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Assessment: Exam 3 > Neurologic system > Flashcards

Neurologic system Flashcards

1
Q

Cranial nerve I: ________ (sensory)

  • Function?
  • Abnormal?
A

Olfactory
Smell

Anosomia: possible causes include upper res infection; tobacco/cocaine; fracture of cribriform plate or ethmoid area; frontal lobe lesion. tumor in olfactory bulb or tract

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2
Q

Cranial nerve II: ______(sensory)

*Function?

A

Optic

vision

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3
Q

Cranial nerve III: __________ (mixed)

*Function?

A

Oculomotor
Motor-most EOM movement, opening of eyelids
parasympathetic-pupil constriction, lens shape

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4
Q

Cranial nerve IV: ________ (motor)

*Function?

A

Trochlear
Down and inward movement of eye

Abnormal: caused by fracture of orbit, or brainstem tumor

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5
Q

Cranial nerve V: __________ (mixed)

*function?

A

Trigeminal

motor: muscles of mastication
sensory: sensation of face and scalp, cornea, mucous membranes of mouth and nose

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6
Q

Cranial nerve VI: _________ (motor)

*function?

A

Abducens
Lateral movement of eye

abnormal: failure to move side to side, diplopia on lateral gaze. from brainstem tumor or trauma, fracture to orbit.

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7
Q

Cranial nerve VII: ________ (mixed)

*function?

A

Facial
motor: facial muscles, close eye, labial speech, close mouth. (abnormal: bell’s palsy (LMN) causes paralysis of entire half of face)

sensory: taste (sweet, sour, salty, bitter) on anterior two thirds of tongue (UMN lesions (stroke, tumor, inflam) cause of paralysis of lower half of face.
parasympathetic: saliva and tear secretion

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8
Q

Cranial nerve VIII: _________ (sensory)

*Function?

A

Acoustic

hearing and equilibrium

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9
Q

Cranial nerve IX: _____________ (mixed)

*Function?

A

Glossopharyngeal

motor: pharynx (phonation and swallowing)
sensory: taste on posterior one third of tongue, pharynx (gag reflex)
parasympathetic: parotid gland, carotid reflex

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10
Q

Cranial nerve X: ________ (mixed)

*Function?

A

Vagus

motor: pharynx and larynx (talking and swallowing) abnormal: bilateral cranial nerve X lesion, dysphagia, fluids regurgitate through nose.
sensory: general sensation from carotid body, carotid sinus pharynx, viscera
parasympathetic: carotid reflex

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11
Q

Cranial nerve XI: ______ (motor)

*Function?

A

Spinal
movement of trapezius and sternomastoid muscles

abnormal: absent movement: neck injury, torticollis

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12
Q

Cranial nerve XII: ___________ (motor)

*Function?

A

hypoglossal
Movement of tongue.

abnormal: deviates to one side (LMN lesion), slowed rate of mvmt (bilateral upper motor neuron lesion)

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13
Q

The subjective data includes: ______, head injury, dizziness/vertigo, _______, tremors, weakness, _________, numbness or tingling, difficulty swallowing, difficulty speaking, significant past history, environmental/occupational hazards

A

headache
seizures
incoordination

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14
Q

True ______ is rotational spinning caused by neurologic disease in the vestibular apparatus in the ear or in the vestibular nuclei in the brainstem

A

vertigo

  • room spins: objective
  • you are spinning: subjective

** make sure to distinguish from dizziness

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15
Q

Any weakness or problem moving any body part? generalized or local? does it occur with particular mvmt? for example proximal or large muscle weakness, is it hard to get out of bed, or reach for an object? for small or distal…is it hard to open a jar, write, walk without tripping?

A
  • Paresis is a partial or incomplete paralysis
  • Paralysis is a loss of motor function due to a lesion in the neurologic or muscular system or loss of sensory innervation
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16
Q

Any problems with coordination? balance?, any falling? which way? Do you legs seem to give way?

A

Dysmetria is the inability to control the distance, power, and speech of a muscular action

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17
Q

Any numbness or tingling in any body part? does it feel like pins and needles? Onset?does it occur with activity?

