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128 Cards in this Set
- Front
- Back
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The BRAIN and SPINAL CORD make up what neurological system
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CENTRAL NERVOUS SYSTEM CNS
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The Somatic and Automatic divisions make up what neurological system
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PERIPHERAL NERVOUS SYSTEM PNS
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The 3rd largest cause of DEATH is due to
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Stroke (CVA)
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what is the first leading cause of death
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Coronoray Artery Disease CAD
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Cerebrospinal fluid CSF is formed where
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in the ventricles
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where is the BRAIN located?
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in the Cranial Cavity
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what is divided into Right and Left hemisphere, consisting of FOUR LOBES
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Cerebrum
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Name the FOUR lobes
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Frontal
Parietal Temporal Occipital |
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= LOBE =
Reasoning Personality SPEECH Respiratory Voluntary EYE movement MEMORY GI BLOOD PRESSURE Executive Control |
FRONTAL LOBE
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= LOBE =
TOUCH POSITIONING Sensory Input (Size, Shapte, Weight) SENSATION |
PARIETAL LOBE
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= LOBE =
HEARING INTERPRETATION DETAILED MEMORY STORAGE |
TEMPORAL LOBE
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=LOBE=
VISION |
OCCIPITAL LOBE
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What consists of the
MIDBRAIN PONS MEDULLA OBLONGATA? |
Brainsteam
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What is the relay center of the brain
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Midbrain
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What does the Medulla Oblongata control?
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Respiratory FUnction
Heart Rate and Force Blood Pressure IT IS LIFE THREATENING |
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What links the brain structures?
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Pons
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what is located behind the brainstem under cerebrum, divided into Right and LEft hemisphere, functions
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Cerebellum
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The nurse is working with trauma victim from a motor vehicle accident, the pt is having difficulty identifying the position of body parts that cannot be seen - what area of the brain is recieved trauma?
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parietal lobe (body positoning)
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where is the spinal cord located?
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the vertebral canal
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what functions for coordination and smoothing of voluntary movements and equilibrium and maintains muscle tone?
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Cerebellum
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where exactly is the spinal cord located?
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extends from MEDULLA OBLOGONTA to L1 (first lumbar vertebra)
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The spinal cord is NOT AS LONG AS SPINAL CANAL
T/F |
TRUE
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what surrounds brain matter (spinal cord area)
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white matter
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what controls reflexes?
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spinal cord
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what originates in AFFERENT nerve fibers of peripheral nerves, are carried through posterior dorsal root into the spinal cord
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SENSORY impulses
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what is conducted to muscles by 2 descending pathways - PYRAMIDICAL and EXTRAPYRAMIDICAL
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MOTOR impulses
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What conducts impulses up to the brain - responsible for simple reflex activitiy
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spinal cord
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S.A.M.E.
SENSORY = AFFERANT MOTOR = EFFERANT |
S.A.M.E.
SENSORY = AFFERANT MOTOR = EFFERENT |
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what carries information to and from the C.N.S. , this is the HIGHWAY
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Peripheral Nervous System PNS
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The peripheral nervous system consists of how many pairs of cranial nerves
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TWELVE
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31 PAIRS of CRANIAL NERVES =
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8 CERVICAL
12 THORACIC 5 LUMBAR 5 SACRAL 1 COCCYGEAL |
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what pathways go TOWARDS the brain?
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Afferant
(AT) = AFFERANT = TOWARDS /AT |
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what pathways go AWAY from the brain
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EFFERANT (AWAY)
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ONE
OF OUR TEACHERS TOOK A FALL AFTER GIVING VERY SEXY HEAD |
OLFACTORY
OPTIC OCULOMOTOR TROCHLEAR TRIGEMINAL ABDUCENS GLOSSOPHARYNGEAL VAGUS SPINAL ACCESSORY HYPOGLOSSAL |
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patient has lost his sense of smell - what cranial nerve is affected?
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(1) OLFACTORY
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how do you test for OLFACTORY CRANIAL NERVE
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scents under nose
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patient is having difficulty w vision, what cranial nervse is affected?
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(2) OPTIC
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how do you test for 2 OPTIC cranial nerve
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snellen eye chart
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Trouble with EYE MOVEMENT, could have which cranial nerve damaged?
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(3) OCULOMOTOR
(4) TROCHEAL (6) ABDUCENS |
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How do you test for eye damage (oculomotor, trocheal, abducens)
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Pen light
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Abducens is what cranial nerve damage and how is it affected?
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Abducens (EYES SIDE TO SIDE)
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pt is having trouble CHEWING, FACIAL SENSATION, what cranial nerve is damageD?
