Term
| What are the 6 components for a neurological physical examination? |
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Definition
1. Mental Status: Cerebral Cortex
2. Cranial Nerves: Brainstem
3. Cerebellum and Motor system: Cerebellum, cerebral cortex, corticospinal and extrapyramidal tracts
4. Sensory system: Cerebral cortex, spinal cord/spinothalamic tract and posterior columns
5. Reflexes |
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Term
| What are the two major divisions to the nervous system? |
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Definition
1. Central Nervous system: brain and spinal cord
2. Peripheral Nervous system: 12 pairs cranial nerves and 31 pairs of spinal nerves |
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Term
| What are the central components of the CNS? |
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Definition
1. Brain and brainstem
2. Cerebellum
3. Spinal cord |
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Term
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Definition
| Bundle of fibers outside the CNS |
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Term
| 2 types of peripheral nerve fibers are: |
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Definition
1. Efferent: motor messages from the CNS out to muscles, organs, and glands
2. Afferent: sensory messages to the CNS from sensory receptors |
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Term
| What are the 2 main functions of the peripheral nervous system? |
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Definition
1. Somatic: skeletal muscles (voluntary movement)
2. Autonomic: smooth muscles (involuntary movement) |
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Term
| List the 12 cranial nerves. |
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Definition
CNI-Olfactory
CNII-Optic
CNIII-Oculomotor
CNIV-Trochlear
CNV-Trigeminal
CNVI-Abducens
CNVII-Facial
CNVIII-Acoustic
CNIX-Glossopharyngeal
CNX-Vagus
CNXI-Spinal-Accessory
CNXII-Hypoglossal |
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Term
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Definition
| Autonomic nervous system reacts causing bradycardia AND allows vasodilation in the extremity vessels - decrease blood - decrease O2 - on floor |
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Term
| What are the symptoms of expressive dysphagia? |
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Definition
-Can understand what others are saying
-Words are slow and laborious, but meaningful
-Often gets frustrated |
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Term
| What are the symptoms of receptive dysphagia? |
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Definition
-Little or no comprehension of words
-Spoken words are fluent and nonsensical
-No idea the words and language are wrong |
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Term
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Definition
| A neurological scale that aims to give a reliable, objective way of recording the conscious state of a person. The score ranges between 3 (deeply unconscious) and 15 |
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Term
| What part of the nervous system does each vital sign correlate to? |
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Definition
HR = Vagus
Respiratory = Medulla, pons
BP=Medulla
Temp = Hypothalamus |
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Term
| How do you test each of the cranial nerves? |
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Definition
1. Olfactory: smell
2. Optic: snellen
3, 4, and 6. Oculomotor, Trochlear, Abducens: PERRLA, EOM
5. Trigeminal: clench teeth, light touch on face
7. Facial: Smile, frown, puff cheeks out
8. Acoustic: Whisper test, Rinne, Weber
9, 10. Say "Ahh," Gag reflex, taste
11. Spinal accessory - turn head and shrug shoulders against resistance
12. Hypoglossal - stick out tongue, speaking |
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Term
| What would an abnormal finding during rapid rhythmic alternating movements be indicative of? |
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Definition
| Possible cerebral disease . . . or drunk. Either one. |
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Term
| What would an inability to walk straight be indicative of? |
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Definition
| Cerebral Disease (MS) . . . or he's drunk. |
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Term
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Definition
Stand upright, place feet together, then close eyes for 20 sec
Positive test menas loss of balance - cerebellar disorder (MS, drunk) altered proprioreception |
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Term
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Definition
| Pt holds a "pizza box" at chest level - with supinated palms, close eyes and holds for 20 sec. |
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Term
| What would abnormal muscle tones indicate? |
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Definition
-Flaccid: polio, Guillan-Barre
-Spastic: cerebral palsy, spinal cord injury
-Rigid: tetanus
-Cogwheel rigidity: parkinonism |
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Term
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Definition
| Familiar item in hand. If unable to ID, it means sensory cortex lesion |
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Term
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Definition
| "Write" number in palm and ID. If unable to ID, it indicates sensory cortex lesion |
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Term
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Definition
1. Involuntary
2. Helps maintain muscle tone
3. Permits quick response to bad stimuli |
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Term
| 5 components needed for DTR response (IMPORTANT TO KNOW HINT HINT!) |
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Definition
1. Intact sensory nerve (afferent)
2. A functional synapse in the cord
3. An intact motor nerve fiber (efferent)
4. Neuromuscular joint
5. A competent muscle |
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Term
| Charting deep tendon reflexes |
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Definition
| Rated from 0 (no response) and 4+ (very brisk - clonus present) |
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Term
| If reflexes are hyperactice, what should you do? |
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Definition
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Term
| If assessing a comatose patient for deterioration, what should you do? |
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Definition
| Check for Babinski response |
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Term
| Order of the deterioration of LOC |
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Definition