A

Paresthesia is an abnormal sensation (e.g burning, tingling)

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18
Q

Any problem speaking with forming words or with saying what you intended to say? Onset, how long?

A

Dysarthria is difficulty forming words; dysphasia is difficulty with language comprehension or expression

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19
Q

For the aging adult: any problems with dizziness? does this occur when you first sit or stand up, head mvmt, walk after eating? occur with any medications?

A

diminished cerebral blood flow and diminished vestibular response may produce staggering with position change, which increases risk for falls.

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20
Q

For aging men. do you ever get up at night and then feel faint while standing to urinate?

A

micturition syncope

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21
Q

For aging adult: have you noticed any decrease in memory, change in mental function? any confusion? did this come on suddenly or gradually?

A

Memory loss and cognitive decline are early indicators of alzheimer disease and can be mistaken for normal cognitive decline of aging

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22
Q

For aging adult:

  • Have you ever noticed any tremors? hands, face? worse with anxiety, activity, rest? What is it relieved by?
  • Any sudden vision change, fleeting blindness? occur with weakness/ loss of consciousness?
A
  • Senile tremor is relieved by alcohol, but this is not a recommended treatment. assess if abusing alcohol in effort to relieve tremor.
  • With any vision changes screen for symptoms of stroke
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23
Q

A complete neurologic exam includes mental status, _____ nerves, motor system, ______ system, reflexes.

A

cranial

sensory

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24
Q

For cranial nerve I (Olfactory), do not test routinely.

  • Test in those who report loss of smell, those with head ____, and those with abnormal mental status, and when the presence of a intracranial _____ is suspected.
  • First assess _______ by asking pt to occlude one nostril at a time and to sniff, then with person’s eye closed, present an ______ substance (Coffee, toothpaste, vanilla)
A

Trauma
lesion
patency
aromatic

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25
Q

One cannot test smell when air passages are occluded with upper _____ infection or with ________.

A

respiratory

sinusitis

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26
Q

_______: Decrease or loss of smell occurs bilaterally with tobacco smoking, allergic rhinitis, and cocaine use.

*Unilateral los of smell in the absence of nasal disease in ______ anosmia

A

Anosmia

Neurogenic

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27
Q

To test cranial nerve II (Optic): test visual ____ and test visual fields by _________.

*_______ with increased intracranial pressure; optic atrophy.

A

acuity

confrontation- Stand in front of pt, 2 ft away. direct pt to cover one eye with an opaque card, and with the other eye to look straight at you. cover your own eye opposite to the person’s covered one. You are testing the uncovered eye. Hold your finger in front and advance from the periphery in several directions.

papilledema

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28
Q

To test cranial nerves III (oculomotor), IV (trochlear), and VI (Abducens):

  • Palpebral fissures are usually equal in width or close.
  • Ptosis (drooping) occurs with _______ gravis, dysfunction of cranial nerve III or ______ syndrome
  • Check pupils for size, regularity, equality, direct and consensual light reaction, and ________. Increasing intracranial pressure causes a sudden, unilateral, dilated, and ________ pupil.
  • Assess _______ mvmt by the cardinal positions of gaze. Strabismus (deviated gaze) or limited mvmt. Nystagmus (back and forth oscillation of the eyes). These occurs with disease of the _______ system, cerebellum, or brainstem.
A 
Myasthenia 
Horner 
accomodation 
nonreactive 
extraocular 
vestibular
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29
Q

To test Cranial nerve V (Trigeminal)

Motor: Assess the muscles of _______ by palpating the ______ and masseter muscles as the person clenches their teeth.

*indicates decreased strength on one or both sides, ______ in jaw movement, or pain with clenching of teeth.

Sensory: Have pt close eyes, test ____ _____ sensation by touching with cotton wisp to 3 areas on each side of face (forehead, cheeks, and chin).
-Ask the person to say “now” whenever the touch is felt. This test all three divisions of the nerve 1.) ophthalmic, 2.) maxillary, and 3.) mandibular.

*decreased of unequal sensation. with a _____, sensation of face and body is lost on the opposite side of the lesion.

