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Health Assessment Exam 4 > Neurologic system > Flashcards

Neurologic system Flashcards

0
Q

What does the peripheral nervous system include?

A

12 pairs of cranial nerves

31 pairs of spinal nerves

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1
Q

What does the central nervous system include?

A

Brain and spinal cord

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2
Q

Cerebral cortex

A

Outer layer of nerve cells

Thought, memory, reasoning, sensation, voluntary movement

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3
Q

Frontal lobe

A

Personality, behaviors, emotions, intellectual function

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4
Q

Precentral gyrus

A

Of the frontal lobe initiates voluntary movement

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5
Q

Parietal lobe

A

Post central gyrus located in the parietal lobe is the primary center for SENSATION

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6
Q

Occipital lobe

A

Visual receptor center

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7
Q

Temporal lobe

A

Auditory reception center w/functions of hearing, taste and smell

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8
Q

Wernickes area

A

In temporal lobe
Language comprehension

Receptive aphasia

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9
Q

Receptive aphasia

A

Damage to the wernickes area

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10
Q

Broca’s area

A

Frontal lobe
Motor speech

Expressive aphasia

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11
Q

Expressive aphasia

A

Can’t talk but understand what is being said

Damage to Broca’s area

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12
Q

When does damage occur

A

Neurological cells deprived of blood

Cerebral artery becomes occluded or when cerebral artery becomes occluded

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13
Q

Dermatome

A

A circumscribed skin area that is supplied mainly from one spinal cord segment through a particular spinal nerve

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14
Q

C6 dermatome

A

Thumb

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15
Q

C7 dermatome

A

Middle finger

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16
Q

C8 dermatome

A

Fifth finger

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17
Q

T1 dermatome

A

Axilla

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18
Q

T4 dermatome

A

Nipple

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19
Q

T10

A

Umbilicus

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20
Q

L1

A

Groin

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21
Q

L4

A

Knee

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22
Q

Syncope

A

A sudden loss of strength, a temporary loss of consciousness (a faint) due to lack of cerebral blood flow

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23
Q

Vertigo

A

Rotational spinning

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24
Q

Aura

A

A subjective sensation that precedes a seizure, could be auditory, visual or motor

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25
Q

Paresis

A

Partial or incomplete paralysis

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26
Q

Dysmetria

A

The inability to control the distance, power and speed of a muscular action

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27
Q

Parenthesia

A

An abnormal sensation (burning, tingling)

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28
Q

Dysarthria

A

Difficulty forming words

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29
Q

Stroke risk factors

A

Increased blood lipids
Family history
Medications for high blood pressure
Blood thinners

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30
Q

Who is more prevalent for strokes (culture)

A

American Indians/native Alaskans followed by African Americans

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31
Q

Stroke belt

A

Southeast us

High percentage of people with hypertension

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32
Q

Heatstroke

A

Hyperthermia (too hot) extremely high fevers, summer

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33
Q

If you have ….. You’re more prone to stroke

A

Diabetes, heart disease (plaques)

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34
Q

CN I

Olfactory

A

Sensory

Origin: Nasal chamber

Smell

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35
Q

CN II

Optic

A

Sensory

Origin: retina

Vision

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36
Q

CN III

Oculomotor

A

Motor

Origin: midbrain

All ocular muscles except lateral rectus and superior oblique

Parasympathetic— Pupil constriction

37
Q

CN IV

Trochlear

A

Motor

Origin: Midbrain

Down and in eye motion

38
Q

CN V

Trigeminal

A

Mixed

Origin: Pons and midbrain

Motor– Muscles of mastication

Sensory– sensation of face, scalp, cornea, mucous membranes of mouth and nose

39
Q

CN VI

Abducens

A

Motor

Origin: pons

Lateral (abduction) of eye

40
Q

CN VII

Facial

A

Mixed

Origin: pons

Motor— facial muscles, close eyes, labial speech

Sensory— taste (sweet, salty, sour, bitter) on anterior 2/3 of tongue

Parasympathetic— saliva and tear secretion

41
Q

CN VIII

Acoustic

A

Sensory

Origin: pons

Hearing and equilibrium

42
Q

CN IX

Glossopharyngeal

A

Mixed

Origin: medulla

Motor— pharynx (phonation and swallowing)

