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NSG 1600 - Midterm > NSG 1610 - Neurological System/Assessment > Flashcards

NSG 1610 - Neurological System/Assessment Flashcards

1
Q

What is the function of the cerebral cortex?

A

divides into left and right hemispheres with 4 lobes

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2
Q

What is the function of the basal ganglia?

A

controls autonomic associated movements (i.e., swinging arms while walking)

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3
Q

What is the function of the thalamus?

A

main relay station - sensory pathway to the brainstem and spinal cord

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4
Q

What is the function of the hypothalamus?

A

control center - temperature, HR, BP, sleep, pituitary gland (hormones), coordinates autonomic nervous system

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5
Q

What is the function of the cerebellum?

A

motor coordination and voluntary movements - equilibrium, muscle tone, coordinate and smooth movement

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6
Q

What is the function of the brainstem?

A

collection of nerve fibres, midbrain, pons, medulla

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7
Q

What is the function of the spinal cord?

A

main pathway for ascending and descending - connects the brain to the spinal nerves

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8
Q

what are the protective mechanisms of the brain?

A

CSF, blood-brain barrier, and meninges

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9
Q

What are the 12 cranial nerves?

A

I - olfactory
II - optic
III - oculomotor
IV - trochlear
V - trigeminal
VI - abducens
VII - facial
VIII - acoustic
IX - glossopharyngeal
X - vagus
XI - spinal
XII - hypoglossal

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10
Q

What is the function of cranial nerves I and II? Are they sensory, mixed, or motor?

A
  • both are sensory
  • smell and visual acuity
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11
Q

What is the function of cranial nerves III and IV? Are they sensory, mixed, or motor?

A
  • Mixed and motor
  • functions to control pupillary reflex and extraocular eye movement
  • Controls lateral and downward movement of the eyeball
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12
Q

What is the function of cranial nerves V and VI? Are they sensory, mixed, or motor?

A
  • mixed and motor
  • sensations of the cornea, skin of the face, and nasal mucosa
  • controls lateral movement of the eyeball
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13
Q

What is the function of cranial nerves VII and VIII? Are they sensory, mixed, or motor?

A
  • mixed and sensory
  • VII motor - movement and strength of the facial muscles
  • VII sensory - taste on the anterior 2/3 of the tongue
  • ability to hear
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14
Q

What is the function of cranial nerves IX and X? Are they sensory, mixed, or motor?

A
  • both are mixed
  • swallowing, allows the soft palate to rise symmetrically and the uvula to remain in midline & taste (sensory)
  • pharynx/larynx for talking and swallowing (motor) & carotid body and carotid reflex (sensory)
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15
Q

What is the function of cranial nerves XI and XII? Are they sensory, mixed, or motor?

A
  • both motor
  • controls movement of the trapezius and sternomastoid muscles, which should be equal and strong
  • supplies the intrinsic and extrinsic muscles of the tongue
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16
Q

How many pairs of spinal nerves are there? How many within each spinal region?

A
  • 31 pairs
  • Cervical (8)
  • Thoracic (12)
  • Lumbar (5)
  • Sacral (5)
  • Coccygeal (1)
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17
Q

What are dermatomes?

A

level of the skin innervated by specific spinal nerves

Dermatomes are the area of skin supplied by cutaneous branches of a single cranial or spinal nerve

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18
Q

What are the differences between somatic and autonomic nerve fibres?

A
  • somatic is skeletal, voluntary muscles
  • autonomic is smooth, involuntary muscles
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19
Q

What is the purpose of the sensory pathways in the CNS?

A

Focuses on skin, muscles, tendons, organs, and mucous membranes

Allow our body to monitor conscious sensations (perception of temperature and pain), internal organ functions, reflexes and body positions

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20
Q

What are assessing in the posterior (dorsal) columns of the brain?

A

Assessing the client’s ability to determine position without looking (proprioception), vibration (striking a tuning fork and placing it near either a toe or finger joint)

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21
Q

what is stereogenesis?

A

testing a client’s ability to close their hand around a common/familiar object and tell us what it is with their eyes closed

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22
Q

what are we assessing in the spinothalamic tract?

A

Assessing the client’s ability to have transmitting sensations of pain, temperature, crude or light touch (transmitted to the thalamus which travels to sensory cortex of the brain for interpretation)

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23
Q

what is the function of the corticospinal/pyramidal tract?

