health assessment mid-term: neuro

Card Set Information

Author:
jam110007
ID:
205638
Filename:
health assessment mid-term: neuro
Updated:
2013-03-07 06:37:06
Tags:
health assessment mid term neuro
Folders:

Description:
health assessment mid-term: neuro
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user jam110007 on FreezingBlue Flashcards. What would you like to do?


  1. central nervous system consists of what two anatomical structures?
    • - brain 
    • - spinal cord
  2. peripheral nervous system is made up of what types of nerves and how many?
    • - 12 pairs of cranial nerves
    • - 31 pairs of spinal nerves and thier branches
  3. cerebral cortex is the center for what in humans?
    the center for the highest function and governs thought, memory, reasoning, sensation and voluntary movement
  4. hemispheres four lobes consist of ?
    • - frontal
    • - parietal 
    • - temporal 
    • - occipital 
    • - wernicke's area (part of temporal )
    • - broca's area (part of frontal)
  5. cerebrum
    • - ability to think 
    • - enclosed by 3 membrane layers called meninges
    • ----dura mater
    • ---- arachoid mater
    • ---- pia mater
  6. increased intracranial pressure
    • If blood or fluid accumulates between these layers, pressure builds inside the skull and compromises brain function.
    • Can also occur with tumor growth or fluid build-up in brain tissue
  7. Damage to any of these specific cortical areas produces a corresponding loss of function how?
    • -such as motor weakness
    • -loss of sensation
    • -impaired ability to understand and process language
  8. Components of the CNS- divisions of the cerebrum
    • Basal ganglia
    • Thalamus (in the diencepalon)
    • Hypothalamus (in the diencephalon)
    • cerebellum
  9. Basal ganglia
    coordinates the muscle movements of the body - cognitive and emotional
  10. Thalamus (in the diencepalon)
    • regulates counsioness 
    • - sleep patterns
    • - how alert we ate
  11. Hypothalamus (in the diencephalon)
    nervous system and endocrine system which is regulated by the pituitary gland
  12. cerebellum
    motor control coordination and preciseness (such as stacking blocks)
  13. Brain Stem
    • Central Core of the brain
    • Consists of 3 areas
    • Complex network of sensory fibers that control
  14. brain stem consists of what three structural parts?
    • Midbrain
    • Pons
    • Medulla oblongata
  15. brain stem controls what three complex systems?
    • Respiratory
    • Cardiovascular
    • Vegatative
  16. Peripheral Nervous System
    -carries sensory messages to the CNS from sensory receptors, motor messages from the CNS out to muscles and glands, as well as autonomic messages that govern the internal organs and blood vessels
  17. afferent
    sensory
  18. efferent
    motor
  19. what subjective data do we collect?
    • Headache
    • Seizure
    • Syncope
    • Pain
    • Parasthesia
    • Gait Disturbance
    • Visual Changes
    • Memory Disorders
    • Difficulty with speech or Swallowing
  20. subjective data: headache
    could be vascular headache, intercranial pressure, migraine - pain aseessment ?s
  21. Subjective Data: Syncope
    loss of consciousness (blacked out)
  22. Subjective Data: Pain
    lack of feeling in any part of the body, tingling/numbness.
  23. Subjective Data: Visual Changes
    visual distubances, blurring, loss of sight, double vision
  24. Subjective Data: Memory Disorders
    short term memory problems, long term memory problems
  25. Neuro Exam Sequence
    • Mental Status
    • Cranial Nerves
    • Sensory System
    • Motor System
    • Reflexes
  26. Mental Status
    • Level of Consciousness such as
    • - awake
    • - alert
    • - oriented x3

