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Health Assessment > Unit 3: Neurological Assessment, Cranial Nerves, Musculoskeletal Assessment > Flashcards

Unit 3: Neurological Assessment, Cranial Nerves, Musculoskeletal Assessment Flashcards

1
Q

the brain, spinal cord, and the meninges comprise what part of the neurological system?

A

CNS

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2
Q

the cranial nerves and spinal nerves comprise what neurological system?

A

PNS

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3
Q

the sympathetic and parasympathetic systems comprise what system?

A

ANS

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4
Q

what joins the left and right hemispheres of the brain?

A

corpus callosum

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5
Q

people with epilepsy have seizures that travel through this and may be removed when seizures do not stop with anti-seizure medications

A

corpus callosum

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6
Q

what are the four lobes

A

frontal, parietal, temporal, and occipital

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7
Q

includes the thalamus and the hypothalamus

A

diencephalon

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8
Q

this is the relay station and reflexes are located here

A

brainstem

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9
Q

this makes up the brainstem

A

midbrain, pons, and medulla

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10
Q

lose reflexes and can’t breathe

A

damage to brainstem

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11
Q

breathing and heart rate are affected by this system

A

Autonomic

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12
Q

this is responsible for coordinating movement and maintaining equilibrium

A

cerebellum

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13
Q

atlas is C_

A

1

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14
Q

axis is C_

A

2

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15
Q

column where motor (efferent fibers) exit and carry muscle impulses to produce voluntary movements that involve skill and purpose

A

anterior/ventral

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16
Q

column where sensory (afferent fibers) enter

A

posterior/dorsal

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17
Q

T or F? Gray matter is where nerves are and where electrical signals travel

A

True

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18
Q

in the brain which matter is on the outside

A

gray matter

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19
Q

in the brain which matter is on the inside

A

white

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20
Q

down descending tracts

A

motor impulses

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21
Q

up ascending tracts

A

sensory impulses

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22
Q

how many pairs of spinal nerves are there?

A

31

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23
Q

how many cervical spinal nerves are there

A

8

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24
Q

how many lumbar spinal nerves are there

A

5

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25
Q

how many sacral spinal nerves are there

A

5

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26
Q

how many thoracic spinal nerves are there

A

12

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27
Q

how many coccygeal spinal nerves are there

A

1

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28
Q

“rest and digest” nerves

A

parasympathetic

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29
Q

“fight or flight” nerves

A

sympathetic

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30
Q

which type of nerves constrict pupils, stimulate saliva, and slow heart beat

A

parasympathetic

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31
Q

which type of nerves dilate pupils, inhibit saliva, and increase heart beat

A

sympathetic

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32
Q

which type of nerves constrict airways, stimulate activity of stomach, and inhibit the release of glucose; stimulating gallbladder

A

parasympathetic

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33
Q

which type of nerves stimulate activity of intestines, contract bladder, and promote erection of genitals

A

parasympathetic

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34
Q

which type of nerves relax airways, inhibit activity of stomach, and stimulate release of glucose; inhibit gallbladder

A

sympathetic

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35
Q

which type of nerves inhibit activity of intestines, secrete epinephrine and norepinephrine, relax bladder, and promote ejaculation and vaginal contraction

A

sympathetic

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36
Q

what carries cranial and spinal nerves

A

impulses

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37
Q

T or F? Heart and glands have involuntary smooth muscles.

A

True

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38
Q

demyelination of nerves

A

multiple sclerosis

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39
Q

blockage in an artery causes ischemia of brain tissue because of the lack of blood

A

ischemic stroke

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40
Q

blood vessel in brain bursts, leaking blood into brain causing pressure on brain and blood is toxic

A

hemorrhagic

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41
Q

what occurs in pt with epilepsy

A

seizures

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42
Q

20

A

increased ICP

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43
Q

Inflammation of meninges

A

meningitis

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44
Q

f

A

spinal cord compression

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45
Q

neurological disorder PNI

A

peripheral nerve impairment

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46
Q

nerves do not work as well (diabetics last stage)

A

neuropathy

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47
Q

glaucoma causes this, increased pressure in eyeball

A

increased intra-ocular pressure

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48
Q

pins and needles

A

paraesthesia

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49
Q

headaches, seizures, dizziness, numbness, paraesthesia, sensory loss, weakness, decr. lvl of consciousness, dysphagia, tics, loss of bowel/bladder control, and paralysis

A

neurological common complaints

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50
Q

blood clot or plaque that blocks blood flow or hemorrhage of vessels in the brain

A

stroke

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51
Q

many of the same pt with coronary artery disease are at risk for this

A

CVA

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52
Q

north carolina, georgia, alabama, mississippi, louisiana, arkansas, tennessee

A

stroke belt

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53
Q

have the highest levels of HTN and obesity

A

non-hispanic african americans

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54
Q

have more stiffening of carotid arteries with age

A

hispanic and african americans

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55
Q

what type of stroke is this

A

ischemic

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56
Q

what type of stroke is this

A

hemorrhagic

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57
Q

HTN, DM, heart disease, smoking/exposure to secondhand smoke, age and gender, race and ethnicity, personal/family hx, brain aneurysms or arteriovenous malformations (AVMs), alcohol/drugs, certain medical conditions, lack of physical activity, overweight/obesity, stress/depression, unhealthy cholesterol lvls, unhealthy diet, and prolonged NSAID med use.

