Neurologic System Flashcards

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ml3923
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78401
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Neurologic System Flashcards
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2011-04-09 15:48:25
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Neurologic assessment
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NURS 3320 Test 4
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  1. Frontal Lobe
    • Personality
    • Behavior
    • Emotions
    • Intellectual function
  2. Parietal Lobe
    Primary center for sensation
  3. Occipital Lobe
    Primary visual Receptor
  4. Temporal Lobe
    Primary Auditory reception center
  5. Wernicke's Area
    Language comprehension
  6. Broca's Area
    Mediates motor speech
  7. Cranial Nerve 1
    Type and Function
    • Olfactory
    • Sensory
    • Smell
  8. Cranial Nerve 2
    Type and Function
    • Optic
    • Sensory
    • Vision
  9. Cranial Nerve 3
    Type and Function
    • Oculomotor
    • Both
    • Motor: most extraoculomotor muscle movement, opening of eyelids
    • Parasympathetic: Pupil constriction, lens shape
  10. Cranial Nerve 4
    Type and Function
    • Trochlear
    • Motor
    • Down and inward movement of eye
  11. Cranial Nerve 5
    Type and Function
    • Trigeminal
    • Both
    • Motor: Muscles of mastication
    • Sensory: Sensation of face and scalp, cornea, mucous membranes of mouth and nose
  12. Cranial Nerve 6
    Type and Function
    • Abducens
    • Motor
    • Lateral movement of eye
  13. Cranial Nerve 7
    Type and Function
    • Facial
    • Both
    • Motor: Facial muscles, close eye, labial speech, close mouth
    • Sensory: Taste(sweet, salty, sour, bitter) on anterior 2/3 of tongue
  14. Cranial Nerve 8
    Type and Function
    • Acoustic
    • Sensory
    • Hearing and equilibrium
  15. Cranial Nerve 9
    Type and Function
    • Glossopharyngeal
    • Both
    • Motor: Pharynx (phonation and swallowing)
    • Sensory: Taste on posterior 1/3 of tongue, pharynx (gag reflex)
  16. Cranial Nerve 10
    Type and Function
    • Vagus
    • Both
    • Motor: Pharynx and Larynx (talking and swallowing)
    • Sensory: General sensation from carotid body, carotid sinus, pharynx, viscera
  17. Cranial Nerve 11
    Type and Function
    • Spinal
    • Motor
    • Movement of trapezius and sternomastoid muscles
  18. Cranial Nerve 12
    Type and Function
    • Hypoglossal
    • Motor
    • Movement of tongue
  19. Cerebrum
    • "Thinking brain"
    • Deals with thought, memory, reasoning, sensation, and voluntary movement
  20. Basal Ganglia
    Controls the automatic associated movements of the body (ex. arm swinging while walking)
  21. Thalamus
    Main relay station for nervous system
  22. Hypothalamus
    • Major control center that has many vital functions
    • Regulates temp, HR, and BP control
    • Sleep center
    • Anterior/Post. pituitary gland regulator
    • Coordinates ANS activity and emotional status
  23. Cerebellum
    • "Doing brain"
    • Concerned with motor coordination of voluntary movements, equilibrium, and muscle tone
    • DOES NOT initiate movement but coordinates and smooths movements
  24. 3 Parts of Brain Stem
    • Midbrain
    • Pons
    • Medulla
  25. Midbrain
    • Merges into thalamus and hypothalamus
    • Contains many motor neurons and tracts
  26. Pons
    Contains ascending and descending fiber tracts
  27. Medulla
    • Connects brain and spinal cord
    • Contains autonomic centers (Respiration, heart, GI)
    • Pyramidal Decussation occurs
  28. Pyramidal Decussation
    Crossing of the motor fibers
  29. Spinal Cord
    • Contains fiber tracts that connect brain to spinal nerves
    • Mediates reflexes
  30. Spinothalamic Tract
    • Sensory Pathway
    • Transmits pain, temperature, and crude/light touch
  31. Posterior (Dorsal) Columns
    • Sensory Pathway
    • Conduct sensations of position (proprioception), vibration, and finely located touch (stereognosis)
  32. Corticospinal or Pyramidal Tract
    • Motor Pathway
    • Permits very skilled and purposeful movements
  33. Extrapyramidal Tract
    • Motor Pathway
    • Permits gross automatic movements such as walking
  34. Cerebellar System
    • Motor Pathway
    • Coordinates movement, maintains equilibrium, and helps maintain posture
  35. Upper Motor Neurons
    • Located completely in the CNS
    • Examples are cpticospinal, corticobulbar, and extrapyramidal tracts
    • Ex. of UMN diseases: CVA, cerbral palsy , and MS
  36. Lower Motor Neurons
    • Located in the PNS
    • ANY MOVEMENT must be translated into action by lower motor neuron fibers
    • Ecamples are cranial and spinal nerves
    • Ex. of LMN diseases: Spinal cord lesions, Poliomyelitis, and amyotrophic lateral sclerosis
