Ch 27 Health Assessment

Front 1

The neurologic system is responsible for coordinating and regulating all body functions. It consists of two structural components. What are they?

Back 1

1. The central nervous system (CNS)

2. The peripheral nervous system.

Front 2

The _____ encompasses the brain and spinal cord, which are covered by meninges, three layers of connective tissue that protect and nourish the CNS. T

Back 2

CNS

Front 3

The ______________ is filled with cerebrospinal fluid, which is formed in the ventricles of the brain and flows through the ventricles into the space. This fluid-filled space cushions the brain and spinal cords, nourishes the CNS, and removes waste materials.

Back 3

subarachnoid space

Front 4

What are the four major divisions of the brain?

Back 4

1.Cerebrum

2. Diencephalon

3. Brain stem

4. Cerebellum

Front 5

The _____________ a bundle of nerve fibers responsible for communication between the hemispheres

Back 5

corpus callosum

Front 6

Each hemisphere of the Cerebrum sends and receives impulses from the opposite sides of the body and consists of four lobes that are ______,______,________, and ________

Back 6

frontal, parietal, temporal, and occipital

Front 7

The ___________ lies beneath the cerebral hemispheres and consists of the thalamus and hypothalamus.

Back 7

diencephalon

Front 8

Most sensory impulses travel through the gray matter of the __________, which is responsible for screening and directing the impulses to specific areas in the cerebral cortex.

Back 8

thalamus

Front 9

The _________ (which is part of the autonomic nervous system, which is a part of the peripheral nervous system) is responsible for regulating many body functions including water balance, appetite, vital signs (temperature, blood pressure, pulse, and respiratory rate), sleep cycles, pain perception, and emotional status.

Back 9

hypothalamus

Front 10

The ____________ serves as a relay center for ear and eye reflexes and relays impulses between the higher cerebral centers and the lower pons, medulla, cerebellum, and spinal cord.

Back 10

midbrain

Front 11

The _______ links the cerebellum to the cerebrum and the midbrain to the medulla. It is responsible for various reflex actions.

Back 11

pons

Front 12

The _____________contains the nuclei for cranial nerves and has centers that control and regulate respiratory function, heart rate and force, and blood pressure.

Back 12

medulla oblongata

Front 13

The ___________ does not initiate movement, its primary functions include coordination and smoothing of voluntary movements, maintenance of equilibrium, and maintenance of muscle tone.

Back 13

cerebellum

Front 14

The spinal cord is located in the vertebral canal and extends from the medulla oblongata to the _________vertebra.

Back 14

first lumbar L1

Front 15

This cranial nerve carries smell impulses from nasal mucous membrane to brain? What is it?

Back 15

I (olfactory)

Front 16

This cranial nerve carries visual impulses from eye to brain.

Back 16

II (optic)

Front 17

This cranial nerve contracts eye muscles to control eye movements (interior lateral, medial, and superior), constricts pupils, and elevates eyelids

Back 17

III (oculomotor)

Front 18

This cranial nerve contracts one eye muscle to control inferomedial eye movement.

Back 18

IV (trochlear)

Front 19

This cranial nerve carries sensory impulses of pain, touch, and temperature from the face to the brain Influences clenching and lateral jaw movements (biting, chewing)

Back 19

V (trigeminal)

Front 20

This cranial nerve controls lateral eye movements

Back 20

VI (abducens)

Front 21

This cranial nerve contains sensory fibers for taste on anterior two thirds of tongue and stimulates secretions from salivary glands (submaxillary and sublingual) and tears from lacrimal glands.

