Term
| what are the four major blood vessels that feed the brain? |
|
Definition
| two vertebral and two carotid arteries |
|
|
Term
| what do the common carotid arteries branch into |
|
Definition
|
|
Term
| what part of the brain does the to internal carotid's supply blood and oxygen to |
|
Definition
| anterior and middle areas of the brain |
|
|
Term
| what is the primary pathway for messaging between the parts of the brain and the body |
|
Definition
|
|
Term
| what spinal pathway enters and exits the spinal cord at the same level and does not need to travel up and down the way other stimuli does? |
|
Definition
|
|
Term
| what is a function of the cells in the dorsal portion of the and neural horn of the spinal cord |
|
Definition
|
|
Term
| West Main patient of the cells in the ventral horn of the spinal cord |
|
Definition
| it plays a part in voluntary and reflex motor activity |
|
|
Term
| what type of matter surrounds the four horns of the spinal cord |
|
Definition
|
|
Term
| what does white matter consist of |
|
Definition
| myelinated fibers grouped in vertical columns |
|
|
Term
| what does the dorsal white matter contain |
|
Definition
| a ascending tracts which carry impulses up the spinal cord to higher sensory centers |
|
|
Term
| what does the ventral white matter contain |
|
Definition
| descending tracks which transmit motor impulses down from higher motor centers to the spinal cord |
|
|
Term
| what is the afferent pathway |
|
Definition
| the sensory or ascending neural pathway |
|
|
Term
| the sensory impulses travel on two major pathways, what are they? |
|
Definition
|
|
Term
| what type of sensations does the dorsal horn transmit |
|
Definition
|
|
Term
| where dose the dorsal horn's signals travel to? |
|
Definition
|
|
Term
| when sensations to the ganglia transmit |
|
Definition
| touch pressure and vibration |
|
|
Term
| what your pyramidal system responsible for |
|
Definition
| finding skilled movements of skeletal muscle |
|
|
Term
| what does extrapyramidal system control |
|
Definition
|
|
Term
| what does the peripheral nervous system include |
|
Definition
| cranial nerves, spinal nerves, and autonomic nervous system |
|
|
Term
| how many pair of cranial nerves are there |
|
Definition
|
|
Term
| how many pair of spinal nerves are there |
|
Definition
|
|
Term
| what does cranial nerve 1 (olfactory) transmit |
|
Definition
|
|
Term
| what is cranial nerve two ( optic) transmit |
|
Definition
|
|
Term
| what does cranial nerve three ( optic) transmit |
|
Definition
| most eye movement, pupillary constriction, upper eyelid elevation |
|
|
Term
| what does the neuromotor four (trochlear) transmit |
|
Definition
|
|
Term
what does the cranial nerve five (trigeminal) transmit
|
|
Definition
| chilling, corneal reflex, face and scalp sensations |
|
|
Term
| what is the cranial nerve six ( abducens) transmit |
|
Definition
|
|
Term
| what does the cranial nerve seven (facial) transmit? |
|
Definition
| expressions of the forehead, eye, mouth and taste |
|
|
Term
| what does the cranial nerve number eight (acoustic) transmit |
|
Definition
|
|
Term
| what does cranial nerve number nine (glossopharyngeal) transmit? |
|
Definition
| swallowing, salivation, and taste |
|
|
Term
| what does cranial nerve 10 ( Vegus) transmit |
|
Definition
| swallowing, gag reflex, talking, sensations of the throat, larynx, and abdominal viscera , activities of thoracic and abdominal viscera, such as heart rate and peristalsis |
|
|
Term
| what does cranial nerve 11 ( accessory) transmit |
|
Definition
| shoulder movement and head rotation |
|
|
Term
| what does cranial nerve 12 ( hypoglossal) transmit |
|
Definition
|
|
Term
| the autonomic nervous system is divided into what two parts |
|
Definition
the sympathetic nervous system and
the parasympathetic nervous system |
|
|
Term
| what does the sympathetic nervous system control |
|
Definition
Lisa constriction
elevated blood pressur
enhance blood flow to skeletal muscle
increased heart rate and contractility
increased respiratory rate
smooth muscle relaxation
pupil dilation
sweat secretion |
|
|
Term
| If your patient is suffering from a neurologic disorder, what may you hear reports of? |
|
Definition
| headaches, motor disturbances (such as weakness, paresis, and paralysis), seizures, sensory deviations, and altered level of consciousness (LOC). |
|
|
Term
| If your pt has a hx of HA what types of questions should you ask? |
|
Definition
| How often do you have them? What precipitates them? |
|
|
Term
| if you patient has neurologic problems what types of questions should you ask about dizziness? |
|
Definition
| Do you ever feel dizzy? How often do you feel this way? What seems to precipitate the episodes? |
|
|
Term
| if you patient has neurologic problems what types of questions should you ask about numbness and tingling |
|
Definition
Do you ever feel a tingling or prickling sensation or numbness? If so, where?
