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43 Cards in this Set
- Front
- Back
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cerebellum
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coordinated movement, balance, voluntary movements, muscle tone
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cerebrum
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largest part of brain, 4 lobes
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frontal lobe
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voluntary motor
broca's area - making words personality, behavior, emotions |
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parietal lobe
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sensation, body location, shape
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brainstem
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midbrain - motor neurons + tracts pons - ascending/descending fiber tracts
medulla oblongota - respiration, heart, GI cranial nerves 3-12 |
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occipital
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vision
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temporal
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auditory, comprehension of spoken/written language
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diencephalon
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thalmus - relay station for nervous system; sensory pathways of brain stem/spine synapse
hypothalmus - temp, HR, BP ,sleep, pituitary gland, emotions |
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spinal cord
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31 segments, each segment has a pair of spinal nerves protruding
grey matter contains nerve roots, compression causes loss of sensation/pain |
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spinal cord areas
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cervical, thoracic, lumbar, sacral, coccyx
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pathways of the CNS
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sensory - conscious sensation , internal organs, body position, reflexes
motor pathways |
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sensory cortex
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brain map of body, some organs absent (referred pain)
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spinothalmic tract (sensory pathways)
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lateral - pain + temp
anterior - crude tough |
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posterior (dorsal) columns (sensory pathways
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position, vibration, finely localized tough
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motor pathways
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corticospinal/pyramidal (voluntary movement, detailed)
extrapyramidal (muscle tone, walking) cerebellar system - movement, equilibrium, posture |
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upper motor neurons
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descending motor fibers
within CNS send impulses to lower neurons |
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lower motor neurons
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peripheral system
"final common pathway" direct contact with muscles |
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peripheral nervous system - types of reflec arcs
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deep tendon (knee jerk)
superficial (corneal) visceral (PERRLA) pathologic |
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components of reflex arc
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intact sensory nerve
functional synapse in the cord intact motor nerve fiber neuromuscular junction competent muscle |
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autonomic nervous system
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somatic fibers - skeletal (voluntary)
autonomic - smooth (involuntary) cardiac muscles, glands |
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general health history
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changes in movement - gait
chronic disease medications alcohol drugs visual disturbances, tremors, parasthesia injury to head/spinral cord surgery stroke seizures headaches vertigo |
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physical exam
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mental status + LOC
speech cranial nerve functions gait - balance + symmetry extremities for muscle strength |
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complete mental status exam
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behavioral change, brain lesions, aphasia, sx of psych illness
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stroke sx
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one-sided weakness
drooping aphasia unilateral paralysis difficulty swallowing |
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test cerebellar function
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romberg test
tandem walking hop on alternating feet knee bends coordination - touch nose, finger to thumb, finger to finger, heel to shin |
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assess peripheral nerves - sensation
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sensation - flex muscles, cotton swab, vibration, discrimination testing
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PNS - deep tendon reflexes
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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 |
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PNS - superficial reflexes
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babinski
abdominal cremateric plantar |
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multiple sclerossi
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progressive demylination
autoimmune - virus sx - fatiuge, depression, paresthesias signs - focal muscle weakness, ocular changes, bowel/bladder/sex dfx, spastic |
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meningits
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inflammation of tissue around brain
bacteria, virus, fungs signs - stiff neck, brudzinskis + kernigs sign, decreases LOC, coma, agitation, irritability sx: severe headahce, fever, malaise |
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Encephalitis
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Inflammation of brain tissue and meninges
Caused by bacteria, viruses, fungi, and parasites; viral encephalitis most common |
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enephalitis findings
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headache, lethargy, fever, nuchal rigidity
decrease LOC, motor weakness, tremors, seizures, + babinskis |
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spinal cord injury
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vertebral fx/dislocation - car/sport injuries
cervical cord - quadriplegia paralysis below level of injury, loss of bowel/bladder control |
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Parkinson’s disease
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Develops slowly as brain’s dopamine-producing neurons in substantia nigra of basal ganglia degenerate; second most common neurodegenerative disease after Alzheimer’s
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parkinson's Clinical findings
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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 |
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Cerebrovascular accident (stroke)
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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
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Clinical findings: cerebrovascular accident (stroke)
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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 |
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Alzheimer’s disease
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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 |
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Clinical findings: Alzheimer’s disease
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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 |
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Bell’s palsy – cranial nerve 7, facial nerve
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Acute unilateral paralysis of facial nerve
80% of clients recover fully after few weeks or months; young ages Etiology unknown – viral? |
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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) |
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Guillain-Barré syndrome
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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 |
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Clinical findings: Guillain-Barré syndrome
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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 |
