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NURS 202 > Neuro > Flashcards

Neuro Flashcards

1
Q

Afferent neurons

A

carry signals from the periphery to the CNS

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2
Q

Efferent neurons

A

carry signals from CNS out to the periphery

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3
Q

The lobes of the brain are commonly used for what during a physical exam?

A

landmarks

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4
Q

Frontal lobe

A

emotional/behavioral, voluntary movements

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5
Q

Temporal lobe

A

auditory

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6
Q

Parietal lobe

A

sensation

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7
Q

Wernicke’s area

A

responsible for comprehension of speech

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8
Q

Broca’s area

A

responsible for production of speech

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9
Q

Hypothalamus

A

central control center of the brain

responsible for vital signs

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10
Q

Midbrain, pons and medulla

A

part of the brainstem and is the central core of the body

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11
Q

Spinal cord

A

mediates reflexes

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12
Q

Cranial nerve I type and name

A

sensory

olfactory

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13
Q

Cranial nerve II

A

sensory

optic

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14
Q

Cranial nerve III

A

mixed

occulomotor

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15
Q

Cranial nerve IV

A

motor

trochlear

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16
Q

Cranial nerve V

A

mixed

trigeminal

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17
Q

Cranial nerve VI

A

motor

abducens

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18
Q

Cranial nerve VII

A

mixed

facial

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19
Q

Cranial nerve VIII

A

sensory

acoustic

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20
Q

Cranial nerve IX

A

mixed

glossopharyngeal

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21
Q

Cranial nerve X

A

mixed

vagus

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22
Q

Cranial nerve XI

A

motor

spinal

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23
Q

Cranial nerve XII

A

motor

hypoglossal

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24
Q

Cranial nerve I assessment

A

have patient close eyes, occlude one nostril and have them smell something

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25
Q

Cranial nerve II assessment

A

Snellen

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26
Q

Cranial nerve III, IV, VI assessment

A

PERRLA and 6 cardinal gazes

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27
Q

Cranial nerve V assessment

A

palpate temporal and masseter muscles for mastication

also have them close their eyes and touch cotton swab to face

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28
Q

Cranial nerve VII assessment

A

have patient smile, frown, close eyes, puff cheeks and then suck them back in

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29
Q

Cranial nerve VIII assessment

A

hearing acuity

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30
Q

Cranial nerve IX and X assessment

A

depress tongue with tongue blade and watch uvula contraction while patient says “ahh”
test gag reflex

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31
Q

Cranial nerve XI assessment

A

check sternomastoid and trapezius muscles for equal size and strength by having patient shrug against resistance

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32
Q

Cranial nerve XII assessment

A

inspect tongue; have them say “light”, “tight” and “dynamite” and make sure speech is clear and distinct

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33
Q

The cerebellum is responsible for?

A

equilibrium

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34
Q

Aphasia

A

loss of ability to express or understand speech

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35
Q

Ataxia

A

lack of muscle control or coordination of voluntary movements; looks similar to being drunk

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36
Q

Decerebrate rigidity

A

result of midbrain lesion
exaggerated extensor posture
arms will be extended with wrists turned out
legs will be extended with feet internally rotated
head will be arched backwards

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37
Q

Decorticate rigidity

A

result of severe damage to the brain
exaggerated flexed posture
arms will be at the chest with hands clenched
legs and knees will be internally rotated and feet may cross

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38
Q

Dysphasia

A

deficiency in generation or understanding of speech

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39
Q

Dysphagia

A

difficulty swallowing

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40
Q

Hemiplegia

A

paralysis of one side of the body

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41
Q

Paraplegia

A

paralysis of legs or lower body

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42
Q

Tic

A

repetitive twitching that can usually be surpressed

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43
Q

Tremor

A

rhythmic involuntary movement of opposing muscle groups

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44
Q

Tension headache origin

A

musculoskeletal

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45
Q

Tension HA definition

A

mild-moderate HA that is a less disabling form of migraine

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46
Q

Tension HA location

A

bandlike; on both sides of the head, forehead or back of the head

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47
Q

Does a tension HA throb or pulse?