|
|
|
Term
| why should you ask your patient with neurological deficits about chronic health problems |
|
Definition
| Many chronic diseases affect the neurologic system, so ask questions about the patient's past health and what medications he's taking. |
|
|
Term
| what family health history information should you collect from you patient with neurological problems |
|
Definition
| Ask if anyone in the family has had diabetes, cardiac or renal disease, high blood pressure, cancer, a bleeding disorder, a mental disorder, or a stroke. |
|
|
Term
| when assessing neural function how should you begin your assessment? |
|
Definition
| Beginning with the highest levels of neurologic function and working down to the lowest |
|
|
Term
| what five areas should be assessed on a basic neurologic assessment |
|
Definition
• mental status • cranial nerve functions
• sensory function • motor function • reflexes. |
|
|
Term
| what three things should be checked during a mental status exam? |
|
Definition
• LOC
• speech
• cognitive function |
|
|
Term
To quickly screen your patient for disordered thought processes, WHAT QUESTIONS SHOULD YOU ASK.
An incorrect answer to any question may indicate the need for a complete mental status examination. One quick tip: Make sure that you know the correct answers before asking the questions. |
|
Definition
What's your name? - person
What's your mother's name? - other people
What year is it? - time
Where are you now? - place
How old are you? - Memory
Where were you born? - Remote memory
What did you have for breakfast?- Recent memory
Who's President of the United States now?- General knowledge
Can you count backward from 20 to 1?- Attention span and calculation skills |
|
|
Term
| What is the earliest and most sensitive indicator that his neurologic status has changed. |
|
Definition
| any change in the patient's LOC |
|
|
Term
|
Definition
| Patient follows commands and responds completly and appropriately to stimuli. |
|
|
Term
| what does the termLethargic mean? |
|
Definition
| Patient is drowsy, has delayed responses to verbal stimuli, and may drift off to sleep during the exami¬ nation. |
|
|
Term
| what does the term stupors mean? |
|
Definition
| Patient requires vigorous stimulation for a response. |
|
|
Term
| what does the term, comatose mean? |
|
Definition
| Patient doesn't respond appropriately to verbal or painful stimuli and can't follow commands or communicate verbally. |
|
|
Term
| when assessing arousal to stimuli how should the nurse proceed? |
|
Definition
Start by quietly observing the patient's behavior. If the patient is sleeping, try to rouse him by providing an appropriate stimulus, in this order:
1. auditory
2. tactile
3. painful |
|
|
Term
| what should the nurse assess for when listening to the patient speaks |
|
Definition
| Listen to how well the patient expresses thoughts. Does he choose the correct words or seem to have problems finding or articulating words? |
|
|
Term
| What is dysarthria and how should it be assessed for? |
|
Definition
difficulty forming words
ask the patient to repeat the phrase, "No ifs, ands, or buts."
Assess speech comprehension by detemuning the patient's ability to follow instructions and cooperate with your examination. |
|
|
Term
what areas should be assessed to test cognitive function
9 |
|
Definition
| memory • orientation • attention span • calculation ability • thought content • abstract thinking • judgment • insight • emotional status. |
|
|
Term
| how would you know you patients short-term memory is intact |
|
Definition
| A patient with intact short-term memory can generally remember and repeat five to seven nonconsecutive numbers right away and again 10 minutes later. |
|
|
Term
| what type of orientation is usually disrupted first in an neurologically disturbed patient |
|
Definition
time is usually disrupted first
orientation to person, last. |
|
|
Term
| why does a nurse need to assess the pattern? |
|
Definition
| Disordered thought patterns may indicate delirium or psychosis. |
|
|
Term
| how should the nurse assess thought pattern? |
|
Definition
| by evaluating the clarity and cohesiveness of the patient's ideas. Is his conversation smooth, with logical transitions between ideas?Does he have hallucinations or delusions? |
|
|
Term
| how should the nurse assess the patient's judgment |
|
Definition
asking him how he would respond to a hypothetical situation.
