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Terms in this set (88)
What is the central nervous system made up of?
Brain and spinal cord
What is the peripheral nervous system made up of?
Cranial nerves and dermatomes.
Describe the voluntary nervous system:
Allows for voluntary movements of the body, like the skeletal muscles.
Describe the autonomic nervous system:
Controls involuntary movements of the body.
The two divisions of the ANS are the:
S___________ Nervous system
P___________ Nervous system
SYMPATHETIC NERVOUS SYSTEM
PARASYMPATHETIC NERVOUS SYSTEM
What is the function of the parasympathetic nervous system?
What is the function of the sympathetic nervous system?
The cerebrum is divided into ___ hemispheres and each hemisphere is divided into ___ lobes.
The cerebrum is divided into 2 hemispheres and each hemisphere is divided into 4 lobes.
What are the 4 lobes of the brain?
Are each of the hemispheres and lobes separate from each other or are they interconnected?
Tracts interconnect each lobe and hemisphere.
What lobe is Brocca's area located?
What occurs if the Brocca's area is damaged?
Damages the SPOKEN part of speech so the patient is able to write something down without difficulty but is not able to say/speak it. "You know what you want to say, you just cant get it out." Can be VERY frustrating for the patient.
Damage to the Brocca's area results in expressive/receptive aphasia?
Ethics and judgement come from which lobe?
Memory comes from which lobe?
Voluntary movement comes from which lobe?
Emotions and intellectual activity come from which lobe?
Sensory impulses are received and interpreted in which lobe? (Ex: You walk outside with a tee-shirt on and it is 20 below, you decide to turn around and go back inside to put on a jacket)
Recognition of body parts and awareness of body position (proprioception) comes from which lobe?
Perception and interpretation of sound come from which lobe?
What lobe is Wernicke's area located?
What happens if Wernicke's area is damaged?
Patient does not receive impulses correctly, therefore are able to speak but words are jumbled and don't make sense.
Damage to Wernicke's area results in expressive/receptive aphasia?
Integration of taste, smell, balance, emotion, and personality comes from what lobe?
What lobe is the primary vision center?
What lobe interprets visual data?
(Ex: We see the snow on the trees outside so we interpret that the weather is cold)
What is the pleasure system of the brain, responsible for sexual pleasure and pleasure from recreational drug use.
What is the difference between full and focused neuro exam?
Full requires testing EVERYTHING, whereas focused focuses on the main key points.
What is assessed during the neuro exam?
Mental status (LOC, orientation, thought process)
Balance and equillibrium
Sensation of extremities
Deep tendon reflexes
What should you do/ask them when assessing mental status with these questions?
-Physical appearance and grooming
PHYSICAL APPEARANCE: are they dressed appropriately for the situation and the weather?
BEHAVIOR: are they behaving appropriately?
ABSTRACT REASONING: give them a proverb to interpret.
JUDGEMENT: give them an "if, then" situation.
MEMORY: make sure you KNOW the CORRECT answer.
EMOTIONAL STABILITY: are their emotions in check and appropriate for the situation?
The CNS recieves impulses and integrates them into responses. What are the motor and sensory functions of the CNS?
MOTOR: integration of voluntary movement
SENSORY: controls muscle tone, equilibrium, and posture
What are the three pathways of the motor system?
What function does the pyramidal pathway have?
Voluntary, purposeful movement
Skilled, complicated, delicate movements
What function does the extrapyramidal pathway have?
Involuntary movement (muscle tone)
Controls gross intentional movement (walking)
What function does the cerebellar pathway have?
Finer functions like coordination, posture, equillibrium) ex. threading a needle
Describe cerebellar ataxia gait:
-Unsteady on feet and shaky
-Bent over slightly
-Neurological disorders, MS, drug or ETOH use
Describe scissors gait:
-One side is weaker than the other side.
-Weak side is bent and drug along.
Describe foot drop gait:
-Raises foot high so that they don't drag their toes on the ground.
Describe waddling gait:
-Pregnancy and young infants with rounded bellies.
Describe parkinsonian gait:
-Trouble getting initiated walking.
-Leaned forward to get body moving.
-Shakiness with walking.
Describe spastic gait:
-Body itself is stiff and no bending of knees.
-Due to neurological problems or disuse.