A

mediates voluntary movement, skilled and purposeful movements

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24
Q

what is the purpose of the extrapyramidal tracts?

A

maintains our muscle tone and allows us to have controlled body movements (no jerking or spasticity)

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25
Q

what is the function of the cerebellar system?

A

coordinates our movements, maintains equilibrium, and helps us to maintain posture

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26
Q

what is the function of the upper motor neurons?

A

influence or modify lower motor neurons and are originating from the upper spinal cord

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27
Q

what is the function of the lower motor neurons?

A

located mostly in the PNS and have control of the trunk/legs, along with some arm movements

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28
Q

Which part of the spine is associated with the biceps and brachioradialis reflex?

A

C5-C6

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29
Q

Which part of the spine is associated with the triceps reflex?

A

C7-C8

30
Q

Which part of the spine is associated with the quadriceps/patellar reflex?

A

L2-L4

31
Q

Which part of the spine is associated with the achilles reflex?

A

L5-S2

32
Q

Which part of the spine is associated with the superficial plantar reflex?

A

L4-S2

33
Q

Which of the reflexes are testing deep tendons?

A

biceps, triceps, brachioradialis, quadriceps/patellar

34
Q

describe the reflex scale and what each number relates to

A

0 no detectable response
1+ sluggish, minimal response
2+ immediate, strong response (expected/normal)
3+ brisker than expected
4+ very brisk response, hyperactive, clonus observed

35
Q

define ptosis

A

upper eyelid drooping

36
Q

define strabismus

A

both eyes not lining up in the same direction

37
Q

define atrophy

A

wasting away or degeneration of muscles, cells, etc.

38
Q

define hypertrophy

A

increase of muscle mass - building of cells

39
Q

define paresis

A

muscular weakness caused by nerve damage - partial paralysis

40
Q

define flaccidity

A

condition of being soft or limp

41
Q

define hypo/hyper algesia

A

capacity to feel pain

42
Q

define hypo/hyper aesthesia

A

to experience sensation, perception, or sensitivity

43
Q

What could difficulties in performing rapid alternating movements or finger-to-finger tests indicate damage in?

A

the cerebellum and coordination

44
Q

What 12 questions should you ask when obtaining subjective data in a neuro assessment?

A
  1. headache
  2. head injury
  3. dizziness/vertigo
  4. seizures
  5. tremors
  6. weakness
  7. incoordination
  8. numbness/tingling sensations
  9. difficulty swallowing
  10. difficulty speaking
  11. significant past history
  12. environmental and occupational considerations
45
Q

what are the two types of vertigo? describe them

A
  1. subjective - the individual feels they are spinning while the room stays still
  2. objective - the room is spinning while the individual remains still
46
Q

What are 4 additional subjective data questions you would ask older adults during a neuro assessment?

A
  1. risk for falls
  2. cognitive function
  3. tremor
  4. vision (changes to)
47
Q

When would you complete a screening neurological exam?

A

in a healthy pt. with no significant health hx issues

48
Q

when would you complete a complete neurological exam?

A

pt. who has neurological concerns, noticing signs of dysfunction

49
Q

when would you complete a neurological re-check exam?

A

pt. showing deficits or changes that need to be re-assessed (worsening or improving)

50
Q

How would you test cranial nerve I?

A

OLFACTORY NERVE
client occludes one nostril, takes a deep breath in (both sides).

Then, pt. closes the eyes and is instructed to smell an object

51
Q

How would you test cranial nerve II?

A

OPTIC NERVE
- use Snellen chart to determine visual acuity

52
Q

How would you test cranial nerve III, IV, VI?

A

OCULOMOTOR, TROCHLEAR, ABDUCENS

inspect pt. for uniform opening of upper/lower eyelids (palpebral fissure). Assess PERRLA and six cardinal positions of gaze. Looking for nystagmus, unilateral drooping, and pupil size.

53
Q

How would you test cranial nerve V?

A

TRIGEMINAL
(Motor) feel pt. open/close their jaw. Then, get pt. to grit their teeth and try to separate jaw. Looking for crepitus and other ailments.

(Sensory) Test sensation of 3 facial zones (forehead, middle face, and chin/lower jaw). Pt. closes eyes and you ask where you are touching w/ cotton ball.

54
Q

How would you test cranial nerve VII?

