study guide and exam review combined Flashcards
Cranial Nerve I
olfactory: test nose for smell
How would we test Cranial Nerve I ?
ask patient to close their eyes and mouth. You will occlude one side of nostril and put something with a strong smell (like a coffee bag) under the open side. Ask the patient to identify the smell.
should be something the general population could identiy as a smell
Cranial Nerve II
optic nerve; checking visual acuity
How do we test Cranial Nerve II ?
Snellen chart
Cranial Nerve III
oculomotor; observe eyes for pupillary size, shape, equality, contruction, and accommodation.
How do you test cranial nerve III, IV, and XI ?
The 6 cardinal fields of gaze
don’t forget PERRLA
Cranial Nerve IV
trochlear
Cranial nerve V
Trigeminal nerve; observing movement and sensation
How do you test cranial nerve V ?
Feel the jaw on both sides and have pt clench teeth. Should bilaterally be strong muscles, then for sensation have the pt close their eyes. You will use a small cotton ball to lightly touch their forehead, left cheek, and right cheek. Patient should feel equally on each side.
Cranial Nerve VI
abducens; look for extraocular muslcle movements
Cranial Nerve VII
facial; observing movement
How do you test for cranial nerve VII ?
Ask the patient to raise eyebrows, puff out cheeks, and smile.
Cranial Nerve VIII
acoustic; three different tests - whisper test, weber, and rinne.
how do you perform the whisper test?
CN VIII
stand behind patient and have them cover the opposite ear. whisper an easy word to the patient like dog or cat. Instruct the pt to repeat the word you say. Perform this on both sides.
How do you perform the weber test?
CN VIII
strike a tuning fork and then place on top of pt head in the center. Ask the pt if they can hear the sound in one or both ears. Should be heard equally in both ears.
How do you perform the rinne test?
CN VIII
strike the tuning fork and then place on pt mastoid bone behind ear. Instruct the pt to let you know when they can no longer hear the sound. When they do, move it near their ear canal and ask if the sound is louder.
pt should be able to hear louder in ear canal
Cranial Nerve IX
glossopharyngeal; checking if uvula and soft palate are symmetrical
How do you test cranial nerve IX ?
Ask the patient to say “ahh” and use penlight to see uvula
Cranial Nerve X
vagus; gag reflex and soft palate movement
How do you test cranial nerve X ?
ask pt to swallow; should be easy
Cranial Nerve XI
Accessory muscles; test shoulder and neck muscles for strength and movement
How do you test cranial nerve XI ?
instruct pt to shrug shoulders against your hands resistance; have them turn into your hand with their cheek as you resist (on both sides)
Cranial Nerve XII
hypoglossal; inspect tongue for movement, symmetry, strength, and absence of tumors
How do you test cranial nerve XII ?
ask pt to stick their tongue straight out and then from side to side
What are 4 specific questions for Level of Consciousness?
who are you? ; where are you? ; what year is it? ; why are you here?
What is a migraine
a neurological condition characterized by intense, throbbing headaches often accompanied by nausea, vomiting, and sensitivity to light and sound.
What are signs and symptoms of a Migraine?
throbbing pain, nausea, photophobia, phonophobia and auras
What is a tension headache?
Usually caused by stress or muscle tension, presenting as a dull, aching pain around the forehead and temples
most common type of headache
What are signs and symptoms of a tension headache?
a dull, band-like pressure around the head
can be stress related
What is a cluster headache?
a severe, sharp pain around one eye, often accompanied by tearing and nasal congestion that occur in cyclical patterns
What are signs and symptoms of a cluster headache?
typically unilateral, severe pain around the eye, tearing, nasal congestion
What is a cornea?
covers iris and pupil and is transparent, avascular, and richly innervated with sensory nerves. it allows light transmission through lens to retina
What is the sclera?
the fibrous outer layer; tough; “white” of eye
What is the lens?
a clear, curved, structure that focuses light onto the retina
What is the retina?
the inner layer, extension of central nervou system (CNS); contains rods and cones which perceive images and colors in response to varying light stimuli
What is the optic nerve?
causes blind spot at center of vision
What is a nystagmus?
rapid, involuntary eye movement due to neurological conditions or intoxication.
What is the Iris?
in the middle layer anteriorly, is circular, muscular membrane that regulates pupil dilation and constriction via the oculomotor nerve, cranial nerve III.
