Neurology Assessment / quick knowledge

Describe the tonic phase of a tonic-clonic seizure.
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Describe the tonic phase of a tonic-clonic seizure.
The tonic phase is characterized by increased muscle tone and can be identified by recognizing systemic, prolonged contraction of muscles - the "stiffening" of the patient.
Image: Describe the tonic phase of a tonic-clonic seizure.
What is paresthesia?
Numbness and/or tingling
Define the term "coma."
A state of unconsciousness from which a patient cannot be awakened or aroused.
When treating an asthma patient, what assessment findings would suggest that sympathetic beta-2 receptor sites have been engaged?
The innervation of sympathetic beta-2 receptors causes bronchodilation. Therefore, you should note increased tidal volume and better air flow.
Describe the assessment findings commonly associated with a simple partial seizure.
A simple partial seizure is characterized by uncontrolled movement in a single area of the body.
What is expressive aphasia?
A difficulty speaking characterized by a loss of the ability to produce language. In this case, the patient would know what they want to say but have difficulty with the cognitive production of the words.
Image: What is expressive aphasia?
Describe how you would assess arm drift using the Cincinnati Prehospital Stroke Scale:
Ask the patient to hold their arms out in front of their body with their palms up. Have the patient close their eyes and hold this position for 10 seconds. Arms moving asymmetrically from this position or pronation of palms are considered positive findings.
What is the principal task of afferent nervous pathways?
To bring sensory messages to the brain
What is the chief purpose of the reticular activating system?
To regulate consciousness
What is decerebrate posturing?
Decerebrate posturing is the involuntary straightening (extension) of arms and neck away from the core of the body. It is typically associated with severe neurologic injury.
Image: What is decerebrate posturing?
What is the principal function of the medulla oblongata?Autonomic function such as control of breathing and cardiovascular activityDescribe the clonic phase of a tonic-clonic seizure.The clonic phase is characterized by regular contraction and relaxation of paired muscle groups. This commonly produces a jerking motion in the extremities.Describe Cheyene-Stokes Respirations:A pattern of breathing characterized by increasingly deeper and faster respirations, followed by short periods of apneaHow does multiple sclerosis impair neurologic function?Multiple sclerosis impairs neurologic function by inflammation of nerve cells and the destruction of myelin sheathing.What is hemiparesis?Unilateral (one sided) weakness.When considering the Glascow Coma Scale, what best verbal response score should be given if a patient gave a confused verbal response to your question?A confused verbal response would be awarded a "4" in the best verbal response section.Describe ataxic respirations.Complete irregularity of respiration frequently associated with irregular pauses and periods of apneaWhat disease process will commonly cause cogwheel rigidity in the assessment of the motor response in the extremities?Neuromuscular diseases, especially Parkinson's disease.What is hemiplegia?Unilateral (one sided) paralysisDescribe an absence seizure.An absence seizure is characterized by a brief loss of awareness/consciousness and occasional loss of muscle control.In what geographic region of the brain is the vision center located?The occipital cortexWhat is Korsakoff's syndrome?Korsakoff's syndrome is a neurological disorder characterized by severe dementia and disorientation typically caused by chronic alcohol intake and prolonged thiamine deficiency.What is the hallmark assessment finding for a patient that has meningitis?Nuchal rigidity/neck painAmyotrophic Lateral Sclerosis is also known as:ALS or Lou Gehrig's diseaseWhat is the Circle of Willis?The joining area of several arteries at the base of the brain. It is the principal source of blood supply to the brain.What is a dermatome?A topographical area of the body surface that is innervated by one spinal nerve root.What cranial nerve would likely be compressed if unequal pupils are noted on the assessment of a head injury patient?The oculomotor nerve (III)When using the Glascow Coma Scale to assess a patient's best motor response, how would only withdrawing from pain be scored?In the best motor response section only being able to withdraw from pain would be awarded a "4."Describe Kussmaul breathing.An abnormal