For example, what would he do if he were in a public building and the fire alarm sounded? Evaluate the appropriateness of his answer. |
|
|
Term
| how should the nurse assess the patient's emotional status |
|
Definition
| Note his mood, emotional lability or stability, and the appropriate¬ ness of his emotional responses. Also, assess the patient's mood by asking how he feels about himself and his future. |
|
|
Term
| What cranial nerves are more vulnerable to the effects of increasing intracranial pressure (ICP). |
|
Definition
• optic (II)- check visual acuity
• oculomotor (III)- check pupil size
• trochlear (IV)- check downward and inward eye movement.
• abducens (VI)- lateral eye movement |
|
|
Term
| how would you assess cranial nerve number one the olfactory nerve |
|
Definition
| check patency of each nostril, have the patient close their eyes. occlude one nostril have the patient smell pungent odor and repeat on the other side |
|
|
Term
| how would you assess the optic nerve cranial nerve number two |
|
Definition
| check visual acuity, visual fields, and retinal structure to this by asking the patient to read newspaper starting with large headings and moving to smaller print. |
|
|
Term
| how would you assess the oculomotor cranial nerve number three |
|
Definition
| check pupil size, people shape, and pupillary response to light. |
|
|
Term
| How would you assess the coordinated function of the oculomotor (CN III), trochlear (CN IV), and abducens (CN VI) nerves simultaneously. |
|
Definition
Make sure that the patient's pupils constrict when exposed to light and that his eyes adapt to seeing objects at various distances. Ask the patient to follow your finger through six cardinal positions of gaze:
1.left superior
2.left lateral
3.left inferior
4.right superior
5.right lateral
6.right inferior |
|
|
Term
| How would you assess the sensory portion of the trigeminal nerve (CN V)? |
|
Definition
| gen tly touch the right and left sides of the patient's forehead with a cotton ball while his eyes are closed. Instruct him to tell you the moment the cotton touches each area. Compare the patient's responses on both sides.Next, repeat the entire procedure using a sharp object, such as the tip of a safety pin. Ask the patient to describe and compare both sensations. |
|
|
Term
| How would you assess the motor function of the trigeminal nerve (CN 5) |
|
Definition
| ask the patient to clench his teeth while you palpate his temporal and masseter muscles. |
|
|
Term
| How would you assess the motor portion of the facial nerve (CN VII)? |
|
Definition
ask the patient to: • wrinkle his forehead • raise and lower his eyebrows • smile to show his teeth • puff out his cheeks.
Also, with the patient's eyes tightly closed, attempt to open his eyelids. As you conduct each part of this test, look for symmetry. |
|
|
Term
| How would you assess the sensory portion of the facial nerve (CN VII)? |
|
Definition
| Test the taste sensation by placing items with various flavors on the patient's tongue. Use items such as sugar (sweet), salt, lemon juice (sour), and quinine (bitter). Between items, have the patient wash away each substance with a sip of water. |
|
|
Term
| How would you assess the acoustic nerve (CN VIII) |
|
Definition
| stand on the opposite side and whisper a few words. Find out whether the patient can repeat what you said. Test the other ear in the same way. |
|
|
Term
| How would you assess the vestibular portion of the acoustic nerve (CN VIII) |
|
Definition
| observe the patient for nystagmus and disturbed balance. Note reports of the room spinning or dizziness. |
|
|
Term
| How would you assess the glossopharyngeal nerve (CN IX) and vagus nerve (CN X) together? |
|
Definition
| Assess these nerves, first, by listening to the patient's voice. Then check the gag reflex by touching the tip of a tongue blade against the posterior pharynx and asking the patient to open wide and say "ah." Watch for the symmetrical upward movement of the soft palate and uvula and for the midline position of the uvula. |
|
|
Term
How would you assess the
spinal accessory nerve (CN XI)? |
|
Definition
Note shoulder strength and symmetry while inspecting and palpating the trapezius muscles.
apply resistance from one side while the patient tries to return his head to midline position. Look for neck strength. Repeat on the other side. |
|
|
Term
How would you assess the
hypoglossal nerve (CN XII) |
|
Definition
1.Ask the patient to stick out his tongue. Look for any deviation from the midline, atrophy, or fasciculations.
2. Test tongue strength by asking the patient to push his tongue against his cheek as you apply resistance. Observe the tongue for symmetry.