    do they know person. place, and time
  27. Changes in Level of Consciousness
    • Confusion
    • Lethargy
    • Stupor
    • Coma
    • Brain Death
  28. LOC is the most sensitive indicator of?
    a change in neurological status
  29. what should we look for in mental status?
    • Attention
    • Memory
    • Judgment
    • Insight
    • Spatial perception
    • Calculation
    • Abstract reasoning
    • Thought process & Content
    • Suicidal ideation
  30. Mental Status:Attention
    ability to repeat info or perform
  31. Mental Status:Memory
    short-term/long-term
  32. Mental Status:Judgment
    safety issues
  33. Mental Status:Insight
    realistic perception of self
  34. Mental Status:Spatial perception
    draws objects
  35. Mental Status:Calculation
    ability to calculate
  36. Mental Status:Abstract reasoning
    underlying meaning
  37. Mental Status:Thought process & Content
    logical/coherent
  38. Mini Mental Status Screening
    • Assesses cognitive functioning
    • Assists in identification of delirium/dementia
    • Score: 24-30 Normal; < 24 – impaired functioning
  39. Cranial Nerves
    • Olfactory- I
    • Optic - II
    • Oculomotor - III
    • Trochlear - IV
    • Trigeminal – V
    • Abducens - VI
    • Facial – VII
    • Acoustic – VIII
    • Glosopharyngeal – IX
    • Vagus – X
    • Spinal Accessory – XI
    • Hypoglossal - XII
  40. Cranial Nerve Mnemonics by name
    On Old Olympus Towering Tops A Fin and German Viewed Some Hops
  41. Cranial Nerve Mnemonics by function
    Some Say Marry Money But My Brother Says Bad Business Marry Money
  42. CN I Olfactory
    Smell
  43. how would you test small
    • olfactory I nerve 
    • Eyes closed
    • Block one nostril
    • Inhale deeply
    • Present one odor at a time
    • Compare both nares
    • Then introduce another scent
  44. CN ll Optic
    Vision
  45. CN lll Oculomotor
    Most eye movement, pupillary constriction, upper eye lid elevation
  46. CN lV Trochlear
    Down and in eye movement
  47. CN V Trigeminal
    • Sensory: Facial sensation
    • - ophthalmic
    • - maxillary
    • - mandibular
    • - corneal reflex

    Motor: Chewing
  48. Trigeminal – Sensory Testing
    take a cotton ball and wisps it across random parts of the body
  49. Trigeminal – Motor Testing
    press against the temporal and tmj
  50. CN Vl Abducens
    Lateral eye movement
  51. CN Vll Facial (motor)
    Motor: Expressions – frown, raise eyebrows, wrinkle forehead, smile show teeth, whistle, puff out cheeks, close eyes tight against resistance
  52. Bells Palsy
    • Paralysis of the Facial Nerve
    • Note the asymmetry of the palpebral fissures and the nasolabial folds

    viral infection can affect 7th cranial nerve on one side of the face
  53. Chvostek’s Sign
    • test the stability of facial nerve by
    • Neuro excitability of the facial nerve
    • Normal: no twitching when it is stimulated
    • If twitch/muscle spasm present → hypocalcaemia or tetanus
  54. CN VII - Facial (sensory)
    • Sensory – taste
    • Sweet/Salty – tip of the tongue
    • Sour - tip of tongue & borders
    • Bitter - back of tongue
  55. CN Vlll Acoustic
    Hearing and balance
  56. CN lX Glossopharyngeal
    Swallowing, salivating, and taste
  57. CN X Vagus
    Swallowing, gag reflex, talking, pharyngeal movement, activities of the thoracic and abdominal viscera, such as heart rate and peristalsis
  58. CN Xl Accessory
    Shoulder movement and head rotation
  59. CN XI – Spinal Accessory
    as patient to move against your resistance
  60. CN Xll Hypoglossal
    • Tongue movement
    • - ask patient to say "light, tight, dynamite"
  61. Sensation - Exteroreceptive is controlled by?
    • Pain Temperature
    • Lateral Spinal Thalmic Tract – Thalamus – Sensory Cortex
  62. Sensation - Discrimination is controlled by?
    Dorsal Column – Thalamus – Sensory Cortex
  63. Exteroceptive Sensation - what type of test should we run
    •  Sensation
    • Superficial pain – safety pin
    • Temperature – hot/cold
  64. Exteroceptive Sensation: light touch
    • - patient eyes closed
    • - distal to proximal 
    • - check for symmetry
  65. Exteroceptive Sensation - Superficial pain
    Dull vs sharp
  66. Proprioceptive Sensation should test what
    • Motion and Position
    • Vibration Sense
  67. Cortical Sensation
    • Stereognosis: identifying obbject in hand without looking
    • Graphesthesia
    • Two-Point Discrimination
    • Extinction
  68. Extinction
    ability to feel two points simultaneously and feel when one was removed
  69. Decerebrate Rigidity (positioning)
    • Ominous Sign – brainstem, midbrain, upper pons lesion
    • Arms – stiffly extended, adducted, internal rotation, palms pronated
    • Legs – stiffly extended, plantar flexion
    • Teeth clenched, back hyperextended
  70. Decorticate Rigidity (positioning)
    • Cerebral Cortex hemisphere lesion
    • Flexion of Arms, Wrist, Fingers
    • Adduction of arms
    • Legs – extension, internal rotation, plantar flexion
  71. Pronator Drift
    they should be able to extend their hands- but a person who has weakness to one side of the body - the weakened side will go down
  72. Coordination
    Test of the integration of the pre-motor cortex, basal ganglia, cerebellum, vestibular system (ear), posterior column, and peripheral nerves
  73. Romberg Test
    • Patient stands erect w/ feet together, hands at side, and eyes open
    • Then patient closes their eyes
    • Note ability to maintain balance
    • Normal: Maintains balance with minimal swaying for 20 seconds
  74. Reflex actions
    Automatic response to an adequate stimuli
  75. type of reflexes
    • Muscle stretch
    • Deep tendon
    • Superficial
    • Pathological
  76. Deep Tendon Reflexes (DTR’s): Biceps
    • Biceps
    • C 5 & C 6
    • Contraction of biceps
    • Flexion of elbow

