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NUR 502 > Neuro (complete) > Flashcards

Neuro (complete) Flashcards

1
Q

Central nervous system made up of:

A

Brain
Spinal cord

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2
Q

Peripheral nervous system made up of..

A

Everything else!
* “All nerve fibers outside
the brain and spinal cord”
* Includes autonomic
nervous system

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3
Q

Cerebral cortex (location, function)

A

cerebrum’s outer layer of nerve cells; controls most conscious processes
Cerebral cortex is center of functions governing thought, memory, reasoning, sensation, and voluntary movement

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4
Q

LOBES OF THE CEREBRAL CORTEX

A

Parietal
occipital
frontal
temporal

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5
Q

Parietal lobe (location/function)

A

Sensation/ Top back

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6
Q

Frontal lobe (Location/function)

A

“Personality”
* Behavior
* Emotions
* Intellectual
function
* Broca’s area

**Front lobe

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7
Q

Occipital lobe (Location/function)

A

Vision- back of head

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8
Q

Temporal lobe (Location/function)

A

Auditory
* Hearing
* Taste
* Smell
* Wernicke’s area

**Side of head

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9
Q

Cerebellum

A

The “auto pilot”
* Voluntary movement
* Equilibrium
* Muscle tone
* Coordination of movement

**below occipital

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10
Q

Brain stem

A

basic functions of life

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11
Q

Autonomic nervous system (Sympathetic)

A

“Fight or flight” response
* Increased HR, BP, RR
* Decreased Peristalsis
* Secretion of epinephrine and
norepinephrine
* Bronchiole dilation

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12
Q

Autonomic nervous system (parasympathetic)

A

Maintaining normal body
functions
* Maintains (“normalizes”) BP,
HR, RR
* Increased Peristalsis
* Bronchiole constriction

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13
Q

Brain stem is made up of…

A

Midbrain/Pons/Medulla

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14
Q

Midbrain controls…

A

thalamus/hypothalamus

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15
Q

Pons controls…

A

respiratory centers

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16
Q

Medulla controls…

A
  • Ascending & descending tracts
  • Autonomic centers
  • Respiration, heart, GI
  • CN VII to XII
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17
Q

Cerebellum

A

Complex motor coordination for
* Movement
* Equilibrium
* Posture
* Receives information about muscle/joint position

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18
Q

How to assess for cerebellar functin?

A

Romberg Test
* Finger-to-finger
* Finger-to-nose
* Heel-to-shin
* Rapid alternating
movements

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19
Q

Pathways- sensory and motor direction

A

sensory-ascending
motor-descending

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20
Q

Corticospinal (pyramidal) tract

A

MOTOR PATHWAY OF THE CENTRAL NERVOUS SYSTEM
Motor fibers travel from
motor cortex to
brainstem, where they
cross and go down the
opposite (contralateral)
side

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21
Q

Describing Motor Function

A
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22
Q

Spinothalamic tract

A

Sensory fibers: transmit
pain, temperature,
touch

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23
Q

Posterior column

A
  • Position
  • Vibration
  • Fine touch
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24
Q

DESCRIBING SENSORY FUNCTION

A
  • Touch, pain, temperature
    * Light/dull (Sternal rub)
  • Vibration (tuning fork)
  • Proprioception
  • Romberg
  • Stereognosis (Put object in persons hands)
  • Graphesthesia (use pen to draw on their hands)
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25
Q

4 types of reflexes

A
  • Deep tendon (DTR)
  • Superficial
  • Visceral
  • Pathologic
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26
Q

Deep tendon reflex types

A

Biceps
* Triceps
* Brachioradialis
* Patellar
* Achilles tendon
* quadriceps

27
Q

Deep tendon reflex grading
superficial reflex grading

A
  • 0 = Absent
  • 1 = Weak
  • 2 = Normal
  • 3 = exaggerated
  • ## 4 = Hyperreflexia+- Present
    0-absent
28
Q

HISTORY: PERTINENT TO
NEUROLOGICAL ISSUES

A
29
Q

SIGNS AND SYMPTOMS (5)

A

Headache
* Mental status change- confusion, lethargy,
agitation, restlessness
* Dizziness, vertigo, syncope
* Numbness or loss of sensation
* Deficits of the 5 senses

30
Q

Tools for assessing (5)

A
  • Flashlight
  • Cotton
  • Object with sharp and dull sides
  • Vibration (tuning) fork
  • Reflex hammer
31
Q

