Central Nervous System
Brain, Spinal Cord
4 major division of the brain?
Cerebrum, diencephalon, brain stem, cerebellum
R/L hemisphere, connected by callosum (responsible for communit. between spheres) has 4 lobes known as gray matter which mediate higher thinking.
- thalamus, screens/ directs sensory impulses to specifc cerebral cortex
- hypothalmus, regulates vital signs.
- midbrain, eye/ear reflex.
- pons, links cerebellum, cerebrum, and midbrain to medulla
- medulla oblongata, regulates respir. funct; heart rate; and force/ blood pressure.
located behind brainstem and under cerebrum
-maintenance of equilibrium and voluntary movements.
personality, emotions, voluntary skel. actions, broca area (speech)
tactile sensation - touch, pain, temperature, and shapes.
receives and interprets impulses from ear
-wernicke area, interp. auditory stimuli
primary visual receptor center
-influence ability to read with understanding.
What is the second part of the CNS?
-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
= fight/flight activated during stress
= increase pulse rate, dilate pupils/bronchiole
= restores/maintain body funct.
=decrease rate, increase digestion..etc..
numbness, tinging, burning sensations (paresthesia)
-seizures, headaches, dizziness, decreased smell/taste, changes in vision, difficulty speaking/swallowing, muscle weakness, tremors, bowel/bladder, memory loss.
mental status, cranial nerves (DR), motor/cerebellum sys, sensory sys, reflexes(DR).
Head to toe examination (provides info. about cerebral cortex funct)
- identifies problems with (intellect, communication, emotion)
info regarding motory/sensory messages head to neck.
Motor and Cerebellar sys, assess condition and movement of muscles.
-romberg test (cannot stand with feet together)
-shuffling, stiff gait
-stooped over position
-Flexed arm closed to body, drags toe of leg and circles outward and forwar. -stroke victims
lifts foot with bent knee with each step, - ballerina position
Testing Balance (one foot in front of the other)
Standing and hopping on one foot
Finger to nose
Testing Rapid Alternating Movement
flipping hand over, repeatedly
provides info regarding the integrity of the spinothalmic tract, posterior columns of the spinal tract, and parietal lobes of the brain.
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.
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)
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
eye contact, emotionless, drooping, staring, watchful
hygiene and dress
Alert and awake
alert to person, place, day and time, responds to questions correctly
client opens eyes, answers questions, falls back asleep
client opens eyes to loud voice, responds slowly with confusion, seems unaware of environment
awakens to vigorous shake or painful stimuli but returns to unresponsive sleep
unresponsive to all stimuli, eyes stay closed
Glasgow Coma Scale
-eye opening response
-most appropriate verbal response
-most integral motor response (arm)
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.
knows who and where they are; current month/year
ability to focus and stay attentive and follow directions without difficulty
recalls recent events without difficulty
correctly recalls past events
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..