Neurologic System (Chapter 24) Flashcards
3 parts of the nervous system
central
autonomic
peripheral
central nervous system
brain, spinal cord
autonomic
unconsious
peripheral nervous system
cranial nerves
nerves carry to CNS via
affernet
nerves carry from CNS via
efferent
cerebellum
occipital lobe, equilibrium, coordination of voluntary movement
thalamus
relay station, receive info
hypothalamus
HR, BP, temp, respiration, sleep
brain stem is composed of
midbrain, pons, medulla
what cranial nerves are in the brain stem
3-12
spinal cord mediates
reflexes
aphasia
inability to communicate through speech
ataxia
inability to coordinate movement
cerebella ataxia
S&S of parkinsons
dysphasia
difficulty speaking
dysphagia
difficulty swallowing
flaccidity
no resistance to gravity
who might have flaccidity
stoke pts
hemiplegia
paralysis on one side of body
Tic
involuntary/ impulsive repetitive twitch of muscle
a tic can be neurologic or
psychogenic
tremor
sign and symptom of med/patho, involuntary contraction of opposing muscle
who might have a tremor
cerebella disease
MS, or parkinsons
deserebrate and decorticate
postal positions may seen in patient with neurologic event
dercebrate
ominous: prognosis is very poor
brain stem injury/damage, lesion in brainstem at midbrain/upper pons
decorticate
arms pulled forward, lesion at or above brain stem
seizure phases
preictal
ictal
postictal
preictal
aura: subjective sensation that precedes a seizure
auditory, visual, motor
ictal
seizure is actually occurring
most become incontinent
crash cart for airway
put pt on side
do not hold pt down
pt loses relfexes
nursing intervention: timer, monitor, stay with pt
pad side rails, 4 side rails
postictal
first thing to do is assess
vitals and airway
aging adult
atrophy
absent Achilles reflex
irregular pupil shape
order of neurologic exam
mental status
cranial nerves
motor nerves
sensory
reflex
ABCT
apperence
behavior
cognition
thought process
testing muscle strength
hand grasp with push and pull
plantar flexion and dorsi flexion with resistance
when asking pt to squeeze and dominant hand is same as yours
cross hand so dominant hands are together
balance test
gait, Romberg test, rapid alternating movement
rombergtest -
hold, no swaying
Romberg test +
sway, fall, lose balance
rapid alternating movement
pat knees with backs and fronts of hands
finger-finger test
finger nose
heel shin
when doing reflexes we need pt to be full relaxed otherwise
tendon is stretched
biceps is the only test that is
indirect
what will the forearm do when doing biceps test
forearm will flex
the reflex tests
triceps, brachiradialis, quadriceps, achilles, biceps
parkinsons dysfunction type
motor system
parkinsons have a defect of
extrapyridimal tracts
parkinsons apperence
tremors/rigitiy/ cogwheel rigidity
stooped posture
steps short and shuffling
pill rolling maneuver with fingers
flat expression, staring, expressionless
babinski relfex
upper motor neuron lesion
when is it okay to have positive babinski reflex
infants
neurologic recheck
level of consiousness
motor function
pupillary response
vital signs
glasgow
glasgow categories
eye, motor, verbal
normal glasgow
15
glasgow indicating a coma
7/8
stroke is the leading cause of
long term disability
TIA vs stroke
TIA is a spasm and symptoms resolve
stroke is when symptoms get worse
test for cranial nerve I
test sense of smell in those that report loss of smell with persons eyes closed, occude one nostril and present a familiar aromatic substance
test for cranial nerve II
test visual acuity and visual fields by confrontation
test for III, IV, VI
check pupils for size, regularity, equality, direct and consensual light reaction and accommodation
assess extra ocular movements by cardinal positions of gaze
test for V
motor: asses muscles of mastication by palpating temporal and master muscles as person clenches teeth, muscles should feel strong on both sides
sensory: persons eyes closed, test light touch sensation by touching a cotton wisp to persons face: forehead, cheeks, and chin
test for VII
note mobility and facial symmetry as person responds to request to smile, frown and close eyes tightly, lift eyebrows and show teeth
have person puff cheeks and then press puffed cheeks in
test for VIII
hearing acuity by ability to hear normal conversation and by whisper test
test for IX and X
depress tongue with blade and note pharyngeal movement as person says ahhh or yawns
uvula and soft palate should rise midline and tonsil pillars should move medially
touch posterior pharyngeal wall with tongue blade and note gag relfex, voice should sound smooth
test for XII
inspect tounge no wasting or tremors should be present , note forward thrust in midline as person protrudes tongue
ask person to say light, tight, dynamite
test for XI
examine neck muscles for size, check strength by asking person to rotate head against resistance applied to side of chin
ask person to shrug shoulders against resistance
olfactory
smell
optic
vision
oculomotor
extra ocular movement, pupil constriction, down and inward movement of eye
trochlear
down and inward movement of eye
trigeminal
mastication and sensation of face scalp and cornea
abducens
lateral movement of eyes
facial
tasting on the anterior two thirds of tongue, closing eyes
acoustic
hearing and equilibrium
glossopharyngeal
phonation, swalloing, tasting on the posterior third of tounge
vagus
talking, swallowing, and sensory information from pharynx and carotid sinus
spinal
movement of trapezius and sternomastoid muscle
hypoglossal
movement of tounge
