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NURS 203 > Unit 4 - Neuro Motor/Reflexes > Flashcards

Unit 4 - Neuro Motor/Reflexes Flashcards

1
Q

What parts make up the Central Nervous System?

A

Brain + Spinal Cord

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2
Q

What parts make up the Peripheral Nervous System?

A

All nervous tissue outside of CNS, Spinal nerves and Cranial Nerves

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3
Q

What does the term, Crossed representation mean?

A

The left side of the brain communicates with the right side of the body
The right side of the brain communicates with the left side of the body

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4
Q

The Nervous System is created of what two systems?

A

Central Nervous System (CNS)

Peripheral Nervous System (PNS)

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5
Q

What are some of the general responsibilities of the Nervous Systems?

(what do they do in the body?)

A

Various Senses
Speech, memory, emotions + thoughts
Control body movements
Regulate internal organs

Carries out the majority of the functions needed to maintain life.

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6
Q

The nervous system is grouped into what 3 basic functions?

A
  1. Sensory - detect stimuli
  2. Integrative - Processes information, then decides what to do
  3. Motor - activation of muscles and glands
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7
Q

What is an example of involuntary muscles within the body?

A

Cardiac muscle, smooth muscles

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8
Q

What is responsible for voluntary muscle movements within the body?

A

Skeletal muscles

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9
Q

Brain Structures

What makes up the Cerebrum? (“Seat of intelligence”)

A

Left and Right Hemispheres
Cerebral Cortex
Basal Ganglia

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10
Q

Brain Structures

What make up the Diencephalon?

A

Thalamus + Hypothalamus

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11
Q

What grows faster, white or grey matter?

A

Grey matter grows faster, this is why the brain is so lumpy because when we are growing up it needs more room as its growing so it will start folding in on itself.

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12
Q

Cerebral Cortex Lobes

What part of the lobe is responsible for voluntary movement, personality, emotions or “who we are”?

A

Frontal Lobe

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13
Q

Cerebral Cortex Lobes

What lobe is the primary sensation centre?

A

Parietal

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14
Q

Cerebral Cortex Lobes

What is the purpose for the Occipital lobe?

A

Primary visual receptor centre

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15
Q

Cerebral Cortex Lobes

What is the purpose of the Temporal lobe?

A

Primary auditory centre

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16
Q

Cerebral Cortex Lobes

Where would you find Broca’s area?

A

Within the frontal lobe

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17
Q

Cerebral Cortex Lobes

Where would you find Wernicke’s area?

A

Within the temporal lobe

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18
Q

Cerebral Cortex Lobes

What type of aphasia would occur if Broca’s area is damaged?

A

Expressive Aphasia - They have word comprehension, but are unable to say them. Babbles and noises may be heard but they can not form the words for speech.

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19
Q

Cerebral Cortex Lobes

What type of aphasia would occur if Wernicke’s area is damaged?

A

Receptive Aphasia - They do not have word comprehension and are unable to understand what is being said. They have the ability to speak and form words coherently but unsure of proper use of words. May talk infant like.

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20
Q

Cerebral Cortex Lobes

If you are unable to voluntary move your hand or fingers, damage would occur in what area?

A

Precentral Gyrus - Primary motor area (along the central sulcus within the Frontal lobe)

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21
Q

Cerebral Cortex Lobes

If you are unable to feel sensation in your lips and tongue, damage must have occurred in what area?

A

Postcentral gyrus - Primary sensory area (along the central sulcus within the parietal lobe)

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22
Q

What is the function of the Basal Ganglia?

A

control of automatic movements (Walking, swinging of arms)

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23
Q

True or false.

If someone is experiencing Extrapyramidal Symptoms, such as tardive dyskinesia, it is happening within the cerebrum.

A

True - EPS is a condition that affects the Basal Ganglia which is found in the Cerebrum.

Parkinson’s disease have degeneration of the basal ganglia and can not be reversed. Where as people who suffer from EPS, can have it corrected with medication adjustments and reversed.

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24
Q

What is the purpose of the Thalamus?

A

Is it the major relay station of the brain, information gets sent to the thalamus (from the brain or body) and it sends it where it needs to go (within the brain from the body, or from the body to the brain.)

Last stop before the cerebral cortex.

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25
Q

What part of the brain regulates hormones, body temperature, appetite, pleasure, pain, sleep and wake cycle?

A

The Hypothalamus

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26
Q

What connects the two hemispheres?

A

Corpus Callosum

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27
Q

White or grey matter;

What is used for communication within the brain?

A

White Matter

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28
Q

White or grey matter;

What is used in more complex things such as thinking/feeling and higher level of functions?

A

Grey Matter

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29
Q

What is the purpose of the Cerebellum?

A

Blending skill movements and responsible for balance and posture

  • It coordinates movement but does not start the movement.
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30
Q

What are 3 areas that you will find within the brainstem?