A

No

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48
Q

Tension HA duration

A

30 minutes to days

49
Q

Tension HA quality

A

dull, aching, diffuse

50
Q

Tension HA timing and triggers

A

situational, response to overwork or stress

not worsened by physical activity

51
Q

Migraine HA definition

A

genetically transmitted vascular origin
prodrome aura
2-3 times more common in women than men

52
Q

Migraine HA location

A

can be unilateral or bilateral

behind eyes, temple or forehead

53
Q

Migraine HA character

A

throbbing

pulsing

54
Q

Migraine HA duration

A

rapid onset

peaks 1-2 hours after and lasts 4-72 hours

55
Q

Migraine HA timing and triggers

A

2/month that last 1-2 days
1 in 10 patients have one every week
triggered by hormones, foods, hunger
stress letdown, sleep deprivation

56
Q

Cluster HA definition

A

Rare, intermittent

excruciating, unilateral with autonomic symptoms

57
Q

Cluster HA location

A

always unilateral

behind eyes, temple, forehead or cheek

58
Q

Cluster HA character

A

piercing, burning, continuous

59
Q

Cluster HA duration

A

abrupt onset, peaks in minutes, lasts 45-90 minutes

60
Q

Cluster HA quantity and severity

A

Severe

can occur multiple times a day in clusters which can sometimes last weeks

61
Q

Cluster HA timing

A

1-2/day
each lasts 0.5-2 hours
this will last for months and then patient will go into remission

62
Q

Cluster HA triggers

A

alcohol, stress, daytime napping, wind/heat exposure

63
Q

Acute vs chronic headache

A

acute headaches have been present for hours or days, are usually severe, and are seen in the ER
chronic headaches have been present for months or years, vary in severity and are often seen by PCP

64
Q

What is the most important thing to ask when assessing a TBI?

A

Did the patient lose consciousness? For how long?

65
Q

What is the most important question to ask as it relates to headaches?

A

Have you had any unusually frequent or severe headaches?

66
Q

Objective vertigo

A

stationary objects in the environment are moving

67
Q

Subjective vertigo

A

the person feels as if they are moving

68
Q

Preictal phase

A

usually starts with an aura

69
Q

Aura

A

a subjective sensation that definitively precedes a seizure; can be auditory, visual or motor

70
Q

Ictal phase

A

actual seizure

71
Q

Postictal phase

A

After seizure

72
Q

What questions should be asked regarding the postictal phase?

A

Do you sleep? Do you have confusion, weakness, headache, or muscle aches?

73
Q

What commonly occurs in patients who are in the ictal phase of a seizure?

A

Loss of control of bowel and/or bladder

74
Q

What questions should be asked regarding seizures?

A

When did they start? How often do they occur? Do you have an aura? Where in the body do they occur? Do you have any associated signs? Are there are precipitating factors (discontinuing medication, fatigue, stress, hypoglycemia etc)?

75
Q

What is the most important question that must be asked and addressed when it comes to tremors?

A

How do tremors affect the patient’s ADLs?

76
Q

Paresis

A

partial or incomplete paralysis

77
Q

Paralysis

A

completenly absent movement

78
Q

Expressive dysphasia is also known as?

A

Broca’s

79
Q

Broca’s dysphasia?

A

patient understands/comprehends but cannot respond

80
Q

Receptive dysphasia is also known as?

A

Wernicke

81
Q

Wernicke dysphasia

A

they can respond but cannot understand or comprehend

82
Q

Global dysphasia

A

combination of both expressive and receptive dysphasia

83
Q

What is the most important thing to remember when assessing atrophy in the aging adult?

A

It may not be from a neurological deficit, it may just be related to advanced age

84
Q

What is the correct order of the neurological exam?