A

risk factors for stroke

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58
Q

why do NSAIDs cause strokes?

A

they damage kidneys-> kidneys affect blood pressure-> blood pressure increases risk for stroke

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59
Q

sudden numbness or weakness of the face, arm, or leg (esp. once sided), sudden confusion, trouble speaking or understanding speech, sudden trouble seeing in one or both eyes, sudden trouble walking, dizziness, loss of balance, or coordination, and sudden severe headache w/o known cause

A

CVA assessment findings

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60
Q

there are 3 factors in ICP, increase in one causes a decrease in another (keeping ICP the same in the brain), the body can absorb CSF, decrease bloodflow.

A

monroe kelley doctrine

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61
Q

normal ICP

A

5-15 mmHg

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62
Q

MD: patient is in danger if ICP keeps going up bc brainstem can herniate down causing death since the brainstem is being strangled (controls breathing and heart rate) :

A

ICP above 20

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63
Q

once overcompensation is done, there is a limit to how much it can decrease the pressure

A

increased ICP

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64
Q

headache that is worse when waking, better through out the day because once you stand up more flow circulates releasing pressure on the brain. if ICP has increased, bed should be elevated

A

s&s

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65
Q

nausea/vomiting, photophobia, blurred vision

A

s&s

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66
Q

tools: cotton ball, cotton-tipped applicator, objects to feel, paperclip, tuning fork, reflex hammer

A

assessment of the peripheral nervous system

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67
Q

decreased ability to hear, see, sense (taste, scent, light touch, and pain), vibratory sensations at ankles, position sense in greater toe, intentional tremors, reduced muscle mass from degeneration of muscle fibers.

A

older adult considerations CVA

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68
Q

hand or head tremors or dyskinesia (repetitive movements of the lips, jaw, or tongue), slow, certain gait with wide base and bent-forward appearance, decreased reaction time that may slow response of DTRs, and achilles and plantar reflexes that are difficult to elicit or absent

A

older adult considerations CVA

69
Q

how do you test level of consciousness

A

glascow coma scale

70
Q

glascow scale of 3

A

worst

71
Q

glascow scale of 15

A

best

72
Q

pt is verbally oriented, eyes are spontaneous, and obey motor commands, what is the glascow scale?

A

15

73
Q

writing a number in hand

A

graphesthesia

74
Q

motor and cerebellar f(x), rapid alternating movements (finger to nose), heel to shin, gait, balance, involuntary movements, sensory f(x), sharp/dull, light touch, vibratory sensation, proprioception, two point discrimination, and point localization.

A

focused neuro check

75
Q

familiar object in hand

A

stereognosis

76
Q

sharp/dull, vibratory sensation, proprioception, stereognosis, two-point discrimination, and graphesthesia

A

sensory neuro exam

77
Q

react when pinch, remove intubation

A

localizing

78
Q

indicate brain injury: 7

A

severe

79
Q

indicate brain injury: 10

A

moderate

80
Q

indicate brain injury: 14

A

mild

81
Q

what do you do if GCS is less than 8?

A

intubate

82
Q

loss of proprioception, motor pain temp is still present, remember that posterior is sensory

A

posterior cord syndrome, spinal cord injury

83
Q

rapid alternating movements (finger to nose), heel to shin, gat, balance (Romberg), and involuntary movements

A

motor coordination neuro exam

84
Q

swaying/movement feet apart for balance

A

positive romberg

85
Q

ask client to stand erect with feet together, note unsteadiness or swaying, have client close eyes for 20 seconds, and make sure they do not fall.

A

romberg test

86
Q

test where you lift up or push toes and fingers down

A

proprioception

87
Q

before doing the reflex test what would you ask the patient to do?

