus
a set of rapid, rhythmic contractions of the same muscle
99
hyperreflexia
an exaggerated reflex usually from high cortical levels as seen with upper motor neuron lesions (stroke)
100
hyporeflexia
an Absence of reflex
this is a lower motor neuron problem, This is usually seen in spinal cord injury patients
101
areflexia
no reflex activity
102
Babinski Reflex
abnormal except in infancy
the abnormal response is dorsiflexion of the great toe and fanning of all toes. Babinski
disappears in children by 18-24 months
adults upper motor neuron disease of the corticospinal tract
103
Cerebellum
Responsible for motor control
includes muscle tone, equilibrium, and balance as it relates to movement
104
Brain stem
controls basic body functions such as breathing, swallowing, heart rate, blood pressure, consciousness, and whether one is awake or sleepy
consists of the midbrain, pons, and medulla oblongata
105
Frontal lobe
skeletal movement,
talking and writing
emotions
ability to learn and think abstractly
problem solving
106
Temporal
hearing and olfactory stimuli
memory and learning because of integration of the hippocampus
107
Pariteal lobe
perception and interpretation of pain, temperature, touch and texture
108
occipital lobe
visual recognition and interpretation of visual stimuli
