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Health Assessment final > Neurological > Flashcards

Neurological Flashcards

1
Q

What does the CNS consist of?

A

Brain and spinal cord

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2
Q

What does the PNS consist of?

A

12 pairs of cranial nerves
31 pairs of spinal nerves
ANS (parasympathetic and sympathetic)

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3
Q

What is the sympathetic nervous system responsible for?

A

Fight or flight

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4
Q

What is the parasympathetic nervous system responsible for?

A 
Rest and digest
Salivation
Lacrimation
Urination
Defecation
Digestion
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5
Q

What are the layers of the spinal cord?

A 
Epidural space
Dura mater
Subdural space 
Arachnoid mater
Subarachnoid mater
Pia mater
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6
Q

What is dura mater?

A

Protective covering for brain tissue

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7
Q

What makes up brain matter?

A

Gray and white matter

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8
Q

Do we have more gray or white matter?

A

Gray (demyelinated)

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9
Q

What does arachnoid mater do?

A

Like a spiderweb, holds white mater in place

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10
Q

What is pia mater?

A

Mater full of nerves and blood supply to brain

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11
Q

Where is CSF found?

A

Subarachnoid space

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12
Q

What does CSF do?

A

Provides cushion
Removes metabolic waste
Provides nutrition
Maintains normal ICP

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13
Q

What factors increase ICP?

A 
BP sometimes
Hypotonic solutions
Lots of Na
Lying down flat
Rectal temps/suppositories (usually)
Constipation/anything that increases strain (coughing)
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14
Q

What are the parts of the brain?

A

Cerebrum (cerebral cortex)
Cerebellum
Brainstem
Diencephalon

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15
Q

What makes up the diencephalon?

A

Hypo and thalamus

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16
Q

What vessels supply the brain?

A

2 internal carotid arteries

2 vertebral arteries

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17
Q

What is the largest part of the brain?

A

Cerebrum

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18
Q

Into what 4 parts is the cerebrum divided?

A

Frontal
Parietal
Temporal
Occipital

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19
Q

What is the frontal lobe responsible for?

A 
Personality
Speech
Memory
Behavior
Emotion
Intellectual function
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20
Q

What is the parietal lobe responsible for?

A

Sensation

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21
Q

What is the temporal lobe responsible for?

A

Hearing
Taste
Smell

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22
Q

What is the occipital lobe responsible for?

A

Visual reception

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23
Q

What is the hypothalamus responsible for?

A 
Homeostasis
Body temp
Hunger
Thirst
Storage and secretion of hormones
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24
Q

What is the thalamus responsible for?

A

Relays info to parts of cerebral cortex

Regulates states of sleep and wakefulness

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25
Q

What can damage of the thalamus lead to?

A

Coma state

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26
Q

What two systems does the hypothalamus connect and how?

A

Hypothalamus connects the CNS with the endocrine system through the pituitary gland

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27
Q

Where is the diencephalon located?

A

On top of the brainstem

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28
Q

What does the brainstem consist of?

A

Midbrain
Pons
Medulla oblongata

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29
Q

What is the midbrain responsible for?

A

Processing visual and auditory info
Initiating involuntary motor responses
Maintaining consciousness.

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30
Q

What is the pons responsible for?

A

[physically] Connecting cerebellum to brainstem

Motor control

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31
Q

What is the medulla responsible for?

A

[physically] Connects brain and spinal cord
Involuntary functions Primitive life maintenance
Heart function
Breathing
Sneezing
Coughing
Vomiting

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32
Q

What happens if the brainstem herniates?

A

One is clinically dead by law

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33
Q

What is the cerebellum responsible for?

A

Coordination of voluntary movement
Equilibrium/balance
Muscle tone
Proprioception

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34
Q

What does a cerebellar injury lead to?

A

Uncoordinated movement

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35
Q

What is ataxia?

A

Uncoordinated movement

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36
Q

What is the spinal cord?

A

Continuation of the medulla

“Central highway” for sensory and motor impulses

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37
Q

Where does the spinal cord begin?

A

The base of the skull (foramen magnum)

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38
Q

What is the cauda equina?

A

Where L1 and L2 branch into lumbar and sacral nerve roots

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39
Q

What are the pairs of spinal nerves?

A 
8 cervical
12 thoracic
5 lumbar
1 coccygeal
5 sacral
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40
Q

What do motor (efferent) roots do?

A

Carry impulses from brain to the spinal cord to the muscles & glands

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41
Q

What do sensory (afferent)

A

Carry impulses from sensory receptors of the body through the spinal cord to the brain

42
Q

What is a dermatome?

A

Band of skin innervated by the sensory nerve root of a single spinal segment

43
Q

When testing sensation, what area should be tested first?

A

Distal point

44
Q

What is hypoesthesia?

A

Decreased sensation

45
Q

What is hyperesthesia?

A

Excessive sensation

46
Q

What is anesthesia?

A

Loss of sensation

47
Q

What is paresthesia?

A

Numbness, tingling, burning

48
Q

What is the reflex arc?

A

Tapping the tendon of a partially stretched muscle, activating sensory fibers within the muscle

49
Q

What abnormal sensation can be present in diabetes?

A

Paresthesia, which turns into hypoesthesia

50
Q

When is hyperesthesia seen?

A

Shingles - touching hand and feeling like there’s something there
CNS defect

51
Q

How does a reflex arc work?

A

Impulses travel to the spinal cord via peripheral nerves where they cross the NMJ and the muscle contracts

52
Q

When is hypoesthesia seen?

A

Old age - reflexes decrease

53
Q

What is CN I?

A

Olfactory
Sensory
Smelling odors with eyes closed

54
Q

What is CN II?

A

Optic
Sensory
Snellen/confrontation

55
Q

What is CN III?