A 
mastication 
temporal 
asymmetry 
light touch 
stroke
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30
Q

To test Cranial nerve VII (Facial):

Motor function: note mobility and facial symmetry as the person responds to these requests: smile, frown, close eyes tightly, lift eyebrows, show teeth, and puff cheeks

Sensory function: do not test routinely, only when you suspect a facial nerve injury.

A

Abnormal::

  • Muscle weakness is shown by flattening of the nasolabial fold, drooping of one side of the face, lower eyelid sagging, and escape of air from only one cheek that is pressed in.
  • Loss of mvmt and asymmetry of mvmt occur with both CNS lesions (e.g. brain attack or stroke that affects the lower face on one side) and PNS lesions (e.g. bell’s palsy that affects the upper and lower face on one side)
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31
Q

To test cranial nerve VIII (acoustic/vestibulocochlear): test hearing acuity by the ability to hear normal conversation and by what other test?

A

whispered voice test

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32
Q

To test cranial nerves IX (glossopharyngeal) and X (vagus):

*Motor: Depress the tongue with a tongue blade, and note pharyngeal movement as the person says “ahh” or yawns; the _____and soft palate should rise in the midline, and the tonsillar pillars should move medially. Also note gag reflex (hypo, hyper, absent). note voice sounds smooth and not strained.

  • absence or asymmetry of soft palate mvmt or tonsillar pillar movement. Following a stroke, dysfunction in swallowing may increase risk for aspiration
  • hoarse or brassy voice occurs with vocal cord dysfunction; nasal ____ occurs with weakness of soft palate.

*Sensory: Cranial nerve IX does mediate taste on the ______ 1/3 of the tongue, but technically, the sensation is to difficult to test.

A

uvula
twang
posterior

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33
Q

To test cranial nerve XI (spinal): examine the _________ and trapezius muscle for for equal in size.
*Ask pt to rotate head and shrug shoulders against resistance.

Abnormal findings: ______, muscle weakness or paralysis occurs with a stroke or following injury to the peripheral nerve (e.g. surgical removal of lymph nodes)

A

Sternomastoid

atrophy

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34
Q

To test cranial nerve XII (hypoglossal): inspect the _____. No wasting or tremors should be present. Ask pt to say “light, tight, dynamite”, and note the lingual speech

Abnormal:

  • Atrophy
  • _________ (muscle twitch).
  • Tongue deviates to side with lesions of the hypoglossal nerve (when this occurs, deviation is toward the paralyzed side)
A

tongue

fasciculations

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35
Q

To assess motor system: inspect and palpate for size, strength (test muscle groups), tone (move extremities through passive ROM).

Abnormal: size:: Atrophy-abnormally small muscle with wasted appearance; occurs with ______, injury, _____ motor neuron disease such as polio, diabetic neuropathy. Hypertrophy-increased size and strength; occurs with _______ exercise.

Strength: paresis or weakness is diminished strength; paralysis or plegia is absence of _______.

Tone:

  • Limited ROM
  • Pain with motion
  • _______- decreased resistance, hypotonia occur with peripheral weakness.
  • spasticity and rigidity- types of increased resistance that occur with central weakness.
A 
disuse
lower 
isometric 
strength 
flaccidity
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36
Q
  • Assess cerebeller function by inspecting gait for balance, should be ______, arm-swing should be opposite, stepping coordination, and rhythm.
  • Abnormal: Stiff, immobile posture. _______ or reeling. wide base of support. Lack of arm swing or rigid arms. Unequal rhythm of steps. slapping of food. scraping of toe of shoe. _____-uncoordinated or unsteady gait.
  • Inspect gross motor & balance function
  • _____ walking (toe to heal): abnormal: crooked line of walk. widens base to maintain balance. staggering, reeling, loss of balance. An ataxia that did not appear with regular gait may appear now. inability to tandem walk is sensitive for an ______ motor neuron lesion, such as MS, and for acute cerebellar dysfunction, such as ______ intoxication
  • tip-toe walking
  • heel walking
  • Abnormal: muscle weakness in the legs prevents this.
  • Inspect Romberg test (pt balance for 20 seconds). Abnormal: a positive test occurs with cerebellar ataxia (MS, Alcohol intox, loss of ______, and loss of vestibular function)
  • Inspect RAM (rapid alternating mvmt). Abnormal: lack of coordination. slow clumpsy, and sloppy response is termed Dysdiadochokinesia and occurs with ______ disease.
A 
smooth
staggering
ataxia 
tandem 
upper
alcohol 
prioception 
cerebellar
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37
Q

