Neuro Flashcards
What do neurons do?
nerve cells within the brain and spinal cord that receive sensory input and send motor commands to the body
What consists of the CNS? (2)
brain and spinal cord
What consists of the PNS? (3)
cranial nerves, spinal nerves, ANS
Cerebrum lobes (4)
fronta;, parietal, temporal, occipital
function and location of frontal lobe
- located in the front of the brain
- function: concentration, abstract though, memory, motor function
parietal lobe location and function
- located posterior to frontal lobe
- Function: sensory perception
Temporal lobe location and function
- inferior to frontal/parietal lobes
- function: auditory function, understanding of language and music
Occipital lobe location and function
- posterior to parietal lobe
- function: visual interpretation and memory
Parts of brain stem (3)
- midbrain
- pons
- medulla oblongata
Midbrain location and function
- connects pons and cerebellum
- auditory and visual reflexes
Pons location and function
- in front of cerebellum between the midbrain and medulla
- contains motor and sensory pathways
- portions of the pons control respirations
Medulla oblongata function (2)
- contains reflex centers for BP, respirations, HR, coughing, vomiting and swallowing
- responsible for arousal and sleep-wake cycle
location and function of cerebellum
- controls fine movement, balance and proprioception
- under the cerebrum and behind the brain stem
Spinal cord (connects w hat? composed of..protected by)
- connects the brain to the periphery
- composed of motor and sensory roots
- protected by the vertebral column
cranial nerves (how many? Which are sensory? motor? both?)
-12 pairs
-3 are sensory
-5 motor
4 are both
3 sensory cranial nerves
I, II, VIII
5 motor cranial nerves
III, IV, VI, XI, XII
4 Sensory AND motor cranial nerves
V, VII, IX, X
How many pairs of spinal nerves are there?
31
Spinal nerves (location and how many) 5
- cervical –> 8
- thoracic –> 12
- Lumbar –> 5
- sacral –> 5
- coocygeal –> 1
What does the ANS do?
regulates the body’s unconscious actions and activities of internal organs
PNS parts
Sympathetic –> “fight or flight”
Parasympathetic –> “rest and digest”
Common Concerning Symptoms of the Nervous System (8)
- HA
- dizziness or vertigo
- Generalized or focal weakness
- numbness
- abnormal or loss of sensations
- loss of consciousness, syncope, or near-syncope
- seizures
- tremors or involuntary movements
In terms of LOC, what does Alert mean?
responds readily, but may be confused
In terms of LOC, what does lethargic mean?
drowsy, but can be aroused
In terms of LOC, what does obtunded mean?
difficult to arouse, cannot make a complete sentence, requires repeated stimulation
In terms of LOC, what does stuporous mean?
no verbal response, responds to pain by moving extremities
In terms of LOC, what does comatose mean?
no evidence of awareness
What does mental status assess?
appearance, behavior, grooming, personal hygiene
How to assess orientation
- person
- place
- time
- situation
What does the mini mental status exam screen for? How many points are there?
- cognitive dysfunction or dementia
- 0-30 points
CN I…What is it? How to test
- Olfactory
- have pt sell something with eyes closed and identify smell
CN II…What is it? How to test
- Optic
- Snellen eye chart (visual acuity) and Visual fields (test peripheral vision)
CN III…What is it? How to test
- Oculomotor
- pupillary symmetry, constriction, accommodation
- test using pen light
CN III abnormal
ptosis and strabismus
CN IV… What is it? How to test?
- trochlear
- bring finger toward pt nose and watch how eyes move
Abnormal for CN IV
pt unable to look medially
CN V…What is it? (motor + sensory)
-Trigeminal
Motor –> chewing, clenching jaw
Sensory –> facial sensation (touch, pain, temp)
CN VI…What is it? how to test?
- Abducens (eyeball movements)
- Follow the tip of a pen without moving head
CN VII..What is it? (Sensory + motor).
