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Neurologic System
Ch. 23
65
Nursing
Undergraduate 3
11/08/2012

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Cards

Term
central nervous system
Definition
brain & spinal cord
Term
peripheral nervous system
Definition

includes all nerve fibers outside the brain & spinal cord; 

12 CN

31 SN

all their branches

Term
sensory (afferent) messages
Definition
PNS carries these TO the CNS from sensory receptors
Term
motor (efferent) messages
Definition
messages FROM the CNS go to muscles and glands, as well as autonomic messages that govern the internal organs and BV
Term
cerebral cortex
Definition
center for the human's highest funtions, governing thought, memory, reasoning, sensation, and voluntary movement
Term
frontal lobe
Definition
areas concerned with personality, behavior, emotions, and intellectual function
Term
parietal lobe
Definition
primary center for sensation
Term
occipital lobe
Definition
primary visual receptor center
Term
temporal lobe
Definition

behind the ear

primary auditory reception center with functions of hearing, taste, and smell

Term

Wenicke's area

(temporal lobe)

Definition
associated with language comprehension
Term

Broca's area

(frontal lobe)

 

Definition
mediates motor speech
Term
basal ganglia
Definition

large bands of gray matter buried deep within the hemispheres;

form subcortical motor system (extrapyramidal)

help initiate & coordinate movement & control automatic associated movements of the body 

(e.g. the arm swing alternating with the legs during walking)

Term
thalamus
Definition
main relay station where the sensory pathways of the spinal cord, cerebellum, and brainstem form synapses (sites of contact between two neurons) on their way to the cerebral cortex
Term
hypothalamus
Definition

major respiratory center with basic vital functions:

temperature, appetite, sex drive, heart rate, and BP;

sleep center, anterior & posterior pituitary gland regulator;

coordinator of autonomic nervous system activity & stress response

Term
brainstem
Definition
central core of the brain consisting mostly of nerve fibers
Term
midbrain
Definition

most anterior part of the brainstem that still has the basic tubular structure of the spinal cord;

merges into the thalamus & hypothalamus;

contains many motor neurons & tracts

Term
pons
Definition

enlarged area containing ascending sensory & descending motor tracts;

has two respiratory centers (pneumotaxic & apneustic) that coordinate with the main respiratory center in the medulla 

Term
medulla
Definition

continuation of the spinal cord in the brain that contains all ascending & descending fiber tracts;

has vital autonomic centers (respiration, heart, gastrointestinal function);

nuclei for CN 8-12

*pyramidal decussation (crossing of motor fibers) occurs here*

Term
spinal cord
Definition

long, cylindric structure of nervous tissue about as big around as the little finger;

occupies the upper 2/3 of the vertebral canal from the medulla to lumbar vertribra L1-L2;

mediates reflexes of posture control, urination, & pain response

Term
crossed representation
Definition
notable feature of the nerve tracts; the left cerebral cortex recieves sensory information and controls motor function to the right side of the body, whereas the right cerebral cortex likewise interacts with the left side of the body
Term
sensory pathways
Definition
sensation travels in the afferent fibers in the peripheral nerve, then through the posterior (dorsal) root, and then into the spinal cord
Term
spinothalamic tract
Definition
contains sensory fibers that transmit sensations of pain, temperature, & crude or light touch
Term
proprioception
Definition
without looking, you know where your body parts are in space and in relation to each other
Term
stereogenesis
Definition
without looking, you can identify familiar objects by touch
Term
corticospinal or pyramidal tract
Definition
"higher" motor system that allows humans to have very purposeful movements
Term
extrapyramidal tracts
Definition
all the motor nerve fibers originating in the motor cortex, basal ganglia, brainstem, and spinal cord that are outside the pyramidal tract
Term
cerebellar system
Definition
complex motor system coordinates movement, maintains equlibrium, and helps maintain posture
Term
posterior (dorsal) column
Definition
these fibers conduct sensations of position, vibration, and finely localized touch
Term
cranial nerves
Definition

enter and exit brain rather than spinal cord

- 12 pairs -

Term
AGING ADULT
Definition

atrophy with steady loss of neuron structure in brain and spinal cord;

people over 65 show general loss of muscle bulk, loss of muscle tone in face, neck, and around spine, decreased muscle strength, impaired fine coordination, and agility, loss of vibratory senses at ankles, decreased or absent Achilles reflex, pupillary miosis, irregular pupil shape, and decreased pupillary reflexes


*these findings would be considered abnormal in young adults*

Term
AGING ADULTS
Definition

-velocity of nerve conduction decreases making reaction to time slower in some older persons

-increased delay at synapse results in deminished sensation of touch, pain, taste, and smell

-motor system may show general slowing down of movement, muscle strength and agility decreases