______ is a clumsy mvmt with overshooting the mark and occurs with cerebellar disorders or acute alcohol intoxication.

____- ________ is a constant deviation to one side.

______ tremor when reaching to a visually directed side.

A

Dysmetria

past-shooting.

intention

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38
Q

To assess the sensory system by testing bilateral perception of each of these tests:

  1. ) ______ pain (use tongue blade, tear and half and use sharp and dull end to test pt in multiple spots)
  2. ) ____ touch: use cotton against skin, ask pt to tell when felt
  3. ) _______: use tuning fork on foot to test distal areas, if felt, can stop test.
  4. ) _______ (position/motion sense): hold fingers. ask pt to say whether up or down. abnormal: loss of position sense. problems with tactile discrimination (fine touch) occurs with lesions of the sensory cortex or posterior column
  5. ) ________ (object recognition)
  6. ) ________ (# recognition) use end of hammer to write a diff # on each hand
  7. ) Two-point discrimination: apply two sharp points of tongue blade and note the distance at which person no longer perceives two separate points.
  8. ) _____- use 2 sharp ends of tongue blade and see if pt can distinguish if they feel one or two. Abnormal: sensory cortex lesion (for all of these tests). the stimulus is extinguished on the side opposite the cortex lesion
  9. ) Point Location- Touch the skin, and ask pt to put your finger where I touched you.
A 
Superficial 
light
vibration 
Kinesthesis 
Stereognosis 
Graphesthesia
Extinction
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39
Q

Decreased pain sensation: _______

A

Hypoalgesia

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40
Q

Absent pain sensation: __________

A

analgesia

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41
Q

Increased pain sensation: _________

A

Hyperalgesia

42
Q

Decreased touch sensation: _________

A

Hypoesthesia

43
Q

Absent touch sensation:__________

A

Anesthesia

44
Q

Increased touch sensation: ________

A

Hyperesthesia

45
Q

If a pt is unable to feel vibration (from tuning fork). Loss of this sense occurs with peripheral neuropathy (e.g. ______ and alcoholism). often, this is the first sensation lost.

Peripheral neuropathy is worse at the _____ and gradually improves as you move up the leg, as opposed to a specific nerve lesion, which has a clear zone of deficit for its _______

A

diabetes

46
Q

________: the inability to identify objects correctly. occurs in sensory cortex lesions (e.g. stroke)

A

astereognosis

47
Q

Assess reflex function by testing what deep tendon reflexes?

A 
Biceps 
Triceps
Brachioradialis 
Patellar (quadriceps)
Achilles
48
Q

Assess superficial reflexes: _____ (babinski): dorsi flex foot, and draw a upside down J.

**Except in infancy, the abnormal response is ______ of the big toe and fanning of all toes, which is a positive sign, also called “upgoing toes”. This occurs with ____ motor neuron disease of the corticospinal (or pyramidal) tract.

A

Plantar
dorsiflexion
upper

49
Q

Assess ______ irritation: Brudzinski’s sign (support pt put hands on shoulders and as pt to lift head, knees should not rise or is pos (hurts in the neck), and _____ sign (Nurse flexes pt knee and bring to their chest, if positive, pt will resist and pull up neck/complain of pain)

A

meningeal

Kernig

50
Q

______ is a set of rapid, rhythmic contractions of the same muscle.

A

Clonus

**A hyperactive reflex with sustained clonus (lasting as long as the stretch is held) occurs with upper motor neuron disease.

