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HCD III Module C: Intracranial Regulation A&P/ Neurological Assessment
Terms in this set (41)
Largest portion of the brain = 80% of total wt.
Location: underneath the frontal bone of the skull (posterior ends at central fissure)
Moral, ethical, social values
Long-term and short-term memory
Motor strip - opposite side of body (CN III, IV, VI, IX X, XII)
speech center and formulation of speech = damage results in "Expressive" or "Nonfluent" Aphasia (understands; can't speak)
Paralysis; Sequencing; Attending; labile
Damage to Frontal Lobe
Loss of simple movement of various body parts (__).
Inability to plan a sequence of complex movements needed to complete multi-stepped tasks, such as making coffee (__).
Loss of spontaneity in interacting with others.
Loss of flexibility in thinking.
Persistence of a single thought (Perseveration).
Inability to focus on task (__).
Mood changes (Emotionally __).
Changes in social behavior.
Changes in personality.
Difficulty with problem solving.
Inability to express language (Broca's Aphasia).
Location: posterior to the frontal lobe behind central fissure.
Sensory strip for opposite side of body
Recognition of object by size, shape, wt, texture
Body part awareness
Interpretation of pain, touch, pressure
located in parietal /temporal lobes - understanding of written/verbal words = damage results in Receptive" or Fluent" Aphasia (hears; can't interpret)
Damage to Parietal Lobe:
Inability to attend to more than one object at a time
Inability to name an object (__)
Inability to locate the words for writing (__)
Problems with reading
Difficulty with drawing objects
Difficulty in distinguishing left from right
Damage to Parietal Lobe:
Difficulty with doing mathematics (__)
Lack of awareness of certain body parts and/or surrounding space (__) that leads to difficulties in self-care
Inability to focus visual attention
Difficulties with eye and hand coordination
Location - beneath the temporal bone in the lateral portion of the cranium. (Speech, hearing, behavior)
Special senses - taste, smell
Interpretive area - integrates sounds, thoughts, emotions
Prosopagnosia; Wercicke's Aphasia; sexual
Damage to Temporal Lobe:
Difficulty in recognizing faces (__).
Difficulty in understanding spoken words (__).
Disturbance with selective attention to what we see and hear.
Difficulty with identification of, and verbalization about objects.
Short term memory loss.
Interference with long term memory.
Increased and decreased interest in __ behavior.
Inability to categorize objects (Categorization).
Right lobe damage can cause persistent talking.
Increased aggressive behavior.
Location: most posterior portion where all other lobes meet. (back) Separated from cerebellum by the tentorium
Visual recognition of objects - Interpretation of vision
Color Agnosia; illusions; blindness; Movement Agnosia
Damage to Occipital Lobe:
Defects in vision (Visual Field Cuts).
Difficulty with locating objects in environment.
Difficulty with identifying colors (__ __).
Production of hallucinations.
Visual __ - inaccurately seeing objects.
Word __ - inability to recognize words.
Difficulty in recognizing drawn objects.
Inability to recognize the movement of object (__).
Difficulties with reading and writing.
Location: Separated from cerebrum by the structure of tentorium cerebelli, called "little brain" or "hind brain".
Muscle tone associated with equilibrium, orientation in space, locomotion, and posture. (balance, coordination of voluntary movement)
Damage to Cerebellum:
Loss of ability to coordinate fine movements.
Loss of ability to __.
Inability to reach out and grab objects.
__ Speech (Scanning Speech).
Inability to make rapid movements.
Diencephalon ("between brain")
Lies at top of brainstem surrounding 3rd ventricle
Has 4 regions: Hypothalamus, Thalamus, Subthalamus & Epithalamus
Relay station for both motor and sensory activity, basic neuronal activity, and memory, thought, emotion and complex behavior.
All sensory pathways communicate with the thalamus except the olfactory.
Motor activity control of the thalamus includes coordination and integration (smooth response).
