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92 Cards in this Set
- Front
- Back
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Two parts of CNS |
Brain and spinal cord |
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5 structures of the brain |
* Cerebrum * cranial nerves * brain stem * cerebellum * basal ganglia |
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Four parts of the spinal cord |
* Ascending tracts * descending tracts * upper motor neurons * lower motor neurons |
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Structure of cerebrum |
* two hemispheres * four lobes. (frontal, parietal, occipital, temporal) |
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Two functions of frontal lobe |
* voluntary movements * repetitive fine movement |
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Two functions of the parietal lobe |
* "processing center" interpretation of sensory data (tactile, visual, smell, hearing, and taste) * proprioception |
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Function of the occipital lobe |
Vision and interpretation of visual data |
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Two functions of the temporal lobe |
* perception and interpretation of sounds and determination of source of sounds * role in taste smell and balance |
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6 functions of the basal ganglia |
1. Control of voluntary motor movements. 2. Procedural learning. 3. Routine behaviors or habits. 4. Eye movements. 5. Cognition. 6. Emotion |
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2 common diseases related to the basal ganglia |
Parkinson's and Huntington's diseases |
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Functions of the cerebrum |
*Higher functioning, intelligence and personality. *Thinking and learning, *creativity, *five senses, *memory and *emotion problem solving *decisions |
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Motor cortex |
* Separates the parietal lobe from the frontal lobe * controls the muscles to most of the body * electrical pulses generating movement |
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Somatosensory cortex |
Located between parietal lobe and frontal lobe *control sensation around body |
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Corpus callosum |
* Located between the two hemispheres * allows communication between hemispheres |
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Left side of the brain |
* relates to right side of body * spatial orientation * face recognition * body image |
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Right side of brain |
* relates to left side of the body * math, logic, language |
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Which cranial nerves are located within the brainstem |
Cranial nerves 3 through 12 |
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Function of brainstem |
*Connect cerebrum and spinal cord origin of 10 of the cranial nerves *nerve connection that passes through the brain stem * regulation a basic reflexes like heart rate reading swallowing blinking Etc |
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Three nerve connections that pass through the brainstem |
* Motor (corticospinal tract) * Fine touch, vibration, and proprioception (posterior column). *Pain, temperature, itch and crude touch (spinothamalamic tract) |
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4 functions of the cerebellum |
1. Processes sensory information from the eyes ears and touch. 2. Coordinates reflexive control, muscle tone , equilibrium, coordination, and precision 3. Cognition - attention and language 4. Does not initiate movement, but receives input for sensory systems |
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Three functions of the spinal cord |
1. Conduit for motor information that travels down the spinal cord. 2. Conduit for sensory information that travels up the spinal cord. 3. Center for coordinating certain reflexes |
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How many pairs of spinal nerves are there |
31 |
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5 types of spinal nerves |
8 cervical. 12 thoracic . 5 lumbar. 5 sacral. 1 coccygeal |
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3 spinal tracts (2 ascending, 1 descending) |
1. Posterior dorsal column (ascending) 2. Spinothalamic tract. (ascending) 3. Pyramidal or corticospinal tract (descending) |
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Where are Lower Motor Neurons located?
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* Located mostly in the peripheral nerve system (PNS)
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What's the function of the lower motor neurons?
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* Transmits sensory signal into motor actions in the muscle (any movement must be translated into action by the lower motor neurons--cranial nerves, spinal nerves) |
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Where are the upper motor neurons located?
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* Originates and terminates in the CNS
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What is the function of the upper motor neurons?
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Role is the influence, direct and modify spinal signals
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How do the upper motor neurons affect movement?
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Can only affect movement through the Lower Motor Neurons.
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What are some examples of subjective data a patient may give you regarding a neuro problem?
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* Headache * Pain * Back problems * Seizures * Vertigo/syncope * Weakness * Neuropathy * Cognition/memory |
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What are some examples of pertinent family history with neuro problems?
