1010- Test 2 Neuro Assessment, A&p, Loc, Iicp

Front 1

The CNS is composed of the

Back 1

spine and brain

Front 2

The PNS is composed of the

Back 2

spinal nerves and cranial nerves.

Front 3

The autonomic nervous system is composed of the

Back 3

sympathetic and parasympathetic nerves.

Front 4

The ____ is the larger portion or center of the neuron. The ___ brings messages to the cell body and the ____ carries the messages away from the cell body to the synapse.

Back 4

cell body
dendrites
axon

Front 5

The ____ are the shorter part of the neuron.

Back 5

dendrites

Front 6

3 parts of a neuron are the

Back 6

cell body
dendrite
axon

Front 7

The ____ is the cell body and the dendrites.

Back 7

grey matter

Front 8

The ____ is the myelinated tissues.

Back 8

white matter

Front 9

____ is a sheath on some of the nerves that helps the nerve to conduct messages faster.

Back 9

Myelin

Front 10

____ is the primary intracellular electrolyte.

Back 10

Potassium

Front 11

____ is the primary extracellular electrolyte.

Back 11

Sodium

Front 12

____ fuels the Sodium-Potassium pump.

Back 12

Oxygen

Front 13

High potassium affects _____.

Back 13

muscles

Front 14

_____ are chemical messengers that transmit information or messages throughout the nervous system.

Back 14

Neurotransmitters

Front 15

____ is an excitatory neurotransmitter. It's kind of like stepping on the accelerator.

Back 15

Acetylcholine

Front 16

____ is an excitatory or inhibitory neurotransmitter.

Back 16

Norepinephrine

Front 17

Nerves that transmit impulses through the release of acetylcholine (ACh) are called _____.

Back 17

cholinergic.

Front 18

A person with a frontal lobe tumor may have loss of ____ or ____.

Back 18

memory or personality changes.

Front 19

Two major neurotransmitters are

Back 19

acetylcholine and norepinephrine.

Front 20

Nerves that transmit impulses through the release of norepinephrine (NE) are called _____.

Back 20

adrenergic

Front 21

The ____ is an important structure of the brain that integrates motor and sensory information with appropriate responses.

Back 21

cerebrum

Front 22

The cerebrum is the ____ of the brain at the _____.

Back 22

large portion
front and side

Front 23

The cerebrum is divided into 4 lobes:

Back 23

-frontal
-temporal
-parietal
-occipital

Front 24

The ____ lobe of the brain is responsible for memory and me. It is a large part of who we are.

Back 24

frontal

Front 25

The ____ lobe of the brain is associated with vision.

Back 25

occipital

Front 26

The ____ lobe of the brain is associated with hearing and smelling.

Back 26

temporal

Front 27

The _____ lobe of the brain is associated with pain, coldness, and light touch.

Back 27

parietal

Front 28

The ____ is at the back of the brain and is responsible for coordination of voluntary responses.

Back 28

cerebellum

Front 29

The ____ contains the pons, medulla, and midbrain. It has cell bodies of cranial nerves, reticular formation, and projection tracts.

Back 29

brain stem

Front 30

The ____ is part of the brain stem that has to do with the sleep wake cycle.

Back 30

reticular formation

Front 31

The ____ are paths along which messages flow.

Back 31

projection tracts

Front 32

If a patient has a high brain stem injury we often see _____.

Back 32

sudden death

Front 33

The ____ is responsible for sorting and processing. It also is first perception of pain.

Back 33

thalamus

Front 34

Brain Stem CPR is something you can't live without.

Back 34

Cranial nerves
Projection tracts
Reticular system

Front 35

The ____ is responsible for automatic movement.

Back 35

basal ganglia

Front 36

The ____ is the body's neuroendocrine control center. It controls temperature and water metabolism.

Back 36

hypothalamus

Front 37

The ___ are the supporting cells of the nervous system. They are the glue that holds the brain together.

Back 37

glia

Front 38

The glia are ____-like.

Back 38

web

Front 39

____ transmit information via myelin sheath and synapses.

Back 39

Neuron

Front 40

The 4 major types of arteries that supply the brain with blood are the

Back 40

-vertebral arteries
-basilar arteries
-carotid arteries
-cerebral arteries (external-->internal-->middle)

Front 41

The vertebral arteries merge into one _____.

Back 41

basilar artery

Front 42

The carotid arteries come up the front and split into the

Back 42

external cerebral, internal cerebral and middle cerebral arteries.

Front 43

The ____ serves the brain stem and posterior portion of the brain.

