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health assessment exam 2 > neurological system > Flashcards

neurological system Flashcards

1
Q

what is CSF and what is contained in it?

A

is a colorless, odorless fluid containing

- glucose, electrolytes, oxygen, water, carbon dioxide, and leukocytes

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2
Q

where does csf circulate

A

circulates around the brain and spinal cord

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3
Q

what does csf provide?

A

provides cushion, maintains normal intracranial pressure, nutrition, and removes metabolic wastes

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4
Q

what does the nervous system control

A

controls body function through voluntary and autonomic response to external and internal stimuli

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5
Q

structural divisions of the nervous system are:

A
  • central nervous system (CNS), which consists of the brain and spinal cord
  • peripheral nervous system (what you feel)
  • autonomic nervous system (flight/fight)
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6
Q

what does the skull protect

A

protects brain

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7
Q

what is the foramen magnum

A

large oval opening at base of skull

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8
Q

3 layers of meninges

A
  • dura mater: outer double layer
  • arachnoid: middle menigeal layer
  • pia matter: inner meningeal layer
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9
Q

what can a neurological screening evaluate

A

major indicators of neurological funcation and assist with recognition of areas of dysfunction

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10
Q

examination components

A
  • mental staus examination to test brain function
  • assessment of cranial nerve actions
  • motor function to test cerebellar function
  • sensory function
  • reflexes
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11
Q

equipment

A
  • snellen and rosenbaum eye chart s
  • aromatic substacnes
  • tongue blades
  • penlight
  • tuning fork
  • relfex hammer
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12
Q

intracranial regulation

A

mechanisms that facilitate or impair neurologic function

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13
Q

interrrelationships

A
  • brain requires oxygenation

- respiratory and cardiovascular systems impacted by neurological control

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14
Q

extensions of neurological function

A
  • sensory perception

- tactile perception

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15
Q

alert

A

client is responsive and able to open eyes and answer questions spontaneously and appropriately

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16
Q

lethargic

A

the client is able to open their eyes and respond but is drowsy and falls alseep readily

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17
Q

obtunded

A

client responds to light shaking but can be confused and slow to respond

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18
Q

stuporous

A

client requires painful stimuli (pinching a tendon or rubbing the sternum) to achieve a brief response

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19
Q

comatose

A

there is no response to repeated painful stimuli

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20
Q

decorticate rigidity

A

flexion and internal rotation of upper extremity joints and legs
- flex toward body involuntary in clients who are comatose

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21
Q

decerebrate rigidity

A

neck and elbow extension, with the wrists and fingers flexed
- flew out involuntary

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22
Q

inspecting

A
  • assess apperance by observing hygiene, grooming, and clothing choice
  • consider cultural preferences
  • assess mood by inspecting mannerism and actions during interactions
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23
Q

expected findings for insepction

A

client makes eye contact and emotions correspond to the conversation and situation

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24
Q

memory

A

both recent and remote

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25
Q

how do you test recent knowledge?

A

ask the client to repeat a series of numbers

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26
Q

how to test remote knowledge

A

ask the client to state their birth date or mother’s maiden name (verifiable)

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27
Q

how to test someone’s level of knowledge

A

ask the client what they know about their current hospitalization or illness

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28
Q

how to assess the ability for calculation

A

ask the client to count backwrd from 100 by 7s

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29
Q

how to assess abstract thinking

A

ask the client the interpreation of a cliche (“cat got you r tongue”)
- demonstrates higher level of thought processes

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30
Q

how to assess insight

A

perform an objective assessment of the clients perception of illness

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31
Q

how to assess judgment

A

ask client about the soltuion to a specific dilemma

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32
Q

how to assess the thought process

A

note processing differences (rapid change of topic) and use of nonsense words

33
Q

thought content

A

note the presence of delusions, hallucinations, and other ideas the client presents during the interview

34
Q

what should be expected of speech

A

speech and language and features (quality, quantity, and volume to be articulate and responses to be meaningful and appropriate

35
Q

standardized screening tools

A

use the mini-mental state examination to assess cognitive status objectively

evaluates

  • orientation to time and place
  • attention and calculation of counting backward by sevens
  • registatring and recalling objects
  • language, including naming of objects, following of commands
36
Q

time, place, person

A

ask if orientation is a concern during history

37
Q

date and time

A

first orientation to disappear

- only a problem if remains disoriented after being reoriented

38
Q

place

A

second orientation to disappear

39
Q

person

A

last orientation to disappear

40
Q

orientation returns in what order

A

opposite in which it is lost

41
Q

glasgow coma scale

A

obtain a baseline assessment of the cleints leevl of consciousness and for ongoing assessment