51
Q

_______ is the exaggerated reflex seen when the monosynaptic reflex arc is released from the usually inhibiting influence of higher cortical levels. this occurs with _____ motor neuron lesion (stroke)

A

hyperreflexia

upper

52
Q

_______, which is the absence of a reflex, is a ______ neuron problem. it occurs with interruption of sensory afferents or destruction of motor efferents and anterior horn cells (S.C. injury)

A

hyporeflexia

lower

53
Q

For the aging adult: conduct same assessment.
* Hand muscle atrophy is _______ with disuse and degenerative arthropathy.

  • distinguish senile tremors (which are occasionally occur) from tremors of parkinsonism. The latter includes rigidity and slowness and weaknes of voluntary mvmt
  • absence of rhythmic reciprocal gait pattern is seen in parkinsonism and _______
  • Loss of sensation of vibration to ankle malleolus is common and achilles DTR are ususally lost after age 65.
  • note any difference in sensation between left and right sides, which may indicate a neurologic deficit.
A

worsened

hemiparesis

54
Q

A weak grip occurs with UMN and LMN disease and with local hand problems (______, carpal tunnel syndrome)

A

arthritis

55
Q

Pronator drift is a downward unilateral drift and turning in of the forearm that occurs with mild _______.

A

hemiparesis

56
Q

Any abnormal posturing, decorticate (hands flexed on stomach/abnormal flexion) rigidity, or decerebrate (arms, hands lying down and flexed at wrist/abnormal extension) rigidity indicates _____ brain injury

A

diffuse

57
Q

In a brain injured person, a sudden unilateral dilated and nonreactive pupil is ominous. Cranial nerve III runs parallel to the brainstem. when increasing intracranial pressure pushes the brainstem down ( _____ _______), it puts pressure on cranial nerve III, causing pupil dilation.

A

uncal herniation

58
Q

To test hospitalized patients who have head trauma or a neurologic deficit due to a system disease process. monitor closely for improvement or deterioration in neuro status and for any signs of increasing _______ pressure. For a recheck what abbreviated sequence should you use?

A

intracranial

Level of consciousness
motor function
pupillary response
vital signs

59
Q

For a recheck, a change in the level of ______is the single most important factor in this. It is the earliest and most sensitive index of change in neurologic status.

  • Ask the person:
  • _______: their name; place: where are you; time: what is the date?
  • Attention span (pt attentive since you already asked questions)
  • ____ memory: use 4 unrelated words, note intact after asking throughout assessment (roughly 3 times)
  • _______memory: What happened on 911? or other history questions; note intact
  • New learning: already assessed by the 4 words
  • Evaluates _____ reasoning skills: ask nonreligious proverb. What do you think this means?
  • Evaluate decision making skills: do you wear a seatbelt, safety: tell me about sun exposure? etc.
A 
consciousness 
orientation 
recent
remote
abstract
60
Q

The ______reflex shows signs of increasing intracranial pressure: blood pressure- sudden elevation with widening pulse pressure; pulse-decreased rate, slow and bounding.

A

Cushing

61
Q

The Glasgow coma scale is divided into three areas: eye opening, _____ response, and motor response

A

verbal

  • each area is rated separately , and a # is given for pt best response, the three # are added; the total score reflects the brains functional level.
  • serial assessment can be plotted on a graph to illustrate whether the pt is stable, improving, or deteriorating.
  • A normal person has a rate of 15, whereas a score of 7 or less reflects a coma
  • assess the functional state of the brain as a whole.
62
Q

What are the 10 warning signs of Alzheimer disease?

A
  1. ) Memory loss (most common early signs of dementia)
  2. ) Losing track (difficulty performing familiar tasks)
  3. ) Forgetting words (problems with language)
  4. ) Getting lost (disorientation to time and place)
  5. ) poor judgement (ex: minimal clothing in cold)
  6. ) abstract failing (problem with abstract thinking)
  7. ) losing things
  8. ) mood swings or change in behavior
  9. ) personality change
  10. ) growing passive (loss of initiative)
63
Q

_______ is decreased muscle tone or hypotonia; muscle feels limp, soft and flabby. muscle is weak and easily fatigued. Associated with LMN injury anyhwere from the anterior horn cell in the SC to the peripheral nerve (peripheral neuritis, poliomyelitis, guillain-barre syndrome); early stroke and SCI are this at first.