Facial nerve
Motor –> facial expression
Sensory –> taste
How to test CN VII (sensory and motor)
Motor –> raise eyebrows, smile, frown, puff out cheeks
sensory –> have pt taste something and describe it
CN VIII…What is it? How to test
- Acoustic (hearing)
- whisper test, differentiate sounds in right and left ear
CN IX…what is it? (sensory + motor)
- Glossopharyngeal
- motor –> ability to swallow
- Sensory –> gag reflex, taste on posterior tongue
How to test CN IX? (sensory + motor)
Motor –> have pt say “ahhhh” to check soft palate elevation
sensory –> stroke right or left pharynx to promote gag reflex
CN X…What is it? (motor and sensory)
-Vagus nerve
-motor –> ability to swallow
Sensory –> gag reflex
How to test CN X..(sensory and motor)
- Motor –> have pt say “ahhh”
- sensory –> stroke right or left pharynx to promote gag reflex
CN XI…What is it? How to test
- Accessory nerve –> movement of head and shoulders against resistance
- have pt turn head from side to side and shrug shoulders. (check for symmetry)
CN XII…What is it? How to test?
- hypoglossal –> movement of tongue
- Have pt stick out tongue and move from side to side
What is two point discrimination?
pt is touched with two sharp objects to see if they feel 2 spots or just one
What is tactile identification?
Pt is given a common object with eyes closed and is asked to say what it is
What is agnosia?
loss of ability to recognize objects through a particular sensory system (tactile, visual)
What does bicep flexion test?
C5, C6
What does biceps extension test
C6, C7, C8
What does wrist flexion test
C6, C7, C8
What does Wrist extension test
C5, C6
What does Hand grip test
C7, C8, T1
What does finger abduction test
C8, T1
What does thumb opposition test
C8, T1
What does hip flexion test
L2, L3, L4
What does hip extension test
L5, S1
What does hip adduction test
L2, L3, L4
What does hip abduction test
L4, L5, S1
What does knee flexion test
L4, L5, S1, S2
What does knee extension test
L2, L3, L4
What does dorsiflexion test
L4, L5
What does plantar flexion test
S1, S2
What does motor assessment assess? (4)
- muscle appearance
- muscle tone
- muscle strength
- done against resistance
Grading of deep tendon reflexes
\+4 --> hyperactive with clonuse \+3 --> increased (hyperactive) \+2 --> normal \+1 --> decreased (hypoactive) 0 --> no reflex
What DTR may be absent in older adults and may not be of concern?
achilles
How to test bicep reflex and what is tested?
- strike bicep tendon over flexed elbow
- tests C5, C6
How to test tricep reflex and what is tested?
- Strike triceps tendon above the elbow with arm flexed and hanging freely
- Tests C7, C8
How to test bracioradialis reflex and what is tested?
- Strike brachioradialis tendon 1-2 inches above the wrist with forearm resting on the lap
- Tests C5, C6
How to test patellar reflex and what is tested?
- Strike the patellar tendon just below the patella with legs hanging
- Tests L2, L3, L4
How to test achilles reflex and what is tested?
- Strike stretched achilles tendon
- Tests S1
What deep tendon reflexes are tested? (5)
- biceps
- tricep
- brachioradialis
- patellar
- achilles
Which superficial reflexes are tested? (4)
- corneal
- gag
- upper and lower abdominal
- perianal
Most common superficial reflexes that are tested (2)
gag and corneal
How are superficial reflexes graded
+ or -
How to test for corneal reflex
use a clean cotton swab and lightly touch the outer corner or each eye on the sclera –> if the pt blinks it is +
How to test for gag reflex
touch back of pharynx with cotton tipped applicator -> + if pt “gags”
What are pathologic reflexes?
emergence of previous reflexes that disappeared when venous system matured
Name the 3 pathologic reflexes
- babinski
- sucking
- palmar grasp reflex
Cerebellar function tests (coordination and gait)
- coordination –> rapid alternating movements, point-to-point test, heel-to-shin test
- gait –> walk on heels and toes
How to test for balance?
Romberg test, hopping in place, walk heel to toe
What is the Romberg test?
-pt can be seated or stand with feet together first with eyes open then closed after 20 seconds (a loss of balance is abnormal and is considered a + Romberg test)