A

relax and position properly

88
Q

palpate the tendon, briskly strike tendon, compare response of one side to the other, and the pointed end should be used for small area, wider end for more tender area

A

reflex exam

89
Q

reflex grade: 4+

A

hyperreflexia with clonus

90
Q

reflex grade: 0

A

absent

91
Q

reflex grade: 3+

A

exaggerated response

92
Q

reflex grade: normal

A

2+

93
Q

reflex grade: decreased

A

1+

94
Q

proprioception is preserved, loss of motor, pain, and temp, anterior is motor

A

anterior cord syndrome, spinal cord injury

95
Q

injury can result in sacral (still have bowel and bladder f(x) but have weakness in extremities) weakness is more prominent in the upper extremities than lower extremities

A

central cord syndrome, spinal cord injury

96
Q

hemisection (one side of spinal cord is damaged and the other side is not), motor impulse from left side of brain makes right side of body move, there can be sensory but no motor on the same side

A

brown-sequard syndrome

97
Q

results in quadriplegia, paralysis or weakness of legs and arms, may result in breathing difficulties (injury of C3 or higher may pt will not be able to breathe)

A

cervical spine spinal cord injury

98
Q

results in paraplegia, paralysis or weakness of legs, loss of bladder control or bowel function

A

injury of thoracic/lumbar spine

99
Q

T or F? A negative Babinski is a normal finding

A

true

100
Q

T or F? flexion of toes is a normal finding in adults

A

true

101
Q

T or F? fanning of toes is a normal finding in adults

A

false, only normal in infants

102
Q

repeated rapid contractions or oscillations of the ankle and calf muscle, while supporting leg briskly dorsiflex the foot toward the client’s head, is usually seen with lesions of upper motor neurons

A

clonus

103
Q

normal or abnormal: anosmia

A

abnormal, its the inability to smell

104
Q

nerve that carries smell impulses from nasal mucous membrane to the brain, sensory

A

olfactory

105
Q

nerve that carries visual impulses from eye to brain, sensory

A

optic

106
Q

nerve that tests: visual acuity, round red reflex, and peripheral vision

A

optic

107
Q

what are abnormal findings for nerve II

A

presbyopia, myopia, and missing more than a line in the Rosenbaum chart

108
Q

what is a normal finding for the peripheral vision/confrontation test?

A

see examiner’s finger at the same time

109
Q

what test is failed when there is a delayed perception showing reduced peripheral vision, glaucoma, tumor/lesion, cataracts, retinal damage, stroke

A

peripheral/confrontation test

110
Q

how to test: you’re in front of pt, cover opposite eye while looking directly at each other, and assess 3 different angles on each side.

A

peripheral/confrontation test

111
Q

normal finding: red reflex observed in each eye when pt looks directly at light source

A

round red reflex

112
Q

what abnormal findings can be found with the round red reflex test?

A

Papilledema (blurred margins), cataract (enlarged), and retinoblastoma (leukocoria) is seen as white

113
Q

has motor f(x), contracts eye muscles to control eye movements (interior lateral, medial, and superior), constricts pupils, and elevates eyelids.

A

oculomotor

114
Q

how to test: pupillary response to light (direct and indirect) and accommodation and convergence in both eyes.

A

oculomotor

115
Q

pupils should be

A

3-5 mm, round and equal bilaterally, restrict to light (PERRLA- pupils, equal, round, reactive to light and accommodation), accommodation to where pupils constrict and converge when focused on near object

116
Q

pt looks straight ahead w/ dim lights, pen light should eval each pupil at one time, assess size, shape, and response of pupil w/ direct light and indirect to where you look at the response of the other.

A

pupillary light reflex

117
Q

test: pt follow penlight without moving head

A

accommodation

118
Q

nerve III abnormal findings

A

fixed, unequal, pupils do not constrict and converge

119
Q

contracts one eye muscle to control infero-medial eye movement

A

nerve IV: trochlear

120
Q

controls lateral eye movements

A

CN VI: abducens

121
Q

no drooping bilaterally is a normal finding for which CN?

A

CN III: oculomotor

122
Q

which test is this: inspect margins of eyelids of each eye, cardinal fields of gaze test, corneal light reflex, and cover/uncover test?

A

tests extra-ocular muscle function

123
Q

drooping of eyelid due to weak eye muscles, seen in myasthenia gravis due to stroke, increased ICF, Bell’s palsy (can go away).

A

ptosis

124
Q

quivering of the eye

A

nystagmus

125
Q

tests CN III, IV, and VI

A

cardinal field test

126
Q

misalignment of the eye

A

strabismus

127
Q

detects deviation in alignment or strength

A

cover and uncover test

128
Q

how to test: ask pt to stare ahead and focus on a distant object, cover one eye with card and remove, observe covered eye for any movement

A

cover/uncover test

129
Q

T or F? normal finding for cover/uncover test: both eyes move, phoria (misalignment of the eyes so that their natural resting point is not perfectly aligned), strabismus (misalignment of the eye), tropia

A

false

130
Q

corneal light reflex

A

assesses parallel alignment of eyes

131
Q

how to test for the corneal light reflex

A

hold pen light 12 inches away and shine toward the bridge of the nose while pt stare ahead, note location of light reflected on both eyes

132
Q

light is reflected on the same spot bilaterally (parallel alignment)

