NUR 202 Final Exam Flashcards
What are the major functions of the cerebellum
Equilibrium
Motor function of voluntary movement
Muscle tone
What are the major functions of the frontal lobe
Personality
behavior
emotions
intellectual function
What are the major functions of the parietal lobe
sensation
What are the major functions of the temporal lobe
auditory reception center:
- hearing
- taste
- smell
What are the major functions of Wernicke’s area; damage to this area can cause
language and comprehension (temporal lobe)
- receptive aphasia
- person hears sound, but cannot comprehend
What are the major functions of Broca’s area; damage to this area can cause
motor speech (frontal lobe)
- expressive aphasia
- person cannot talk
- person understands what you said, but cannot talk back
What are the major functions of the basal ganglia
subcortical-associated motor system: controls automatic associated movements of the body (e.g. arms swinging when you walk)
What are the major functions of the hypothalamus
Major respiratory center
sleep center
anterior and posterior pituitary regulator
coordinates autonomic nervous system and stress response
basic vital functions:
- temperature
- heart rate
- blood pressure
- appetite
- sex drive
What three structures make up the brainstem
Medulla
Pons
Midbrain
What is the major function of the brainstem
central core of brain that is mostly nerve fibers
contains origin of cranial nerves III-XII
What is the major function of the spinal cord
mediates reflexes
- posture control
- urination
- pain response
What is the major function of the thalamus
main hub where the sensory pathways of the spinal cord, cerebellum, basal ganglia, and brainstem form synapses
contains connections that are crucial for human emotion and creativity
List the cranial nerves (name and number)
I- Olfactory
II - Optic
III- Oculomotor
IV- Trochlear
V- Trigeminal
VI - Abducens
VII- Facial
VIII- Acoustic
IX- Glossopharyngeal
X- Vagus
XI- Spinal accessory
XII- Hypoglossal
What is amnesia
memory loss due to brain injury, illness, or the effects of drugs or alcohol
What is aphasia
difficulty speaking
- receptive
- expressive
- global
What is apraxia
difficulty with skilled movement due to brain disease or damage
What is ataxia
impaired balance or coordination due to brain damage, nerve damage, or muscle damage
What is a coma
Period of prolonged unconsciousness due to illness or injury
What is decerebrate rigidity
Rigidity associated with a poor prognosis; most ominous; indicates lesion in the brainstem at the midbrain or upper pons
Upper extremities:
- stiffly extended
- adducted
- internal rotation, palms pronated
Lower extremities:
- stiffly extended
- plantar flexion
Teeth clenched
Back hyperextended
What is decorticate rigidity
Indicates lesion in cerebral cortex
Upper extremities:
- flexion of arm, wrist, and fingers
- adduction of arm (tight to thorax)
Lower extremities:
- extension
- internal rotation
- plantar flexion
What is dysarthria
slurred speech due to weakness in the muscles used for speaking
What is dysphasia
Difficulty speaking due to brain disease or damage
What is dysphagia
Difficulty swallowing
What is flaccidity
Decreased muscle tone; muscle feels limp, soft, and flabby
due to injury in a peripheral nerve
What is hemiplegia
Spastic or flaccid paralysis of one side of the body (right or left)
What is paralysis
Decreased or loss of motor function caused by issues with the nerves or muscles
What is paraplegia
Symmetric paralysis of both lower extremities
What is paresthesia
Tingling (pins and needles) sensation usually in the hands, arms, legs, or feet
caused by lack of blood flow to an extremity
What is spasticity
Increased muscle tone due to injury of a spinal nerve
What is a tic
Involuntary, compulsive, repetitive twitching of a muscle group
usually neurological but can also be psychogenic
What is a tremor
Involuntary contraction of opposing muscle groups; rhythmic back-and-forth movement
may occur at rest, or with voluntary movement
always disappear while asleep
can be due to a cerebellar disease
What are the three phases of a seizure
Preictal phase
Ictal phase
Postictal phase
What is happening during the preictal phase
Aura - subjective sensation felt by the person about to have a seizure (can be auditory, visual, or motor)
What is happening during the ictal phase
The seizure is actively occurring
Person may experience:
- involuntary movements
- incontinence
- withdrawal
- loss of consciousness
What is happening during the postictal phase
After the seizure is finished the person may experience:
- deep sleep
- fatigue
- confusion
- headache
You are caring for a patient and notice that they are beginning to have a seizure, what do you do
- call for help
- clear the area of potential hazards (the patient may already be on seizure precautions, so the bed rails may be up and padded)
