Week 9 - Neuro Flashcards
Frontal lobe
concerned with personality, behaviour, emotions and intellectual function
Parietal lobe
primary centre for sensation
Occipital lobe
primary visual receptor center
Temporal lobe
primary auditory reception centre
Wernicke’s area
Associated with language comprehension. Located in temporal lobe.
What happens is wernicke’s area is damaged?
receptive aphasia: a person hears words but they have no meaning
Brocas area
Located in the frontal lobe. Mediates motor speech.
what happens if broca’s area is damaged?
expressive aphasia. The person cannot talk but they can understand speech.
A bundle of fibres outside the CNS
nerve
Cranial Nerve 1
olfactory nerve
How do you test CN 1?
test sense of smell one nostril at a time
Cranial nerve 2
optic nerve
How do you test CN 2?
- Snellen - visual acuity
2. Confrontation test - visual fields and peripheral vision
CN 3
oculomotor nerve
CN 4
trochlear
CN 6
Abducens nerve
Which 3 cranial nerves are tested together?
3,4 and 6 (CNs 3,4 and 6 make the eyes do tricks)
How do you test cranial nerves 3, 4 and 6
PERRLA and cardinal positions of gaze
CN 5
trigeminal nerve
How do you test CN 5?
palpate the temporal and master muscles as the patient clenches the teeth and then test light tough sensation with a cotton wisp
Cranial nerve 7
facial nerve
How do you test cranial nerve 7
ask the patient to frown, close eyes tightly, lift eyebrows, show teeth and puff cheeks. Note symmetry
Cranial nerve 8
acoustic nerve
How do you test CN 8
test hearing acuity by using the whispered voice test
Cranial nerve 9
glossopharyngeal
CN 10
Vagus
How are CNs 9 and 10 tested?
depress the tongue and note movement as the patient says “ahhh”
Cranial nerve 11
spinal accessory nerve
How is cranial nerve 11 tested?
check the strength of the sternomastoid and the trapezius muscles
Cranial nerve 12
hypoglossal nerve
How is CN 12 tested?
make the patient stick out their tongue, There should be no tremors
What does the Romberg test assess?
cerebellar function (balance)
What does the rapid alternating movements assess?
cerebellar function (coordination)
Heel to shin test
is assessed on every stroke patient. If the person fails they could have cerebellar dysfunction
Clonus
set of rapid, rhythmic contractions of the same muscle
4+ reflex
very brisk, hyperactive of clonus, indicative of disease
3+ reflex
brisker than average, may indicate disease
2+ reflex
average, normal
1+ reflex
diminished, low normal
0 reflex
no response
Spasticity
an early sign of cerebral palsy. In affected infants, after you release the flexed knees, the legs quickly extend and adduct
What is the earliest and most sensitive indicator of neurological status?
change in LOC
Complacency of a previously combative patient can suggest
a change in the level of consciousness
How does pupil dilation occur with increased ICP
increasing ICP pushes the brainstem down, which puts pressure on cranial nerve 3
What is cushings triad
widening pulse pressure, irregular breathing and bradycardia
What does a GCS of 7 or lower suggest?
coma
Peripheral neuropathy
loss of sensation that occurs with diabetes and alcohol use
Decorticate rigidity
flexion of arms, wrists and fingers. Arms are tightly crossed across chest. Feet are plantar flexed
What does decorticate rigidity indicate?
a hemispheric lesion of the cerebral cortex
decerebrate rigidity
arms stiffly extended by sides and internally rotated, palms are pronated
what does decerebrate rigidity suggest
it is an ominous sign of a lesion in the brain stem