    you use a reflex hammer - with the thumb of your hand you want to locate the tendon and using your thumb your strike the area with the hammer- you will feel/see a slight movement
  77. Deep Tendon Reflexes (DTR’s): Brachioradialis
    • Brachioradialis
    • C 5 & C 6
    • Flexion and supination of forearm
  78. DTR’s: Triceps
    • C 7 & C 8
    • Contraction of triceps and extension of arm
  79. DTR’s: Patellar
    • L 2, L 3, L4
    • Contraction of quadriceps and extension of leg
  80. DTR’s: Achilles
    • L 5, S 1, S 2
    • Contraction of calf muscles and plantar flexion of foot
  81. babinski
    when the toes dorsi felx instead of planter flex 

    abnormal = pathological in adults (great toe dorsiflexes away from the stimulus )- okay in a child up to the age of two
  82. Superficial Reflexes
    • Abdominal
    • Plantar
    • Cremastic - males
    • Bulbocavernosus - males
  83. Cremastic - males
    this is for someone with some spinal cord injury
  84. Bulbocavernosus - males
    grab to glands of the penis and squeeze it - the penis will retract from the from the stimulus - not often dun
  85. Meningeal Irritation
    • Nuchal Rigidity
    • Kernig’s Sign 
    • Brudzinski Sign
  86. Nuchal Rigidity
    resistance w/ neck flexion
  87. Kernig’s Sign
    resistance to leg extension and pain after the knee was flexed
  88. Brudzinski Sign
    legs flex with deliberate neck flexion
  89. Increased Intracranial Pressure (ICP) causes what?
    • Change in LOC - **initial sign**
    • Cushing’s Reflex (late signs):
  90. Cushing’s Reflex
    • Elevated systolic pressure
    • Widening Pulse pressure
    • Bradycardia
    • Apnea Spells
    • = impending brain stem herniation
  91. Glasgow Coma Scale
    • Eye Opening 1-4
    • Best Verbal Response 1-5
    • Best Motor Response 1-6
    • Normal: Score 15
    • Below 8: Coma
  92. Glasgow Coma Scale: eyes open
    • 4 – Spontaneous
    • 3 – To speech
    • 2 – To pain
    • 1 - Absent
  93. Glasgow Coma Scale: Verbal Response
    • 5 - Converses/oriented
    • 4 – Converses/disorient
    • 3 – Inappropriate
    • 2 – Incomprehensible
    • 1 - Absent
  94. Glasgow Coma Scale: motor response
    • 6 – Obeys Commands: Response to pain
    • 5 – Localizes pain
    • 4 – Withdraws(flexion)
    • 3 – Decorticate
    • 2 – Decerebrate
    • 1 - Absent

    Below 7-8 = Coma

What would you like to do?

Home > Flashcards > Print Preview