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NURS 210 > Neurological System > Flashcards

Neurological System Flashcards

1
Q

cns

A
  • the BRAIN & SPINAL CORD
  • 12 pairs
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2
Q

pns

A
  • ALL NERVE FIBERS that are OUTSIDE the brain & spinal cord
  • 31 pairs
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3
Q

midbrain

A

the RELAY CENTER for our EYE & EAR REFLEXES
- relays between CEREBRUM & BRAIN STEM

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4
Q

pons

A

links the CEREBELLUM to the CEREBRUM
links the MIDBRAIN to the MEDULLA
- reflex actions

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5
Q

medulla

A

controls our RESPIRATORY, HR, fORCE & BP

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6
Q
A
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7
Q

cerebellum

A
  • important for COORDINATION & maintaining EQUILIBRIUM & MUSCLE TONE
  • important for our PRIMARY FUNCTIONS
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8
Q

what is the DIFFERENCE BETWEEN AFFERENT & EFFERENT IMPULSES?

A

afferent:
- sends impulses UP to the brain

efferent:
- sends impulses DOWN to the glands & muscles

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9
Q

describe the ANS

A
  • has impulses from BOTH CRANIAL & SPINA:
  • important for maintaining HOMEOSTASIS
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10
Q

what are the TWO COMPONENTS of the ANS?

A

SYMPATHETIC;
fight or flight response

PARASYMPATHETIC;
the rest and digest response

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11
Q

what to do before STARTING a NEURO ASSESSMENT?

A
  • want to EXPLAIN the procedure
  • instruct family members NOT to answer questions for the patient
    **want a CLEAR BASELINE for the patient
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12
Q

what is the PURPOSE OF THE ASSESSMENT (6)?

A

we want to cover;

  1. LOC & MENTATION
  2. MOVEMENT
  3. SENSATION
  4. CEREBELLAR FUNCTION
  5. REFLEXES
  6. CRANIAL NERVES
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13
Q

how do we EVALUATE LOC & MENTATION?

A
  • looking at the patient’s ORIENTATION & MEMORY
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14
Q

what does the PATIENT have to be orientated to?

A
  • PERSON
  • PLACE
  • TIME
  • SITUATION
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15
Q

lethargic

A

the PATIENT is DROWSY but is able to be awakened
- can have slow or inattentive answers

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15
Q

full consciousness

A
  • ALERT
  • ATTENTIVE
  • follows commands
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16
Q

obtunded

A

the patient is DIFFICULT to AROUSE & needs CONSTANT STIMULATION

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17
Q

stuporous

A

patient needs VIGOROUS & CONTINUOUS STIMULATION in order to stay awake–often needing a PAINFUL STIMULUS
- can often MOAN briefly etc…

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18
Q

comatose

A

no response to any stimulation even if painful
- no movement or sounds made

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19
Q

what are the THREE RESPONSES we look for in the GLASGOW COMA SCALE? what are the ranges of points?

A
  1. EYE OPENING RESPONSE
  2. VERBAL RESPONSE
  3. MOTOR RESPONSE

out of 15 points!

anything lower than 8 can an indicate a SEVERE BRAIN INJURY

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20
Q

definition of AVPU

A

a - patient is AWAKE
v - patient responds to VERBAL STIMULATION
p - patient responds to PAINFUL STIMULATION
u - patient is COMPLETELY UNRESPONSIVE

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21
Q

how do we DIVIDE MEMORY?

A
  1. IMMEDIATE MEMORY
  2. SHORT-TERM MEMORY
  3. REMOTE MEMORY
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22
Q

immediate memory

A
  • quick repetition of recent events
    ex. testing three objects
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23
Q

short-term memory

A
  • memory of something that occurred recently in the past few days
    ex. holidays or breakfast for the day
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24
Q

remote memory

A

memory of the DISTANT PAST–looking at yers or decades
**typically is the LAST TO GO

25
Q

definition of SYNCOPE

A

feeling faint

26
Q

definition of VERTIGO

A

spinning type of sensation

27
Q

definition of DISEQUILIBRIUM

A

feeling of unsteadiness

28
Q

what do we use during a SENSORY EXAMINATION?

A
  • use of different objects;
    soft or dull test
  • use of cotton balls, paper clips or a reflex hammer
29
Q

how do we test our MOTOR SKILLS?

A
  • testing the CRANIAL NERVES
  • want to utilize alternating movements within the extremities
30
Q

how do we TEST FOR BALANCE?

A

use of the ROMBERG TEST

  • want the patients to close their eyes for around 20 seconds and to stand still
    **want to have arms ready in case they fall or sway
    **swaying is relatively a normal sign
31
Q

stereognosis

A

identification of a FAMILIAR OBJECT by TOUCH or MANIPULATION

32
Q

definition of GRAPHESTHESIA

A

identification of letter or number being drawn on the palm of the hand

33
Q

sensation

A

identification of the body area being touched

34
Q

which DEEP TENDON REFLEXES do we test? (5)

A
  1. BICEPS
  2. BRACHIORADIALIS
  3. TRICEPS
  4. PATELLAR
  5. ACHILLES
35
Q

what is the BABINSKI TEST?