Sensory— taste on posterior one-third on tongue, gag reflex , ear pain

Parasympathetic— parotid gland, carotid reflex

43
Q

CN X

Vagus

A

Mixed

Motor— pharynx and larynx (talking and swallowing)

Sensory— General sensation from carotid body, carotid sinus, pharynx, viscera , hunger

Parasympathetic— carotid reflex, peristalsis, digestive juices, breathing, heart rate

44
Q

CN XI

Spinal accessory

A

Motor

Origin: medulla and cord

Movement of trapezius and sternomastoid muscles

Neck and shoulder girdle motion

45
Q

CN XII

Hypoglossal

A

Motor

Origin: medulla

Speech, eating (movement of tongue)

46
Q

Autonomic

A

Part of the Peripheral nervous system

Smooth muscles, cardiac muscles, glands

Involuntary

47
Q

Somatic

A

Part of the peripheral nervous system

Somatic fibers innervate the skeletal ( voluntary) muscle

48
Q

Testing CN I (olfactory nerve)

A

Assess Patency (occlusive nostril and sniff)

Use aromatic substance… Ask to Identify odor

49
Q

Testing CN II (optic nerve)

A

Cardinal fields of gaze

Examine ocular funds with ophthalmoscope

Papillae dens with increased intracranial pressure; optic atrophy

50
Q

Testing CN III, IV, VI

Oculomotor, trochlear, abducens

A

Ptosis -CN III

Strabismus, nystagmus
Pupil size, regularity, equality, direct and consensual light reaction and accommodation

51
Q

Testing CN V (trigeminal nerve)

A

MOTOR

Muscles of mastication by palpating TMJ

Clench, open and close mouth

SENSORY - light touching of face with cotton wisp, corneal reflex (CN V and VII)

52
Q

Testing CN VII( facial nerve)

A

Motor—Smile show teeth, close eyes against nurses attempt to open them

Sensory— test only when suspect facial nerve injury, taste (applicator with different tasting solutions)

53
Q

Testing CN VIII (vestibulocochlear nerve)

A

Whispered voice test

54
Q

Testing CN IX and X (glossipharyngeal and vagus nerve)

A

Motor— depress tongue and say ahhhh (should see midline rise in tongue and uvula) , gag reflex

Sensory — test too difficult

55
Q

Testing CN XI (spinal accessory nerve)

A

Press cheek on nurses hands, press up with shoulders on nurses hands

56
Q

Testing CN XII (hypoglossal nerve)

A

Inspect tongue (should see no tremors) speech is clear and distinct ( sounds of letters l,t,d,n)

57
Q

Flaccidity

A

Decreases resistance, hypotonia occur with peripheral weakness

58
Q

Testing cerebellar function

A

Balance tests, gait, Romberg test (eyes close feet together), rapid alternating movements (RAM) , finger to finger test , finger to nose test, heel to shin test

59
Q

When is a Romberg test positive? What causes this?

A

Loss of balance that occurs when closing eyes

Sensory loss

Occurs with cerebellar ataxia (multiple sclerosis, alcohol intoxication)

60
Q

Testing the spinothalamic tract

A

Pain (sharp/dull) , temperature (tuning fork-metal feels cool, warmth of nurses hand) , light touch (cotton wisp)

61
Q

Hypoesthesia

A

Decreased touch sensation

62
Q

Anesthesia

A

Absent touch sensation

63
Q

Hyperesthesia

A

Increased touch sensation

64
Q

Clonus

A

A set of rapid, rhythmic contractions of the same muscle

65
Q

Biceps reflex

A

C5 and C6

66
Q

Spasticity

A

Increased tone, hypertonic, increased resistance to passive lengthening

Upper motor neuron injury
(Paralysis with stroke develops spasticity days or weeks after incident)

67
Q

Rigidity

A

Constant state of resistance (dystonia— resists passive movement in any direction)