Back 43

vertebral arteries

Front 44

The ____ is the small area at the top of the brain where all the arteries of the brain come together. It is a back-up system of blood supply.

Back 44

Circle of Willis

Front 45

Blood clots in the arteries of the brain come from either the ___ heart, ____, ____ system, or the ____ brain branches.

Back 45

Blood clots in the arteries of the brain come from either the Left heart, aorta, vertebral/basilar system, or the middle cerebral brain branches.

Front 46

A _____ stroke is very deadly because they carry so much blood.

Back 46

vertebral artery or basilar artery

Front 47

Blood clots in the legs cause _____.

Back 47

pulmonary embolisms

Front 48

___ heart blood flow goes to the subclavian and up.

Back 48

Left

Front 49

____ heart blood flow goes to the lungs and back down.

Back 49

Right

Front 50

Sympathetic nerve endings secrete _____.

Back 50

norepinephrine

Front 51

The ____ mobilizes energy for the fight/flight response.

Back 51

sympathetic nervous system

Front 52

Parasympathetic nerve endings secrete ____.

Back 52

acetylcholine (ACh)

Front 53

The ____ conserves energy for normal functioning.

Back 53

parasympathetic

Front 54

Adrenergic nerves have the same actions as ____ medications.

Back 54

anticholinergic

Front 55

Cholinergic nerves have the same actions as _____ medications.

Back 55

cholinergic

Front 56

Action of anticholinergic meds
____ pupils
____ intraocular pressure
____ bronchi
____ pulse
____ BP
____ sphincters (GI/Urinary)
____ GI motility
____ cardiac arterioles
____ blood glucose
____ nasal secretions

Back 56

Action of anticholinergic meds
dilate pupils
elevate intraocular pressure
dilate bronchi
increase pulse
increase BP
contract sphincters (GI/Urinary)
decrease GI motility
dilate cardiac arterioles
elevate blood glucose
decrease nasal secretions

Front 57

If a patient cannot pee they may be given ____ medications.

Back 57

cholinergic

Front 58

If a patient has COPD they should not take _____ medications.

Back 58

cholinergic

Front 59

If a patient has glaucoma they should take ______ medications.

Back 59

cholinergic

Front 60

____ medications are good for motion sickness.

Back 60

Anticholinergic

Front 61

Sometimes there will be diseases that cause ____ spinal fluid pressure.

Back 61

elevated

Front 62

CSF is made from filtered blood in the ____ of the brain and circulates through the _____.

Back 62

ventricles
meninges

Front 63

The 3 layers of the meninges of the brain are

Back 63

-pia
-arachnoid
-dura

Front 64

The ____ is the layer of meninges that is a delicate film that adheres to the brain.

Back 64

pia

Front 65

The ___ is the layer of the meninges that is a weblike combination of cells.

Back 65

arachnoid

Front 66

The ____ is the layer of the meninges that is a tough, durable, fabric-like substance that adheres to the skull.

Back 66

dura

Front 67

The ventricles are where ____ is made.

Back 67

CSF

Front 68

The composition of CSF includes:

Back 68

-WBCs
-glucose
-protein
-immunoglobulins (sometimes)

Front 69

CSF should not have ____. This only occurs with injuries or a traumatic spinal fluid tap.

Back 69

RBCs

Front 70

The thick rubbery cord that runs down our back is called the ____.

Back 70

spinal cord

Front 71

The spinal cord is surrounded and protected by ____ vertebrae.

Back 71

33

Front 72

Between each vertebrae there is an _____.

Back 72

interverterbal disc

Front 73

The spinal cord extends from the ____ to the ____.

Back 73

medulla to the first lumbar vertebrae.

Front 74

The purpose of the spinal cord is to...

Back 74

conduct messages to and from the brain as a reflex center.

Front 75

In the PNS there are ___ pair of spinal nerves. Each of the spinal nerves contains sensory and motor fibers.

Back 75

31

Front 76

In the PNS there are ____ pair of cranial nerves. They are sensory and motor.

Back 76

12

Front 77

____ are automatic, rapid and involuntary motor response.

Back 77

Reflexes

Front 78

Reflexes are dependent on 5 things:

Back 78

-receptor
-sensory neuron
-integration center
-motor neuron
-effector

Front 79

The ____ picks up the message.

Back 79

receptor

Front 80

The ____ recognizes what is going on and starts carrying the message forward.

Back 80

sensory neuron

Front 81

The ____ tells the body that something needs to be fixed.

Back 81

integration center

Front 82

The ____ carries efferent impulses.

Back 82

motor neuron

Front 83

The ____ is the area that responds.

Back 83

effector

Front 84

The ____ regulates the internal environment of the body.