breathing pattern that is characterized by regular, rapid and typically very deep breathing.What is dysarthria?Defective speech caused by a motor defectDescribe the assessment findings commonly associated with complex partial seizures.Complex partial seizures commonly involve a loss of awareness to the patient's surroundings and often involve rhythmic purposeful movements.Describe the postictal phase of a tonic-clonic seizure.The postictal phase follows the clonic phase and is characterized commonly by a period of unconsciousness followed by a gradual improvement in mental status.What is Cushing's Triad?Increasing blood pressure, decreasing pulse rate and patterns of abnormal respirations associated with rising intracranial pressure.Describe apneustic respiration.An abnormal pattern of breathing characterized by an exaggerated inspiratory phase and ineffective expiratory attempts.What are the two main divisions of the nervous system?The central nervous system and the peripheral nervous systemWhat is the principal function of the cerebrum?Intellectual functions such as conscious thought and memoryWhat are the two divisions of the autonomic nervous system?The sympathetic and the parasympathetic nervous systemsWhat is receptive aphasia?A difficulty in communication characterized by the inability to comprehend language or speak with appropriately meaningful wordsWhen considering the Glascow Coma Scale, what is the best possible score when assessing eye opening?The best possible score associated with spontaneous eye opening would be a "4."Define status epilepticusTwo or more generalized seizures uninterrupted by a period of lucidity. Some references also use this term to describe a prolonged seizure that lasts more than 10 minutes.What is a myotome?A set of muscle and connective tissues innervated by a single spinal nerve root.With regard to seizures, what is an aura?An aura is a sensation that a seizure is about to begin. This sensation can involve any of the senses.What is the principal task of efferent nervous pathways?To control motor functionWhat is dysarthria?The inabilty of the muscles of the mouth to form words. A physical inability or difficulty speaking.With regard to a stroke patient, what does the phrase "last known normal" or "time zero" commonly refer to?"Last known normal" or "time zero" commonly refers to the last time the patient was sign/symptom free. (onset)In what geographic region of the brain is the speech center located?The temporal lobeWhat past medical history is most commonly associated with an embolic stroke?Carotid artery disease.Describe the common presentation of a patient with a vascular headache.Severe typically unilateral pain, sensitivity to light, nausea and vomitingWhat is Wernicke's encephalopathy?A condition associated with altered mental status and memory loss usually as a result of chronic alcohol intake and a deficiency in thiamine.What is decorticate posturing?Flexion of the arm and legs pulled toward the core of the body. Remember the core.What cranial nerves are tested by asking your patient to follow your finger with his eyes?Oculomotor (III)Trochlear (IV)Abducens (VI)What effect would the engagement of muscarinic (parasympathetic) receptor sites have on the heart?Decreased heart rateDescribe how you would assess facial droop using the Cincinnati Prehospital Stroke Scale:Ask the patient to grin or show you their teeth then assess facial symmetry.If a patient were classified a "P" on the AVPU scale, what would that indicate?A "P" would indicate that the patient is only responsive to painful stimuli.What are the three elements of the Cincinnati Prehospital Stroke Scale?Facial droopArm driftAbnormal speechWhat is mydriasis?A dilated pupilDescribe two assessment findings that would indicate stimulation of the sympathetic nervous system.Increased heart rate Pale skin/delayed capillary refill time due to vasoconstriction Could also include: Dilation of pupilsDescribe the common presentation of a patient with a cluster headache.Unilateral pain commonly associated with the facial/sinus area. Rhinorrhea and/or tearing are also common.What is dysphasia?Difficulty speakingWhat is diplopia?Double visionWhat past medical history is most commonly associated with a hemorrhagic stroke?HypertensionWhat is miosis?A constriction of the pupilDescribe central neurogenic hyperventilation.An abnormal pattern of respiration characterized by deep, rapid and regular ventilations.How is a transient iscemic attack (TIA) different from a stroke?A TIA is self-limiting, meaning it is temporary and subsides on its own. By definition, a TIA lasts less than 24 hours.