A
  1. Mid-brain
  2. Pons
  3. Medulla oblongata
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31
Q

Midbrain, Pons or Medulla;

What contains ascending/descending fibre tracts?

A

Pons

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32
Q

Midbrain, Pons, or Medulla;

What connects the spinal cord to the thalamus and hypothalamus?

A

Midbrain

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33
Q

Midbrain, Pons, or Medulla;

What controls vital functions (such as heart rate, breathing)?

A

Medulla Oblongata

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34
Q

What is the purpose of the brainstem?

A

Connects the spinal cord to the brain.

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35
Q

True or false.

If you damage your brainstem, you will still be able to function and live normally.

A

False

More chances then not, when your brainstem is damaged, you will not survive.
You can be placed on life support to stay alive, but generally you will never be able to function normally again.

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36
Q

What part of the spinal cord contains dozens of sensory and motor tracts?

A

White matter

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37
Q

How many sections of each spine are there of the following;

Cervical Vertebrae
Thoracic Vertebrae
Lumbar Vertebrae
Sacral Vertebrae

A

Cervical - 7
Thoracic - 12
Lumbar - 5
Sacral - 5

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38
Q

How many sections of each spine are there of the following;

Cervical Spinal Nerves
Thoracic Spinal Nerves
Lumbar Spinal Nerves
Sacral Spinal Nerves

A

Cervical - 8
Thoracic - 12
Lumbar - 5
Sacral - 5

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39
Q

Approximately where does the proper spinal cord end?

A

Around L1/L2

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40
Q

What is found in the spine after the spinal cord ends?

A

Spinal fibres

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41
Q

What is the thought and purpose of the spine ending and the fibres beginning?

A

So that we are able to access the spinal column without damaging it. (Think about where we are placing needles for spinals and epidurals)

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42
Q

True or false.

Sensory impulses can be sent to the spinal cord and a reflex impulse can be sent back right away.

A

True.

Sensory impulses can be dealt with quickly in the spinal cord and sent back for quick reflex abilities OR if it the spine doesn’t deal with it immediately it will be sent up the cord to the brain to deal with and then the impulse will be sent back down with the response.

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43
Q

What are the two primary sensory pathways of the spinal cord?

A

Spinothalamic

Posterior dorsal columns

44
Q

Which sensory pathway deals with vibration, stereognosis, proprioception, and fine touch?

A

Posterior Dorsal Columns

45
Q

What is stereognosis mean?

A

The ability to perceive and recognize the form of an object in the absence of visual and auditory information, putting an object in your hand and having the ability to tell what it is.

(putting a coin in your hand with your eyes closed, you’d be able to tell it was a coin just by the touch, texture, size etc)

46
Q

What does proprioception mean?

A

The sense of the relative positions of one’s own parts of the body and the position it is in. The ability to sense the orientation of your body in your environment.

(You can tell that your arm is raised about your head, when you eyes is closed)

47
Q

What sensory pathway deals with pain, temperature, and crude touch?

A

Spinothalamic

48
Q

What are the 3 main motor pathways?

A

Pyramidal (Corticospinal)
Extrapyramidal
Cerebellum

49
Q

What part of the motor pathway have direct, skilled and purposeful movements (such as writing)?

A

Pyramidal (Corticospinal)

50
Q

What part of the motor pathway is for movement, equilibrium, and posture?

A

Cerebellum

51
Q

What part of the motor pathway have indirect; gross movement, respond to movement of the head, and express emotion?

A

Extrapyramidal

52
Q

What is the purpose of upper motor neurons?

A

Influence lower motor neurons, i.e. extrapyramidal or corticospinal tracts

Upper sends to the lower

53
Q

What is the purpose of the lower motor neurons?

A

Leaving the spinal cord, located in periphery, Final common pathway

Lower send it out of the spinal cord to complete motor movement

54
Q

What diseases are found to affect upper motor neurons?

A

CVA, Cerebral Palsy, MS

55
Q

What diseases are found to affect lower motor neurons?

A

Cranial and Spinal nerves diseases such as Bell’s Palsy, Poliomyelitis, ALS

56
Q

What are the two parts that make up the Peripheral Nervous System (PNS) ?

A

Somatic Nervous System

Autonomic nervous system

57
Q

What system in the PNS is voluntary?

A

Somatic nervous system

58
Q

What PNS system’s goal is to maintain homeostasis (Involuntary)?

A

Autonomic nervous system.

59
Q

What part of the PNS has the fight or flight?

A

Sympathetic

60
Q

What part of the PNS has the rest and digest?

A

Parasympathetic

61
Q

What are plexuses?

A

A network of nerves or vessels in the body, an intricate weblike formation.

62
Q

How many spinal nerves are there related to the spinal column?