A 
Oculomotor
Motor
H test
Levetator palpebral muscle
Pupil constriction - direct and indirect (consensual)
56
Q

What is CN IV?

A

Trochlear
Motor
H test

57
Q

What is CN V?

A 
Trigeminal
Sensory
Regions of face sensation on both sides: temporal, maxillary, mandibular feeling
Corneal reflex
Motor
Movement of jaw
58
Q

What is CN VI?

A

Abducens
Motor
H test

59
Q

What is CN VII?

A 
Facial
Sensory
Anterior ⅔ of tongue taste
Motor
Smile, frown, puff cheeks, move eyebrows
60
Q

What is CN VIII?

A

Vestibulocochlear
Sensory
Hearing
Whisper, weber (lateralization), rinne

61
Q

What is CN IX?

A 
Glossopharyngeal
Sensory
Posterior ⅓ of tongue taste
Motor
Gag reflex/AHHHH
62
Q

What is CN X?

A 
Vagus
Sensory
Relay information to organs/glands of body (did not study)
Motor
Gag reflex/AHHHH
63
Q

What is CN XI?

A

Accessory
Motor
Shrugging shoulders, turning of head

64
Q

What is CN XII?

A

Hypoglossal
Motor
Tongue movement - up, down, side to side

65
Q

How do you check cerebral function?

A 
Brief (mini) Mental Status
LOC
Remote memory (LTN)
Recent memory
Orientation (person, place, time, situation - A&Ox4)
Mood
Thought content
Test balance & coordination
Point to Point
- Upper Extremities
- Lower Extremities.
Alternating Movements:
- Upper Extremities
- Lower Extremities.
Gait
Tandem Gait
Romberg
66
Q

How do you test proprioception?

A

Touch eye and touch nurse’s finger, then close eyes and continue to test

67
Q

What is the alternating movement test?

A

Take body part and flip back and forth

68
Q

What is tandem gait walking?

A

Walking heel to toe

69
Q

What is the Romberg test?

A

Pt must be standing
Should be able to stand feet together hands to sides with eyes closed for 20-30 seconds
Cerebellar lesion will force someone to step out when they close their eyes
+ Romberg - sign of cerebellar dysfunction

70
Q

How is sensory interpreted?

A

By the cerebral cortex

71
Q

How do you assess sensory?

A 
Upper and lower extremities
Sharp and soft objects
Distal parts first
Tuning fork on joint
Position sense
Two point discrimination
Stereognosis
Extinction
Point location
72
Q

How does paresthesia affect sensory assessment?

A

May prevent pt from feeling the touch

73
Q

How do you test position sense?

A

Have pts put hands in correct anatomical position
Move their finger up, down, left, right to demonstrate
Have pt close eyes and ask in what direction you’re moving their finger

74
Q

How do you test two point discrimination?

A

Only do pads of fingers and thighs
Tell pt you’ll touch area with object
Say you’re touching at two points
Have pt close eyes and ask them to say when they don’t feel 2 points anymore
Body cannot discriminate between feeling 1 point and 2 points once the points are close enough together
You can usually feel 2 points for up to 5 mm

75
Q

How do you test stereognosis?

A

Ask pt to identify familiar object in hard with eyes closed

76
Q

How do you test graphesthesia?

A

Drawing numbers on the pt’s hand with their eyes closed

77
Q

How do you test extinction?

A

Touch either one or both sides have pt close eyes and say if you touched one or both sides

78
Q

How do you test point location?

A

Close pt’s eyes and touch a point in their body. Have pt open eyes and touch where you touched

79
Q

What is spasticity?

A

Muscle in constant contraction
Stiff
Harder to do passive ROM

80
Q

What is rigidity?

A

Increased muscle tone leads to rigidity

Harder to do passive ROM

81
Q

What is flaccidity?

A

Decreased muscle tone

Easier to do passive ROM

82
Q

What is a resting tremor?

A

Tremor at rest

83
Q

What is an intention tremor?

A

Tremor during movement/use of muscle

84
Q

What is a fasciculation?

A

Spasm of muscle during tired; pulsating
Not related to a disorder
Overuse/tired muscle

85
Q

What is a seizure?

A

Abnormal electrical conduction of the brain

86
Q

When do seizures occur?

A 
Epilepsy
High fever
Hitting head
Swelling of brain
Too much alcohol
Amphetamines
Any brain injury can increase risk
(Turn pt on side)
87
Q

What is a tic?

A

Brain imbalance
Can be verbal/motor
Ex: tourette’s

88
Q

How do you test muscle strength?

A

ROM against resistance

89
Q

How do you elicit a DTR?

A

Briskly tap the tendon of a partially stretched muscle

90
Q

What spinal cord segment is related to the triceps?

A

Cervical 6, 7

91
Q

What spinal cord segment is related to the patellar?

A

Lumbar 2, 3, 4

92
Q

What spinal cord segment is related to the achilles?

93
Q

What spinal cord segment is related to the biceps?

A

Cervical 5, 6

94
Q

What spinal cord segment is related to the brachioradialis?

A

Cervical 5, 6

95
Q

What movement occurs in bicep DTR?

A

Elbow flexion

96
Q

What movement occurs in tricep DTR?

A

Elbow extension

97
Q

What movement occurs in patellar DTR?

A

Extension of leg (usually runs +3)

98
Q

What movement occurs in achilles DTR?

A

Plantar flexion

99
Q

What movement occurs in superficial plantar DTR?

A

Flexion of toes

100
Q

How do you look for superficial plantar DTR?

A

Start on outer portion of foot and scrape up and across toes

101
Q

What does it mean when the big toe dorsiflexes and other toes fan out?

A

It’s positive Babinski sign

Normal in babies, not normal in adults

Health Assessment final (6 decks)

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