3. Test the patient's speech by asking him to repeat the sentence, "Round the rugged rock that ragged rascal ran." |
|
|
Term
| What are the five types of sensations an nurse should assess for in the sensory system? |
|
Definition
| pain, light touch, vibration, position, and discrimination. |
|
|
Term
| How should the nurse assess for pain sensation? |
|
Definition
have the patient close his eyes; then touch all the major dermatomes, first with the sharp end of a safety pin and then with the dull end. Proceed in this order: • fingers
• shoulders • toes • thighs • trunk.
start in the area with the least sensation and move toward the area with the most sensation. |
|
|
Term
| How should the nurse assess for the sense of light touch? |
|
Definition
using a wisp of cotton or tissue. Lightly touch the patient's skin; don't swab or sweep the skin.
A patient with peripheral neuropathy might retain the sensation for light touch after losing pain sensation. |
|
|
Term
| How should the nurse assess for response to vibration? |
|
Definition
| tap a low-pitched tuning fork on the heel of your hand, and then place the base of the fork firmly over the distal interphalangeal joint of the index finger. Then move proximally until the patient feels the vibration; everything above that level is intact. |
|
|
Term
If the patient's vibratory sense is intact, you do not need to test for the position sense
True or False? |
|
Definition
True
If the patient's vibratory sense is intact, further testing for position sense isn't necessary because they follow the same pathway. |
|
|
Term
| How should the nurse assess for position sense? |
|
Definition
| have the patient close his eyes, grasp the sides of his index finger and move it back and forth. Ask the patient what position the finger is in. |
|
|
Term
|
Definition
| the cortex's ability to integrate sensory input. |
|
|
Term
|
Definition
| the ability to discriminate the shape, size, weight, texture, and form of an object by touching and manipulating it. |
|
|
Term
| How should the nurse assess for stereognosis? |
|
Definition
| ask the patient to close both eyes and open one hand. Then place a common object, such as a key, in the hand and ask the patient to identify it. |
|
|
Term
| If the pt fails the stereognosis test what test should you do next? |
|
Definition
| graphesthesia- While the patient's eyes are closed, draw a large number on the palm of one hand and ask the patient to identify the number. |
|
|
Term
|
Definition
| the failure to perceive touch on one side. |
|
|
Term
| How would the nurse assess for Extinction? |
|
Definition
| have the patient close his eyes, touch one of his limbs, and then ask where you touched him. |
|
|
Term
|
Definition
| muscular resistance to passive stretching |
|
|
Term
| How would the nurse assess for muscle tone in the arm? |
|
Definition
move the patient's shoulder through its passive range of motion (ROM); you should feel a slight resistance.
When you let the patient's arm drop to his side, it should fall easily.
|
|
|
Term
| How would the nurse assess for arm muscle strength? |
|
Definition
| ask the patient to push you away as you apply resistance. Then ask the patient to extend both arms, palms up. Have him close his eyes and maintain this position for 20 to 30 seconds. Observe the arm for downward drifting and pronation. |
|
|
Term
| How would the nurse assess for coordination and balance through cerebellar testing. |
|
Definition
| Note whether the patient can sit and stand without support. If appropriate, observe as the patient walks across the room, turns, and walks back. |
|
|
Term
| When cerebellar dysfunction is present, how might the pt gait apper |
|
Definition
the patient has a wide-based, unsteady gait.
Deviation to one side may indicate a cerebellar lesion on the side. |
|
|
Term
| What is the Romberg's test used for? |
|
Definition
| to evaluate cerebellar synchronization of movement with balance. |
|
|
Term
| How should the Romberg's test be preformed? |
|
Definition
Have the patient stand with his feet together, arms at his sides, and without support. Note his ability to maintain balance with both eyes open and then closed. (Stand nearby in case the patient loses his balance.)
If the patient has trouble maintaining a steady position with eyes open or closed, cerebellar ataxia may be present. |
|
|
Term
| How would the nurse assess the extremities for coordination? |
|
Definition
| having the patient touch his nose and then your outstretched finger as you move it. Have him do this faster and faster. His |
|
|
Term
| What is an appropriate motor responses in an unconscious patient? |
|
Definition
localization or withdrawal
This means that the sensory and corticospinal pathways are functioning. |
|
|
Term
What is an inappropriate,motor responses in an unconscious patient?
|
|
Definition
| decorticate or decerebrate posturing, indicate a dysfunction. |
|
|
Term
| What knowlage is gained by assess deep tendon and superficial reflexes |
|
Definition
| the integrity of the sensory receptor organ. You can also evaluate how well afferent nerves relay sensory messages to the spinal cord or brain stem segment to mediate reflexes. |
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