  37. Peripheral Nervous systen us nade up of _____.
    12 pairs of cranial nerves, 31 pairs of spinal nerves, and all their branches
  38. Afferent messages
    Sensory
  39. Efferent messages
    Motor
  40. PNS carries ____ to the CNS from _____.
    • afferent messages
    • sensory receptors
  41. PNS carries ____ from the CNS to ____.
    • efferent messages
    • muscles and glands
  42. S.A.M.E.
    • Sensory are Afferent
    • Motor are Efferent
  43. Deep Tendon Reflex
    Ex. Patellar
  44. Superficial Reflex
    • Corneal Reflex
    • Abdominal Reflex
  45. Visceral Reflex
    Pupillary response to light and accomodation
  46. Pathologic Reflex
    • Abnormal
    • Ex. Plantar Reflex
  47. Spinal Nerves
    • Named for the region of the spine they exit: 8 cervical, 12 Thoracic, 5 lumbar, 5 sacral, 1 coccygeal
    • Contain both sensory and motor fibers
  48. Autonomic Fibers
    • Innervate smooth(involuntary) muscles, cardiac muscle, and glands
    • Mediate unconscious activity
  49. Somatic Fibers
    Innervate skeletal (voluntary) muscles
  50. Paresis
    Partial or Incomplete paralysis
  51. Dysmetria
    Inability to control ROM of muscles
  52. Parasthesia
    Abnormal sensation, such as burning, numbness, or tingling
  53. Paralysis
    Loss of motor function due to a lesion in the neurologic or muscular system or loss of sensory innervation
  54. Dysarthria
    Difficulty forming words
  55. Dysphasia
    Difficulty with language comprehension or expression
  56. How to test Cranial Nerve 1
    Have pt occlude one nostril and identify the smell and repeat on the other side with a different smell
  57. Anosmia
    • Decrease or loss of smell
    • Occurs with tobacco smoking, allergic rhinitis, and cocaine use
  58. Neurogenic anosmia
    Unilateral loss of smell with absence of nasal disease
  59. How to test Cranial Nerve 2
    • Test visual acuity and visual fields by confrontation
    • Use opthalmoscope to examine ocular fundus
  60. How to test Cranial Nerves 3, 4, and 6
    • Palpable fissures equal in width
    • PERRLA
    • Six cardinal positions of gaze
  61. Nystagmus occurs with disease of what 3 things?
    • Vestibular system
    • Cerebellum
    • Brain stem
  62. Ptosis occurs with what 2 diseases?
    • Myasthenia gravis (CN 3)
