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Test 3 Assessment of Nervous System (Neuro AP) Flashcards

1
Q

Brain (_____):

What are the Protective Layers of the Brain?

A

Protective layers:

  • Scalp
  • Skull
  • Meninges (covers brain and spinal cord
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2
Q

In the scalp, which layer contains the blood vessels?

What happens when this layer is injured?

A
  • Middle Layer

- The blood vessels contract poorly when injured.

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3
Q

What are the 4 bones of the Skull?

A

Frontal, parietal, temporal, occipital

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4
Q

What is a fossae?

A

Fossae (Indentions inside the skull)

  • 3 depressions in the base of the skull
  • Anterior, middle, posterior
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5
Q

In the fossae, what is contained in the:

Anterior?

Middle?

Posterior?

A
  • Anterior contains the frontal lobes.
  • Middle contains the temporal, parietal, and occipital lobes,
  • Posterior contains the brain stem and the cerebellum
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6
Q

What are the layers of the meninges in order from outermost- to innermost- layer?

What are significant points about each layer?

A

Meninges:

  • Dura mater: Directly beneath the skull, consists of two layers. The outermost adheres to the skull. The inner layer extends into the cranial space.
  • Arachnoid membrane: delicate, fragile membrane that surrounds the brain. Below this is the subarachnoid space which consists of a fine web-like structure that connects to the pia mater. CSF and cerebral arteries and veins are located here.
  • Pia mater: The INNERMOST portion of the meninges, it follows all of the folds and convolutions of the brain’s surface.
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7
Q

What are the divisions of the brain (with the subdivisions, if applicable)?

Which is the major part of the brain?

A

Divisions of the brain:

  • Cerebrum (Major part of the brain)
  • Telencephalon (2 cerebral hemispheres) joined by the corpus callosum (to make connection)
  • Brain Stem
  • Midbrain
  • Pons
  • Medulla

*Cerebellum (Back of the brain)

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8
Q

What are the frontal lobes responsible for?

What are 8 functions that fall under this responsibility?

A

Frontal lobes:

***Responsible for higher cognitive functions.

These include:

  • Voluntary eye movement
  • Access to current sensory data
  • Access to past information or experience
  • Affective response to a situation
  • Regulates behavior based on judgment and foresight
  • Judgement
  • Ability to develop long term goals
  • Reasoning, concentration, abstraction
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9
Q

What strip correlates to the frontal lobe, and which side of the body is effected?

What is located in the inferior frontal gyrus?

What is this responsible for?

What will damage here cause?

A

***“MOTOR STRIP” for opposite side of body.

  • **Broca’s area: located in the inferior frontal gyrus is responsible for the motor aspects of speech.
  • Damage to left –> Damage to right Side (and vice versa)

***Damage here will cause EXPRESSIVE APHASIA (cannot make the words out with mouth, but I understand what I want to say)

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10
Q

What are the parietal lobes responsible for?

What are 8 functions that fall under this responsibility?

Where does the parietal lobe receive data from?

A

Parietal Lobes:

***Responsible for Understanding sensation, texture, size, shape and spatial relationships.

***Receives data from the skin (Pain, heat, cold, pressure).

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11
Q

What strip correlates to the parietal lobes, and which side of the body is effected?

What is this responsible for?

What type of person would this be important to have functioning properly?

A

***“SENSORY STRIP” for the opposite of the body.
Awareness of position in space.

***Processes sensory and SPATIAL AWARENESS
Key component in EYE-HAND COORDINATION and arm movement.
PLAYS a ROLE in our SENSATIONS of TOUCH, SMELL, and TASTE.

***When someone is a musician, this is important.

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12
Q

What are the temporal lobes responsible for?

What are other responsibilities of the temporal lobes?

A

Temporal Lobes:

***Auditory center for sound interpretation

-Seizures! (Auditory, visual and sensory hallucinations)
-Special senses of taste and smell
-Vestibular sense
-Interpretative area…integrates sounds, thoughts and emotions
(memory, understanding music, aggressiveness, and sexual behavior.)