42
Q

what does the glasgow coma scale look at

A

eye, verbal, and motor response, and assigns a number values based on the clients response
- highest level 15 (awake & full consciousness)

43
Q

altered level of consciousness (LOC)

A

nurse can determine if the pt. is alert and oriented by the way questions are answered during interview

44
Q

what does change in loc show

A

earliest and most sensitive idicator of alterations in cerebral function

45
Q

what is wakefullness controlled by

A

brainstem

46
Q

what is the awareness - higher level function controlled by

A

reticular activating system

47
Q

test cerebral function for….

A

balance and coordination

48
Q

tests for balance

A
  • romberg test
  • stand on one foot
  • tandem walking
  • hopping on one foot
    knee bending
49
Q

motor function

A

assess coordination by asking the client to extend the arms and rapidly touch one finger to the nose, alternating hands, and than doing it with eyes closed

50
Q

expected findings of motor function

A

smooth, coordinated movement

  • assess gain when client is awake and unaware
  • gait is steady, smooth and coordinated
51
Q

romberg test

A

(pt. standing)- feet together, arms at side eyes open/closed. client should stand with minimal swaying

52
Q

heel to toe walk

A

walk heel to toe

53
Q

how do you assess muscle strength

A

assess the strength of muscle groups by asking the client to push or pull against resistance
- strength would be equal or slightly stronger on the dominant side of the body

54
Q

when preformign sensory function you should preform test on….

A

al four extremities

55
Q

how can you assess pain sensation

A

alterating sharp and dull objects on the skin and asking the client to report what they feel

56
Q

assessing vibration

A

have client report when and where tehy feel the handle of the vibrating tunning fork on their skin

57
Q

two point discrimination

A

open paperclips to determine the smallest distance between the two points at which client can still feel the two points on skin and not just one

58
Q

stereognosis

A

place afamilar object in clients hand and ask them to identify it

59
Q

graphesthesia

A

trace a number on the clients palm with the blunt end of a pencil and ask them to identify it

60
Q

how are reflexes tested

A

observing muscle movement in response to sensory stimuli

61
Q

deep tendon reflexes

A

responses to stimulation of tendon that streches neuromuscular spindles of muscle group

62
Q

what happens when you strike a deep tendon

A

stimulates a sensory neuron that travels to spinal cord where it stimulates an interneuron, which stimulates a motor neuron to create movement

63
Q

deep tendon grade/ documentation

A 
4+= very brisk with clonus (normal)
3+= more brisk than average
2+= expected
1+= diminished 
0+= no response
64
Q

findings with aging

A

short term mem declin e
diminished reflex and reaction times
altered vibration, position, hearing, vision, smell, and deep pain
slower fine finger movement
increased difficulty learning complex or abstract data
fewer brain cells, smaller brain volume, deteriorating nerve cells, fever neurotransmitter
impaired balance
decreased touch sensation

65
Q

assessing neuro system in older adults

A

follows same procedure as younger adults

  • test for balance and gait are often assessed for older adults to identify those at risk for falls
66
Q

brain stems

A
  • pons relays impulses to brain centers and lower spinal nerves
67
Q

how many cranial nerves are there

A

12

68
Q

how many motor fibers

A

5

69
Q

how mnay sensory

A

3

70
Q

how many motor and sensory

A

4

71
Q

disorders of neuro

A 
meningitis
encephalitis
multiple sclerosis
parkinsons disease
seizures
headaches
72
Q

kernigs sign

A

flexing one leg than extending knee

- no pain

73
Q

brudzinskis

A

flexes hip and knee in response to head flexion

74
Q

spinal cord injury

A

any tramatic disruption of spinal cord

- veterbral fractures, dislocations, cars, sport injurys

75
Q

complete spinal cord injury to cervical spinal cord

A

quadriplegia

76
Q

aleheimers

A

incurable, degeneraive neurologic disorder, begins with decline in memory

77
Q

cerebrovascular accident (CVA, stroke)

A

when cerebral blood vessels become occluded by thrombys or embolus, or when intracranial hemorrhage occurs, brain tissue become ischemic, resulting in CVA or stroke

78
Q

aphasia/dysphasia

A

trouble communicating

health assessment exam 2 (5 decks)

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