Nuerologic Flashcards
Intracranial pressure is made up of:
- Brain tissue (88%)
- Cerebrospinal fluid (10%)
- Intravascular blood (2%)
central nervous system is made up of:
- brain
- brain stem
- spinal cord
Part of your brain that controls your emotions, intellect, personality and behavior
Frontal lobe
Part of your brain that controls sensations
parietal lobe
part of your brain that controls vision
occipital lobe
part of your brain that is your relay center for brain messages sent back and forth from cranial and spinal nerves
thalamus
part of brain that controls: respiratory**
temperature, BP, HR, appetite, sex drive & sleep
Hypothalamus
There are ___ cranial nerves
___ motor
—- sensory
____ both
12 cranial nerves
5 pair motor
3 pair sensory
4 pair both
There are \_\_\_\_ spinal nerves \_\_ cervical \_\_\_\_ thoracic \_\_\_\_ sacral \_\_\_\_ coccygeal
31 spinal nerves 7 pair cervical 12 pair thoracic 5 pair sacral 1 pair coccygeal
Because an infants neruological system hasn’t fully developed yet, they have:
primitive reflexes- until 1 yr old
sensations at birth- suckling etc
As an adult ages, the weight of their brain decreases by ____ due to:
15% due to loss of neurons
Objective data to include in a neurological exam:
- mental status (A/O x3)
- Cranial Nerve tests- #3 (occular nerve)
- Motor system- gait
- Sensory System- hearing loss, tingling, numbness
- Reflexes- lesions on spinal cord or brain (hyperactive)
Types of LOC (level of consciousness (5))
- Alert (awake, having conversation)
- Lethargic ( drift to sleep)
- Obtunded ( difficult to wake up. loud shout/shake)
- Stupor ( semi-coma. sternal rub sometimes doesnt wake them)
- Comatose
Three checks for mental status
- LOC
- Orientation
- Memory (loss)
A persons memory can be lost:
Immediate (2 seconds after you tell them something)
Recent (24 hours)
Remote (certain event)
Abstract ( difference between chair & car)
Confabulation ( make up info thats not real)
Cranial Nerve I
Olfactory- smell
Cranial Nerve II
Optic: visual acuity near vision visual fields optic disc
Carnial Nerve III
Occulomotor:
close eyelids
eye movement
size of pupil
Cranial Nerve IV (4)
Trochlear
downwards and inward eye movement
Cranial Nerve V
Trigeminal motor function (clench teeth, mastoid muscle strength) sensory function (corneal reflex, discriminate between sharp and dull with cotton ball)
Cranial Nerve VI
Abducens
Outward/lateral eye movement
PERRLA stands for:
Pupils are Equal, Round, and Reactive to light and Accomodation
To test your Equal Occular Motor’s you:
hold a pen light and motion through 6 cardinal fields of gaze
Cranial Nerve VII
Facial
- Motor function: facial expressions (frown, smile etc)
- Sensory Function: identify sweet vs salty on anterior -portion of tongue
Cranial nerve VIII
Acoustic
- “whisper test”
- “Normal Conversation”
Cranial nerve IX
Glossopharyngeal
- gag reflex
- swallow
Cranial nerve X
Vagus
- gag reflex
- palate and uvula movement
- clear speech (light, bright, dynamite)
Cranial nerve XI
Spinal Accessory
- neck & shoulder muscle strength
Cranial Nerve XII
Hypoglossal
- tongue movement
- speech
Involuntary movement of the muscles include:
- Tic- constant twitching of muscles
- Tremor- common in alcoholics/ back & forth movement
- Chorea- sudden, rapid, jerking movement
- Athetosis- continuous twitching
Balance Tests include:
- Gait ** assess first**
- Tandem Walking (heel to toe)
- RombergTest (stand still and look for swaying)
- Shallow knee bend (MS or obese)
Types of coordination and skilled movements
Rapid Alternating Movements
Finger-To-Finger Test
Finger-To-Nose Test
Heel-To-Shin Test
decrease in neuron function. Decreases pain sensation in older adults
Hypoalgesia
abscense of pain
Analgesia
Increased sensitivity to pain. (low tolerance)
Hyperalgesia
decreased sensation to pain
Hypoesthesia
absent sensation to touch
Anesthesia
Hyperesthesia
^^ hyper response to touch
Types of reflexes (4)
- Deep Tendon- patellar knee jerk
- Superficial- corneal reflex, abdominal
- Visceral- pupillary response to light
- Pathologic- abnormal (Babinski or extensor plantar reflex)
the reflex where you stroke up side of groin and R or L side of scrotum elevates
Cremasteric Reflex (L1-L2) (superficial reflex)
What two reflexes test L4-S2?
- Planter Reflex in adults
2. Babinski Reflex in kids
The neurologic recheck has 4 steps which are:
- Level of consciousness
- Motor Function
- Pupillary response
- Vital signs
loss of ability to recognize importance of sensory impressions
agnosia
loss of ability to express thoughts in writing
agraphia
loss of pain sensation
analgesia
loss of ability to perform purposeful movements in the absence of sensory or motor damage
apraxia
inability to perform coordinated movements
ataxia
bizarre, slow, twisting, writhing, movement, resembling a snake or worm
athetosis
sudden, rapid, jerky, purposeless movement involving limbs, trunk or face
chorea
rapidly alternating involuntary contraction and relaxation of a muscle in response to sudden stretch
Clonus
bundle of fibers outside of the CNS
nerve
part of brain that doesn’t initiate the movement but coordinates and smooths it
cerebellum
cranial nerves III through XII original from nuclei in the ___
brainstem
Lower motor neurons (LMNs) that enter and exit the brain rather than the spinal cord
cranial nerves
spinal nerves are mixed nerves because they contain:
both sensory and motor fibers
occurs with myasthenia gravis, dysfunction of cranial nerve III or Horner syndrome
Ptosis (drooping of the eye)
the cause of a sudden, unilatera, dilated, and nonreactive pupil
Increasing intracranial pressure
What are common cerebellar function tests that check coordination of skilled movements?
- rapid alternating movements (RAM)
- finger-to-finger test
- finger-to-nose test
- heel-to-shin test
the inability to feel vibrations is often the first sensation lost in ___ and ___ patients
diabetic & alcoholics
how do you test a persons Kinesthesia?
move their finger up and down then left to right. Ask them to tell you what you did. (loss of position sense)
inability to identify objects correctly. occurs in sensory cortex lesions (stroke)
Astereognosis
the ability to read a number by having it traced on the skin
Graphesthesia
Deep Tendon Reflexes (5)
- Biceps (C5-C6)
- Triceps C7)
- Brachioradialis (C5-C6)
- Quadriceps
- Achilles
a set of rapid, rhythmic contractions of the same muscle
clonus
reflexes that have sensory receptors in the skin rather than the muscle
superficial (cutaneous reflexes)
- abdominal, cremasteric, plantar reflex (Babinksi in babies)
if a patient has had a stroke. Ask them to put their arms straight out infront of them with palms supine. What would you see?
Palmar drift
hld for 10 sec.
normal size of pupil:
3-5mm
when the HR decreases, BP ^ and pulse pressure widens
Cushing Reflex from ^ inter-cranial pressure
flexion of upper extremities with extension & internal rotation of lower extremities
Decorticate
hemispheric lesion of cerebral cortex
Extension of upper extremities with palms pronated & extension of lower extremities
Decerebrate
lesion in brain stem or upper pons
prolonged arching o fback with head and heels bent backward
Opisthotonos
meningeal irritation