Damage to basal ganglia with Parkinsonism

68
Q

Cogwheel rigidity

A

Type of rigidity in which the increased tone is released by degrees during passive range of motion so it feels like small, regular jerks

Parkinsonism

69
Q

Hemiplegia

A

Spastic or flaccid paralysis of one side (right or left) of body and extremities

70
Q

Paraplegia

A

Symmetric paralysis of both lower extremities

71
Q

Quadriplegia

A

Paralysis in all four extremities

72
Q

Paresis

A

Weakness of muscles rather than paralysis

73
Q

Fasciculation

A

Rapid continuous twitching Id resting muscle or part of muse without movement of king that can be seen by clinicians or felt by patient

Fine- lower motor neuron disease

Coarse- cold exposure or fatigue and is not significant

74
Q

Myoclonus

A

Rapid sudden jerk

A hiccup Id a myoclonus of diaphragm

Single arm or limb is normal when falling asleep

Severe with grand mal siezures

75
Q

Rest tremor

A

Occurs when muscles are quiet and supported against gravity (hand in lap)

Parkinson’s- thumb and opposing fingers

76
Q

Intention tremor

A

Older people

Voluntary movement as in reaching toward a visually guided targets

77
Q

Chorea

A

Sudden, rapid, jerky purposeless movements involving limbs trunk or face

78
Q

Athetosis

A

Slow twisting movement resembling a snake or worm

Cerebral palsy

Disappears with sleep

79
Q

Peripheral neuropathy

A

Loss of sensation most severe distally

Diabetes, chronic alcoholism, nutritional deficiency

80
Q

Individual nerves or roots (sensory loss)

A

Decrease or lass of all sensory modalities. Area of sensory loss corresponds to distribution of the involved nerve

Trauma, vascular occlusion

81
Q

Spinal cord hemisection (brown-sequard syndrome)

A

Loss of pain and temperature, vibration

Meningioma, neurofibromas, cervical spondylosis, multiple sclerosis

82
Q

Complete transaction of the spinal cord

A

Complete loss of all sensory modalities below level of lesion. Condition is associated with motor paralysis and loss of sphincter control

Spinal cord trauma
Demyelinating disorders
Tumor

83
Q

Thalamus (patters of sensory loss)

A

Loss of all sensory modalities on the face, arm, and leg in the side contralateral to the leis on (in brain)

Vascular occlusion

84
Q

Cortex (sensory loss)

A

Loss of descrimination

Cerebral cortex, parietal lobe lesion (ex: CVA, stroke)

85
Q

Decorticate rigidity

A

Upper extremeties— flex ion of arm, wrist, and fingers;

Addiction of arm (tight against thorax)

Lower extremeties— extension, internal rotation, plantar flex ion,

Indicated hemispheric lesion of cerebral cortex

86
Q

Decerebrate rigidity

A

Upper extremities stiffly extended, addicted, internal rotation, palms pronated

Lower extremities stiffly extended, plantar flex ion, teeth clenched, hyperextended back

Indicated lesion in brainstem at midbrain or upper pons

87
Q

Flaccid quadriplegia

A

Complete loss of muscle tone and paralysis of all four extremities

Indicated completely nonfunctional brainstem

88
Q

Opisthotonos

A

Prolonged arching of the back with head and heels bent backward

Indicated meningeal irritation

89
Q

Brudzinski (pathological reflexes)

A

Method of testing: with one hand under the neck and the other hand on the persons chest, sharply flex chin on chest and watch hips and knees

Abnormal response (reflex is present)— resistance and pain in neck, with flexion of hips and knees

Indicates meningeal irritation (meningitis)

90
Q

Grasp (frontal release signs)

A

Method of testing — touch Palm with your finger

Abnormal reaponse (reflex is present)— uncontrolled, forced grasping (grasp is usually last of these signs to appear, so it’s presence indicates severe disease)

Indicates there is an unilateral frontal lobe lesion on contralateral side; when bilateral, diffuse bifrontal lobe disease

Health Assessment Exam 4 (4 decks)

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