A 
mental status (ABCTs; A&O)
cranial nerves
motor nerves
sensory 
reflexes
85
Q

Appearance

A

body movements
dress
grooming
hygiene

86
Q

Behavior

A

LOC
facial expressions
speech
mood and affect

87
Q

Cognition

A 
orientation
attention span
recent memory
remote memory
new learning
88
Q

Thought processes

A

logical content
perceptions
suicidal ideations

89
Q

What tests do we use to test muscle strength?

A

Hand grasp with push-pull

Plantar flexion and dorsiflexion with resistance

90
Q

What tests can we use to test cerebellar function?

A

Gait
Romberg
Rapid Alternating Movement

91
Q

Gait test

A

watch patient walk 10-20 feet, turn and return to the starting point; have patient walk heel-toe in a straight line
normal gait is smooth and rhythmic

92
Q

Romberg test

A

ask patient to stand up with feet together and arms at side; when stable, have patient close eyes and hold position for 20 seconds

93
Q

Positive vs negative Romberg test

A 
positive = excessive swaying present
negative = no swaying present
94
Q

What are the various RAM tests?

A 
Knee pat with hand flip
Thumb to finger 
Finger to finger (patient to yours)
Finger to nose (patient touches their own nose after touching your finger)
Heel to shin
95
Q

What RAM tests are included in the NIH stroke scale?

A

Finger to finger
Finger to nose
Heel to shin

96
Q

Bicep reflex test process and what it tests

A

hold patient’s forearm, place thumb over bicep tendon, hit with reflex hammer
C5 and C6

97
Q

Tricep reflex test process and what it tests

A

suspend arm at bicep, strike directly above elbow at tricep tendon
C7 and C8

98
Q

Brachioradialis relfex test process and what it tests

A

hold thumbs to suspend arms strike right above radial styloid process
C5 and C6

99
Q

Quadricep reflex test process and what it tests

A

let lower legs dangle freely and strike right below knee cap

L2 - L4

100
Q

Achilles reflex test process and what it tests

A

knee flexed with hip externally rotated, hold foot in dorsiflexion and strike behind the foot at the heel
L5-S2

101
Q

Reflex scale

A 
4-point
4+ = very brisk
3+ = brisker than average
2+ = average
1+ = diminished
0 = none
102
Q

What type of dysfunction is Parkinson’s disease?

A

motor system dysfunction

103
Q

Definition of Parkinson’s disease?

A

defect of extrapyramidal tracts

104
Q

What are the defining characteristics of Parkinson’s disease?

A 
tremors
rigidity
cogwheel rigidity in hands
stooped posture
short and shuffling gait
flat, staring, expressionless face
pill rolling maneuver with fingers
105
Q

Which is more ominous; decerebrate or decorticate posturing?

A

decerebrate

106
Q

Location of lesion in decerebrate vs decorticate rigidity

A

brain stem at midbrain or upper pons vs. lesion at or above brain stem

107
Q

What does a positive babinski reflex indicate?

A

upper motor neuron lesion

108
Q

Who has the responsibility of notifying family of status of a brain dead patient?

A

nurse

109
Q

What must be checked when doing a neurological recheck?

A

LOC, motor function, pupillary response, vital signs, glasgow coma scale

110
Q

Why do we perform a neuro recheck?

A

monitor those with established neurologic deficits

111
Q

GCS definition

A

standardized objective assessment that defines the LOC of a person by using a numeric scale

112
Q

What GCS score will a fully alert, healthy human have?

A

15

113
Q

What GCS score reflects a coma?

A

7 or less

114
Q

What is the leading cause of long term disability and the 3rd leading cause of death?

A

stroke

115
Q

What are the most common symptoms of a stroke?

A

weakness in face or arms unilaterally, confusion, slurred speech, changes in vision, trouble walking, sudden and severe headache

116
Q

TIA

A

ministroke
isn’t permanent
usually caused by a spasm

117
Q

What are the three main causes of stroke?

A

HTN
cigarette smoking
cardiac disorder

118
Q

Modifiable risk factors for stroke

A 
smoking
obesity
HTN
diabetes
heart disease
119
Q

Nonmodifiable risk factors for stroke

A 
age
family history
sex
race
prior stroke

NURS 202 (4 decks)

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