Preform these assessments of cerebellar function:
-Hop in place
COORDINATION (increasingly rapid movements):
-Finger to nose
-Finger to thumb
-Finger to nose to examiners fingers
-Heel to shin
What is a positive Romberg's test?
Pt stands with feet together and hands at the sides. Eyes are closed for about 20 seconds. Normally patient may move around slightly but shouldn't lose footing. A positive Rhomberg's means that the patient looses footing.
When testing sensory function, test ____, _____, and _____ touch.
When testing sensory function, test SOFT, DULL, and SHARP TOUCH.
What sites are routinely evaluated with testing sensory function?
-Lower and upper arms
-Lower and upper legs
Sensory function is done with patients eyes open /closed.
Sensory function is done with patients eyes CLOSED.
Pain and temperature are apart of the posterior column/lateral spinothalmic/anterior spinothalmic tract?
Anterior spinothalamic tract
Crude touch is apart of the posterior column/lateral spinothalmic/anterior spinothalmic tract?
Lateral spinothalamic tract
Position, vibration, and fine tough are apart of the posterior column/lateral spinothalmic/anterior spinothalmic tract?
What do you do when doing stereognosis?
Have patient put both hands out with eyes closed. Place two different familiar objects in each hand. Have them feel the objects and guess what they are.
What do you do when doing graphesthesia?
Patient has eyes closed. Nurse will draw a number or letter in the patients palm.
What do you do when doing two point discrimination?
Have 2 points, bring points in closer and closer until patient tells you they feel one point instead of two. Patients eyes should be closed.
What do you do when doing testing with vibration?
With patients eyes closed, strike a tuning fork and put it on the joints of the fingers and toes.
What do you do when testing the position of the joints?
With patients eyes closed, move joints up and down and they should be able to tell you what direction and location.
What is the function of the brainstem?
Controls many involuntary functions. VITALS.
What are the structures of the brainstem?
How many pairs of spinal nerves do we have?
What is a sensory fiver that supplies and revieves information in a specific body distribution?
Motor fibers are assessed with _____'s
Motor fibers are assessed with DTR's
Function of olfactory (I) nerve:
Function of optic (II) nerve:
Function of oculomotor (III) nerve:
Opening of eyelids
Function of trochlear (IV) nerve:
Downward and inward movement of the eye
Function of trigeminal (V) nerve:
Sensation of face
Function of abducens (VI) nerve:
Lateral movement of the eye
Function of facial (VII) nerve:
Movement of facial muscles
Taste on anterior 2/3 of tongue
Function of acoustic (VIII) nerve:
Hearing and equillibrium
Function of glossalpharyngeal (IX) nerve:
Phonation and swallowing
Taste on posterior 1/3 of tongue
Function of vagus (X) nerve:
Phonation and swallowing
General sensation from the body
Function of spinal accessory (XI) nerve:
Allows you to shrug shoulders
Function of hypoglossal (XII) nerve:
Movement of tongue
What position should patients joints be in when testing reflexes?
Joints should be relaxed with tension on the tendon.
Assess these reflexes:
What reflex should occur when doing a DTR on the bicep?
Pulling back of the arm
Flexion of fingers
What reflex should occur when doing a DTR on the tricep?
Extension of the elbow
What reflex should occur when doing a DTR on the brachioradialis?
Flexion of fingers
What reflex should occur when doing a DTR on the patella?
Extension of the knee
What reflex should occur when doing a DTR on the achilles?
What is a normal and abnormal Babinski reflexes?
Normal: Flexion of toes
Abnormal: Dorsiflexion of the great toe with fanning of the toes.
How do you score reflexes?
4=brisk, hyperactive with intermittent clonus
What is intermittent clonus?
Spasming when testing reflexes
What are isometrics and why are they performed?
Used when reflexes are symmetrically diminished or absent. May enhance the reflex response. Isometric contraction of another muscle, not the muscle being tested. Ex: when you are testing the bicep reflex, pinch butt muscles.
When testing upper, have to test lower isometrics
When testing lower, have to test upper isometrics
As individuals get older, they have a faster/slower response?
As individuals get older, they have increased/decreased proprioception.
As individuals get older, they have increased/decreased sensation in lower extremities?
As individuals get older, they have a increased/decreased response to smell?
As individuals get older, they have an increased/decreased response to pain?
T/F: There is decreased perfusion to the brain due to decrease cerebral perfusion.
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