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13
Q

What is located in the Temporal Lobe?

What can happen if this is damaged, and what does this mean?

A

***Wernicke’s Area for Speech

***Damage can cause RECEPTIVE APHASIA, which means you cannot understand and sounds like a different language to you.

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14
Q

What are the Occipital Lobes responsible for?

What can happen if this is damaged?

A

Occipital Lobes:

  • **Responsible for Vision!
  • Visual recognition of objects
  • Reading comprehension

***Damage here will cause blindness.

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15
Q

What does the Limbic Lobes regulate?

What is this involved in the formation of?

What is this closely associated with?

A

***Limbic System regulates emotion and memory.

***Involved in the formation of long-term memory.

***Closely associated with the olfactory structures.

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16
Q

Where is the diencephalon located?

What does it connect?

What does it enclose and contain?

A

Diencephalon:

***Located in the posterior part of the forebrain.

***Connects the midbrain with the cerebral hemispheres.

***Encloses the third ventricle, and contains the thalamus and hypothalamus.

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17
Q

What parts of the brain are contained in the diencephalon?

A

Diencephalon contains:

  • Epithalamus & pineal gland
  • Thalamus
  • Hypothalamus
  • Pituitary gland
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18
Q

What does Thalamus mean?

Where does it sit?

What is the thalamus called?

A

Thalamus:

***Thalamus means “inner room”

***It sits deep in the brain at the top of the brainstem.

***The thalamus is called the “Gateway to the Cerebral Cortex,” as nearly all sensory inputs pass through it to the higher levels of the brain.

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19
Q

Where is the hypothalamus located?

What does the hypothalamus form parts of?

What does the hypothalamus interconnect?

A

Hypothalmus:

***Located in the b
asal region of the diencephalon

***Forms part of the walls of the third ventricle

***Interconnects with the limbic system, midbrain, thalamus, & pituitary gland

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20
Q

What does the hypothalamus regulate?

What hormone is secreted from the pituitary gland?

A

Hypothalamus:

Regulates:

  • Temperature regulation
  • Food and water intake
  • Behavior
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21
Q

What are the 3 components of the brain stem structure?

What is located in the brainstem that is very important?

A
  • Midbrain
  • Pon
  • Medella

The respiratory center is located in the pons and medulla of the brainstem.

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22
Q

Where is the cerebellum located?

A

Cerebellum:

***Located at the rear of the cerebrum, and above the brain stem.

***Takes over the learned, repetitive tasks (riding a bike), while voluntary motor activity is located in the motor cortex.

***It influences muscle tone associated with EQUILIBRIUM, orientation in space, locomotion, and posture.

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23
Q

What does the cerebellum help provide?

What term would be associated with a problem in the cerebellum?

A

***The Cerebellum helps provide smooth, coordinated body movements.

***Ataxic (think cerebellum):
LACK of Muscle Coordination

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24
Q

How would the brain be determined normal on a CT scan (slice of the brain):

  • Longitudinal fissure?
  • Ventricles?
  • What would a backup of fluid look like?
  • Fissures should be?
A

***Longitudinal fissure should be MIDLINE = No pressure on either side

***Lateral ventricles should be EQUAL in size.

***Increased size of ventricles from a backup of fluid.

***Fissures should be wrinkled (Smoothness = Pressure= BAD)

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25
Q

Physical examination: TERMS

A patient responds immediately to minimal external stimuli.

A

Alert

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26
Q

Physical examination: TERMS

Patient is disoriented to time or place but usually oriented to person, with impaired judgement and decision making and decreased attention span.

27
Q

Physical examination: TERMS

Patient is disoriented to time, place, and person with loss of contact with reality and often had auditory or visual hallucinations.

28
Q

Physical examination: TERMS

Patient displays a state of drowsiness or inaction in which the patient needs an increased stimulus to be awakened.

