|Central Nervous System||Brain, Spinal Cord|
|4 major division of the brain?||Cerebrum, diencephalon, brain stem, cerebellum|
|cerebrum||R/L hemisphere, connected by callosum (responsible for communit. between spheres) has 4 lobes known as gray matter which mediate higher thinking.|
|diencephalon|| below cerebrum|
- thalamus, screens/ directs sensory impulses to specifc cerebral cortex
- hypothalmus, regulates vital signs.
|Brain stem|| 3 parts|
- midbrain, eye/ear reflex.
- pons, links cerebellum, cerebrum, and midbrain to medulla
- medulla oblongata, regulates respir. funct; heart rate; and force/ blood pressure.
|Cerebellum|| located behind brainstem and under cerebrum|
-maintenance of equilibrium and voluntary movements.
|frontal lobe||personality, emotions, voluntary skel. actions, broca area (speech)|
|parietal lobe||tactile sensation - touch, pain, temperature, and shapes.|
|temporal lobe|| receives and interprets impulses from ear|
-wernicke area, interp. auditory stimuli
|occipital lobe|| primary visual receptor center|
-influence ability to read with understanding.
|What is the second part of the CNS?|| Spinal cord|
-conducts sensory impulse up the ascending tract to brain
-conducts motor impulses down the descending tract to neurons that stimulate glands and muscles.
- responsible for simple reflex activities
|Peripheral Nervous Sys.|| carry info to/from CNS, cranial nerves (12 pairs), and spinal nerves (31 pairs).|
-cranial nerves 12 pairs, trans. motor/sensory messages
-spinal nerves 31 pairs, two types
*somatic = voluntary skeletal
*autonomic = involuntary smooth
|AutonomicNervous Sys|| *maintains homeostasis |
= fight/flight activated during stress
= increase pulse rate, dilate pupils/bronchiole
= restores/maintain body funct.
=decrease rate, increase digestion..etc..
|Subjective data|| numbness, tinging, burning sensations (paresthesia)|
-seizures, headaches, dizziness, decreased smell/taste, changes in vision, difficulty speaking/swallowing, muscle weakness, tremors, bowel/bladder, memory loss.
|Objective data||mental status, cranial nerves (DR), motor/cerebellum sys, sensory sys, reflexes(DR).|
|Mental status|| Head to toe examination (provides info. about cerebral cortex funct)|
- identifies problems with (intellect, communication, emotion)
|Cranial Nerves||info regarding motory/sensory messages head to neck.|
|Romberg Test|| Motor and Cerebellar sys, assess condition and movement of muscles.|
|Cerebellar Ataxia|| Staggering, unsteady|
-romberg test (cannot stand with feet together)
|Parkinsonian Gait|| -shuffling, stiff gait|
-stooped over position
|Spastic Hemiparesis||-Flexed arm closed to body, drags toe of leg and circles outward and forwar. -stroke victims|
|Foot drop||lifts foot with bent knee with each step, - ballerina position|
|Tandem Walking||Testing Balance (one foot in front of the other)|
|Tandem Balance||Standing and hopping on one foot|
|Testing Coordination||Finger to nose|
|Testing Rapid Alternating Movement||flipping hand over, repeatedly|
|Sensory System||provides info regarding the integrity of the spinothalmic tract, posterior columns of the spinal tract, and parietal lobes of the brain.|
|Reflexes|| provides clues to the integrity of deep and superficial reflexes.|
-deep reflexes depend upon intact sensory motor nerve and competent muscle.
- superficial reflexes depend on skin receptors rather than muscles.
|Sensory Tests|| touch, pain sensation|
test two point discrimination
stereognosis - tactile discrimination
*eyes closed place familiar object in hand and ask pt to identify it by feel.
|Quick Neuro check|| level of consciousness|
orientation of time, place, person
sensation in extremities/trunk
|Assess. Mental Status|| Refers to the level of cognition, emotional funct, stability|
-reflected in speech, appearance, and thought patterns
-ability to think clearly and respond appropriately
-function effectively with ADL (activities of daily living)
|consciousness||awake/alert, lethargic, obtunded/stupor, verbal, tactile, and painful|
|Posture and Body Move.||tense, stiff, nervous, fidgety, slumped, bizarre|
|Behavior and Affect||Cooperative or not; apathy or crying; incongruent|
|Facial expression||eye contact, emotionless, drooping, staring, watchful|
|Presentation||hygiene and dress|
|Alert and awake||alert to person, place, day and time, responds to questions correctly|
|Lethargy||client opens eyes, answers questions, falls back asleep|
|Obtunded||client opens eyes to loud voice, responds slowly with confusion, seems unaware of environment|
|Stupor||awakens to vigorous shake or painful stimuli but returns to unresponsive sleep|
|Coma||unresponsive to all stimuli, eyes stay closed|
|Glasgow Coma Scale|| -eye opening response|
-most appropriate verbal response
-most integral motor response (arm)
|Eye opening||spontaneous opening, responds to commands, responds to painful stimuli, no response.|
|Most appropriate verbal||oriented, confused, inappropriate words, incoherent, no response|
|Most integral motor||obeys verbal commands, localize pain, withdrawls from pain, flexion (decorticate rigidity), extension (decerebrate rigidity), no response.|
|Orientation||knows who and where they are; current month/year|
|concentration||ability to focus and stay attentive and follow directions without difficulty|
|Recent memory||recalls recent events without difficulty|
|Remote memory||correctly recalls past events|
|Alzheimer Disease|| repeatedly ask the same question|
become lost, disorientated in familiar places
cannot follow directions
disorientated date and time
doesn't recognize and is confused about familiar people
has difficulty with routine task
neglects personal hygiene, safety, etc..