CEREBRAL FUNCTION

A
  • Behavior
  • Level of consciousness: time, place, person
  • Glasgow Coma Scale
  • Memory: immediate, recent, remote
  • Mathematical ability
  • Thought process
  • Judgment
  • General knowledge
  • Communication
32
Q

CRANIAL NERVES (CNS)

A
  • I: Olfactory
  • II: Optic
  • III: Oculomotor
  • IV: Trochlear
  • V: Trigeminal
  • VI: Abducens
  • VII: Facial
  • VIII: Acoustic
  • IX: Glossopharyngeal
  • X: Vagus
  • XI: Spinal Accessory
  • XII: Hypoglossal

oh, oh, oh, to, touch, a, female, ass. Great, vag, soft, hands

33
Q

Sensory nerves

which cranial nerves are sensory

A
  • I: Olfactory
  • II: Optic
  • VIII: Acoustic
34
Q

Motor

A
  • IV: Trochlear
  • VI: Abducens
  • XI: Spinal Accessory
  • XII: Hypoglossal
35
Q

Sensory and motor

which cranial nerves

A
  • III: Oculomotor
  • V: Trigeminal
  • VII: Facial
  • IX: Glossopharyngeal
  • X: Vagus
36
Q

Cranial Nerves I,II

A
  • I: Olfactory
    • Smell
    • Non-noxious smells
    • Sensory
  • II: Optic
    • Vision
    • Requires ophthalmoscope
    • Sensory
37
Q

CRANIAL NERVES: III, IV, VI

A
  • III: Oculomotor (Motor)
    * Pupil dilation and constriction
    * PERRLA
  • IV: Trochlear (Motor)
  • VI: Abducens: Eye movement (Motor)
    * EOMs of cardinal gaze
    * Nystagmus? (back and forth eye movement)
    * Unilateral or bilateral?
    * Frequency?
    * Plane of movement?
  • Strabismus? (one eye wonky, lazy eye
  • Ptosis? Droopy eye lid
38
Q

PERRLA

A
  • P = Pupils
  • E = equal (as in size)
  • R = Round
  • R = Reactive to
  • L = Light, and
  • A = Accommodation
  • Can only be assessed in an alert individual
39
Q

CRANIAL NERVE: V (TRIGEMINAL)

A

Motor and Sensory
* Motor function: Chewing
* Have patient clench teeth clench, then palpate temporal and masseter muscles
* Sensory function
* Facial sensation
* Taste at anterior tongue

40
Q

CRANIAL NERVES: VII (FACIAL)

A
  • Facial muscles for expression
    * Have client “smile, frown, close eyes tight, lift brows, show teeth, puff cheeks”
    Sensory
    * Taste on anterior tongue
    * Tested only if injury occurs or is suspected
    * Salt, lemon juice, sugar
41
Q

CRANIAL NERVES: VIII, IX

A
  • VIII: Vestibulocochlear or Acoustic
    * Sensory for hearing and equilibrium
    * Requires special equipment to fully assess
    * Bedside assessment with conversation
    * Balance (vestibulocochlear)
  • IX: Glossopharyngeal
    * Sensory: taste (post tongue)
    * Motor: pharyngeal muscles (swallowing)
42
Q

CRANIAL NERVE: X (VAGUS)

A

Motor
* Pharyngeal muscles (swallowing)
* Consider the patient with stroke
* Assess gag
Sensory
* Viscera of thorax and abdomen

43
Q

Why else is the Vagus nerve
important?

A

The heart rate can drop so low that people will pass out if they “bear down” too much.

44
Q

CRANIAL NERVES: XI, XII (MOTOR)

A
  • XI: Spinal accessory (turning head right and left)
    * Trapezius and sternomastoid movement
    * Have patient turn head and apply resistance
    * Assess shoulder shrug
  • XII: Hypoglossal
    * Tongue movement
45
Q

DEVELOPMENTAL CONSIDERATIONS: INFANTS

A
46
Q

Sensory Assessment (Superficial and Deep)

A
  • Superficial:
    • Pain
    • Temperature
      • Light touch
  • Deep Sensation
    * Vibration
    * Position (kinesthesia)
    • Tactile discrimination
      * Stereognosis
    • Graphesthesia
47
Q