29
Q

Physical examination: TERMS

Patient displays dull indifference to external stimuli, and response is minimally maintained. Questions are answered with a minimal response.

30
Q

Patient can be aroused only by vigorous and continuous external stimuli. Motor response is often withdrawal or localizing to stimulus.

31
Q

Physical examination: TERMS

Vigorous stimulation fails to produce any voluntary neutral response.

32
Q

In the neuro assessment, what are the respiratory patterns in order of severity (Bottom of the list being the worst)?

A

Respiratory patterns (In order of severity):

  • Cheynes-Stokes
  • Central neurogenic hyperventilation
  • Apneustic
  • Cluster
  • Ataxic: Gasping (KNOW THIS IS WORST THAN Cheynes-Strokes)
33
Q

Respiratory Patterns: TERMS

Rhythmic crescendo and decrescendo of rate and depth of respiration includes brief periods of apnea.

A

Cheyne-Strokes

34
Q

Respiratory Patterns: TERMS

Very deep, very rapid respirations with NO apneic periods

A

Central neurogenic hyperventilation

35
Q

Respiratory Patterns: TERMS

Prolonged inspiratory and/or expiratory pause of 2-3 seconds.

36
Q

Respiratory Patterns: TERMS

Clusters of irregular, gasping respirations separated by long periods of apnea.

A

Cluster Breathing

37
Q

Respiratory Patterns: TERMS

Irregular, random pattern of deep and shallow respirations with irregular apneic periods.

A

Ataxic Breathing

38
Q

Glasgow Coma Scale:

What are the Categories and maximum scores for each?

What is the Maximum score?

What is the minimum score, and what would the person be classified as?

A

Glasgow Coma Scale:

4 - E = Eye Opening
5 - V = Verbal Response
6 - M = Motor Response

Max score: 15

Minimum score: 3 (Brain Dead)

39
Q

Glasgow Coma Scale:

What are the score descriptions for eye opening? (Total score: 4)

A

Glasgow Coma Scale: E

4 - Spontaneous Eye Opening
3 - Eye opening to Speech
2 - Eye opening to Pain
1 - No eye Opening

40
Q

Glasgow Coma Scale:

What are the score descriptions for Verbal Opening? (Total score: 5)

A

Glasgow Coma Scale: V

5 - Oriented
4 - Confused Conversation
3 - Inappropriate Conversation
2 - Incomprehensible Speech
1 - No Speech
41
Q

Glasgow Coma Scale:

What are the score descriptions for Motor Opening? (Total score: 6)

A

Glasgow Coma Scale: M

6 - Obeys Commands
5 - Localizing responses to pain
4 - Generalized withdrawal to pain
3 - Flexor posturing to pain
2 - Extensor posturing to pain
1 - No motor response to pain
42
Q

Abnormal Motor Function: TERMS

Occurs without regard to external stimuli and may not occur by request.

A

Abnormal Motor Function: TERMS

Spontaneous

43
Q

Abnormal Motor Function: TERMS

Occurs when the extremity opposite the extremity receiving pain crosses midline of the body in an attempt to remove the noxious stimulus from the affected limb.

A

Abnormal Motor Function: TERMS

Localization

44
Q

Abnormal Motor Function: TERMS

Occurs when the extremity receiving the painful stimulus flexes normally in an attempt to avoid the noxious stimulus.

A

Abnormal Motor Function: TERMS

Withdrawal

45
Q

Abnormal Motor Function: TERMS

Abnormal flexion response the may occur spontaneously or in response to noxious stimuli

A

Abnormal Motor Function: TERMS

Decortication

46
Q

Abnormal Motor Function: TERMS

Abnormal extension response that may occur spontaneously or in response to noxious stimuli.

A

Abnormal Motor Function: TERMS

Decerebration

47
Q

Abnormal Motor Function: TERMS

No response to painful stimuli.