Regulating and maintaining internal body environment by:
Temp regulation -
low body temp causes vasoconstriction
increased body temp causes vasodilation
ANS responses (involuntary) - (parasympathetic & sympathetic)
Regulation of food and water intake - water thru ADH release
Control of hormonal secretions of the pituitary
Behavioral responses. - aggression, pleasure, punishment, sexual activities
Interacting with the limbic system to generate physical responses to emotions (ie: blushing).
located below the thalamus and is integrated with extrapyramidal tracts (gross motor) of the ANS and basal ganglia
location: dorsal portion; contains the pineal gland (believed to play a role in physical growth and sexual development)
has a role in the regulation of hormone production of all other endocrine organs
Seven major hormones are released/inhibited: ACTH (adrenocorticotropic), TSH (thryroid stim.), GH (growth), PRL (prolactin), LH (luteinizing), MSH (melanocyte - stim), and FSH (follicle stim).
Do not produce hormones, but secretes: ADH and oxytocin
Bridge b/t the cerebral hemispheres and the spinal cord
Only connection between the cerebellum and the cortex.
Origin of CN III & IV
Contains "aqueduct of Sylvius (connects 3rd & 4th ventricle)
controls eye movement (and some hearing function)
Controls some flexor muscles tone
Controls reflex motor movement in response to visual and auditory stimuli
involved in voluntary movement; if it doesn't function then you have tremors movement likes in parkinson's
Origin of CN V thru CN VIII
Transmits information between brain stem and cerebellum
two respiratory control centers:
Apneustic (controls length of inspiration and expiration)
Pneumotaxic (controls the rate of respirations)
Origin of CN IX thru CN XII
lower most portion of the brainstem and becomes the spinal cord (where crossing of motor fiber occurs).
Controls the mouth and neck, and the section of the body enclosed by the ribs and abdomen
Contains both gray matter nuclei and white matter fiber tracts
Role - provide a balance between the excitatory and inhibitory stimuli to maintain normal muscle tone, which supports the body against gravity
RAS (reticular activating system) - located in the same area as reticular formation.
Has two main levels:
lower - assists with control of sleep/wake cycles and consciousness.
Upper - allows the ability to focus attention on a specific task (ability to concentrate)
vital capacity; dysphagia; balance
Damage to Brain Stem:
Decreased __ __ in breathing, important for speech.
Swallowing food and water (__).
Difficulty with organization/perception of the environment.
Problems with __ and movement.
Dizziness and nausea (Vertigo).
Sleeping difficulties (Insomnia, sleep apnea)
Level of Consciousness
Most reliable index of neurological functioning - and often EARLIEST sign of problem!!!
can be very subtle
2 components of LOC:
__ - assess pt ability to respond to verbal/noxious stimuli (lower level)
__ - concerned with orientation to person/place/time/situation (higher level)
Changes in orientation answers may be first sign of neurological degeneration
lose __ first, then time, then place, then __
responds to minimal external stimuli (you're wide awake)
drowsy or inactive; requires ↑ stimulus to awaken, is easily arousable
very drowsy; follows simple commands when stimulated
aroused only by vigorous/continuous external stimulation
absent arousal and awareness
Oculocephalic Reflex (dolls eye phenomenon)
quickly turn head to one side.
Eyes should move conjugately to opposite side of turned head. (if turn left to head, eyes should rotate to the right)
If eyes do NOT move in this manner: indicative of significant brain stem damage
Oculovestibular Reflex (ice water calorics)
Instill ice water into unconscious patient's ear
Intact brain stem: the eyes should deviate conjugately (with slow, tonic nystagmus) toward side of cold water irrigation
If eyes do NOT move in this manner: indicative of brain stem damage/loss of function.
(abnormal flexion): goes to the core; everything flexes forward toward the core
systolic hypertension (but diastolic stays fairly stable, so widening pulse pressure)
Change in respiratory pattern
Cushing's Triad includes what 3 things?
This is a late finding of increased ICP
eye, verbal, motor
Glasgow coma scale measures best response of 3 things?
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