Back 21

VII (facial)

Front 22

This cranial nerve contains sensory fibers for hearing and balance

Back 22

VIII (acoustic, vestibulocochlear)

Front 23

This cranial nerve Contains sensory fibers for taste on posterior third of tongue and sensory fibers of the pharynx that result in the “gag reflex” when stimulated

Back 23

IX (glossopharyngeal)

Front 24

This cranial nerve carries sensations from the throat, larynx, heart, lungs, bronchi, gastrointestinal tract, and abdominal viscera Promotes swallowing, talking, and production of digestive juices

Back 24

X (vagus)

Front 25

This cranial nerve Innervates neck muscles (sternocleidomastoid and trapezius) that promote movement of the shoulders and head rotation. Also promotes some movement of the larynx

Back 25

XI (spinal accessory)

Front 26

This cranial nerve innervates tongue muscles that promote the movement of food and talking.

Back 26

XII (hypoglossal)

Front 27

Patients who are experiencing symptoms associated with the neurologic system (such as headaches or memory loss) may be very fearful that they have a serious condition such as a _______________ or _________________

Back 27

metastatic brain tumor or Alzheimer's.

Front 28

True or false
Morning headaches that subside after arising may be an early sign of increased intracranial pressure such as with a brain tumor.

Back 28

true

Front 29

Imbalance and difficulty coordinating or controlling movements are seen in neurologic diseases involving the cerebellum, basal ganglia, extrapyramidal tracts, or the vestibular part of cranial nerve _____________.

Back 29

VIII (acoustic)

Front 30

Dizziness or lightheadedness may be related to these four disorders:

Back 30

1. carotid artery disease

2. cerebellar abscess

3. Meniere's disease

4. inner ear infection.

Front 31

A decrease in the ability to smell may be related to a dysfunction of cranial nerve___________or a brain tumor.

Back 31

I (olfactory)

Front 32

A decrease in the ability to taste may be related to dysfunction of cranial nerves ___________ or _____________.

Back 32

VII (facial) or IX (glossopharyngeal).

Front 33

Ringing in the ears and decreased ability to hear may occur with dysfunction of cranial nerve______________.

Back 33

VIII (acoustic)

Front 34

Changes in vision may occur with dysfunction of cranial nerve __________, increased intracranial pressure, or brain tumors.

Back 34

II (optic)

Front 35

Damage to cranial nerves _____________,_________, or _________ may cause double or blurred vision

Back 35

III (oculomotor), IV (trochlear), or VI (abducens)

Front 36

Transient blind spots may be an early sign of a ______________.

Back 36

cerebrovascular accident (CVA).

Front 37

Injury to the _____________ can impair the ability to use or understand verbal language.

Back 37

cerebral cortex

Front 38

True or false

Difficulty swallowing may relate to CVA, Parkinson's disease, myasthenia gravis, Guillain-Barré syndrome, or dysfunction of cranial nerves IX (glossopharyngeal), X (vagus), or XII (hypoglossal).

Back 38

True

Front 39

true or false

Recent memory (24-hour memory) is often impaired in amnestic disorders, Korsakoff's syndrome, delirium, and dementia.

Back 39

true

Front 40

Remote memory (past dates and historical accounts) may be impaired in____________disorders.

Back 40

cerebral cortex

Front 41

_______________ can result from a deficiency in niacin, folic acid, or vitamin B12.

Back 41

Peripheral neuropathy

Front 42

What are the 5 warning signs of a CVA aka stroke?

Back 42

1. Sudden numbness (face, arm, leg), especially if on only one side of body

2. Sudden confusion, trouble speaking or understanding speech

3. Sudden vision problems in one or both eyes

4. Sudden trouble walking, dizziness, loss of balance or coordination

5. Sudden severe headache with no known cause

Front 43

If meningitis is suspected, the examiner may try to elicit _____________ and __________signs, which are characteristic of meningeal irritation.

Back 43

Brudzinski's and Kernig's

Front 44

When testing cranial nerve I you find that your patient can not identify the smell. What medical terminology would you use to document this in your finding?

Back 44

neurogenic anosmia

Front 45

______________ occurs with increased intracranial pressure from intracranial hemorrhage or a brain tumor.

Back 45

Papilledema

Front 46

___________(drooping of the eyelid) is seen with weak eye muscles such as in myasthenia gravis.

Back 46

Ptosis

Front 47

__________ is the rhythmic oscillation of the eyes

Back 47

Nystagmus

Front 48

Limited eye movement through the six cardinal fields of gaze is an indicator of ____________

Back 48

increased intracranial pressure.