What is the pupil?
A central opening of iris and allows tranmission of light to retina
What are some conditions that can affect the eye?
cataracts (cloudy lens); glaucoma (increased intraocular pressure); macular degeneration (loss of central vision).
Dizziness
lightheadedness, unsteadiness, feeling faint, or feel like you are going to fall down
Vertigo
the environment around you feels like it spinning; often caused by inner ear disorders
What does a stage 1 pressure ulcer look like?
reddened unbroken, nonblanchable skin; still intact
What does a stage 2 pressure ulcer look like?
skin is broken; called partial thickness b/c it involves epidermis and dermis
What does a stage 3 pressure ulcer look like?
now involving subcutaneous tissue
What does stage 4 pressure ulcer look like?
muscle and bone are now exposed
What does ABCDE stand for?
Asymmetry, border (rigid or irregular), color (variation), diameter (greater than 6mm), evolution (changing)
What is cellulitis?
infection that is localized, red and warm to touch
What is eczema?
a chronic inflammatory skin condition causing red, itchy and dry patches
What are signs and symptoms of eczema?
itching, redness, swelling, thickened skin, oozing blisters
What is Psoriasis?
an autoimmune disorder leading to rapid skin cell turnover, causing scaly plaques
What are signs and symptoms of psoriasis?
silvery-white scales, red patches, itching, joint pain (psoriatic arthritis)
Fungal infections
skin infections caused by fungi (ringworm and athletes foot)
What are signs and symptoms of fungal infections?
red, itchy, scaly rashes, peeling, cracking skin, thickened nails
Dermatitis
inflammation of the skin caused by irritants, allergens, or underlying conditions
What are signs and symptoms of dermatitis?
redness, itching, swelling, blisters, crusting
What are signs of abuse?
bruises in different stages of healing, fearful behavior, inconsistent injury explanations
What are some questions you can ask a child to help gather information for suspected abuse?
ask them, “ did you fall?” or “ did you have an accident at home?”
What is Parkinsons?
a progressive neurodegenerative disorder that affects movement due to the loss of dopamine- producing neurons in the brain
What are signs and symptoms of parkinsons disease?
tremors, hunched with shuffling gait, pill rolling hand motion, postural instability
Guillain- Barré Syndrome
a rare autoimmune disorder in which the body’s immune system attacks the peripheral nerves, leading to muscle weakness and paralysis
what are symptoms of guillain barre syndrome?
ascending muscle weakness, tingling sensations, loss of relfexes, potential respiratory failure
What is Meningitis?
an infection or inflammation of the meninges caused by bacteria, viruses, fungi, or parasites
What are signs and symptoms of meningitis?
altered mental status, stiff neck, fever, severe headache, and sensitivity to light
What is aphasia?
difficulty talking or communicating
what is expressive aphasia?
the pt knows what they want to tell us, but cant get it out
Pain tolerance
it is unique to the person ; ex: getting a tattoo on the finger may really hurt one person but their friend will experience little to no pain.
Pain threshold
the point at which we consider something painful (general)
ex: cutting finger is painful
acute
under 6 months, sudden onset
just happened, new trauma or injury
chronic
longer than 6 months, slow and steady onset
radiating pain
pain felt in different areas then where the injury or illness is occuring
What are some questions you would ask a seizure patient?
“what do you feel or experience right before a seizure?” ; “What triggers your seizures?”
we want to be aware so we can help
glascow coma scale
highest = 15; lowest =3 (brain dead)
higher score the better; less than 8 intubate
delirium
marked by confusion, agitation, and altered consciousness; rapid onset and reversible
dementia
chronic cognitive decline affecting memory, reasoning, and daily functioning ; irreverisble with a slow and gradual onset
remote memory
longer memory (hildhood)
“where did you go to school?”
short term memory
recent events
“what did you eat for breakfast?”
what are some symptoms of alcohol withdrawal?
sweaty, agitated, tremors in hand, fever, increased blood pressure, delirirum or seizures, and GI upset
comatose
pt is unresponsive and wont open their eyes
hair and skin get color from what
melanocytes
what is bipolar disorder?
a mental health condition characterized by extreme mood swings, including episodes of mania and depression. affects daily life
what is OCD?
Chronic mental condition involving recurring, unwanted thoughts and repetitive behaviors or rituals performed to reduce anxiety. interefere with daily life