-progessive decrease in cerebral blood flow and oxygen consumption may cause dizziness and loss of balance

Term
AFRICAN AMERICANS
Definition

-more likely than whites to have high BP

-tend to have strokes earlier in life & with more severe results than whites

-have almost 2x risk of first stroke compared with whites

Term

deep tendon reflex has _ components:

 

Definition

1) intact sensory nerve (afferent)

2) functional synapse in the cord

3) intact motor nerve fiber (efferent)

4) neuromuscular junction

5) competent muscle

Term
Autonomic Nervous System
Definition

PNS composed of CN & SN

-somatic fibers innervate the skeletal (voluntary) muscles

-the autonomic fibers innervate smooth (involuntary) muscles, cardiac muscles, & glands

 

*ANS mediates unconcious activity*

Term
syncope
Definition

sudden loss of strength, a temporary loss of consciousness (a faint), due to lack of cerebral blood flow

(e.g. low BP)

Term
vertigo
Definition
rotational spinning caused by neurologic disease in the vestibular apparatus in the ear on in the vestibular nuclei in the brainstem
Term
seizures
Definition
occur with epilepsy, a paroxysmal disease characterized by altered or loss of consciousness, involuntary muscle movements, and sensory disturbances
Term
tremor
Definition
involuntary shaking, vibrating, or trembling
Term
paresis
Definition
patrial or incomplete paralysis
Term
paralysis
Definition
loss of motor function due to a lesion in the neurologic or muscular system or loss of sensory innervation
Term
dysmetria
Definition
inablity to control the distance, power, and speed of a muscular action
Term
paresthesia
Definition

abnormal sensation 

(e.g. burning, tingling)

Term
dysarthria
Definition
difficulty forming words
Term
dysphasia
Definition
difficulty with language comprehension or expression
Term
anosmia
Definition
decrease or loss of smell occurs bilaterally with tobacco smoking, allergic rhinitis, & cocaine use
Term
ataxia
Definition
uncoordinated or unsteady gait
Term
Balance Test--Gait
Definition

observe as the person walks 10 to 20 feet, turns, & returns to the starting point

-person should move with sense of freedom

-gait should be smooth, rhythmic, and effortless

Term
The Romberg Test
Definition

-ask person to stand up with feet together & arms at the sides

-once stable, ask person to close the eyes & hold position for 20 seconds

-normally, a person can maintain posture and balance

*positive romberg sign = loss of balance that occurs when closing the eyes*

Term
Rapid Alternating Movements (RAM)
Definition
ask the person to pat the knees with both hands, lift up, then turn hands over, and pat the knees with the backs of the hands. then ask the person to do it faster.
Term
Finger-to-Finger Test
Definition
ask person to use their index finger to touch your finger & then their nose, using different locations for your finger
Term
Finger-to-Nose Test
Definition
ask person to close eyes & stretch out arms; lightly touch the tip of his/her nose with each index finger, alternating hands & increasing speed
Term
Heel-to-Shin Test
Definition

lower extremity coordination test

-ask person (in supine position) to place the heel on the opposite knee & run it down the shin from the knee to the ankle

Term
Grapesthesia
Definition
ability to "read" a number by having it traced on the skin
Term
Reflex Grading Scale
Definition

4+ very brisk, hyperactive with clonus, indicative of disease

3+ brisker than average, may indicate disease, probably normal

2+ average, normal

1+ diminished, low normal, or occurs only with reinforcement

0 no response

Term
clonus
Definition

set of rapid, rhythmic contractions of the same muscle

 

*occurs with upper motor neuron disease*

Term
Aging Adult -- Objective Data
Definition

-use samme examination as with younger adults

-CN mediating taste & smell not usually tested but may show some decline in function

-decrease in muscle bulk most apparant in hand, dorsal hand muscles often look wasted, even with no apparant arthropathy, grip strength remains relatively good

-senile tremors occassionally occur (intention tremor of the hands, head nodding as if saying "yes" or "no", and tongue protrusion)

Term
Abnormalities in CN
Definition

CN 1-anosmia

CN 2- defect or absent central vision

defect in peripheral vision, hemianopsia

absent light reflex

papilledema

optic atrophy

retinal lesions

Term
Neurologic Recheck
Definition

1) LOC

2) motor function

3) pupillary response

4) vital signs

Term
Hand Grasps Check
Definition

-ask person to squeeze your fingers

-offer your two fingers, one on top of the other, so that a strong hand grasp doesn't hurt your knuckles

Term
pronator drift
Definition
downward unilateral drift and turning in of the forearm that occurs with mild hemiparesis
Term
Warning Signs of Alzheimer Disease
Definition

-memory loss

-losing track

-forgetting words

-getting lost

-poor judgement

-abstract failing

-losing things

-mood swings

-personality change

-growing passive

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