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NEURO ASSESSMENT QUIZ
Terms in this set (69)
largest portion of the brain
Includes all the parts within the skull except the medulla, pons, and cerebellum.
It controls and integrates motor, sensory, and higher mental functions, such as thought, reason, emotion, and memory
is the cerebrum's outer layer of nerve cell bodies. Looks like "gray matter" because lacks myelin. Center for highest functioning Each ½ is a hemisphere
personality, behavior, voluntary skeletal muscles, speech, intellectual function - Broca's area
Hearing, taste & smell; Wernicke's area
Reflexes: basic defense mechanisms of nervous system
below level of conscious control permitting quick reaction to potentially painful or damaging situations
Deep tendon reflexes (myotatic), e.g., knee jerk
Superficial, e.g., corneal reflex, abdominal reflex
Visceral (organic) e.g., pupillary response to light
Pathologic (abnormal), e.g., Babinski's reflex or extensor plantar reflex
4 types of reflexes
orneal reflex, abdominal reflex
pupillary response to light
Babinski's reflex or extensor plantar reflex
mediate voluntary movement, particularly very skilled, discrete, purposeful movements, such as writing.
also known as the pyramidal tract) is a newer, "higher" motor system that humans have that permits very skilled and purposeful movements
Sensory - Smell
Sensory - Vision
Visual acuity & (8) peripheral visual fields
Motor - Eye Movement
Pupillary constriction, Eye opening, Extraocular movements
Motor - Eye Movement
Downward & Inward Eye Movements
Motor - Eye Movement
Lateral eye movement
Temporal & masseter muscle movement
Lateral jaw movement
Taste (anterior tongue)
Sensory - Hearing & Balance
Motor/Sensory - Movement of pharynx - Sensation in pharynx (gag), taste (posterior tongue)
Motor/Sensory - Movement of palate, pharynx, larynx
- Sensation of pharynx (gag) and larynx
Motor - Strength and movement of sternocleidomastoid and trapezius muscles
Spinal Accessory 11
Motor - Tongue Movement
is a circumscribed skin area that is supplied mainly from one spinal cord segment through a particular spinal nerve.
which is a form of biologic insurance. That is, if one nerve is severed, most of the sensations can be transmitted by the spinal nerve above and spinal nerve below
Atrophy with steady loss of neuron structure in brain and spinal cord - Causes loss of wt & volume with thinning of cerebral cortex, reduced subcortical brain structures, and expansion of the ventricles
Some aging adults show a slower response to requests, especially for those calling for coordination of movements. - Aging is accompanied by a progressive decrease in cerebral blood flow. In some people this causes dizziness and a loss of balance with position change. Teaching needed to get up slowly.
May have "senile tremors" - Senile tremors are relieved by alcohol, although this is not a recommended treatment. The nurse should assess whether the person is abusing alcohol in an effort to relieve the tremor.
subjective sensation that precedes a seizure; it could be auditory, visual, or motor.
Difficulty forming words
Difficulty with language comprehension or expression
Elevated lead levels may cause a developmental delay or a loss of a newly acquired skill or be asymptomatic
Exposure to lead & children
eyes drift slowly in one direction and then jerk back to the other direction.
disease of the vestibular system, cerebellum, or brainstem.
Severe nystagmus occurs
Increased intracranial pressure; optic atrophy
Muscle weakness or paralysis occurs with a stroke or following injury to the peripheral nerve - Abnormally small muscle with a wasted appearance occurs with disuse, injury, lower motor neuron disease such as polio, diabetic neuropathy. When muscles look asymmetric, measure each in centimeters and record the difference. A difference of <1cm is not significant
Decreased with resistance, hypotonia occur with peripheral weakness - Spasticity & Rigidity - Types of increased resistance that occur with central weakness
Tic tremor, fasciculation, myoclonus, chorea & athetosis
Walking heel to toe - Decreases the base of support and will accentuate any problem with coordination
Tandem walking & its significance
Clumsy movement with overshooting the mark and occurs with cerebellar disorders or acute alcohol intoxication
When reaching to a visually directed object
Loss of vibration sense occurs with peripheral neuropathy e.g. diabetes and alcoholism this is the 1st sensation lost. If no vibrations are felt, move proximally and test ulnar process and ankles, patellae & iliac crest. Compare right and left
What do you do when testing vibration with tuning fork & no vibration is felt?
at the feet and gradually improves as you move up the leg.
Peripheral neuropathy is worse
A set of rapid rhythmic contractions of the same muscle
The exaggerated reflex seen when the monosynaptic reflec arc is released from the usually inhibiting influence of higher cortical levels. This occurs with upper motor neuron lesions - eg. Brain attack
The absence of a reflex is a lower motor neuron problem occurs with interruption of sensory afferents or destruction of motor efferents and anterior horn cells Ex: spinal cord injury
High pitched shrill cry or cat sounding screech occurs
occurs with CNS damage
Weak groaning cry or expiratory grunt occurs
occurs with meningeal irritation - head arched back, stiffness of neck and extension of arms and legs
Upward movement of great toe and fanning of the little toes - Normal in kids <2yrs; Abnormal for adults occurs with pyramidal tract disease
Staggring falling, Weakness climbing up or down stairs occurs with muscular dystrophy
Types of gaits & balance in children
Broad based gait beyond toddlerhood
gross motor skill
Failure to hop after 5 indicates incoordination
Any abnormal posturing decorticating, rigidity or decorticate rigidity indicates diffuse
In brain injured person a sudden unilateral dilated and no reactive pupil
runs parallel to the brain stem. When increasing intracranial pressure pushes the brainstem down (uncal herniation) it puts pressure on cranial nerve III causing pupil dilation
Cranial nerve III
Best eye opening
Best Verbal response
Best Motor Response
Glasgow Coma Scale- describes level of consciousness- numerical value Measures:
Eyes,verbal, and motor response
Glasgow Coma Scale: Divided into 3 areas
15 7 or less is a coma
Fully alert person is
sudden, rapid, jerky, purposeless movement involving limbs, trunk or face Occurs at irregular intervals, not rhythmic or repetitive, more convulsions than a tic. Some are spontaneous and some are initiated. All are accentuated by voluntary acts. Disappears with sleep Common with Sydenham's chorea and Huntingtons disease
slow, twisting, writing, continuous movement, resembling a snake or worm. Involves the distal part of the limb more than the proximal part. Occurs with cerebral palsy. Disappears with sleep. Athetoid hand some fingers are flexed and some extended.
upper extremities - flexion of arm, wrist, and fingers; addiction of arm (tight against thorax). Lower extremities -extension, internal rotation, plantar flexion. This indicates hemispheric lesion of cerebral cortex
upper extremities stiffly extended, adducted, internal rotation, palms prontated. Lower extremities stiffly extended plantar flexion: teeth clenched, hyperextended back. More ominous than decorticate ridgity. Indicates lesions in brain stem at midbrain or upper pons
Complete loss of muscle tone and paralysis of all 4 extremities indicating completely nonfunctional brainstem
Prolonged arching of the back, with head and heels bent backward. This indicates meningeal irritation
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