A
  • use of a reflex hammer to stimulate PLANTAR FLEXION OF THE FOOT
  • stroking of the sole of the foot - J MOTION
  • want to see; toes should CURL DOWN NOT UP **for anyone 2 years and up
36
Q

ankle clonus

A

type of INVOLUNTARY REPETITIVE MUSCLE CONTRACTIONS when a spastic muscle is being stretched
- can see that REFLEXES are HYPERACTIVE

37
Q

what are the CRANIAL NERVES (in order?

A

OLFACTORY (I)
OPTIC (II)
OCULOMOTOR (III)
TROCHLEAR (IV)
TRIGEMINAL (V)
ABDUCENS (VI)
FACIAL (VII)
ACOUSTIC (VIII)
GLOSSOPHARYNGEAL (IX)
VAGUS (X)
SPINAL ACCESSORY (XI)
HYPOGLOSSAL (XII)

38
Q

how do we test CN I?

A

odor identification

39
Q

how do we test CN II?

A

visual acuity/visual fields

40
Q

how do we test CN III, IV, VI?

A

looking at the PUPILS, points of GAZE, and opening of the UPPER EYELIDS

41
Q

how do we test CN V?

A

looking at the FACIAL MUSCLE STRENGTH, sharp vs. dull test

42
Q

how do we test CN VII?

A

looking at FACIAL EXPRESSIONS and speech

43
Q

how do we test CN VIII?

A

hearing screening

44
Q

how do we test CN IX and X?

A

gag reflex & swallowing

45
Q

how do we test CN XI?

A

looking at our TRAPEZIUS & STERNOCLEIDOMASTOID MUSCLES–want pt. to shrug

46
Q

how do we test CN XII?

A

looking at the TONGUE and its movements

47
Q

how can we test ACCURACY OF MOVEMENT?

A

the FINGER to NOSE TEST
the HEEL to SHIN TEST

48
Q

how do we GRADE REFLEXES?

A

graded upon a 4 POINT SCALE

4 - very BRISK + CLONUS + INDICATIVE OF DISEASE
3 - BRISKER than AVG. + can indicate disease
2- average/normal
1 - DIMINISHED/LOW/needs reinforcement
0 - NO RESPONSE

49
Q

definition of MENINGITIS

A

the INFLAMMATION of the BRAIN or SPINAL CORD

50
Q

signs and symptoms of MENINGITIS

A
  • fever, neck stiffness, headaches
  • nausea or sleepiness
  • use of BRUDZINKSKIS SIGN + KERNIGS SIGN
  • use of LUMBAR PUNCTURE & NEURO EXAM
51
Q

definition of CVA/STROKE

A

sudden INTERRUPTION of BLOOD SUPPLY to the part of the brain or RUPTURE of a BV–spilling blood into spaces around the brain cells

51
Q

who is at RISK for CVA?

A
  • hypertensive pts.
  • DM pts.
  • heart dx pts.
  • smokers
  • African American population
  • high cholesterol
52
Q

FAST

A

F - any facial drooping? want pt. to smile
A - any drifting of the arms? want pt. to raise both arms
S - any slurred/strange speech? want pt. to repeat a simple phrase
T - time is crucial! act fast

**can also see student WEAKNESS on ONE SIDE OF THE BODY
**trouble seeing in ONE OR BOTH EYES
**HEADACHES/DIZZINESS/trouble with walking

53
Q

what is the difference between RIGHT and LEFT BRAIN DAMAGE?

A

RIGHT SIDE:
- have LEFT SIDE PARALYSIS
- have LEFT-SIDED NEFLECT
- tend to have more denial of issues & greater impulsive behavior

LEFT SIDE:
- have RIGHT SIDE PARALYSIS
- have impaired speech
- more slower performance & anxiety & depression

54
Q

definition of PERIPHERAL NEUROPATHY

A

disorder of the PNS where there is MOTOR & SENSORY LOSS in distribution of one or more nerves

55
Q

signs & symptoms of peripheral neuropathy

A
  • HYPERALGENISA & ALLODYNIA
  • numbness & tingling in hands or feet
  • muscle weakness
56
Q

decerebrate posture

A

arms & legs are STRAIGHT OUT
toes are DOWNWARD
head & neck are ARCHED BACKWARD
FLEXED WRISTS

57
Q

decorticate posture

A
  • stiff & bent arms
  • arms and fists clenched
  • flexion INWARD
  • plantar flexion of feet
58
Q

definition of PARKINSONS

A

type of SLOW PROGRESSIVE DEGENERATIVE NEUROLOGIC DISORDER wher motor function is affected with behavioral & cognitive issues

59
Q

signs and symptoms of PARKINSONS

A
  • slower movements
  • stooped posture
  • type of SHUFFLING WALK & reduced arm swinging
  • tremors and difficulty of breathing

NURS 210 (11 decks)

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