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Family history of: * Seizures * Migraines (headaches) * Epilepsy * Stroke * AD |
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What are the 5 components to a neuro exam?
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1. Mental Status and Speech 2. Cranial Nerves 3. Motor Function and Coordination (gait) 4. Sensory System 5. Reflexes (Deep tendon) |
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What are 4 ways to perform cerebellar assessment?
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1. Rapid Alternating Movements 2. Pont to point movements 3. Gait 4. Stance (Romberg Test; Pronator Drift) |
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Explain 2 ways to perform Rapid Alternating Movements:
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1. Ask seated patient to pat his knees with both hands, alternating turning up and down the palms and increasing the speed gradually. 2. Ask patient to touch thumb to each finger; one hand at a time; increasing speed |
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What are abnormal findings of Rapid Alternating Movement tests?
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Stiff, slowed, nonrhythmic, or jerky clonic movements
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Name 3 Accuracy of Movement tests to assess cerebellar function:
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1. Finger to nose test (eyes open) 2. Finger to nose test (eyes closed) 3. Heel to shin test |
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How to perform finger to nose test (eyes open)?
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Pt alternates touching index finger to nose then to your finger in multiple locations. Position your finger about 18 inches away so that patient gets full extension of arm. Repeat with other arm. **consistently missing may indicate cerebellar disease |
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How to perform finger to nose test (eyes closed)?
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Have patient close eyes, alternate touching nose with each hand. Other hand outstretched to their side. **movement should be smooth, rapid, and accurate |
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How to perform heel to shin test?
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* Patient may be standing, sitting, or supine * Ask patient to move heel up and down opposite leg from knee to ankle. * Repeat opposite side **movement should be in a straight line--no deviations** |
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List 4 types of gait assessment:
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1. Heel to toe (Tandem Walking) 2. Walk on toes then on heels 3. Hop in place 4. Knee bends |
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List 2 cerebellar assessments of Stance:
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1. Romberg Test 2. Pronator Drift |
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How is the Romberg test performed?
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Have patient stand with arms at side with eyes open...then close eyes. POSITIVE if there is a loss of balance. (decreased proprioception) |
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What can a POSITIVE Romberg test indicate?
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* Cerebellar Ataxia * Vestibular dysfunction * Sensory Loss |
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How does the patient perform the Pronator Drift test?
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* Patient standing with both arms forward and eyes closed. POSITIVE--one arm drifts upward |
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What does a positive Pronator test indicate?
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Contralateral lesions in the corticospinal cord
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List 3 ways to assess sensory and indicate it's pathway (spinothalamic or posterior column):
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1. Pain and Temp (Spinothalamic tracts) 2. Position and Vibration (posterior column) 3. Light touch (both pathways) |
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Is Discriminative Sensations indicative of spinothalamic tract or posterior column?
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Posterior Column
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List 3 types of Discriminative Sensations?
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1. Stereognosis: recognizes familiar objects 2. Graphesthesia: draw an "8" in the hand 3. Two Point discrimination: touch an area on patient's body then remove. Patient should be able to point to where you touched |
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Which tract does touch affect? |
Spinothalamic tract
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Which tract does vibratory sensation affect? (tuning fork between toes) |
Posterior column
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Which tract does Position sense affect? (raise or lower great toe or finger) |
Posterior column
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Are DTR relayed over CNS, PNS, or both?
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Both
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List 3 factors related to deep tendon reflexes:
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1. Intact sensory nerve fibers 2. functional synapse in spinal cord 3. intact motor nerve fibers |
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List the 8 places to test DTR:
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1. Ankle 2. Knee 3. Brachioradialis 4. Biceps 5. Triceps 6. Upper Abdominal 7. Lower Abdominal 8. Plantar |
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Which spinal tract does the ANKLE DTR reflect?
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S1
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Which spinal tracts do the KNEE DTRs reflect?