A

FACIAL

pt. smiles, frowns, lifts their eyebrows, shows teeth, closes eyes (you try to force them open), and puffs cheeks (you try to press them in)

55
Q

How would you test cranial nerve VIII?

A

VESTIBULOCOCHLEAR

complete the whisper voice test

56
Q

How would you test cranial nerves IX and X?

A

GLOSSOPHARYNGEAL and VAGUS

depress pt. tongue and get them to say “ahh”. Looking for uvula to move up.

57
Q

How would you test cranial nerve XI?

A

SPINAL ACCESSORY
pt. turns their head one way and you try to force their head the opposite way.

58
Q

How would you test cranial nerve XII?

A

HYPOGLOSSAL
pt. sticks tongue out. Then with tongue in their mouth, pt. says “light, tight, dynamite”

59
Q

What are we looking for during our inspection and palpation of the muscles in a neuro assessment?

A

size, strength, tone, and involuntary movements

60
Q

What two tests should you perform to test balance and gait in a neurological assessment?

A
  1. gait - pt. walks 3-6m one way and back OR heel to toe test
  2. the romberg test - pt. has feet shoulder width apart, closes eyes and tries to stay standing in position (looking for loss of balance)
61
Q

What 4 tests can we perform to test coordination and skilled movements during a neurological assessment?

A
  1. rapid alternating movements (palms on knees, alternate palmar and dorsal as fast as possible OR thumb to each consecutive finger)
  2. finger-to-finger test (pt. touches their finger to yours then touch their nose)
  3. finger-to-nose test (pt. stands with eyes closed and arms spread horizontally & touch R index finger to nose, followed by L)
  4. heel-to-shin test (pt. runs heel down shin in a proximal to distal motion)
62
Q

What three things are we testing for in the spinothalamic tract (sensory) and how do we test them?

A
  1. pain (use sharp/dull ends of q-tip across pt. body and ask them which end is being used. Min. 2 secs between each test)
  2. temperature (only tested if pain results are abnormal)
  3. light touch (use cotton ball, ask pt. to tell you when they feel touch)
63
Q

What three things are we testing for in the posterior column (sensory)? How do you test them?

A
  1. vibration - apply tuning fork on second joint of index finger and pt. states when the vibration starts and stops
  2. position (kinaesthesia) - pt. closes eyes, passively manipulate finger or big toe, ask whether pointing up or down
  3. tactile discrimination (fine touch) - has five tests (stereo genesis, graphesthesia, two-point discrimination, extinction, and point location)
64
Q

How do you perform each of the five tactile discrimination tests?

A
  1. Stereognosis – pt. closes eyes, place familiar object in their hand and ask what it is
  2. Graphesthesia – pt. closes eyes, trace either a letter or number in their palm
  3. Two-point discrimination – can pt. recognize you are touching 2 points at a time
  4. Extinction – pt. states whether your are touching L/R or both sides
  5. Point location – touch pt. and they identify where they are being touched
65
Q

What 4 things should you assess during a neurological re-check?

A
  1. LOC (person, place, time)
  2. motor function (facial movements, upper extremities, and lower extremities)
  3. pupillary response (PERRLA)
  4. vital signs (temp, pulse, resp.)
66
Q

What is dysarthria?

A

Difficulty forming words

67
Q

What is anosmia?

A

Decrease or loss of smell

68
Q

List the three sections of the Glasgow Coma Scale

A
  1. Eye opening response
  2. Motor response
  3. Verbal response
69
Q

Describe the eye opening response scale for GCS

A

4-point scale:
1. No response
2. Response to pain
3. Response to speech
4. Spontaneous

70
Q

Describe the motor response scale for GCS

A

6-point scale:
1. No response
2. Abnormal extension
3. Abnormal flexion
4. Withdrawal flexion to stimulus
5. Localizes pain stimulus
6. Obeys verbal commands

71
Q

Describe the verbal response scale for GCS

A

5-point scale:
1. No response
2. Speech incomprehensible
3. Speech inappropriate
4. Conversation confused
5. Oriented x3, appropriate

72
Q

Match the following terms
- Expressive aphasia
- Wernicke’s aphasia
- Global aphasia
- Receptive aphasia
- Most common and severe
- Broca’s aphasia

A
  • Broca’s aphasia = expressive aphasia
  • Wernicke’s aphasia = receptive aphasia
  • Global aphasia = Most common and severe

NSG 1600 - Midterm (5 decks)

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