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(5) TRIGEMINAL
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how do you test for trigeminal cranial nerve damage?
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stroke something soft (cotton tissue) on side of face to test for face sensation
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pt is having difficult tasting, smiling, sensation, what c.n. is damaged?
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(7) FACIAL
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how do you you test for 7 facial Cranial nerve damage?
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have them eat something sour or sweet (lemon)
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a patients hearinga nd balance is off, what c.n. is damaged
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(8) ACOUSTIC
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how do you test for 8 ACOUSTIC cranial damage?
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ticking of a watch getting closer to ears
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patient is having trouble swallowing or tasting POSTERIORALLY, what c.n. is damaged
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(9) GLOSSOPHARYNGEAL
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how to test for 9 GLOSSOPHARYNGEAL damage?
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give patient a drink of water to test swallowing
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Patient pharynx, respiratory, breathing, HEART BEAT, circulatory reflex troubles .... what c.n. is damaged
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(10) VAGUS
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how to test for 10 VAGUS c.n. damage
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patient open mouth and say AHH
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what should happen when patients open there mouth and say ahhh to test for 10 VAGUS c.n. damage
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SOFT PALAT SHOULD RAISE
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patient is having shoulders, head movment and strength pain, what c.n. is damaged
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(11) SPINAL ACCESSORY
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How to test for 11 SPINAL ACCESSORY c.n. damage
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put pressure on face and shoulder, have head turn into your hand , assess for pain
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A patient is having pain when sticking tongue out, what c.n. is damaged
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(12) HYPOGLOSSAL
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how do you test for 12 HYPOGLOSSAL C.n. damage
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have patient stick tongue out and move from side to side
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The FIGHT OR FLIGHT system is part of what?
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AUTONOMAIC NERVOUS SYSTEM (part of PNS)
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WHAT 2 BRANCHES are the ANS made of?
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SYMPATHETIC
PARASYMPATHETIC |
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the peripheral nervous system is composed of what
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Spinal Nerves
Cranial Nerves |
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The autonomic nervous system is composed of
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Sympathetic Nervous System
Parasympathetic Nervous System |
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first thing an RN does when assessing neurological changes is
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assess level of consciousness
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The Sympathetic Nervous System (part of the ANS) - what are the 5 E'S
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EMERGENCY
EMBARASSMENT EXCITEMENT EMOTIONS EXCERCISE |
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The Parasympathetic Nervous System (part of the ANS) what is SLUDD
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SALIVATION
LACRIMATION URINATION DIGESTION DEFECATION |
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FIGHT FOR FLIGHT:
An increase of HR, BP, RR DECREASE peristalsis Secretion of Epinephrine/Noepinephrine DILATED pulmonary Bronchioles |
SYMPATHETIC NERVOUS SYSTEM
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Maintaing NORMAL body function,
NORMAL HR BP, RR INCREASE peristalsis Secretes acetoclcholine CONSTRICTS pulmonary bronchioles |
PARASYMPATETIC NERVOUS SYSTEM
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Assessing current emotional, mental capacity and function is the purpose of
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the neurological exam
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the neurological exam is used to detect what
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if nervous system dysfunction is present
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what should you ALWAYS ASSESS FIRST PRIORITY
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AIRWAYS
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Pt lost sense of SMELL, what cranial nerve is effected
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CN 1 (OLFACTORY)
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Pt lost sense of HEARING, what cranial nerve effected
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CN 8 (ACOUSTIC)
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Pt lost MOTOR AND SENSORY FUNCTION , what cn is effected
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CN 5 (TRIGEMINAL)
chewing, facial expression |
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to test TRIGEMINAL, what do you have patient do (5)
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clench teeth , check for TMJ
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pt is losing VISION, what cranial nerve is effected
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CN 2 (OPTIC) snellen chart test
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You should start with what when beginning an interview
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Current Health Problem
(past fam history, lifestyle) |
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Initially during the interview, you can check the patients
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general apperance and posture
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PEERLA = Pupils equal and reactive to light, you must check how
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DARK ROOM, PEN LIGHT IN EYES
PUPIL SHOULD CONSTRICT WITH LIGHT = GET SMALLER!!! |
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Bringing fingers close to eyes to see if pupils constrict (get smaller) is called
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accomodation
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With light, pupils will
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constrict / get smaller
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what is CMS (for NEUROLOGICAL CHECK)
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Circulation Movement Sensation
C = CAPILLARY REFILL M = Wiggle toes and fingers S = pain,numb,tingling |
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An abnormal deep stupor as a result of illness or injury, pt cannot be aroused by external stimuli
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coma
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a condition of unconsiousness
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stuporous
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sliggish level of consciousness is
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lethargic
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best affective in eliciting pain in comatose patient
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applying nailbed pressure
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if a patient does not know awareness of person place time, what must you do
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REORIENT them
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what is general cerebral function?