A

Abnormal Motor Function: TERMS

Flaccid

48
Q

What does a Dermatome Map measure?

What would this tell?

What is the Landmark to Remember?

A

Dermatome Map:

***Measurement of what SENSATIONS a person feels.

***Tells where the spinal cord damage may be according to the sensations and location.

***Landmark: T4 –> Nipple Line

49
Q

Motor (_____ = ______)

Sensory (_____ = ______)

A

Motor (Efferent = Away)

Sensory (Afferent = Receiving)

50
Q

Spinal Nerves:

Which Root?

  • Afferent pathway in which impulses enter the cord
  • Convey sensory input from specific areas of the body known as dermatomes
A

Spinal Nerves:

Dorsal Root (Back)

51
Q

Spinal Nerves:

Which Root?

  • Efferent pathway in which impulses leave
  • Convey efferent impulses from the spinal cord to the body
A

Spinal Nerves:

Ventral Root (Front)

52
Q

Sensory and Motor Tracts:

What do the Ascending tracts to?

What are the 3 Major Ascending Tracts?

A

Sensory and Motor Tracts:

*Sensory –> Carries information to the brain

  • Three Major Sensory Tracts:
  • Spinothalmic
  • Spinocerebellar
  • Posterior Column Tract
53
Q

Sensory and Motor Tracts: Ascending

What do the Spinothalmic tracts do?

Stimulus?

Anterior?
Lateral?

A

Sensory and Motor Tracts: Ascending

***Transmits to the thalamus and then to the cerebrum

***Opposite side of stimulus

  • **Anterior (CRUDE TOUCH, pressure)
  • **Lateral (PAIN, TEMPERATURE)
54
Q

Sensory and Motor Tracts: Ascending

What do the Spinocerebellar tracts do?

Stimulus?

A

Sensory and Motor Tracts: Ascending

***Transmits proprioceptive information from the body to the cerebellum

***Same side as stimulus

55
Q

Sensory and Motor Tracts: Ascending

What do the Posterior Column tracts do?

Stimulus?

A

Sensory and Motor Tracts: Ascending

***Transmits Proprioception, FINE TOUCH, pressure, VIBRATION to primary sensory cortex

***Opposite side of stimulus

56
Q

Sensory and Motor Tracts: Descending

What is the descending tract called?

What does it do?

A

Sensory and Motor Tracts: Descending

***Corticospinal tract

  • **Conscious control of skeletal muscle (Telling what to do)
  • **Relays messages to control Voluntary Muscle Movement!
57
Q

What can occur during deep tendon reflexes, or when you touch a hot stove?

A

Reflex Arc

58
Q

What do Upper motor neurons do?

Where are they located?

A

Upper Motor Neuron:

***Facilitates and inhibits descending supraspinal pathways

***Located entirely in the CNS

59
Q

What are the 6 characteristics of Upper Motor Neuron (UMN) Syndrome?

A

Upper Motor Neurons (UMN) syndrome:

  • Weakness, paralysis
  • **Spasticity
  • Increased tendon reflexes
  • Positive Babinski sign
  • Loss of abdominal reflexes
  • Little or no muscle atrophy
60
Q

What do the Lower Motor Neurons do?

Where are they located?

A

Lower Motor Neuron:

***Linkage between CNS and voluntary muscles

***Located in the CNS and the PNS

61
Q

What position should the patient be in during a Lumbar Puncture?

A

Lumbar Puncture:

***Cannon Ball Position

62
Q

What position should the patient be in during a Lumbar Puncture?

A

Lumbar Puncture:

***Cannon Ball Position

63
Q

What is the normal glucose of CSF?

What happens if glucose is less than this?

A

Cerebral Spinal Fluid:

Normal Glucose –> 50-75 mg/dL
(Two thirds of Blood Sugar value)

If low –> Indication of infection, bacteria eating up the glucose

AH 1 (16 decks)

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