Back 84

autonomic nervous system

Front 85

Acidosis and increased CO2 affect the nervous system by causing ___ and ___.

Back 85

vasodilation and lethargy

Front 86

Alkalosis and decreased CO2 effect the nervous system by causing ___ and ____.

Back 86

vasoconstriction and agitation

Front 87

____ and ____ cause brain cell damage.

Back 87

Hypoglycemia and hypoxia

Front 88

The Cram And Die List reminds us how CO2 can be fatal.

Back 88

Carbon dioxide increases
Acidosis
Dilation (vasodilation)
Lethargy

Vasodilation increases ICP and the person can die.

Front 89

Any cell deprived of oxygen will ____.

Back 89

swell

Front 90

Cells deprived of oxygen swell because...

Back 90

the NaK pump shuts down and Na accumulates in the cell therefore attracting water into the cell.

Front 91

Low ____ and Low ____ stumps the brain.

Back 91

oxygen
glucose

Front 92

A basic neuro check begins with the _____, checking ____, assessing _____, and _____.

Back 92

Glasgow Coma Scale
pupil response
strength/movement
touch/pain

Front 93

A Glasgow Coma score of ___ is a great score.

Back 93

15

Front 94

A Glasgow Coma score of ____ signals severe brain injury. We start talking about organ donation.

Back 94

9

Front 95

When assessing mental status look at the patients ___ and ____.

Back 95

appearance and behaviors.

Front 96

When assessing cognitive function assess the patients ____, _____, and _____.

Back 96

orientation, recent memory, remote memory

Front 97

How did you get to the hospital? assesses a patient's ______.

Back 97

recent memory

Front 98

What president was shot? assesses a patient's ____.

Back 98

remote memory

Front 99

Assessing orientation looks at

Back 99

time, place, person, situation

Front 100

Cranial Nerve I-

Back 100

Olfactory- smell

Front 101

Cranial Nerve II-

Back 101

Optic- visual fields and acuity

Front 102

Cranial Nerve III-

Back 102

oculomotor- EOM's, pupils, upper eye lid raising

Front 103

Cranial Nerve IV-

Back 103

Trochlear- EOM's down and in

Front 104

Cranial Nerve V-

Back 104

Trigeminal- Facial/Corneal sensation, temporal masseter muscles (jaw strength and chewing muscles)

Front 105

Cranial Nerve VI-

Back 105

Abducens- EOM's lateral

Front 106

Cranial Nerve VII-

Back 106

Facial- movement of facial muscles, close eye lids, taste on anterior 2/3 of tongue

Front 107

Cranial Nerve VIII-

Back 107

Acoustic- hearing and balance

Front 108

Cranial Nerve IX-

Back 108

Glossopharyngeal- movement or pharynx and gag reflex, taste on posterior 1/3 of tongue

Front 109

Cranial Nerve X-

Back 109

Vagus- swallowing, gag, vocal cord movement, voice

Front 110

Cranial Nerve XI-

Back 110

Spinal Accessory- shoulder shrug and turn head against resistance

Front 111

Cranial Nerve XII-

Back 111

Hypoglossal- tongue movement for speech and swallowing

Front 112

Cranial nerves ___ and ___ control swallowing.

Back 112

X and XII

Front 113

Cranial nerves ____, ____ and ____ control eye movements.

Back 113

III, IV, and VI

Front 114

Cranial nerves ___ and ____ control the gag reflex.

Back 114

IX and X

Front 115

During visual field testing assess for 2 things

Back 115

loss of peripheral vision
homonomyous hemianopia

Front 116

____ is when a person loses vision is half of their eye.

Back 116

Hemianopia

Front 117

If a person loses vision in the same side of both eyes it is called _____.

Back 117

homonymous hemianopia

Front 118

3 assessments of motor function are:

Back 118

-rapid alternating movement
-precise motor movement
-gait

Front 119

Motor function balance is assessed with the

Back 119

Romberg test.

Front 120

Abnormal reflexes that indicate motor function problems are

Back 120

babinski and abnormal posturing

Front 121

2 types of abnormal posturing are

Back 121

decorticate and decerebrate.

Front 122

____ is when the patient is unable to put their thoughts into language. They can't respond written or verbal.

Back 122

Expressive aphasia

Front 123

____ is when the patient is unable to understand language either verbal or written.

Back 123

Receptive aphasia

Front 124

______ is when a patient is unable to form clear words d/t weakness of the tongue, lips, palate, or respiratory muscles. They can understand instructions.

Back 124

Dysarthria

Front 125

Dysarthria puts a patient at risk for ____ and _____.