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memory
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having a patient repeat numbers after you forward or backwards is
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immediate memory test
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ask patient how long they have been visiting you, when did you set up appointment? this helps the
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recent memory
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where was the person born, past occupations, things that can be verified helps the
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remote memory
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what memory goes first?
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RECENT
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what is the ability to define proverbs, learn a new item, computation skills, asking pt what they may do in certain situations, helps the
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intellectual functioning
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screening tool used to judge mental status with ELDERLY....assesss orientation, registration, attention, recall, language.
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Mini Mental Status
MAX SCORE = 30 23 OR LESS = COG. IMPAIRMENT |
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what causes impairment in orientation, memory or emotions
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OBS
Organic Brain Syndrome |
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progressive and incurable disease where pt cannot remember
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alzheimers disease
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disorder that alters perception, indifferent thinking
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schizophrenia
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physical exam of neuro system is more likely used for screening patients nto necsarrily diagnosing them
t/f |
true
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ability to maintain posture, balance and coordination is called
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proprioreception
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what carry the stimuli and fibers for TOUCH
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posterior columns of spinal cord (proprioreception)
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what integrates muscle contractions for posture
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cerebellum (propriorecption)
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what corrects movement as necessary
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vestibular apparatus (proprioreception)
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how do you test proprioreception and cerebellar function
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finger to nose movements
finger nose finger movements |
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thumb to 4 fingers as rapidly as possible , or slapping thighs alternating hands noting speed and accuraccy helps test
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proprioreceptor and cerebellar function
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pt at risk for increased cranial pressure , what is your PRIORITY to monitor
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unequal pupil size
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stand with feet together with eyes open and then closed, check for sway
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romberg test (proprioreception/cerebellar function)
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have client walk heel toe heel, also called tandem walking or tip toe
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coordination (proprioreception/cerebellar function)
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Testing the dermatomes and major peripheral nerves , skin sensitivity, forehead cheek hand foot, helps to test
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sensory function
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Sensory Function =
absent of normal sensation |
anesthesia
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Sensory Function =
Extreme sensitivy |
hyperesthesia
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Sensory Function =
abnormal weakness in response to a stimulation |
hypoestesia
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Sensory Function =
pins and needles feeling |
pareasthesia
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use wisp of cotton, or sharp paper clip, to different areas of body and ask for localization - compare each side of the body
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light touch sensation
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test sharp and dull with both ends of a safety pin, test hot and cold temp
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pain and temperature sensation
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SENSORY FUNCTION !
use of tuning fork on bony prominence, ask localization and when start/stop |
vibration sense
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SENSORY FUNCTION!
what tests cerebral cortex |
tactile discrimination
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SENSORY FUNCTION!
identify a familar object with eyes through touch and manipulation |
stereognosis
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SENSORY FUNCTION!
identify something traced in teh palm, two point discrimination |
graphesthesia
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what obtains info about reflex arcs and spinal cord segments, elicting through striking a tendon with a reflex hammer
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deep tendon reflexes (reflec arcs and spinal cord segment test)
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grading scale for deep tendon reflex
hyperactive, clonus of tendon, associated with DISEASE, ALL OVER THE PLACE MOVEMENT |
PLUS 4
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grading scale for depe tendon reflex
NORMAL |
PLUS 2
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grading scale for deep tendon reflex
more brisk than normal, not necessarily means disease |
PLUS 3
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WHERE are the deep tendon reflexes tested?
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biceps
triceps brachioradialis patellar knee jerk achilles tendon |
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dorsiflextion of the big toe and fanning of the other toes when teh plantar reflex is done, ADULT is differerent than INFANT
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BABINSKI REFLEX
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What is considered a normal BABINSKI REFLEX
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flexion of the toes
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You want a ___________ BABINSKI
(toes should curl down) |
NEGATIVE BABINSKI = GOOD!
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if toes fan, then you have a
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POSITIVE BABINSKI = BAD
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apply stimulus to lateral portion of foot starting at heel and coming across the ball of foot, check for flexion of the toes, not fanning
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BABINSKI
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ADULT VS INFANT BABINSKI,
IN AN INFANT LESS THAN 18 MONTHS...WHAT SHOULD YOU SEE |
POSITIVE BABINSKI (toes fan)
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a positive Brudzinskis and Kernigs sign =
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abnormal
meningal inflammation |
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an unconscious patient admiited to ER with multiple injuries, what RN intervention is priority
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establish AIRWAY!~
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