GU HA Neuro

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GU HA Neuro
2015-11-16 13:26:53
Seidel advanced health assessment
Ch 21 Neuro
Show Answers:

  1. The _____ lobe contains the motor cortex assoc with VOLUNTARY skeletal movement and fine repetetive motor movement.
  2. Major portion of brain growth occurs when?
    first year of life
  3. What is automatism?
    eyelid fluttering, chewing, lip smacking, swallowing
  4. Ask about hyper- or hypothyroidism?
  5. This nerve is tested when there is a concern with pt's ability to discriminate odors.
    olfactory (CN I)
  6. What is anosmia?
    loss of smell
  7. Anosmia can be caused by trauma to ______ or by ________
    • cribiform plate
    • olfactory tract lesion
  8. When assessing pts with severe, unremitting h/a, evaluate movement of eyes for presence or absence of ________. CN?
    • lateral (temporal) gaze
    • VI
  9. CN _____ is commonly the first to lose fxn w/ ICP.
  10. Evaluate ________ by observing a series of expressions.
    motor fxn (Facial CN VII)
  11. Romberg tests which CN?
    VIII, Acoustic (vestibular fxn)
  12. Sensory fxn of taste over the posterior third of the tongue may be tested during CN _____ evaluation.
    VII (Facial)
  13. The ________ nerve is simultaneously tested during evaluation of vagus nerve for the gag reflex and swallowing.
    glossopharyngeal (CN XI)
  14. To test gag reflex, observe for _____ movement of palate and _______ of pharyngeal muscles.
    • upward
    • contraction
  15. The soft palate should not droop and should have an ______ on either side.
  16. What happens when a pt says, "ah" if the vagus (X) or glossopharyngeal (IX) nerve is damaged and the palate fails to rise?
    uvula will deviate from midline
  17. What is stereognosis?
    identifying familiar objects by touch
  18. Evaluation of size, shape, and strength of trapezius and sternocleidomastoid muscles is done to assess which CN?
    Spinal Accessory (XI)
  19. Which CN is assessed when testing the muscle strength and movement of the tongue?
    Hypoglossal (XII)
  20. Finger-to-nose is performed with pts eyes open or closed?
  21. Pos Romberg indicates what?
    • cerebellar ataxia
    • vestibular dysfxn, OR
    • sensory loss
  22. Evaluate primary and cortical discriminatory sensation by having pt do what?
    • id various sensory stimuli 
    • (at hands, lower arms, abdomen, feet, legs)
  23. Sensory discrimination of the face is performed by evaluating which CN?
    V (Trigeminal)
  24. Where on the body is a stronger stimulus needed for testing sensory discrimination?
    • back
    • butt
    • heavily callused areas
  25. When is temperature and dep pressure sensation tests performed?
    only if superficial pain sensation is not intact
  26. How is deep pressure sensation tested?
    • by squeezing the trapezius,
    • calf,
    • or biceps muscle
  27. What should the pt experience during deep pressure sensation testing?
  28. The tuning fork with lower Hz has ______ reduction of vibration.
  29. Inability to interpret sensations may indicate what?
    a lesion in the sensory cortex or the posterior columns of the spinal cord
  30. How to test graphesthesia?
    draw letter, number, or shape on palm or hand or other body location
  31. What does the Babinski sign indicate?
    • pyramid tract disease
    • (expected finding < 2yoa)
  32. Elicit the upper abdominal reflexes by?
    stroking upward and away from umbilicus
  33. Stroke the inner thigh of the male  (proximal to distal) to elicit what?
    • cremasteric reflex
    • (testicle and scrotum should rise on stroked side)
