Neurological Flashcards
what is the function of the neurological system?
- Perform all physiological function
- Activities of daily living
- Function in society
What is the purpose of a mental status examination?
Assess emotional and cognitive functioning, a structured way of observing and describing a persons’ current state of mind, under the domains of appearance, behaviour, cognition, and thought processes.
What is the purpose of the GCS?
GCS: glasgow coma scale
- to describe the level of consciousness in a person following a traumatic brain injury.
Purpose of cranial nerve examination
Crucial for diagnosing specific lesions in the nervous systems that control speech, smell, movement, sight, touch, etc. Provides information of transmission of motor and sensory messaging.
Purpose of motor & cerebellar examination
To inspect size and symmetry of muscles and test for muscles strength and observe for any fasculations, tics, or tremors (involuntary movements)
Purpose of sensory system examination
To test the intactness of the peripheral nerve fibres, sensory tracts, and higher cortical discrimination. Also ask the patient to identify various sensory stimuli
Define transient ischemic stroke (TIA)
mini stroke caused by a temporary disruption in blood supply to the brain
What is it called when blood flow to brain has stopped due to blockage or rupture
Stroke (aka cerebrovascular accident -CVA)
Define epilepsy
brain activity is abnormal, causing seizures, usual behavior or sensation
What is MS
Multiple sclerosis (MS): condition that affects the brain and spinal cord, causing problems with vision, movement, balance, or sensation
What is polio
(aka poliomyelitis): life-threatening disease that can spread from person to person and infect a person’s spinal card, causing paralysis
What is inflammation of the meninges called?
meningitis
What is inflammation of brain tissue, causing it to swell?
Encephalitis
What aspects does the mental status assessment include?
- Level of Consciousness
- Orientation
- Attention
- Memory
- Language
- Mood and affect
- Abstract reasoning
- Thought process
- Judgments
- Perceptions (visual)
- Learning
What is the structure of a mental status exam?
A- appearance
B: Behaviour
C: cognition
T: Thought process and perceptions
What does the mental mini exam assess?
cognitive functioning only
What are the categories of a GCS?
- eye opening
- motor response
- verbal response
How does the GCS work?
- highest possible score is 15
- higher score = better
- 7 should be concerning
What is cranial nerve i?
and function
olfactory nerve
- smell (sensory)
What is cranial nerve ii? and function
optic nerve
- vision field and acuity (sensory)
What is cranial nerve iii? and function?
oculomotor nerve
- eye muscle & pupil response
What is cranial nerve iv? and function
trochlear nerve
- downward, outward, inward eye movements
What is cranial nerve v? and function
trigeminal nerve
- biting, chewing, sensation of face, corneal reflex (sensory and motor)
What is cranial nerve vi? and function
abducens nerve
- eye movement
what is cranial nerve vii? and function
facial nerve
- facial expression, taste
what is cranial nerve viii? and function
- vestibulocochlear/acoustic nerve
- hearing and equilibrium
What is cranial nerve ix? and function
- glossopharyngeal nerve
- movement in back of throat
what is cranial nerve x? and function?
- vagus nerve
- muscles in throat, taste
what is cranial nerve xi? and function
accessory nerve
- trapezius and sternocleidomastoid muscles (shoulder and neck area)
What is cranial nerve xii? and function?
hypoglossal nerve
- tongue movement, speech
Describe gait assessment
Observe patient to walk 3-6 meters, turns and returns to starting point
Describe tandem walking assessment
Ask patient to walk in straight line in heel-to-toe manner (tandem walking).
- Why: decreases the base of support and accentuates any problem with coordination
Describe Romberg test
Ask patient to stand up with feet together and arms at the sides. Once stable position, ask patient to close eyes and hold position. Wait 20 seconds
describe stereognosis
Tests ability to recognize objects by feeling their forms, sizes, and weights with eyes closed. Test with both hands.
describe graphesthesia
Ability to “read” a number by having it traced on the skin
-Good measure of sensory loss (especially if patient cannot make hand movements for stereognosis)
describe topognosis
recognition of location of a stimulus on skin
What is clonus
set of rapid, rhythmic contractions of the same muscle
What is the purpose of assessing stretch reflexes?
- Reveals intactness of reflex arc at specific spinal levels, as well as normal override on reflex of higher cortical levels
Which reflexes do we assess?
- biceps
- brachioradialis
- triceps
- patellar
- achilles
What spinal level does biceps reflex reflect?
C5/6
What spinal level does brachioradialis reflex reflect?
C5/6
What spinal level does triceps reflex reflect?
C6/7/8
What spinal level does patellar reflex reflect?
L2/3/4
What spinal level does the achilles reflex reflect?
S1/2
What is the type of aphasia where patient understands written and verbal speech but cannot write or speak appropriately when communicating?
Expressive Aphasia (aka Broca’s)
What is Receptive Aphasia?
- aka Wernicke’s
- person cannot understand written or verbal speech
What are the signs of a stroke? (FAST)
F- face: drooping?
A: Arms: can you raise both?
S: Speech: slurred/jumbled?
T: Time to call 911
What are the modifiable risk factors for a stroke?
- Hypertension
- Hyperlipidemia
- Diabetes
- Smoking
- Obesity
- Atrial fibrillation
- Carotid artery stenosis
- Sickle cell disease
What are the non-modifiable risk factors for a stroke?
- age
- gender
- race
- previous TIAs
