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43 Cards in this Set

  • Front
  • Back
cerebellum
coordinated movement, balance, voluntary movements, muscle tone
cerebrum
largest part of brain, 4 lobes
frontal lobe
voluntary motor
broca's area - making words
personality, behavior, emotions
parietal lobe
sensation, body location, shape
brainstem
midbrain - motor neurons + tracts pons - ascending/descending fiber tracts
medulla oblongota - respiration, heart, GI
cranial nerves 3-12
occipital
vision
temporal
auditory, comprehension of spoken/written language
diencephalon
thalmus - relay station for nervous system; sensory pathways of brain stem/spine synapse
hypothalmus - temp, HR, BP ,sleep, pituitary gland, emotions
spinal cord
31 segments, each segment has a pair of spinal nerves protruding
grey matter contains nerve roots, compression causes loss of sensation/pain
spinal cord areas
cervical, thoracic, lumbar, sacral, coccyx
pathways of the CNS
sensory - conscious sensation , internal organs, body position, reflexes
motor pathways
sensory cortex
brain map of body, some organs absent (referred pain)
spinothalmic tract (sensory pathways)
lateral - pain + temp
anterior - crude tough
posterior (dorsal) columns (sensory pathways
position, vibration, finely localized tough
motor pathways
corticospinal/pyramidal (voluntary movement, detailed)
extrapyramidal (muscle tone, walking)
cerebellar system - movement, equilibrium, posture
upper motor neurons
descending motor fibers
within CNS
send impulses to lower neurons
lower motor neurons
peripheral system
"final common pathway"
direct contact with muscles
peripheral nervous system - types of reflec arcs
deep tendon (knee jerk)
superficial (corneal)
visceral (PERRLA)
pathologic
components of reflex arc
intact sensory nerve
functional synapse in the cord
intact motor nerve fiber
neuromuscular junction
competent muscle
autonomic nervous system
somatic fibers - skeletal (voluntary)
autonomic - smooth (involuntary) cardiac muscles, glands
general health history
changes in movement - gait
chronic disease
medications
alcohol
drugs
visual disturbances, tremors, parasthesia
injury to head/spinral cord
surgery
stroke
seizures
headaches
vertigo
physical exam
mental status + LOC
speech
cranial nerve functions
gait - balance + symmetry
extremities for muscle strength
complete mental status exam
behavioral change, brain lesions, aphasia, sx of psych illness
stroke sx
one-sided weakness
drooping
aphasia
unilateral paralysis
difficulty swallowing
test cerebellar function
romberg test
tandem walking
hop on alternating feet
knee bends
coordination - touch nose, finger to thumb, finger to finger, heel to shin
assess peripheral nerves - sensation
sensation - flex muscles, cotton swab, vibration, discrimination testing
PNS - deep tendon reflexes
0-4
triceps reflex - contract tricep + extend elbow
biceps - contract bicep + flex elbow
brachioradial - pronation of forearm + flexion of elbow
patellar - contraction of quad, extension of lower leg
achiles
PNS - superficial reflexes
babinski
abdominal
cremateric
plantar
multiple sclerossi
progressive demylination
autoimmune - virus
sx - fatiuge, depression, paresthesias
signs - focal muscle weakness, ocular changes, bowel/bladder/sex dfx, spastic
meningits
inflammation of tissue around brain
bacteria, virus, fungs
signs - stiff neck, brudzinskis + kernigs sign, decreases LOC, coma, agitation, irritability
sx: severe headahce, fever, malaise
Encephalitis
Inflammation of brain tissue and meninges
Caused by bacteria, viruses, fungi, and parasites; viral encephalitis most common
enephalitis findings
headache, lethargy, fever, nuchal rigidity
decrease LOC, motor weakness, tremors, seizures, + babinskis
spinal cord injury
vertebral fx/dislocation - car/sport injuries
cervical cord - quadriplegia
paralysis below level of injury, loss of bowel/bladder control
Parkinson’s disease
Develops slowly as brain’s dopamine-producing neurons in substantia nigra of basal ganglia degenerate; second most common neurodegenerative disease after Alzheimer’s
parkinson's Clinical findings
Resting tremor (will improve with movement), bradykinesia, and rigidity
Other manifestations: mask-like facies, trunk-forward flexion, muscle weakness, shuffling gait, and finger pill-rolling tremor
Cerebrovascular accident (stroke)
When cerebral blood vessels become occluded by thrombus or embolus, or when intracranial hemorrhage occurs, brain tissues become ischemic, resulting in cerebrovascular accident or stroke
Clinical findings: cerebrovascular accident (stroke)
Signs and symptoms directly related to areas of brain involved and extent of ischemia
Sudden unilateral numbness or weakness of face, arm, or leg
Trouble walking, dizziness, or loss of balance
Sudden, severe headache with no known cause
May be sudden confusion, difficulty swallowing (dysphagia), difficulty speaking or understanding speech (aphasia), or partial loss of vision
Alzheimer’s disease
Incurable, degenerative neurologic disorder; begins with decline in memory
Most common cause of dementia in Western countries
Cause unknown – believed to be genetic; history of tias can be linked to alzheimers
Clinical findings: Alzheimer’s disease
stage 1 (2-4 ys) forget names, misplace items
stage 2 (2-12 years) ADLs difficult, language skills deteriorate, disoriented, confused
final stage - total care
use mini mental exam
Bell’s palsy – cranial nerve 7, facial nerve
Acute unilateral paralysis of facial nerve
80% of clients recover fully after few weeks or months; young ages
Etiology unknown – viral?
Clinical findings
Bell's palsy
History of pain behind ear or face few hours or days before paralysis
Affected side: eye doesn’t close, forehead doesn’t wrinkle, unable to whistle or smile, increased lacrimation (tearing up frequently)
Guillain-Barré syndrome
Widespread demyelinization of nerves of peripheral nervous system (PNS)
80% to 90% recover with few or no residual deficits; however clients may die if respiratory depression develops rapidly
Clinical findings: Guillain-Barré syndrome
Ascending paralysis begins with weakness and paresthesia in lower extremities, and ascends to upper extremities and face.
Descending variation: facial, glossopharyngeal, vagus, hypoglossal CNs downward to hand; can reach feet
Deep tendon reflexes absent