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Inspect margins of the eyelids of each eye.
Assess extraocular movements. If nystagmus is noted, determine the direction of the fast and slow phases of movement
Used to assess what cranial nerves?
Assess CN III (oculomotor), IV (trochlear), and VI (abducens)
Test CN _______
Test motor function. Ask the client to clench the teeth while you palpate the temporal and masseter muscles for contraction
Test sensory function. Tell the client: “I am going to touch your forehead, cheeks, and chin with the sharp or dull side of this safety pin or paper clip
Tests CN ____
Tests motor function of CN _____
Test motor function. Ask the client to:
Puff out cheeks
Close eyes tightly against resistance
Tests CN 7 (facial)
Tests CN ____
CN 7 (facial)
Weber and Rinne tests to assess CN ____
CN 8 (acoustic, vestibulocochlear)
Testing cranial nerves IX and X: checking uvula rise and gag reflex
Ask the client to shrug the shoulders against resistance to assess the trapezius muscle. What cranial nerve does this test?
Test CN 11 (spinal accessory)
To assess strength and mobility of the tongue, ask the client to protrude tongue, move it to each side against the resistance of a tongue depressor, then put it back in the mouth.
Tests CN ____
Test CN XII (hypoglossal)
- Testing cranial nerve XI: assessing strength of trapezius muscle
- Testing cranial nerve XI: assessing strength of sternocleidomastoid muscle
As you flex the neck, watch the hips and knees in reaction to your maneuver. Positive _________ sign
Flex the client's leg at both the hip and the knee, then straighten the knee. Positive ___________ sign
-Wide-based, staggering, unsteady gait
-Romberg test results are positive (client cannot stand with feet together)
-Seen with cerebellar diseases or alcohol or drug intoxication
-Shuffling gait, turns accomplished in very stiff manner
-Stooped-over posture with flexed hips and knees
-Typically seen in Parkinson's disease and drug-induced parkinsonian because of effects on the basal ganglia
-Stiff, short gait; thighs overlap each other with each step
-Seen with partial paralysis of the legs
-Flexed arm held close to body while client drags toe of leg or circles it stiffly outward and forward
-Seen with lesions of the upper motor neurons in the cortical spinal tract, such as occurs in stroke
-Client lifts foot and knee high with each step, then slaps the foot down hard on the ground
-Client cannot walk on heels
-Characteristic of diseases of the lower motor neurons
_______: large oval opening at the base of the skull in the occipital bone through which the spinal cord extends from the medulla oblongata in the brainstem
__________: regulates the bodys internal environment in conjunction with the endocrine system. Has two components: the sympathetic nervous system and the parasympathetic nervous system.
Autonomic nervous system
_________: arises from the thoracolumbar segments of the spinal cord and is activated during stress (the fight or flight response). Actions include increasing blood pressure and HR, vasoconstricting peripheral blood vessels, inhibiting GI peristalsis, and dilating bronchi.
Sympathetic nervous system
___________: arises from craniosacral segments of the spinal cord and controls vegetative functions (breed and feed). Actions are involved in functions assoc. with conserving energy such as decreasing HR and force of myocardial contraction, decreasing BP and respiration, and stimulating GI peristalsis.
Parasympathetic nervous system
_______: progressive demyelination of nerve fibers of the brain spinal cord, an autoimmune disorder initiated by a virus that attacks the myelin at various sites of the CNS.
_______: inflammation of the meninges that surround the brain and spinal cord that could result from invasion of bacteria, viruses, fungi, parasites, and other toxins.
________: inflammation of the brain tissue and meninges caused by bacteria, viruses, fungi, and parasites.
_________: disease that develops slowly as the brains dopamine-producing neurons in the substantia nigra of the basal ganglia degenerate. The disease is char. by resting tremor, bradykinesia, and rigidity. Other manifestations include masklike facies, trunk forward flexion, muscle weakness, shuffling gait, and finger pill rolling tremor.
_________: disorder caused by the occlusion of the cerebral blood vessels by a thrombus or embolus or when intracranial hemorrhage occurs, the brain tissues become ischemic. Hemorrhage can be caused by hypertension or a cerebral aneurysm (a weakened area in an artery that ballons out due to high pressure of blood).
Cerebrovascular accident (stroke)
_______: incurable, degenerative neurolgic disorder that begins with a decline in memory. It is the most common cause of dementia in western countries. Cause is unkown. Theories suggest genetic tendency, env. toxins, altered function of neurotransmitters, autoimmune reaction, or a slow virus as possible contributing factors. Client with a history of small strokes have a tendency to develop disease.
_________: intense paroxysmal pain along one or all three of the branches of the trigeminal nerve (CN 5), also known as tic douloureux. Etiology unkown. Trauma to face or head and infection of teeth or jaw are contributing factors.
______: acute unilateral paralysis of the facial nerve. About 80% of clients recover fully after a few weeks to months.
__________: neuromuscular disease char. by abnormal weakness of voluntary muscles that improve with rest and admin. of anticholinesterase drugs.
______________: acute syndrome char. by widespread demyelinization of nerve of the PNS. Affects the motor component of the peripheral nerve and is believe to be caused by a cell mediated autoimmune response to a viral infections.
Guillain- Barre syndrome