A

31

63
Q

True or False.

If a nerve is damaged, various adjacent nerves and axons will pick up the load.

A

True.

Various nerves form a safety net from the plexus if something were to be damaged, the ones beside it will pick up and help out with the load.

64
Q

What are the other names for the following nerves
Afferent - ?
Efferent - ?

A 
Sensory = Afferent 
Motor = Efferent
65
Q

How do Afferent and Efferent axons move through the spinal nerves?

A

Sensory (afferent) axons enter posterior (dorsal) root, Motor (efferent) axons exit anterior (ventral) root

66
Q

What is a dermatome?

A

A dermatome is an area of skin that is mainly supplied by a single spinal nerve. Each of these nerves relays sensation (including pain) from a particular region of skin to the brain.

67
Q

What is one exception of a spinal nerve that does not have a dermatome?

A

C1 does not have a dermatome attached to it. (This is due to it not having a dermal root).

68
Q

True or False.

There are many spinal nerves that can control your facial movements.

A

False.

No spinal nerves go to the face as that is where your cranial nerves take over.

69
Q

A sensory neuron carries the message from the receptor to the central nervous system (the spinal cord and brain). A motor neuron carries the message from the central nervous system to the effector. What is this process called?

A

A reflex arc.

70
Q

What are considered primitive reflexes?

A

Infantile or Newborn reflexes.

Moro, sucking, etc.

71
Q

Where would you find a superficial reflex?

A

Superficial are also known as cutaneous, a place you would find this would be the abdomen.

72
Q

Where would you find a visceral reflex?

A

Also known as an autonomic reflex, this would be found in the eyes, where a pupillary response to light is automatic reflex that happens naturally.

73
Q

A knee jerk with a stretch is an example of what type of reflex?

A

Deep tendon.

74
Q

What would be an example of a Pathological or abnormal reflex found in adults?

A

The Babinski reflex

75
Q

What is the Babinski reflex?

A

A reflex action in which the big toe remains extended along with fanning of the toes or extends itself when the sole of the foot is stimulated, abnormal except in young infants.

76
Q

What are some main areas to collect for subjective data regarding to the neurological assessment?

A 
Injuries, Concussion
Dizziness or Seizures 
Difficulty speaking/swallowing? 
Vertigo, Pain/headaches 
Tremors/ Weakness, Difficulty with coordination
Numbness or tingling in extremeties
77
Q

What are two areas that are tested for Cerebellar function?

Think broad, not specifics. The two headings that the tests fall under

A

Balance

Coordination + Skilled Movements

78
Q

What is tested regarding balance in the cerebellar function? What would be considered normal for each?

A

Gait - walk 3-6m. It is smooth, rythmic, and effortless, opposing arm swing is coordinated.
Heel to Toe - (tandem walking) should not wobble
Romberg Test - (eyes closed, feet together, hands at side, 20 seconds) no significant swaying, can maintain posture and balance.
Shallow knee bend - (stand on one foot, and bend knee down slowly, or hop in place, complete bilaterally) - normal position sense, muscle strength, balance. note some may not be able to complete this due to obesity or age.

79
Q

What tests would you complete for coordination and skilled movements? What would normal results be?

A

Rapid Alternating Movements - (Pat knees with both palms of hand, turning them over and patting the knees with the dorsa of the hand repeating and increasing in speed) This is done equal turning and a quick rhythmic pace.
Finger to Thumbs - (ask pt to touch each finger to their thumb) Can be done quickly and accurately.
Finger to Finger - Finger to Nose ( Eyes open, their finger to touching your finger, touching their nose to your finger and back to their nose) Accurate and smooth movements.
Heel-to-Shin test - (lower extremity coordination, heel on opposite knee and able to slowly glide it up along shin) should be able to do it midline, straight.

80
Q

What does the term Ataxia mean?

A

Ataxia is a non-specific clinical manifestation implying dysfunction of the parts of the nervous system that coordinate movement, such as the cerebellum. Mainly voluntary coordination of muscle movements.

81
Q

When testing reflexes, what does reinforcement mean?

A

Distraction - if you are unable to provide a reflex, such as a knee jerk, you ask them to pull on their arms and focus on this distraction technique so you are able to elicit the desired response or reflex.

82
Q

How are the deep tendon reflexes graded?

A 
\+4 - Brisk 
\+3 - Brisker then normal 
\+2 - Normal 
\+1 - Weak 
0 - absent
83
Q

What does a positive clonus test mean?

A

Clonus is a sign of certain neurological conditions, particularly associated with upper motor neuron lesions involving descending motor pathways, and in many cases is, accompanied by spasticity (another form of hyperexcitability)

84
Q

In testing reflexes, the spinal nerves C7 and C8 will respond in extension of the forearm (also may show as a hinge movement). Which reflex is this demonstrating?

