neurological Flashcards
CNS includes
Central nervous system (CNS), which includes brain and spinal cord
Peripheral nervous system
which includes all nerve fibers outside brain and spinal cord, Includes 12 pairs of cranial nerves, 31 pairs of spinal nerves, and all their branches
Carries sensory (afferent) messages to CNS from sensory receptors
Motor (efferent) messages from CNS to muscles and glands, as well as autonomic messages that govern internal organs and blood vessels
cerebral cortex
cortex is cerebrum’s outer layer of nerve cells
Cerebral cortex is
center of functions governing thought, memory, reasoning, sensation, and voluntary
Temporal lobe
primary auditory reception center,
Parietal lobe’
postcentral gyrus is primary center for sensation, taste and smell
Occipital lobe
visual receptor center
Wernicke’s area
temporal lobe associated with language comprehension( understanding speech)
Broca’s area
in frontal lobe mediates motor speech
basal ganglia
Gray matter in two cerebral hemispheres that form subcortical associated motor system
Thalamus
Main relay station where sensory pathways of spinal cord, cerebellum, and brainstem form synapses( traffic police organizing everything)
Hypothalamus
Major respiratory center with basic function control and coordination
Cerebellum
Concerned with motor coordination and muscle tone of voluntary movements
Brainstem
Central core of the brain—contains midbrain, pons and medulla
Spinal cord
Main pathway for ascending and descending fiber tracts that connect brain to spinal nerves( highways )
if left side of the body has paralysis, which side will this be seen
Left cerebral cortex receives sensory information from and controls motor function to right side of the body.
Right cerebral cortex likewise interacts with left side of body
upper motor neurons
terminate at the spinal cord
Extrapyramidal tracts include
Motor nerve fibers travel to brainstem crossing to opposite, contralateral side, (pyramidal decussation) and then pass down in lateral column of spinal cord.
Corticospinal or pyramidal tract
subcortical motor fibers that maintain muscle tone and control body movements, especially gross automatic movements, such as walking.
Cerebellar system
Coordinates movement, maintains equilibrium and posture
Receives information on position of muscles and joints, body’s equilibrium, and kind of motor messages sent from cortex to muscles
stroke patients we will see
stiff muscles
roughting reflex
reflex
: basic defense mechanisms of nervous system
cranial nerves
12 pairs
spinal nerves
31 pairs of spinal nerves arise from length of spinal cord and supply rest of body
shingles
dermatomes , will follow a specific place and track based on which spinal nerve is involved
saddle anesthesia
damage to S1and s2
lumbar and saccral dermatomes
Autonomic fibers innervate
smooth (involuntary) muscles, cardiac muscle, and glands.
headache, dizziness vertigo
neurologic recheck examination
on persons with demonstrated neurologic deficits who require periodic assessments.
squueze with your hand and push and pulls
bicep , patellatr tendon, verbalize babinski
Myoclonusrefers
quick, involuntary muscle jerk
Chorea:
neurological disorder characterized by jerky involuntary movements affecting especially the shoulders, hips, and face
Romberg sign
Demonstrates normal position sense, muscle strength, and cerebellar function
Positive Romberg sign indicates loss of balance
Gait:
: observe as the person walks 10 to 20 feet, turns, and returns to starting point
Tactile discrimination
tests also measure discrimination ability of sensory cortex.
Graphesthesia:
ability to “read” a number by having it traced on skin
Two-point discrimination:
test ability to distinguish separation of two simultaneous pin points on skin
Point location
touch skin and withdraw stimulus promptly; ask the person to put finger where you touched
DTR measurement
Measurement of stretch reflexes reveals intactness of reflex arc at specific spinal levels
Limb should be relaxed and muscle partially stretched.
Reflex response graded on 4-point scale
4 = very brisk, hyperactive with clonus, indicative of disease
3 = brisker than average, may indicate disease
2 = Average, normal
1 = diminished, low normal, or occurs with reinforcement
0 = no response
Clonus:
test when reflexes hyperactive
Sustained clonus is associated with UMN disease.
Cremasteric reflex
L1 to L2 On male, lightly stroke inner aspect of thigh with reflex hammer or tongue blade
babinski negative
toes curl down ( normal ), infants have a positive babinski ( flaire their toes
Plantar reflex
L4 to S2
posturing
adduction
coiming into the corre
abduction
arms away from the body
decorticate posturing
glasgow less than 8
we intubate
cogwheel
argument in dopamine levels
Fasciculations
Rapid, continuous twitching of resting muscle
Tic
Involuntary, compulsive, repetitive twitching of a muscle group)
Athetosis
Slow, twisting, continuous movement, resembling a snake or worm)
resting tremour,
usually parkinsons
Intention tremor
Spinal cord hemisection
Brown-Séquard syndrome
Loss of pain and temperature, contralateral side, loss of vibration and position discrimination on ipsilateral side
spinal cord injuries
what happens ?
Decerebrate rigidity
Decorticate rigidity
Upper extremities
Flexion of arm, wrist, and fingers
Adduction of arm: tight against thorax
Kernig’s
In flat-lying supine position, flex thigh on abdomen and extend knee.
Brudzinski
With one hand under neck and other hand on person’s chest, sharply flex chin on chest and watch hips and knees.
head and neck involved
meningitis
