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PD Block III > The Neuro Exam > Flashcards

The Neuro Exam Flashcards

1
Q

what nerves make up the peripheral nervous system?

A

cranial and spinal nerves, and the ascending and descending pathways

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2
Q

what structures make up the central nervous system?

A

brain and spinal cord

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3
Q

function of the autonomic nervous system

A

coordinates and regulates internal organs of the body (cardiac muscle and smooth muscle)

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4
Q

what are the two divisions of the autonomic nervous system?

A
  1. sympathetic: stimulates action during physiologic and psychologic stress
  2. parasympathetic: conserves body resources, maintains day-to-day body functions such as digestion and elimination
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5
Q

cerebrum location

A

main brain structure, w/ two hemispheres each divided into lobes, has a gray outer layer (cerebral cortex)

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6
Q

cerebral cortex

A

outer, gray matter layer of the cerebrum, responsible for general movement, visceral functions, perception, behavior, and integration of these functions

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7
Q

commissural fibers

A

AKA corpus callosum, facilitate coordination between L and R cerebrum hemispheres

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8
Q

location of the frontal lobe

A

forehead region, back to about the ears

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9
Q

function of the frontal lobe

A

motor cortex, voluntary skeletal movement and control of eye movements

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10
Q

location of the parietal lobe

A

posterior to the frontal lobe, anterior to the occipital lobe

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11
Q

function of the parietal lobe

A

processes sensory data, (i.e temp, pressure, pain, size, shape, texture, two-point discrimination), visual, taste, smell, hearing sensations, proprioception (awareness of body position).

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12
Q

location of the occipital lobe

A

posterior

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13
Q

function of the occipital lobe

A

primary vision center and interpretation of visual stimuli

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14
Q

location of the temporal lobe

A

laterally, by the ears on each side

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15
Q

function of the temporal lobe

A

perception of sound and determination of of their source. also involved in processing of taste, smell, and balance. reception and interpretation of speech takes place in specialized Wernicke area w/i temporal lobe.

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16
Q

location and function of the limbic system

A

mediates patterns of behavior that determine survival (e.g. mating, aggression, fear, affection) and reactions to emotions. located deep to the cerebrum.

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17
Q

function of the cerebellum

A

aids motor cortex of cerebrum in voluntary movement, processes sensory info from eyes, ears, touch, and msk.

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18
Q

location of the cerebellum

A

located posteriorly , inferior to occipital lobe and temporal lobes

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19
Q

location of the brainstem

A

between cerebral cortex and spinal cord

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20
Q

function of the brainstem

A

controls many involuntary functions (i.e respiratory, circulatory functions; swallowing, coughing, vomiting, etc; pupillary action)

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21
Q

structures included in the brainstem

A

medulla oblongata (CN IX-XII), pons (CN V-VIII), midbrain (CN III and IV), diencephalon (CN I and II), epithalamus, hypothalamus, pituitary gland

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22
Q

list the cranial nerves in order

A
  1. olfactory
  2. optic
  3. oculomotor
  4. trochlear
  5. trigeminal
  6. abducens
  7. facial
  8. acoustic/vestibulocochlear
  9. glossopharyngeal
  10. vagus
    (11. spinal accessory)
    (12. hypoglossal)
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23
Q

CN I

A

olfactory nerve

sensory: smell reception and interpretation

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24
Q

CN II

A

optic nerve

sensory: visual acuity and visual fields

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25
Q

CN III

A

oculomotor nerve

motor: raise eyelids, most EOMs
parasympathetic: pupillary constriction, change of lens shape

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26
Q

CN IV

A

trochlear nerve

motor: downward movement of eye

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27
Q

CN V

A

trigeminal nerve
motor: jaw opening and clenching, chewing

sensory: sensation of cornea iris, lacrimal glands, conjunctiva, eyelids, forehead, nose, nasal and mouth mucosa, teeth, tongue, ear, facial skin

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28
Q

CN VI

A

abducens nerve

motor: lateral eye movement

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29
Q

CN VII

A

facial nerve
motor: movement of facial expression muscles, except jaw, close eyelids, lip speech sounds

sensory: taste- anterior 2/3 of tongue, sensation to pharynx
parasympathetic: secretion of saliva and tears

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30
Q

CN VIII

A

acoustic nerve

sensory: hearing and equilibrium

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31
Q

CN IX

A

glossopharyngeal nerve
motor: voluntary muscles for swallowing and speaking

sensory: sensation of nasopharynx, gag reflex, taste- posterior 1/3 of tongue
parasympathetic: secretion of salivary glands, carotid reflex
motor: voluntary muscles of speaking, and swallowing

32
Q

CN X

A

vagus nerve
sensory: sensation behind ear and part of external ear canal

parasympathetic: secretion of digestive enzymes; peristalsis, carotid reflex; involuntary action of heart, lungs, digestive tract

33
Q

CN XI

A

spinal accessory nerve

motor: turn head, shrug shoulders, some actions for speaking

34
Q

CN XII

A

hypoglossal nerve

motor: tongue movement for speech sound articulation, and swallowing

35
Q

function of the basal ganglia

A

pathway and processing station between cerebral motor cortex and upper brainstem, refines motor movements

36
Q

at which level does the spinal cord terminate?

A

L1 or L2 of vertebral column

37
Q

function of the spinal cord

A

carries sensory, motor, autonomic impulses between brain and body

38
Q

gross structure of the spinal cord

A

inner, butterfly shaped gray matter; outer white matter

39
Q

the nerve cell bodies of the gray matter of the spinal cord are associated w/ what types of functions?