A

Flaccidity

64
Q

_______is increased tone or hypertonia; increased resistance to passive lengthening; then may suddenly give way (clasp knife phenomenon) like a pocket knife sprung open. Associated with UMN injury to the corticospinal motor tract (e.g. paralysis with stroke develops this days or weeks after incident.

A

Spasticity

65
Q

_____ constant state of resistance, resists passive mvmt in any direction; dystonia. associated with injury to extrapyramidal motor tracts (e.g Basal ganglia with parkinsonism)

A

Rigidity

66
Q

______ rigidity is a type in which the increased tone is released by degrees during passive range or motion so it feels like small, regular jerks. Associated with parkinsonism

A

Cogwheel

67
Q

_______ is decreased or loss of motor power due to problem with motor nerve or muscle fibers

*Causes: Acute: trauma, SCI, stroke, poliomyelitis, polyneuritis, bells palsy

Chronic: muscular dystrophy, diabetic neuropathy, MS.

Episodic: myasthenia gravis

A

paralysis

Patterns include: hemiplegia (one side of body), paraplegia (eg.g both legs), paresis- weakness of muscles

68
Q

Rapid, continuous twitching of resting muscle or part of muscle, without mvmt of limb

Fine: occurs with LMN, associated with atrophy and weakness.
Course: occurs with cold exposure or fatigue and is not significant

A

Fasciculation

69
Q

rapid sudden jerk or a short series of jerks at fairly regular intervals. A hiccup is a _________ of diaphragm. Single arm or leg jerk is normal when person is falling asleep. are severe with grand mal seizures

A

myoclonus

70
Q

involuntary contraction of opposing muscle groups, rhythmic, back and forth mvmt of one or more joints

A

tremor . disappear while sleeping.

71
Q

______ tremor: Rate varies; worse with vol mvmt as in reaching toward a visually guided target. occurs with cerebellar disease and MS

______ tremor (familial)- a type of intention; most common tremor with older people. benign (no associated disease) but causes emotional stress in situations. improves with sedatives, alcohol

A

intention

essential

72
Q

Sudden, rapid, jerky, purposeless mvmt involving limbs, truck, or face, occurs at irregular intervals, not rhythmic or repetitive, mor convulsive than a tic

A

chorea

73
Q

Invol, compulsive, repetitive twitching of a muscle group, due to a neurologic cause (tardive dyskinesias, tourette syndrome) or a psychogenic cause (habit tic)

A

Tic

74
Q

Slow, twisting, writhing, continuous mvmt, resembling a snake or worm, involves distal part of the limb more than proximal. occurs with cerebral palsy. “athetoid” hand-some fingers are flexed and some are extended.

A

athetosis

75
Q

In ______ ______ the arm is immobile against the body.

possible cause include UMN of the corticospinal tract (stroke, trauma)

A

spastic hemiparesis

76
Q

In _______ ______, gait is staggering, wide based. difficulty with turns; uncoordinated mvmt with pos romberg sign
possible cause includes alcohol or barbiturate effect on cerebellum; cerebellar tumor; MS

A

cerebellar ataxia

77
Q

In __________(festinating), posture is stopped, trunk is pitched forward. steps short and shuffled. Difficulty in any change in direction

A

Parkinsonian

78
Q

For abnormal gait pattern, _______: knees cross or are in contact, short steps. due to paraparesis of legs, MS

A

scissors

79
Q

______ or footdrop has a slapping quality-looks as if walking up stairs and finds no stair there. lifts knee and foot high and slaps it down hard and flat to compensate.
-due to weakness of peroneal and anterior tibial muscles;due to LMN lesion at the SC (poliomyelitis)

A

steppage

80
Q

_______occurs with weak hip muscles- when the person takes a step, the opposite hip drops. caused by hip girdle due to muscular dystrophy, dislocation of hips

A

waddling

81
Q

Leg length discrepancy >2.5 cm. due to congenital dislocated hip; acquired shortening due to disease, trauma.