SPINAL NERVES

A

Cervical- C1-C7
Thoracic T1-T12
Lumbar L1-L5
Sacral S1-S5
Coccyx

48
Q

Types of sensations (4)

A
  • Anesthesia: no sensation
  • Hyperesthesia: increased sensitivity
  • Hypoesthesia: loss of sensation
  • Paresthesia: pins and needles
49
Q

NEUROLOGIC ASSESSMENT

A
50
Q

DEVELOPMENTAL CONSIDERATIONS:
THE ELDERLY PATIENT

A

Physiologic changes
General atrophy of neurons
* Brain actually decreases in weight
* Cerebral cortex thins
* Leads to decreased Cognitive brain function (CBF), Cerebral spinal fluid (csf),
* Neural connections slower
* Loss of muscle mass and tone
* Decrease in sensory abilities

Consequences
* Dizziness
* Syncope
* Tremors develop
* Strength (grip) less strong

**High risk for falls

51
Q

NEUROLOGIC CHANGES R/T AGING

A
  • Probable decline in cranial nerve function
  • Senile tremors
    • Benign: intention
      * Dyskinesia: no rigidity
  • Grip remains intact
  • Rapid alternating movements more difficult to perform
  • DTRs less brisk (Deep tendon reflexes)
  • In general, stronger stimuli may be necessary to elicit response
52
Q

ASSESSING MENTAL STATUS

A
  • Is change acute or gradual
  • Orientation
    * Person, place, time
  • Response to pain (Sternal rub)
  • Speech patterns
  • Person’s appearance
  • Coordination
  • Thought process
  • Level of consciousness (LOC)
    * Awake & alert
    * Lethargic
    * Stuporous (really have to shake the pt to rouse them)
    * Comatose
  • Speech patterns
    * Ability to communicate?
    • Appropriate response?
    • Speech rhythm
  • Memory
    * Cerebral function
    * Recent vs. remote memory
    * Immediate memory test (3 words)
  • Intellectual
    * Learning
    * Computation
    * Ability to read
    * Insight
    * Judgment
53
Q

MINI MENTAL STATUS Test

A
  • Max score 30
  • < 23 = cognitive impairment

Orientation?
Registration? (Repeat words back to me)
Naming (what is this object?)
Reading (Can you read this and do what it says?)

54
Q

Superficial reflexes

A
  • Plantar
  • Abdominal
  • Anal
  • Cremasteric: males, stroke the inner aspect of upper thigh (testes will contract)
  • Bulbocavernosus: contraction of the anal sphincter
55
Q

ABNORMAL FINDINGS (Muscle tone and reflexes)

A

Tone
* Flaccidity
* Spasticity
* Rigidity
* Cogwheel rigidity (like a watch hand/arm ticking)

Movement
* Paresis
* Paralysis
* Myoclonus
* Fasciculation/Tic/Tremor
* Resting
* Intention
* Chorea (Tourette’s)
* Athetoid (cerebral palsy)

56
Q

Abnormal pathological reflexes

A
  • Babinski
  • Brudzinski: flex the neck
  • Kernig: extension of
    the knee
57
Q

Abnormal postures

A

*Decorticate rigidity
* Decerebrate rigidity
* Flaccid quadriplegia
* Opisthotonus (Back/neck arches back)

58
Q

NEUROLOGIC INJURY: STROKE

A
  • “3rd most common cause of death in US”
  • Men > women
  • Thrombotic/embolic (clot)
  • Hemorrhagic (pressure build up)
  • Poor control of modifiable risk factors
59
Q

NEUROLOGIC INJURY:
PARKINSON DISEASE

A
  • Damage to extrapyramidal tracts
    * Dopamine loss
  • Classic symptom triad
    • Tremor
      * Rigidity
    • Bradykinesia (slow walking)
  • Flat facial expression
  • Increased Salivation (Drooling)
  • Decreased Eye blink (Dry eyes)
  • Ambulation problems (shuffling feet)
60
Q

ASSESSING THE HOSPITALIZED PATIENT

A
61
Q

NEURO EXAM SCREENING CHECKLIST (4)

A
  • Mental status
  • Cranial nerves
  • Motor function
  • Sensory function
62
Q

Glasgow coma scale

A

Used for TBI patients

63
Q

NIH stroke scale

A

15- item neurological examination stroke scale used to evaluate the effect of acute cerebral infarction on the LOC, language, motor strength, ataxia, dysarthria, and sensory loss.

NUR 502 (13 decks)

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