A

Triceps Reflex

85
Q

In testing reflexes, the biceps reflex will show what type of reflex? What spinal nerves will this affect?

A

Flexion of the forearm - C5 and C6

86
Q

In testing reflexes, the spinal nerves C5 and C6 will respond in slight flexion and supination. Which reflex is this demonstrating?

A

Brachioradialis Reflex

87
Q

In testing reflexes, the spinal nerves L2 to L4 will respond in extension of the lower leg. Which reflex is this demonstrating?

A

Quadriceps or Patellar (“Knee Jerk”)

88
Q

In testing reflexes, the achilles reflex will show what type of reflex? Which spinal nerves are affected?

A

You should FEEL more than seeing as it will plantarflex, feel like pushing a gas pedal. L5 to S2

89
Q

What is a cremasteric response?

A

Rubbing the inside of the thigh and the testicles rise.

90
Q

What is the Glasgow Coma Scale?

A

Glasgow Coma Scale is a neurological scale which aims to give a reliable and objective way of recording the conscious state of a person for initial as well as subsequent assessment.

91
Q

Development consideration.

What ethnicities are at greater risk of diabetes and cardiovascular disease?

A

Indigenous, African and South Asian Persons.

92
Q

Development consideration.

What are some considerations when it comes to the reflexes of older adults?

A

Atrophy r/t loss of neurons
Deep Tendon Reflexes are less brisk
Reduced reaction times; risk for falls

93
Q

What are some modifiable risk factors for stroke?

A

Cardiovascular disease, Hypertension, Smoking/second hand smoke exposure, Diabetes, Atrial fibrillation, Dyslipidemia, Asymptomatic Carotid stenosis, Oral Contraceptives hormone therapy, diet and nutrition, Inactivity, Obesity (fat distribution).

94
Q

What are non-modifiable risk factors for stroke?

A

Age, gender, low birth weight, ethnocultural background, genetic factors.

95
Q

Sudden weakness or numbness in face, arms, or legs, especially on one side of the body, confusion, trouble speaking, or understanding speech, sudden change in vision are all common signs of what ???

A

Stroke (CVA)

96
Q

The medical record indicates that a person has an injury to Broca’s area. When meeting this person you expect:

a) difficulty speaking
b) receptive aphasia
c) visual disturbances
d) emotional lability

A

a) difficulty speaking

97
Q

The control of body temperature is located in:

a) Wernicke’s area
b) the thalamus
c) the cerebellum
d) the hypothalamus

A

d) the hypothalamus

98
Q

The test for stereognosis, you would:

a) have the person, close his or her eyes, then raise the person’s arm and ask the person to describe its location.
b) touch the person with a tuning fork
c) place a coin in the person’s hand, and ask him or her to identify it.
d) touch the person with a cold object

A

c) place a coin in the person’s hand, and ask him or her to identify it.

99
Q

During the examination of an infant, use a cotton-tipped applicator to stimulate the anal sphincter. The absence of a response suggests a lesion of:

a) two-point discrimination
b) reinforcement
c) vibration
d) graphaesthesia

A

b) reinforcement

100
Q

Cerebellar function is assessed by which of the following tests?

a) Muscle size and strength
b) Cranial nerve examination
c) Coordination - hopping on one foot
d) Spinothalamic test

A

c) Coordination - hopping on one foot

101
Q

To elicit a Babinski reflex, the examiner should:

a) gently tap the Achilles tendon
b) stroke the lateral aspect of the sole of the foot from heel to the ball
c) present a noxious odour to a person
d) observe the person walking heel to toe

A

b) stoke the lateral aspect of the sole of the foot from heel to the ball

102
Q

A positive Babinski sign is:

a) dorsiflexion of the big toe and fanning of all toes
b) plantar flexion of the big toe with a fanning of all does
c) the expected response in healthy adults
d) withdrawal of the stimulated extremity from the stimulus

A

a) dorsiflexion of the big toe and fanning of all toes

103
Q

The cremasteric response:

a) is positive when disease of the pyramidal tract is present
b) is positive when the ipsilateral testicle elevates upon stroking the inner aspect of the thigh
c) is a reflex of a receptors in the muscles of the abdomen
d) is not a valid neurological examination

A

b) is positive when the ipsilateral testicle elevates upon stroking the inner aspect of the thigh

104
Q

Senile tremors may resemble Parkinsonism, except that senile tremors do not include:

a) nodding the head as if responding yes or no
b) rigidity and weakness of voluntary movement
c) tremor of the hands
d) tongue protrusion

A

b) rigidity and weakness of voluntary movement

105
Q

People who have Parkinson’s disease usually have which of the following characteristic styles of speech?

a) A garbled manner
b) loud, urgent
c) slow, monotonous
d) word confusion

A

c) slow, monotonous

NURS 203 (8 decks)

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