A

normal finding for corneal light reflex

133
Q

asymmetric position of light d/t deviation of eye alignment

A

abnormal finding for corneal light reflex

134
Q

sensory/motor nerve, carries sensory impulses of pain, touch, and temperature from the face to the brain. influences clenching and lateral jaw movements (biting, chewing)

A

trigeminal

135
Q

able to identify sharp/dull stimuli and light touch

A

sensory portion of the trigeminal nerve test

136
Q

motor portion of the cranial nerve V test

A

clench teeth while palpating temporal and masseter muscles for contraction

137
Q

abnormal findings for cranial nerve V

A

pt is unable to identify sharp/dull sensation or light touch, asymmetric strength, pain, or bilateral weakness.

138
Q

sensory and motor nerve, supplies facial muscles and affects facial expressions (smiling, frowning, closing eyes), contains sensory fibers for taste, stims. secretions from salivary glands and tears from lacrimal glands.

A

CN VII: facial

139
Q

taste test w/ salt, pt smile, frown, wrinkle forehead, show teeth, puff out cheeks, raise eyebrows, and close eyes tightly against resistance.

A

CN VII: facial

140
Q

abnormal finding for CN VII

A

inability to identify flavor, inability to perform movements and/or asymmetrical movements.

141
Q

pt is able to blink eyelids bilaterally when you touch cornea w/ cotton wisp

A

CN V and VII: corneal reflex

142
Q

CN VIII tests

A

whisper test, weber, and rinne

143
Q

sensory, has sensory fibers for hearing and balance

A

CN VIII: vestibulocochlear nerve

144
Q

unilateral conductive and sensorineural hearing, use tuning fork; spin and place bridge next on top forehead, center

A

weber

145
Q

lateralization is an abnormal finding for the rinne test

A

false, its abnormal for the weber test

146
Q

vibrations are heard equally in both ears

A

normal finding for the weber test

147
Q

tests for unilateral conductive hearing, spin tuning fork and place fork on mastoid bone behind ear and as if you can hear then move fork beside ear and ask if they can hear

A

rinne test

148
Q

AC>BC, should hear when next to ear louder

A

rinne

149
Q

has sensory fibers for taste, pharynx which is where the gag reflex would be tested, promotes swallowing movements, sensory and motor

A

CN IX: glossopharyngeal

150
Q

carries sensations from the throat, larynx, heart, lungs, bronchi, GI tract, and abdominal viscera. promotes swallowing, talking, and production of digestive juices, sensory and motor

A

CN X: vagus

151
Q

test where pt has ability to cough, swallow, and talk

A

CN IX glossopharyngeal and X vagus

152
Q

normal findings for IX and X

A

uvula and soft palate rise and fall bilaterally, gag reflex, and able to swallow w/o difficulty and no hoarseness noted

153
Q

motor nerve, control neck and shoulder movement, the intrinsic musculature of the larynx, and the sensitive afferences of the trapezius and sternocleidomastoid musculature

A

CN XI: spinal accessory

154
Q

how to test CN XI:

A

pt shrugs shoulders and turn head side to side against resistance

155
Q

motor, innervates tongue muscles that promote the movement of food and talking

A

CN XII hypoglossal

156
Q

how to test: strength and mobility of the tongue, protrude tongue, move it side to side against resistance

A

CN XII hypoglossal

157
Q

types of muscles

A

skeletal, smooth, and cardiac

158
Q

what does the musculoskeletal system consist of

A

bones, muscles, and joints

159
Q

provide structure and movement for body parts, controlled and innervated by the nervous system

A

musculoskeletal system

160
Q

provide structure, protection, levers, store calcium, and produce blood cells

A

bones

161
Q

head and trunk of the body (80 bones)

A

axial skeleton

162
Q

extremities, shoulders, hips (126 bones)

A

appendicular skeleton

163
Q

spongy, soft, has holes, makes up the inner layer and ends of the bones

A

spongy bone

164
Q

hard, dense, makes up the shaft and the other layer of bone

A

compact bone

165
Q

active cells that form bone tissue, come from the bone marrow and related to structural cells, work in teams to build bone, produce new bone called osteoid which is made of bone and other protein, control calcium and mineral deposition and are found on the surface of the new bone, and can be found in the periosteum, which covers the bones, and helps promote nourishment.

A

osteoblasts

166
Q

cells that degraade or dissolve the bone tissue to initiate normal bone remodeling, come from the bone marrow and are related to white blood cells. they are formed from two or more cells that fuse together, found the surface of the bone mineral next to the dissolving bone.

A

osteoclasts

167
Q

RBCs, platelets, and most white blood cells are made by

A

red bone marrow

168
Q

is mostly composed of fat, fat can be used as a source of energy

A

yellow marrow

Health Assessment (2 decks)

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