Neurological assessment

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Sejune
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Neurological assessment
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2010-11-07 15:33:45
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Neurological assessment
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Neurological assessment
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  1. 4 major divisions of brain
    • Cerebrum
    • Diencephalon
    • Brain stem
    • Cerebellum
  2. What joins the cerebrum?
    Corpus collosum
  3. 4 lobes of Cerebrum
    • Frontal
    • Pariatal
    • Occipital
    • Temporal
  4. Function of grey matter
    • Memory
    • Perception
    • Communication
    • Initiation of voluntary movment
  5. Parietal functions
    • Interprets
    • Tactile sensations (touch, pain, temp, shape 2 point discrimination)
  6. Frontal lobe functions
    • Voluntary and skeletal action
    • Talking, writing, emotions, intellect, reasoning ability, judgement
    • Contains brocas area responsible for speach
  7. Broca's Area
    responsible for speech
  8. Occiptal function
    • Read with understanding
    • visual center
  9. Temporal functions
    • Hearing
    • Contains wernickis area
  10. Wernicke's area
    Located in temoral, interprets auditory stimuli
  11. Consists of the thalamus and hypothalamus
    Diencephalon
  12. Thalamus is composed of what matter?
    Grey
  13. Relays sensory nerve singal between cerebrum brainstem and spinal cord
    Thalmus
  14. Directs impulses to appropriate areas of cerebral cortex
    Thalamus
  15. Dicrects impulese to appropriate areas of cerebral cortex
    Thalamus
  16. regulates water balance
    hypothalamus
  17. appetite
    hypothalamus
  18. visual signs
    hypothalamus
  19. sleep cycles
    hypothalamus
  20. pain perception
    hypothalamus
  21. emotional status
    hypothalamus
  22. controls pituitary gland
    hypothalamus
  23. Located between cerebral cortex and spinal cord
    Brain stem
  24. Consistis primary of nerve fibers
    Brain stem
  25. Has three parts
    Midbrain
    Pons
    Medulla oblongata
    Brain stem
  26. Involved in vision, hearing, eye movements body
    Midbrain
  27. Relays impulses between higher celebral centers and lower pons, medully, cerebellum and spinal cord
    midbrain
  28. Links cerebellum to cerebrum and midbreain to medulla
    pons
  29. Responsible for various reflex actions
    Pons
  30. Contains nuclein for crainal nerves
    medulla oblongota
  31. Has centers controlling and regulating respiratory fucntion, heart rate and force, and blood pressure
    Medulla oblongata
  32. Located behind the brain stem and under cerebrum
    Cerebellum
  33. Coordination
    Cerebellum
  34. Smothing of voluntary movements
    Cerebellum
  35. Maintenance of equilibrium
    Cerebellum
  36. Maintenance of muscle tone
    Cerebellum
  37. Extends from medulla oblongata to 1st lumbar
    Spinal cord
  38. Carries information to and from the CNS
    PNS
  39. has 31 pairs of spinal nerves and 12 pairs of cranial nerves
    PNS
  40. Catagories of spinal nerves
    • Somatic
    • Automatic
  41. Affarent
    Sensory
  42. Motor
    Efferent
  43. Sensory root of each spinal nerve innervates an area of the skin called a
    dermatome
  44. how many pairs of cranial nerves?
