Chapter 65 Assessment of Neurologic Function

Neurotransmitters
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Terms in this set (21)
Neurotransmitters
Communicate messages from one neuron to another or to a specific target tissue
Neurotransmitters can potentiate, terminate, or modulate a specific action or can excite or inhibit a target cell
Many neurologic disorders are caused by an imbalance in neurotransmitters
Autonomic Nervous System
Functions to regulates activities of internal organs and to maintain and restore internal homeostasis
Sympathetic nervous system
"Fight or flight" responses
Main neurotransmitter is norepinephrine
Parasympathetic nervous system
Controls mostly visceral functions
Regulated by centers in the spinal cord, brainstem, and hypothalamus
Neurologic Assessment: Health History
Pain
Seizures
Dizziness (abnormal sensation of imbalance or movement) and vertigo (illusion of movement, usually rotation)
Visual disturbances
Weakness
Abnormal sensations
Past health, family, social history
Neurologic Assessment
Consciousness and cognition: mental status, intellectual function, thought content, emotional status, language ability, impact on lifestyle
Cranial nerves
Motor system: muscle size, muscle tone and strength, coordination and balance, Romberg test
Sensory system: tactile sensation, superficial pain, temperature, vibration and position sense (proprioception)
Reflexes: DTRs, biceps, triceps, brachioradialis, patellar Achilles, superficial, pathologic, plantar (Babinski)
Gerontologic Considerations
Important to distinguish normal aging changes from abnormal changes
Structural and physiologic changes
Motor and sensory alterations
Temperature regulation and pain perception
Determine previous mental status for comparison. Assess mental status carefully to distinguish delirium from dementia
Diagnostic Tests
Computed tomography (CT)
Positron emission tomography (PET)
Single photon emission computed tomography (SPECT)
Magnetic resonance imaging (MRI)
Cerebral angiography
Myelography
Noninvasive carotid flow studies
Transcranial Doppler
Electroencephalography (EEG)
Electromyography (EMG)
Nerve conduction studies, evoked potential studies
Lumbar puncture, Queckenstedt test, and analysis of cerebrospinal fluid
Agnosia
loss of ability to recognize objects through a particular sensory system; may be visual, auditory, or tactile
Ataxia
inability to coordinate muscle movements, resulting in difficulty in walking, talking, and performing self-care activities
autonomic nervous system
division of the nervous system that regulates the involuntary body functions
axon
portion of the neuron that conducts impulses away from the cell body
Babinski reflex (sign):a reflex action of the toes; in adults is indicative of abnormalities in the motor control pathways leading from the cerebral cortexclonus:abnormal movement marked by alternating contraction and relaxation of a muscle occurring in rapid successiondelirium:an acute, confused state that begins with disorientation and if not recognized and treated early can progress to changes in level of consciousness, irreversible brain damage, and sometimes deathflaccidity:displaying lack of muscle tone; limp, floppy parasympathetic nervous system: division of the autonomic nervous system active primarily during nonstressful conditions, controlling mostly visceral functionsdendrite:portion of the neuron that conducts impulses toward the cell bodyposition (postural) sense:awareness of position of parts of the body without looking at them; also referred to as proprioceptionrigidity:increase in muscle tone at rest characterized by increased resistance to passive stretchRomberg test:test for cerebellar dysfunction that can be done with the patient seated or standing; inability to maintain position for 20 seconds is a positive testspasticity:sustained increase in tension of a muscle when it is passively lengthened or stretchedsympathetic nervous system:division of the autonomic nervous system with predominantly excitatory responses; the "fight-or-flight" systemvertigo:illusion of movement in which the individual or the surroundings are sensed as moving