    • Horner's Syndrome
  63. Increased Intracranial Pressure does what to the pupils?
    Causes sudden, unilateral, dilated and nonreactive pupil
  64. How to test Cranial Nerve 5
    • Pt close eyes and touch cotton whisp to forehead, cheeks, and chin
    • Palpate TMJ as person clenches teeth (muscles should be equally strong bi-lat) and try to separate jaws by pushing down on chin while pt clenches jaw
  65. How to test Cranial Nerve 7
    • Pt should correctly identify taste
    • Have pt frown, close eyes tightly (examiner tries to pry open), lift eyebrows, smile, and puff cheeks
  66. How to test Cranial Nerve 8
    Test ability to hear normal conversation, whispered voice test ("baseball"), Weber/Rinne tests
  67. How to test Cranial Nerves 9 and 10
    • Pt should correctly identify taste
    • Check for uvula and soft palate to rise midline and tonsils to move medially; illicit gag reflex
  68. How to test Cranial Nerve 11
    • Have pt rotate head and shrug shoulders against resistance
    • *Turn head side to side to show off your earrings ("accessories")*
  69. How to test Cranial Nerve 12
    • Ask pt to say "light, tight, dynamite" and note that lingual speech sounds are clear and distinct
    • Ask pt to stick out tongue; note that tongue protrudes midline with no tremors
  70. Tandem walking
    Ask pt to walk heel-to-toe in a straight line
  71. Rapid Alternating Movements Tests
    • Opposition (thumb to fingers)
    • Finger-to-finger (pt to examiner)
    • Finger to nose (eyes closed)
    • Heel-to-shin
  72. How to test Superficial Pain
    • Sharp and Dull ends of tongue blade
    • Have pt identify whether it's sharp or dull with eyes closed
  73. How to test Light Touch
    • Apply cotton whisp to skin on arms, forearms, hands, chest, thighs, and legs at random
    • Have pt say "Now" when touched
    • EYES CLOSED
  74. How to test Vibration
    • Place tuning fork on bony surface of fingers and great toe
    • Ask pt to say when vibrations start and stop
    • EYES CLOSED
  75. How to test Kinesthesia
    • Move finger or big toe up or down and ask pt to tell you which way it moved
    • EYES CLOSED
  76. Kinesthesia
    Posistion/Motion Sense
  77. How to test Stereognosis
    • Put familiar object in pt hand and have them identify it
    • EYES CLOSED
  78. Stereognosis
    Object Recognition
  79. How to test Graphesthesia
    • Draw number on pt palm and ask them to identify it
    • EYES CLOSED
  80. Graphesthesia
    Number Recognition
  81. How to Test for Kernig Reflex
    • Pt in flat-lying supine position
    • Raise leg straight or flex thigh on abdomen, then extend knee
    • Resistance to straightening or pain is positive
  82. What is Kernig Reflex indicative of?
    Meningeal irritation
  83. How to Test for Brudzinski Reflex
    • Have pt slex chin to chest
    • Watch hips and knees
    • Resistance and pain in neck, with flexion of hip and knees is positive
  84. What is Brudzinski Reflex indicative of?
    Meningeal irritation
  85. Causes of Paralysis
    • Acute: Trauma, spinal cord injury, brain attack, poliomyelitis, polyneuritis, Bell's Palsy
    • Chronic: Muscular dystrophy, diabetic neuropathy, multiple sclerosis,
    • Episodic: Myasthenia gravis
  86. Hemiplegia
    Spastic or flaccid paralysis of one side (right or left) of body and extremities
  87. Paraplegia
    Symmetric paralysis of both lower extremities
  88. Quadriplegia
    Paralysis in all four extremities
  89. Fasciculation
    • Rapid, continuous twitching of resting muscle or part of muscle, without movement og limb, that can be seen or palpated
    • Can be fine or coarse
  90. Myoclonus
    • Rapid, sudden jerk or a short series of jerks at fairly regular intervals.
    • Severe with gran mal seizures
  91. Rest Tremor
    • Coarse and slow (3 to 6 per second)
    • Partly or completely disappears with voluntary movement
  92. Intention Tremor
    • Rate Varies
    • Worse with voluntary movement
    • Occurs with cerebellar disease and multiple sclerosis
  93. Chorea
    • Sudden, rapid, jerky, purposeless movement involving limbs, trunk, or face
    • Occurs at irregular intervals
    • Common with Sydenham's chorea and Huntington's disease
  94. Athetosis
    • Slow, twisting, writhing, continuous movement, resembling a snake or worm
    • Occurs with cerebral palsy
    • "Athetoid" hand: some fingers are flexed and some are extended
  95. Review Characteristics of Upper and Lower Motor Neuron Lesions
    p. 706
  96. Decorticate Rigidity
    • Upper extremities: Flexion of arm, wrist, and fingers; adduction of arm (ex. tight against thorax)
    • Lower extremities: Extension, internal rotation, plantar flexion
    • Indicates hemispheric lesion of cerebral cortex
  97. Flaccid Quadriplegia
    • Complete loss of muscle tone and paralysis of all four extremities
    • Indicates copletely nonfunctional brain stem
  98. Decerebrate Rigidity
    • Upper Extermities: Stiffly extended, adducted, internal rotation, palms pronated
    • Lower extremities: Stiffly extended, plantar flexion
    • Teeth clenched; hyperextended back
    • Indicates lesion in brain stem at midbrain or upper pons
  99. Opisthotonos
    • Prolonged arching of the back, with head and heels bent backwards
    • Indicates meningeal irritation

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