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Nursing 1180 > Neurological Assessment > Flashcards

Neurological Assessment Flashcards

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1
Q

Number of spinal nerves

A

8C, 12T, 5L, 5S, 1C

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2
Q

Function of the autonomous nervous system

A

Maintains involuntary functions of cardiac and smooth muscle of the viscera and glands

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3
Q

Function of the sympathetic nervous system

A

Produces body to action during periods of physiologic and psychologic stress

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4
Q

Function of the parasympathetic nervous system

A

Complements and counterbalances the SYN to conserve body resources and day-to-day functions

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5
Q

SCAT

A

Sport Concussion Assessment Tool, a way to measure concussions, often used as a baseline

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6
Q

Cranial nerves responsible for difficulty swallowing

A

9 (glossopharyngeal) and 10 (vagus)

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7
Q

Important cranial nerves in neurological assessment

A

2, 3, 7, 9, 10

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8
Q

Three indicators of the Glasgow Coma Scale

A
  1. Eye opening
  2. Verbal response
  3. Motor response
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9
Q

Range of the GCS

A

15 to 3

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10
Q

Oriented x 3

A

Patient knows their name, the time, and their location

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11
Q

GCS eye opening scores

A

4 - Spontaneously
3 - To speech
2 - To pain
1 - None

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12
Q

GCS best verbal response scores

A 
5 - Oriented
4 - Confused
3 - Inappropriate
2 - Incomprehensible
1 - None
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13
Q

GCS best motor response scores

A 
6 - Obeys commands
5 - Localizes
4 - Withdraws
3 - Flexion
2 - Extension
1 - None
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14
Q

Widening pulse pressure

A

Emergency situation; could indicate increasing ICP

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15
Q

Wernicke’s area

A
  • Temporal lobe

- Language comprehension

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16
Q

Receptive aphasia

A

Issues with language comprehension. Speech and writing can be produced, but they do not understand what is being asked of them. They do not know there is a problem

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17
Q

Broca’s area

A
  • Frontal lobe

- Speech production

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18
Q

Expressive aphasia

A

The ability to understand language, but the inability to produce speech

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19
Q

Central pressure points

A

Trapezius squeeze, supraorbital pressure

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20
Q

Decerebrate posture

A
  • Damage to upper brain stem

- Arms adducted/extended, wrists pronated, fingers flexed, legs extended, feet plantarflexed

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21
Q

Decorticate posture

A
  • Damage to corticospinal tract(s)

- Arms adducted/flexed, wrists/fingers flexed on chest, legs extended/internally rotated, feet plantarflexed

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22
Q

20/40 vision

A

Must stand at 20 feet to see what an individual with 20/20 vision can see at 40 feet.

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23
Q

PERRLA

A

Pupils equal, round, reactive to light, and accommodation.

24
Q

How the oculomotor nerve is assessed

A

Pupillary response

25
Q

Direct light reflex

A

Shine light in from temporal area 6 inches in front of the eye. Pupils should constrict briskly.

26
Q

Consensual light reflex

A

Repeat above procedure on same eye but assess other eye for simultaneous constriction of pupil. Repeat light reflex assessments on other eye.

27
Q

Accommodation

A

Ask client to focus on an object in the distance. Both pupils should dilate.

28
Q

Pupillary response in an unconscious person

A

Should still be evident

29
Q

Pupillary response in someone who cannot see out their eye

A

Should not be evident; without sensory input there will be no motor response

30
Q

CN III lesion

A

Loss of consensual pupillary light reflex

31
Q

CN II lesion

A

Loss of direct pupillary light reflex

32
Q

Assessment of oculomotor, abducens, and trochlear nerves

A

Holding up a finger and having the patient follow the finger with their eyes without moving their head

33
Q

Test for sensation in the facial nerve

A

Use the anterior 2/3 of the tongue

34
Q

Test for motor function in the glossopharyngeal and vagus nerve

A

“Aah” uvula and palate rise, or test the gag reflex

35
Q

Test for sensation in the glossopharyngeal and vagus nerve

A

Use the posterior 1/3 of the tongue

36
Q

Spinal testing

A

Assesses movement and power of arms and legs and sensation on skin of arms and legs

37
Q

Test for cerebellar function

A

Uses balance and proprioception, especially through gait

38
Q

Tandem walking

A

Toe-to-heel walking where patients should not need to look at their feet or wobble significantly

39
Q

Romberg’s test

A

Patients close their eyes and stand with their feet together. Wobbling may indicate cerebellar injury

40
Q

Tests for coordination and skilled movements

A

Rapid alternating movements, finger-to-finger test, finger-to-nose test (proprioception), and heel-to-shin test

41
Q

Decreased deep tendon reflexes

A

Indicate a peripheral problem

42
Q

Exaggerated deep tendon reflexes

A

Indicate a central problem

43
Q

Biceps reflex

A
  • C5, C6

- Depress biceps brachii tendon

44
Q

Brachioradialis reflex

A
  • C5, C6, C7

- Strike brachioradialis tendon while arm is relaxed

45
Q

Triceps reflex

A
  • C6, C7, C8

- Tap triceps tendon with sharp end of hammer while forearm is hanging loose at right angle to arm

46
Q

Patellar reflex

A
  • L2, L3, L4

- Strike patellar tendon

47
Q

Ankle jerk reflex

A
  • S1 and S2

- Achilles tendon is tapped while the foot is dorsiflexed

48
Q

Cremasteric reflex

A

Lightly stroke superior and medial part of the thigh.

49
Q

Cremasteric reflex

A

Lightly stroke superior and medial part of the thigh

50
Q

Babinski reflex

A
  • L4 to S2
  • Sole of foot is stimulated with blunt instrument
  • CNS issues will fan toes in response unless they are under age of 2
51
Q

Paralysis

A

Decreased or loss of motor nerve power due to problem with motor nerve or muscle fibres

52
Q

Myoclonus

A

Rapid, sudden jerk at regular intervals (e.g. hiccups)

53
Q

Tic

A

Involuntary, compulsive, repetitive twitching of a muscle group (e.g. wink, grimace, head movement, shoulder shrug)

54
Q

Fasciculations

A

Rapid, continuous twitching of resting muscle that can be seen or palpated (fine or coarse)

55
Q

Localization

A

Unable to follow commands but may move spontaneously or purposefully such as removing O2, IV lines, etc.

Nursing 1180 (8 decks)

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