1. A&O alters
2. Lose ability obey simple commands
3. Then responses deteriorate from purposeless responses to pain
4. Then absence of response to pain
5. Then loss of corneal and gag reflexes |
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Term
| What would cause sudden pupillary dilation and nonreactive pupil? |
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Definition
| Pressure on the brainstem |
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Term
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Definition
| Involuntary extension of the upper extremities as a response to external stimuli |
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Term
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Definition
| Arms are flexed toward chest, fists are clenched, legs are extended, feet turned inward. A person decorticating in response to pain gets a 3 on the Glasgow Coma Scale |
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Term
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Definition
| Positive if hips and knees flex as you flex pt.'s neck, is meningeal sign |
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Term
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Definition
| Flex pt.'s leg at hip and knee, then try to straighten (neck adn back pain & resistance occurs). Positive Kernig's bilateral suggests meningeal irritation |
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Term
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Definition
| Sudden neurologic deficit caused by ischemia or hemorrhage |
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Term
| Transient Ischemic Attack (TIA) |
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Definition
| Focal neurologic deficit lasting <1hr without underlying structural defects, highest risk of stroke within next 30 days |
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Term
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Definition
-Sudden numbness or weakness of the face, arm, or lef
-Sudden confusion or trouble speaking or understanding
-Sudden trouble walking, dizziness, or loss of balance
-Sudden trouble with vision in one or both eyes
-Sudden severe headache |
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Term
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Definition
| Loss of voice that accompanies disease affecting the larynx or its nerve supply |
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Term
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Definition
| Refers to less severe impairment in the volume, quality, or pitch of the voice. For example, a person may be hoarse or only able to speak in a whisper. |
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Term
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Definition
| Refers to a defect in the muscular control of the speech apparatus. Words may be nasal, slurred, or indistinct, but central symbolic aspect of language remains intact. |
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Term
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Definition
| Refers to a disorders in producing or understanding language. It is often caused by lesions in the dominant cerebral hemisphere, usually the left. |
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Term
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Definition
| Start with focal manifestations. Divided into simple partial seizures, which do not impair consciousness, and complex partial seizures, which do. |
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Term
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Definition
| Begin with bilateral body movements, impairment of consciousness, or both. They suggest widespread, bilateral cortical disturbance that may be either hereditary or acquired. |
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Term
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Definition
| May mimic seizures but are due to a conversion reaction (a psychological disorder) |
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Term
| Aortic stenosis and hypertrophic cardiomyopathy |
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Definition
| Vascular resistance falls with exercise, but cardiac output cannot rise |
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Term
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Definition
| Abnormal slowness of movement |
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Term
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Definition
| Refers to a lack of coordination of movement typified by the undershoot or overshoot of intended position with the hand |
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Term
| What is often the first sense lost in peripheral neuropathy? |
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Definition
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Term
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Definition
| Responsible for hearing, taste, and smell |
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Term
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Definition
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Term
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Definition
| Numbness, tingling, burning, crawling |
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Term
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Definition
Dysphasia: Partial or complete impairment of the ability to communicate resulting from a brain injury
Dysphagia: difficulty swallowing |
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Term
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Definition
| Eye twitching because you're tired |
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Term
| Acute care neuro assessment (Glasgow coma) |
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Definition
-LOC
-Motor function
-Pupillary response
-Vital sets
-Add score for each thing, gives you an objective level of deterioration
-If you want neuro checks q15, this is what you would do |
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Term
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Definition
L1 or below: paraplegic
T6 and below: paraplegic
C6 and above: tetraplegia
C4 and above: tetraplegia, ventilator |
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Term
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Definition
| Difficult to arouse (loud noise, vigorous shaking or pain), sleeps most of the time, speech affected |
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Term
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Definition
| Not fully alert, drifts off when not stimulated |
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Term
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Definition
| Need persistent, loud noise or pain for arousal, may respond to stimuli with a groan |
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