A

sensory pathways and autonomic nervous system

40
Q

what types of nerves are contained in the white matter of the spinal cord?

A

ascending and descending tracts

41
Q

function of the ascending spinal tracts

A

mediate sensations, fine touch, two-point discrimination, proprioception.

42
Q

function of the descending spinal tracts

A

convey impulses from brain to muscle groups, control muscle tone, posture, and precise motor movements.

43
Q

upper motor neurons

A

nerve cell bodies for motor pathway that begin and end w/i CNS. influence, direct, modify spinal reflex arcs. upper motor neurons make up the descending pathways from the brain to the spinal cord.

44
Q

lower motor neurons

A

cranial and spinal cord motor neurons, originate in anterior horn of spinal cord and extend into the peripheral nervous system, transmit signals directly to muscles for movement.

45
Q

discuss the difference in injury of the upper vs. the lower motor neurons

A

upper motor neurons: results initial paralysis followed by partial recovery;

lower motor neurons: often results in permanent paralysis

46
Q

number of pairs of spinal nerves

A

31

47
Q

dermatome

A

body distribution patterns that correspond to specific spinal nerves

48
Q

describe the anterior root of the spinal nerves

A

motor or efferent fibers, carry impulses from the spinal cord to the muscles and glands

49
Q

describe the posterior root of the spinal nerves

A

sensory or afferent fibers, carry impules from sensory receptors of body to the spinal cord, then on to the brain

50
Q

describe the structure and function of the sensory (afferent) division of the PNS

A

somatic and visceral sensory nerve fibers

conduct impulses from receptors to send to CNS

51
Q

describe the structure and function of the motor (efferent) division of the PNS

A

motor nerve fibers

conduct impulses from the CNS to effectors (e.g. muscles and glands)

52
Q

how do you assess CN I?

A

one nare at a time, aromatic odors

53
Q

what CNs are being tested w/ EOMS?

A

LR: CN VI
SO: CN IV
everything else: CN III

54
Q

what CNs are being tested w/ pupillary constriction/dilation?

A

CN III

55
Q

name the muscles that control eye movement

A

clockwise from middle: medial rectus, inferior oblique, superior rectus, lateral rectus, inferior rectus, superior oblique

56
Q

what muscles are you checking during motor examination of CN V?

A

trigeminal nerve
masseter, temporalis muscles (clench teeth)

pterygoidius muscle (move jaw from side to side)

57
Q

how do you test CN II?

A

optic nerve

  1. visual acuity
  2. fundoscopy
  3. visual fields to confrontation
58
Q

how do you test CN III?

A
  1. EOMS

2. pupillary constriction/dilation (direct, consensual, accomodation)

59
Q

how to you assess sensory function of CN V?

A

sharp, dull, light
v1 ophthalmic nerve branch
v2 maxillary nerve branch
v3 mandibular nerve branch

60
Q

what are the three sensory branches of CN V?

A

v1: ophthalmic nerve branch
v2: maxillary nerve branch
v3: mandibular nerve branch

61
Q

how do you assess CN VII?

A

facial nerve
elevate eyebrows, close eyes tightly (resist attempted opening), puff out cheeks (resist attempted pressure), smile and show teeth

62
Q

how do you assess CN VIII?

A

acoustic nerve

test gross hearing w/ whisper test, webber and rinne

63
Q

how do you assess CN IX and CN X?

A

glossopharyngeal and vagus nerves

both tested w/ gag reflex (both sides)

64
Q

how do you assess CN XI?

A

spinal accessory nerve.
place hands on shoulders, have them raise against resistance. place hand on cheek and have pt. push head toward your resistance hand. tests trapezius and sternocleidomastoid muscles.

65
Q

how do you assess CN XII?

A

hypoglossal nerve
extend toungue midline, test lateral strength by pushing against pt’s cheek as they resist w/ tongue. also listen for dysarthria.

66
Q

what are the 6 aspects that we are testing in the neuro exam?

A
  1. cerebral function
  2. cerebellar function
  3. cranial nerve function
  4. superficial and DTRs
  5. motor function
  6. sensory function
67
Q

what is controlled by the spinocerebellar tract?

A

(ascending)

proprioception

68
Q

what is controlled by the spinothalamic tract?

A

(ascending)

  1. light touch
  2. crude touch
  3. pressure
  4. temperature
  5. pain
69
Q

what is controlled by the dorsal columns tract?

A

(ascending)

  1. fine touch
  2. 2 point discrimination
  3. proprioception
70
Q

ascending spinal cord tracts

A

mediate sensations, white matter tracts

71
Q

descending spinal cord tracts

A

mediate motor function, grey matter tracts

72
Q

what is controlled by the corticopinal tracts?

A

(descending)

muscle impulses and muscle tone, posture, precise motor movements

73
Q

what is controlled by the corticobulbar tracts?

A

(descending)

innervates motor function of the cranial nerves

74
Q

discuss the signs of UMN lesions

A 
weakness
no to mild atrophy
no fasciulations (muscle twitch)
increased reflexes
increased tone
75
Q

discuss the signs LMN lesions

A 
weaness
atrophy
fasiculations (muscle twitching)
decreased reflexes
decreased tone
76
Q

Brudzinski sign

A

may be present when assessing for neck stiffness, w/ pt. supine, flex neck and observe for involuntary flexion of hips/knees (positive Brudzinski sign), suggests meningitis

77
Q

Kernig’s sign

A

“K for knee”

flex pt. let at the knee and hip when pt. is supine, then attempt to straighten leg, positive Kerig means pt. has pain in lower back and resists leg straightening, suggests meningitis

PD Block III (11 decks)

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