    12
  45. Cranial neves evolve from
    brain or brain stem
  46. Transmit motor or sensory impulses
    crainial nerves
  47. carried by both cranial and spinal nerves
    ANS impulses
  48. Maintains internal homeostasis of the body
    ANS
  49. Incorporates sympathetic and parasympathetic nervous system
    ANS
  50. Fight or flight
    SNS
  51. Activated during stress
    SNS
  52. Decreased gastric secreations
    SNS
  53. Inhibits parastalsis
    SNS
  54. Bronchoiledilation
    SNS
  55. Increased heart rate
    SNS
  56. Dilates pupils and relaxes lens
    SNS
  57. Diverts blood away from GI tract and skin
    SNS
  58. Enhances blood flow to skeletal muscles and lungs
    SNS
  59. Functions to restore and maintain normal body functions
    PNS
  60. Promotes rest and digest response
    PNS
  61. Promotes calming of the nerves and enhances digesting
    PNS
  62. Dilates blood vessels leading to the GI tract
    PNS
  63. Constricts teh bronchiolar diameter when the need for 02 has diminished
    PNS
  64. Stimulates salivary gland secreation and accelerates peristalsis
    PNS
  65. Loss of sensation or gtingling sx of damage to
    brain, spinal cord or periferal nerves
  66. Must achieve a certain blood level to be effective
    Seizure medications
  67. Morning headaches that subside after arising may be an early sign of
    increased interccranial pressure such as that seen with a brain tumor
  68. Dizzyness associated with
    • CAD
    • Cerebellar abcess
    • Menier's disease
    • inner ear infection
  69. difficulty with coordiation in neuro diseases involve
    cerebellum, basal ganglia, extrapyramidal tracts, or vestibular portion of cranial nerve VIII
  70. Decreased smell associated with
    Cranial nerve I or brain tumor
  71. Decreased taste
    Cranial nerves VII or IX
  72. Decrease in smell and taste in older people is
    normal
  73. Ringing in ears caused by dysfunction of which nerve
    VIII
  74. Changes in vesion with cranial nerve
    II
  75. Cranial nerve damage can be caused by
    III, IV, VI
  76. transient blind spot is an early sign of
    stroke
  77. Injury to what can impari the ability to use or understand verbal language
    cerebral cortex
  78. Cranial nerves related to difficulty swallowing
    X, XII
  79. Loss of bowel control or urin retention and bladder distension are seen with
    spinal cord injuries or tumors
  80. muscle weakness or paraysis can result from
    • CVA
    • Spinal cord compression
    • Nerve injury
  81. Progressive weakness is a sx of several
    nervous system diseases
  82. 24 hour, recent memory caused by
    • amnesic disoorders
    • Korsankoffs syndrome
    • Delerium
    • Dementia
  83. Head injuries, even if minor can produce
    long term neurologic deficits and affect level of functioning
  84. peripheral neuropathy can result from deficiencies in
    Niacin, B12, folicc acid
  85. DTR depends on
    Sensory nerve, functional synapse in spinal cord, intact motor nerve, a neuromuscular juntion and ompentent muscles
  86. Neuro check consists of
    • Level of consciousness
    • PUpillary check
    • Movement and strength of extremeties
    • Sensation in extemities
    • Vital signs
  87. DTR grading
    0-4 (4 hyperactive) 0 no response +2 normal +4 hyperactive
  88. Eyes are open and client answers questions but falls back asleep
    Lethargic
  89. Opens eyes to loud voice, responds slowly witht confusion
    Seems unaware of environment
    Obtuned
  90. Awakesn to vigourus shake or painful stinuli but returns to unresponsive sleep
    Stuporia
  91. Unresponsive to all stimuli
    Eyes remain shot
    Coma
  92. Diencephalon, midbrain or pons assumes what posture
    Decerabrate
  93. Decerebrate posture
    Extension posturing
  94. Decorticate posture
    Abnormal flexion
  95. Lesions of corticospinal tract assume ________ posture
    Decorticate
  96. <15 GCS
    some impairment in LOC
  97. <10 GCS
    need for emergency attention
  98. 7 or lower GCS
    In a coma
  99. Score of 3 GCS
    Deep coma
  100. Geriatric depression scale normal
    < or equal to 10
  101. Geriatric depression scale abnormal
    10 - 30
  102. memorey test, over 80 should be able to remember how many of 4 words?
    2-4
  103. normal score for mini mental status exam
    between 24 - 30
  104. Mini mental score of < 21 means
    may be seen in delirium or dementia
  105. Cranial nerve 0
    vestigial
  106. Cranial nerve I testing
    plug nose, test smell in each nare
  107. Cranial nerve II testing
    • Snellen to assess distance vision
    • Assess visual field by confrontation
  108. Cranial nerve III, IV, VI
    • Margins of eyelids of each eye
    • Extraocular movements/cardinal fields
    • Pupillary response to accomodation and light
  109. Cranial nerve V test
    • Clench teeth and palpate temoral and masseter muscles for contraction
    • FOrehead cheeks chin with sharp and dull objects
  110. Cranial Nerve VII test
    • ask to
    • Smile
    • Frown
    • Wrinke forehead
    • Show teeth
    • Puff out cheeks
    • Purse lips
    • Raise eyebrows
    • Close eyes against resistance
  111. Cranial nerve VII testing sensory funtion
    2/3 tongue
  112. Cranial nerve tests IX and X
    Posterior 1/3 tongue
  113. Cranial nerve VIII
    Cover ear and whisper, do on both sides
  114. IX and X tests
    • motor: open and say ah
    • Gag reflux
    • Swallow
  115. XI test
    Shrug against resistance, turn head against resistance
  116. XII test
    Mobility of tonge
  117. astereognosis
    inability to identify objects in hand
  118. brudzinksi's sign
    neck down, hips legs up for meningitis
  119. Kernig's sign
    bend hip and leg and back down, if painful maybe meningieal irritation

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