- note what time the seizure started and when it stopped
- you may need to perform CPR
What are the three types of aphasia
- Expressive (Broca’s)
- Receptive (Wernicke’s)
- Global
What is expressive aphasia
AKA Broca’s aphasia
The person can understand what you are saying, and they know what they want to say, but they cannot respond
Broken speech
What is receptive aphasia
AKA Wernicke’s aphasia
The person does not understand what you are saying, they do not know how to respond, but they respond with fluent speech that sounds unorganized and has nothing to do with what you said to them
Word salad
What is global aphasia
Both expressive and receptive aphasia
What are the components of the mental status exam
A- appearance
B- behavior
C- cognition
T- thought process
How to test cranial nerve I
Olfactory nerve (not often tested)
- occlude one nostril and have them smell something aromatic
- do the same with the other nostril
How to test cranial nerve II
Optic nerve
- test visual acuity (Snellen chart)
- test visual fields (testing peripheral vision)
How to test cranial nerve III, IV, and VI
Occulomotor, Trochlear, Abducens nerves
- Check pupils for size, regularity, equality, direct and consensual light reaction, and accommodation
- assess extraocular movements by having them follow your finger or pen
How to test cranial nerve V
Trigeminal nerve
Motor function:
- assess muscles of mastication by palpating temporal and masseter muscles as person clenches teeth
- Sensory function: with their eyes closed, touch their face in several different spots with a cotton ball to test light touch sensation
How to test cranial nerve VII
Facial Nerve
Motor function:
- note mobility and facial symmetry as they smile, frown, close eyes tightly, lift their eyebrows, and show their teeth
- have person puff out their cheeks then press the air out to see if it escapes evenly
How to test cranial nerve VIII
Acoustic nerve
- test hearing acuity by talking to them and then doing the whisper test
How to test cranial nerves IX and X
Glossopharyngeal and Vagus nerves
Motor function:
- have them say “ahh” and note pharyngeal movement as well as midline rising of the uvula
- touch posterior pharyngeal wall with tongue blade to test the gag reflex
How to test cranial nerve XI
Spinal accessory nerve
- test strength of trapezius muscles: ask person to raise shoulders against pressure as you press down on them
- test strength of sternocleidomastoid muscles: ask person to turn their head against pressure from your hand on their cheek in both directions
How to test cranial nerve XII
Hypoglossal nerve
- inspect tongue for tremors and note midline thrust as they stick out their tongue
- have them say “light, tight, dynamite” and note clear, distinct lingual speech
When inspecting and palpating the muscles, what are your look at specifically
size
symmetry
strength
tone
involuntary movements
(Super Secret STI)
How do you test muscle strength
- Hand grasp with push/pull: have person grab your two fingers on each hand and have them resist you pulling and pushing their hands. Also, cross your arms so that their dominant hand is grabbing your dominant hand
- Plantar flexion and dorsi-flexion against resistance
How do you test cerebellar function
Balance tests
Romberg test
Rapid alternating movements
How do you conduct the balance tests
- have person walk in a straight line for 10-20 feet, turn, then come back to the starting point
- have them walk heel to toe
- have them walk on their toes and then on their heels
How do you conduct the Romberg test
Have person stand tall and once they are stable, have them close their eyes and hold that position for 20 seconds
(make sure to be ready to catch them or be able to push them onto a bed if they begin to fall)
How do you conduct the rapid alternating movements test
- ask person to pat their knees with their palms and then the backs of their hands. Then go faster.
- ask person to touch their thumb to each finger on the same hand and then again in the reverse direction (do this with both hands)
- finger-to-finger: ask person to touch your finger, then touch their nose, then touch your finger again but in a different position
- finger-to-nose: ask person to close their eyes, stretch their arms out to the side and touch their nose with alternating hands and then back
- heel-to-shin: when person is supine, have them take the heel of one foot and rub it from the knee to the ankle on the opposite leg
How do you test a persons sensory perception
- touch various parts of their extremities and have them tell you where you touched them in order to test peripheral nerves
Where do reflexes originate from
Spinal cord
Where on the body do you test for reflexes
Biceps
Triceps
Brachioradialis
Quadriceps
Achilles
What part of the reflex hammer do you use when assessing reflex response
You can use either the pointed or flat side, it doesn’t matter
