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Nursing 6410 - Health Assessment > Neurological > Flashcards

Neurological Flashcards

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1
Q

Structure of CNS

A 
Cerebral Cortex
Frontal lobe
Parietal lobe
Occipital lobe
Wernicke’s area
Broca’s area
Basal ganglia
Thalamus 
Hypothalamus
Cerebellum
Brainstem
Spinal Cord
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2
Q

Pathways of CNS

A

Crossed representation
Sensory Pathways

Motor Pathways
Corticospinal or Pyramidal Tract
Extrapyramidal Tracts
Cerebellar system

Upper and Lower Motor Neurons

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3
Q

Peripheral Nervous System

A

Cranial Nerves
Spinal Nerves
Autonomic Nervous System
Reflex Arc

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4
Q

Components of Neuro Exam

A 
Cerebral
Cranial Nerves 
Cerebellar and Proprioception
Sensory
Reflexes
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5
Q

PMHx

A 
Incoordination
 Numbness or tingling
 Difficulty swallowing
 Difficulty speaking
 Significant past history
 Environmental/ occupational hazards
Headache
Head injury
Dizziness/Vertigo
Seizures
Tremors
Weakness
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6
Q

Equipment

A 
Penlight
Tongue blade
Cotton swab
Tuning fork
Percussion hammer
Occasionally need: familiar aromatic substance
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7
Q

General Cerebral Functions

A 
General Appearance & Behavior
Level of Consciousness
Intellectual Performance 
Emotional Status
Thought Content
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8
Q

Cranial Nerves

A 
I Olfactory
II Optic 
III Oculomotor, IV Trochlear, VI Abducens
V Trigeminal
Motor function
Sensory function 
VI Facial
Motor function
Sensory function
VIII Acoustic
IX Glossopharyngeal, 
X   Vagus
Motor function
Sensory function 
XI Spinal Accessory
XII Hypoglossal
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9
Q

Inspect and palpate Muscles

A 
Muscles
Size
Strength 
Tone
Involuntary Movements
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10
Q

Coordination and Skilled Movement s

A 
Finger to Nose
Finger to Nose and Examiners Finger
Rapid Alternating Movements
Heel down shin
Shallow Knee Bend
Gait
Romberg
Tandem Walking
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11
Q

Sensory Function

A 
Person is alert, cooperative, comfortable
Spinothalamic tract
Pain
Temperature
Light touch
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12
Q

Sensory Function: Posterior column tract

A 
Posterior Column tract
Vibration
Position (Kinesthesia)
Tactile Discrimination (Fine touch)
Stereognosis
Graphesthesia
Two-point discrimination
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13
Q

Sensory system

A 
Superficial Tactile Sensation
Superficial Pain
Sensitivity To Temperature
Sensitivity to Vibration
Deep Pressure Pain
Motion and Position
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14
Q

DTRs

A 
Technique
Grading
Reinforcement
Biceps reflex
Triceps reflex
Brachioradialis reflex
Quadriceps reflex

Achilles reflex
Clonus

Superficial reflexes
Abdominal reflex
Cremasteric reflex
Plantar reflex

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15
Q

Grading reflexes

A

0 no resposne
1+ Diminished, low normal
2+ Average Normal
3+ Brisker than average, may mean disease
4+ Very brisk, hyperactive with clonus, indicative of disease

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16
Q

Testing CN I

A

Cover one nostril and ask the pt to smell a particular scent c their eyes closed
Inflammation of the mucus membrane, allergic rhinitis, and excessive tobacco smoking interfere c sense of smell

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17
Q

Abnormalities of CN III, IV and VI

A

CN VI is the first to lose function in the incidence of increased cranial nerve pressure

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18
Q

Testing CN V

A

Use sharp and dull touch on bilateral sides of the face
Use hot and cold test tubes if unable to distinguish touch
Test using corneal reflex (remove contact lenses) to prevent diminished or absent reflex

19
Q

Testing CN VII

A

Raise eyebrows, squeeze eyes shut, wrinkle forehead, frown, smile and puff out cheeks

20
Q

Abnormal CN V

A

Presence of fasculations, muscle atrophy of face or deviation of jaw

21
Q

Abnormal CN VII

A

Tics, unusual facial movements, asymmetry of expression, mouth drooping, ptosis
Sweet and salty taste is CN VII
Sour and bitter is CN IX

22
Q

Testing of CN IX AND X

A

Gag reflex test

23
Q

Abnormal CN X

A

Drooping or absence of an arch on either side of the soft palate is unexpected
Palate should rise and uvula should stay midline
Test swallowing for aspiration

24
Q

Testing CN XII

A

Move tongue up and down outside of mouth

Have pt press tongue against cheek into your hand

25
Q

Abnormal CN XII

A

Fasculations, asymmetry, atrophy, or deviation from midline is unexpected

26
Q

What to examine for in coordination and fine motor skills

A

affected, quality, rate and rhythm

27
Q

Positive Romberg sign

A

loss of balance
cerebellar ataxia
vestibular dysfunction
sensory loss

28
Q

Evaluation of Gait

A

Should be smooth, regular, rhythm and symmetric stride length
Trunk should sway c gait
Arms should be symmetrical and smooth

29
Q

Evaluation of tandem gait

A 
Note extension of arms for stability 
Instability
Tendency to fall
Lateral staggering or reeling 
Shuffling, widely placed feet, toe walking, foot flop, leg lag, scissoring, loss of arm swing, staggering or reeling
30
Q

Primary sensory function

A

Superfiical touch
Superficial pain
Temperature or deep pressure - squeeze traps, calf or biceps to elicit discomfort
Vibration - Test at bony prominences like finger, toe, sternum, shoulder, elbow, wrist, shin and ankle
Position of joints
Hands, lower arms, abdomen, feet and lower legs

31
Q

Stereognosis

A

Inability to determine an everyday object through touch

Indicating a parietal lobe lesion

32
Q

Two-point discrimination

A

Alternate using a paper -clip or needle against two bilateral areas on a patient

33
Q

Extinction Phenonmenon

A

Simultaneously touch an area on both sides of the patients body using a sharp object

34
Q

Graphesthesia

A

Using a blunt pen or applicator stick, trace a letter, number or shape in the patients hand

35
Q

Point location

A

Touch an area of the patients skin and ask them to point to where they felt the touch

36
Q

Brain Blood Supply

A

Brain receives about 20% of Q from two carotid and two vertebral arteries
Deoxygenated blood flows to venous plexus to the dural sinuses that empty into the internal jugular veins

37
Q

Cerebrum

A

Houses higher mental function and is responsible for general movement, visceral functions, perception and behavior
Comissural fibers allow interconnection of activities between two brain hemispheres

38
Q

Frontal Lobe

A

Voluntary skeletal movement
fine receptive motor movement
controls eye movement

39
Q

Parietal Lobe

A

Processes sensory data
Interprets tactile sensations like heat, pressure, pain, texture
Regulates vision, taste and smell and recognition of body part and body position (proprioception)

40
Q

Occipital Lobe

A

Contains primary vision center

41
Q

Temporal lobe

A

Perception and interpretation of sounds and determination of their source
Also integrates smell, taste and balance
Contains Wernicke’s area - interprets speech

42
Q

Basal Ganglia

A

Refines motor movements

Connects thalamus, motor cortex, reticular formation and the spinal cord

43
Q

Cerebellum

A

Aids motor cortex of the cerebrum of integration of voluntary movement
Processes sensory data from ear, eyes, nose and mouth along with the vestibular system to coordinate muscle tone and balance, and posture

Nursing 6410 - Health Assessment (16 decks)

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