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L2, 3, 4
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Which spinal tracts does the BRACHIORADIALIS DTR reflect?
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C5, C6
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Which spinal tract does the TRICEPS DTR reflect?
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C6
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Which 3 spinal tracts do the UPPER ABDOMINAL DTR reflect?
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T-8 T-9 T-10 |
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Which 3 tracts do the LOWER ABD DTRs reflect?
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T-10 T-11 T-12 |
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Which 2 tracts do the PLANTAR DTRs reflect?
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L-5 S-1 |
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Name 2 types of PLANTAR reflexes.
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BABINSKI CLONUS |
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What may a positive Babinski reflect?
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* CNS lesion * ETOH *Postictal period |
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What is a "true" Babinski?
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Dorsiflexion of the great toe
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What does + CLONUS reflect?
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CNS disease
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Concussion
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An injury to the brain that results in temporary loss of normal brain function. Usually caused by a blow to the head. |
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List 3 principal features of confusion:
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1. inability to maintain a coherent stream of thought 2. A disturbance of awareness with heightened distractibility 3. Inability to carry out a sequence of goal-directed movements |
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SCAT Card:
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Sport Concussion Assessment Form
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3 things the SCAT card evaluates:
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* Loss of consciousness * Seizure activity * Balance problems |
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If a patient has decreased reflexes and muscle tone, they have? Upper motor neuron lesion or lower motor neuron lesion |
Lower motor neuron lesion
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Which part of the brain is responsible for motor learning and timing of motor activity? Cerebrum, Cerebellum, Medulla |
Cerebellum
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If a patient has increased reflexes and muscle tone, do they have an upper or lower motor neuron lesion?
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Upper motor neuron lesion
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Testing station, walking, tandem gait evaluates which type of function?
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Gross motor function
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Rapid alternating movements tests which type of function?
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Fine motor skills
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Which spinal tract do MOTOR neurons follow?
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Descending tract
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Which tract do SENSORY neurons follow?
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Ascending tract
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Where are upper motor neurons located?
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within spinal tract
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Where are Lower motor neurons located?
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Exit the spinal cord through the vertebrae and sacrum
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What is the correct/systematic way to evaluate motor function?
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* Observe * Inspection * Palpation * Muscle tone testing * Strength testing of individual muscle groups |
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If you are checking a patient's Babinski reflex and the big toe extends...is this normal?
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Abnormal--toes should flex
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If someone's reflexes are 2+, what does that mean?
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they are normal
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If a patient's reflexes are 0, what does this mean?
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reflexes are absent
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If a patient's reflexes are 4, what does this mean?
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Hyper and clonus
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Muscle strength testing goes from: Distal to proximal or Proximal to distal? |
Proximal to distal
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Muscle strength testing is graded on a ...to...scale
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0-5
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7 steps to Neuro exam:
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1. Mental status exam 2. Cranial nerves 3. Muscle strength 4. Reflexes 5. Coordination 6. Sensory Function 7. Gait |
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Mental Status:
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Is the patient alert and oriented?
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On Old Olympus Towering Tops A Finn And German Viewed Some Hops
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Olfactory, Optic, Oculomotor, Trochlear, Trigeminal, Abducens, Facial, Acoustic, Glossopharyngeal, Vagus, Spinal Accessary, Hypoglossal |
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List 3 Neuro Maneuvers:
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Nuchal rigidity Brudzinski's Sign Kernig's Sign |
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Nuchal Rigidity:
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Tests for Meningitis or Intracranial hemorrhage * Unable to flex head forward d/t rigidity of neck muscle |
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Brudzinski's Sign: |
* Lay flat, lift patient's head and try to touch chin to chest
* POSITIVE=patient will pull up leg or bend knee
(Meningeal irritation) |
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Kernig's Sign:
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* With patient's knee bent, try to straighten * Will cause pain to lower back if positive (Meningeal irritation) |