A

short leg

82
Q

Characteristics of weakness/paralysis for neuron lesion includes:

  • Upper motor: in muscles corresponding to distribution of damage in pyramidal tract lesion; usually in hand grip, arm extensors, leg flexors
  • lower motor: in ______ muscles served by damaged spinal segment, ventral root, or peripheral nerve
A

specific

83
Q

Characteristics of location for neuron lesion:

  • Upper: descending motor pathways that originate in the motor areas of cerebral cortex and carry impulses to the _____ horn of the SC
  • Lower: Nerve cells that originate in the anterior horn of SC or in brainstem carry impulses by the spinal nerves or cranial nerves to muscles, the “_____ ______ pathway”
A

anterior

final common

84
Q

Example of upper motor neuron lesion: ______

A

stroke

85
Q

Example of lower motor neuron lesion:

A

poliomyelitis, herniated intervertebral disk

86
Q

Characteristic of muscle tone for motor neuron lesion:

  • Upper: increased tone; _______
  • Lower: loss of tone, ________
A

spasticity

flaccidity

87
Q

Characteristic of bulk for motor neuron lesion:

  • upper: may have some atrophy from _____; otherwise normal. no abnormal mvmt
  • lower: atrophy (wasting) may be marked, fasciculations present
A

disuse

88
Q

characteristics of reflexes for motor neuron lesions:

  • Upper: Hyperreflexia, ankle clonus; diminished or absent superficial abdominal reflexes; positive ______ sign
  • Lower: hyoreflexia or areflexia; no babinski sign, no pathologic reflexes
A

babinski

89
Q

What are some possible nursing diagnoses for motor neuron lesions?

  • upper: risk for _______; impaired physical mobility
  • Lower: impaired ______mobilitly
A

contractures

physical

90
Q

Mixed group of paralytic neuromotor disorders of infancy and childhood; due to damage to cerebral cortex caused by a dev. defect, intrauterine meningitis, or encephalitis, birth trauma, anoxia, or kernicterus

A

cerebral palsy

91
Q

Chronic, progressive wasting of skeletal musculature, which produces weakness, contractures, and severes cases res. dysfunction and death. many types exist; the most severe is ducheene dystrophy, characterized by the waddling gait

A

muscular dystrophy

92
Q

Defect of extrapyramidal tracts, in the basal ganglia, with the loss of the neurotransmitter dopamine

A

parkinsonism (classic triad of symptoms: tremor, rigidity, bradykinesia)

93
Q

chronic, progressive, immune-mediated disease in which axons experience inflamm. demyelination, degeneration, and finally sclerosis

A

multiple sclerosis: structures most often involved include the optic, oculomotor nerve. symptoms vary: but include blurred vision, diplopia, extreme fatigue, weakness, spasticity, numbness and tingling, loss of balance.

94
Q

_______ neuropathy includes loss of all modalities. loss is most severe distally (feet and hands)

A

peripheral- possible causes diabetes, chronic alcoholism, nutritional deficiency

95
Q

_____ nerves or roots involves a decrease or loss of all sensory modalities. area of loss corresponds to distribution of the involved nerve.

A

individual-causes include trauma and vascular occlusion

96
Q

Spinal cord _______ (brown-sequard syndrome). involves loss of pain and temperature, contralateral side, starting one to two segments below the level of the lesion.

A

hemisection- causes include meningioma, neurofibroma, cervical spondylosis, MS

97
Q

_______ transection of SC involves a loss of all sensory modalities below the level of the lesion. condition is associated with motor paralysis and loss of sphincter control

A

complete-caused by SC trauma, demyelinating disorder, tumor

98
Q

_______-loss of all sensory modalities on the face, arm, and leg on the side contralateral to the lesion

A

thalamus-vascular occlusion

99
Q

Because pain, vibration, and crude touch are mediated by thalamus, little loss of these sensory functions occur with a _____ lesion. loss of discrimination occurs on the contralateral side. loss of graphesthesia, sterognosis, recognition of shapes and weights, finger finding

A

Cortex-caused by cerebral cortex, parietal lob lesion (stroke)

100
Q

prolonged arching of the back, with head and heels bend backward. indicated meningeal irritation.

A

opisthotonos

Assessment: Exam 3 (3 decks)

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