Back 125

dysphagia and aspiration

Front 126

A _____ looks at the patients blood supply to the brain via x-ray view.

Back 126

cerebral angiography

Front 127

A ____ is a LP with dye in the needle to look at vertebral disks.

Back 127

myelogram

Front 128

A cerebral angiography is done thru the _____.

Back 128

groin

Front 129

____ is the awareness of self and environment and the ability to respond.

Back 129

Consciousness

Front 130

Consciousness follows a predictable _____ to ____ progression.

Back 130

rostral to caudal

Front 131

Consciousness is dependent upon ___ and ____.

Back 131

arousal and cognition

Front 132

Manifestations of consciousness are

Back 132

-arousal (easy/hard)
-cognition (who, what, when, where)
-patterns of breathing changes
-pupillary and oculomotor response changes
-motor function changes

Front 133

_____ is the LOC associated with slowed thinking, poor memory, law attention level, and bewilderment.

Back 133

Confusion/agitation

Front 134

____ is the LOC in which the person is not aware of time or place.

Back 134

Disorientation

Front 135

____ is the LOC in which the person is lethargic and somnolent/sleepy. They are responsive to verbal and tactile stimuli but quickly go back to sleep.

Back 135

Obtundation

Front 136

____ is the LOC in which the person is unresponsive. They may be aroused briefly by vigorous or painful stimuli. They shrink away from the pain or grab at the source but don't actually wake up.

Back 136

Stupor

Front 137

____ is the LOC in which the person does not move spontaneously. They don't respond to stimuli, don't wake up but may moan or groan.

Back 137

Semicomatose

Front 138

____ is the LOC in which the person is unarousable. There is no stirring or moaning. They may have nonpurposeful movements of area stimulated but makes no attempt to withdraw.

Back 138

Coma

Front 139

____ is the LOC in which there is an absence of brain stem reflexes. The person is completely unarousable, unresponsive to pain, impairment of swallowing and no corneal reflexes.

Back 139

deep coma

Front 140

If a person has an altered mental status think
AEIOU and TIPS

Back 140

A- alcohol
E- epilepsy
I- insulin
O- overdose
U- uremia

T- trauma
I- infection
P- psychiatric
S- stroke

Front 141

Uremia is _____.

Back 141

kidney failure

Front 142

If a patient has an altered mental status think

Back 142

decreased glucose
decreased oxygen
medication

Front 143

A ____ is a state of wakefulness with complete lack of cognition and awareness of self or environment.

Back 143

persistent vegetative state

Front 144

____ is the inability to communicate but without loss of awareness or cognition.

Back 144

Locked In Syndrome

Front 145

____ is permanent loss of brain function.

Back 145

Brain death

Front 146

Criteria for death by neurological criteria (Brain death) are:

Back 146

-Apnea
-absent reflexes
-no spontaneous movement
-Flat EEG
-no change over time

Front 147

____ is an increase in blood, brain tissue or CSF. It is a life threatening injury.

Back 147

Increased Intracranial Pressure

Front 148

IICP can come from an increase in blood caused by

Back 148

ruptured aneurysm or hematoma after injury.

Front 149

IICP can come from an increase in tissue caused by

Back 149

brain tumor, premature closure of the fontanels or tissue swelling.

Front 150

IICP can be caused by an increase in CSF related to ____.

Back 150

hydrocephalus

Front 151

Increased blood, tissue, or CSF creates ____ which creates ____ and leads to increased ____.

Back 151

hypoxia
edema
swelling

Front 152

S/Sx of IICP include:

Back 152

decline in LOC
pupil dilation and fixation
widened pulse pressure
Full, bounding pulse
Cheyne- Stokes respirations
Hyperthermia

Front 153

Therapeutic interventions for IICP are

Back 153

-oxygenation
-treatment of cerebral edema
-positioning
-valsalvas prevention
-hypothermia blanket

Front 154

Medications that are used to treat cerebral edema include:

Back 154

mannitol, decadron, and lasiks

Front 155

When using a hypothermia blanket the nurse should

Back 155

assess and protect skin
use a temp probe
prevent shivering

Front 156

____ is a medication that can prevent shivering.

Back 156

Thorazine

Front 157

When positioning a patient with IICP the following should be adhered to

Back 157

HOB elevated
neck straight
no hyperflexion of hips
Tq2h

Front 158

If IICP is not controlled ____ will occur. When this happens the brain shifts out of the foramen magnum or shifts to one side.

Back 158

herniation

Front 159

The earliest sign that there is a problem with the ICP is

Back 159

a change in the level of consciousness