  34. Position of pt when testing deep tendon reflexes.
    sitting or lying down
  35. Hyperactive reflexes suggest a ______ motor neuron disorder.
  36. DTR grade if sluggish or diminished.
  37. DTR grade if active or expected response.
  38. DTR grade if more brisk than expected, slightly hyperactive.
  39. DTR grade if brisk, hyperactive, with intermittent or transient clonus.
  40. DTR grade if no response.
  41. Upper or lower motor neuron disorder?
    increased tone, risk for contractures
  42. Upper or lower motor neuron disorder? decreased tone, muscle flaccidity
  43. Upper or lower motor neuron disorder? little or no muscle atrophy, decreased strength
  44. Upper or lower motor neuron disorder? sensation loss may affect entire limb
  45. Upper or lower motor neuron disorder? loss of muscle strength; muscle atrophy or wasting
  46. Upper or lower motor neuron disorder? Sensory loss follows the distribution of dermatomes or peripheral nerves.
  47. Upper or lower motor neuron disorder? hyperactive DT & abdominal reflexes; positive Babinski
  48. Upper or lower motor neuron disorder? weak or absent DT, plantar, and abdominal reflexes
  49. Upper or lower motor neuron disorder? no fasciculations
  50. Upper or lower motor neuron disorder? fasciculations
  51. Upper or lower motor neuron disorder? damage affects muscle on same side of body
  52. For the achilles reflex, strike the tendon at the level of the ankle ________.
  53. Contraction of the gastrocnemius muscle causes ________ of the foot (Achilles reflex).
    plantar flexion
  54. The monofilament should be applied to each site for ____ seconds.
  55. Nuchal rigidity may be assoc with meningitis and _______.
    intracranial hemorrhage
  56. What is Brudzinski sign?
    involuntary flexion of hips and knees when flexing the neck ~ meningeal irritation
  57. What is the Kernig sign? When is it positive?
    • fled leg at knee and hip when pt is supine, attempt to straighten leg
    • (+) with pain in lower back & resistance to straightening
  58. When may jolt accentuation of headache be performed?
    Pt w/ fever & H/A that leads to suspected dx of meningitis
  59. What is a positive jolt accentuation of h/a?
    increased h/a over baseline when moving head horizontally 2-3 rotations per second
  60. ______ posturing is assoc with injury to corticospinal tracts ABOVE the brainstem.
    Decorticate or flexor
  61. ________ posturing is assoc with injury to the brainstem.
    decerebrate or extensor
  62. Which CN is being tested in a newborn with the optical blink reflex?
    2, 3, 4, 6
  63. Which CN is being tested in a newborn with the rooting and sucking reflexes?
    5 (trigeminal)
  64. Which CN is being tested in a newborn when noting ability to wrinkle forehead (crying) and symmetry of smile?
  65. Which CN is being tested in a newborn with doll's eye maneuver?
  66. Doll's eye maneuver: infant's eye should turn?
    in dxn of rotation & then opposite dxn when rotation stops
  67. If eyes do not move in expected dxn for doll's eye maneuver in newborn, suspect a _______ problem or eye muscle ______.
    • vestibular
    • paralysis
  68. Which CN is being tested in a newborn for swallowing and gag reflex.
    9, 10
  69. What should happen when you pinch an infant's nose?
    mouth will open & tip of tongue will rise in a midline position
  70. The patellar tendon reflexes are present when?
    at birth
  71. The Achilles and brachioradial tendon reflexes appear when?
    6 mos
  72. Positive Babinksi sign is expected until what age?
    16-24 mos
  73. Touching two areas on each side of body simultaneously; sensations should be felt equally and bilaterally.
    Extinction phenomenon
  74. Touch an area on patient’s skin and withdraw stimulus.
    Point location
  75. Used to evaluate the function of specific spine segmental levels
    Superficial and deep tendon reflexes
  76. What are the 3 Superficial Reflexes?
    • Abdominal reflex
    • Cremasteric reflex
    • Plantar reflex
  77. What are the 3 Superficial Reflexes?
    • Abdominal reflex
    • Cremasteric reflex
    • Plantar reflex
  78. Test for ankle ______, especially if hyperactive reflexes noted
  79. Suspect ___________ disease with sustained clonus.
    upper motor neuron
  80. Under what conditions should a patient be tested for clonus?
    When deep tendon reflexes are hyperactive
  81. Abdominal reflexes test the _______ nerves. Testing deep tendon reflexes includes the _________ tracts.
    • thoracic
    • cervical, lumbar, and sacral
  82. _________ is abnormally increased muscle tone
  83. A scissors gait is seen in some people with ______ or _________.
    • cerebral palsy
    • multiple sclerosis
  84. Which CN? Inspect palate and uvula for symmetry with speech sounds and gag reflex. Observe for swallowing ditfficulty
  85. Which CN? Inspect face for muscle atrophy and tremors. Palpate jaw muscles for tone and strength when patient clenches teeth. Test superficial pain and touch sensation. Test corneal reflex.
    Trigeminal! CN V
  86. Which CN? Inspect eyelids for drooping. Inspect pupils' size for equality and their direct and consensual response to light accommodahon. Test extraocular eye movements.
    3, 4, 6