Front 49

__________________ is the paralysis of the oculomotor, trochlear, or abducens nerves

Back 49

Paralytic strabismus

Front 50

_______________ pupils, CNS syphilis, meningitis, brain tumor, alcoholism.

Back 50

Argyll Robertson

Front 51

Constricted, fixed pupils, narcotics abuse or damage to this part of the brain?

Back 51

Pons.

Front 52

If pupils are unilaterally dilated pupil unresponsive to light or accommodation, the nurse suspects damage to cranial nerve_____________

Back 52

III (oculomotor)

Front 53

Patients pupils are constricted and unresponsive to light or accommodation. The nurse suspects ________________

Back 53

lesions of the sympathetic nervous system.

Front 54

Patient presents with bilateral muscle weakness as seen with peripheral or central nervous system dysfunction. Unilateral weakness may indicate a lesion of cranial nerve ___________.

Back 54

V (trigeminal)

Front 55

When testing a patient with sharp and dull stimuli and light touch to the forehead, cheeks, and chin the nurse notices the patients inability to feel and correctly identify facial stimuli. What does he or she suspect?

Back 55

Inability to feel and correctly identify facial stimuli occurs with lesions of the trigeminal nerve or lesions in the spinothalamic tract or posterior columns.

Front 56

Inability to identify correct flavor on anterior two-thirds of the tongue suggests impairment of cranial ___________

Back 56

nerve VII (facial)

Front 57

Test the client's hearing ability in each ear and perform the Weber and Rinne tests to assess the cochlear (auditory) component of cranial nerve

Back 57

VIII (acoustic, vestibulocochlear)

Front 58

When testing these cranial nerves the uvula and soft palate rise bilaterally and symmetrically on phonation.

Back 58

IX (glossopharyngeal) and X (vagus).

Front 59

An absent gag reflex may be seen with lesions of cranial nerves _____________ or ______________.

Back 59

IX (glossopharyngeal) or X (vagus)

Front 60

Dysphagia or hoarseness may indicate a lesion of cranial nerve ______________,____________, or ____________

Back 60

IX (glossopharyngeal) or X (vagus) or other neurologic disorder

Front 61

How would you preform a Romberg test?

Back 61

Ask the client to stand erect with arms at side and feet together. Note any unsteadiness or swaying. Then with the client in the same body position, ask the client to close the eyes for 20 seconds. Again note any imbalance or swaying.

Front 62

If a Romberg test is positive what does it indicate?

Back 62

Swaying and moving feet apart to prevent fall is seen with disease of the posterior columns, vestibular dysfunction, or cerebellar disorders.

Front 63

Inability to stand or hop on one foot is seen with muscle weakness or disease of the _______________.

Back 63

cerebellum

Front 64

Medical Terminology for cerebellar disease.

Back 64

dysdiadochokinesia

Front 65

absence of touch sensation

Back 65

Anesthesia

Front 66

decreased sensitivity to touch

Back 66

Hypesthesia

Front 67

increased sensitivity to touch

Back 67

Hyperesthesia

Front 68

absence of pain sensation

Back 68

Analgesia

Front 69

decreased sensitivity to pain

Back 69

Hypalgesia

Front 70

increased sensitivity to pain

Back 70

Hyperalgesia

Front 71

Temperature and pain sensations travel in the ___________________ , so temperature need not be tested if pain sensation is intact.

Back 71

lateral spinothalamic tract

Front 72

astereognosis is?

Back 72

Inability to correctly identify objects

Front 73

How would you test graphesthesia?

Back 73

Use a blunt instrument to write a number, such as 2, 3 or 5, on the palm of the client's hand then ask the client to identify the number. Repeat with another number on the other hand.

Front 74

To test extinction the nurse would?

Back 74

Simultaneously touch the client in the same area on both sides of the body at the same point. Ask the client to identify the area touched.