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41 Cards in this Set

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Subjective Data for nervous system assessment.
History-
Don't suggest symptoms
Determine onset and course of symptoms - very important
Mental functioning may affect validity.
Subjective Data/Past History
History of trauma or other diseases; family history; medication use.
Subjective Data/Present History
Change in behavior, mood, LOC, sensory problems as vision, hearing, touch.
Objective Data/Neurological examination
Normal changes that occur with aging.
Decrease in weight and size of brain
Reflexes decrease - ankle 1st.
Primitive reflexes appear (sucking, grasping)
Sensations decrease - pain, taste, smell, vision, etc.
WHICH SENSATIONS DECREASE WITH AGE?
PAIN, TASTE, SMELL, VISION, ETC.
DO MOTOR FUNCTIONS CHANGE WITH AGE?
YES - PHYSIOLOGICAL TREMOR (RESTING TREMOR); NEUROMUSCULAR CONTROL DECREASES - UNSTEADY STANCE AND GAIT.
ARE VITAL SIGNS IMPORTANT?
YES- ESPECIALLY RATE AND RHYTHM OF RESPIRATIONS
OBJECTIVE DATA - MOTOR FUNCTION. WHAT TESTS?
TEST MUSCLE STRENGTH, COORDINATION, POSITION SENSE (BALANCE), AND INVOLUNTARY MOVEMENT.
WHAT ARE SOME EXAMPLES OF MOTOR FUNCTION TESTS?
WALK LINE, HOP, STAND ON 1 FOOT, FINGER TO NOSE, HEEL TO SHIN, GRIP STRENGTH
IS ASSYMETRY WITH MOTOR FUNCTION TESTS IMPORTANT?
YES
WHAT IS THE ROMBERG TEST?
WHAT IS NORMAL? ABNORMAL?
MAINTAIN BALANCE WITH EYES CLOSED, FEET TOGETHER. NEGATIVE IS NORMAL; ABNORMAL IN SENSORY ATAXIA
OBJECTIVE DATA - SENSORY FUNCTION. WHAT TESTS?
TEST PAIN, TEMPERATURE, VIBRATION, TOUCH, PROPRIOCEPTION, POSITION SENSE.
WHAT IS STEREOGNOSIS
IDENTIFY OBJECT PLACED IN PALM.
2 POINT DISCRIMINATION?
DISTINGUISH 1 VS. 1 POINT TOUCH.
OBJECTIVE DATA - REFLEX FUNCTION. WHAT TESTS?
KNEE JERK, ACHILLES TENDON, BICEPS
WHAT MAY THE ABSENCE OF REFLEXES INDICATE?
PROBLEMS IN SPECIFIC AREA OR SEVERE CNS DEPRESSION.
BABINSKI REFLEX?
STIMULATE THE BOTTOM OF FOOT WILL CAUSE FLEXION OF TOES IN PERSON OVER AGE 2 YEARS.
IS NEGATIVE BABINSKI REFLEX NORMAL IN ADULT?
YES. IT IS ABNORMAL WITH LESIONS OF PYRIMIDAL TRACTS.
DIAGNOSTIC STUDIES CARE
PRESSURE AT PUNCTURE SITE AND BEDREST FOLLOWING ARTERIOGRAM.
DIAGNOTIC STUDIES NURSING CARE. WHAT SHOULD BE DONE IF CONTRAST MEDIA IS USED?
INCREASE FLUID INTAKE - ORAL OR IV - TO HASTEN EXCRETION.
LUMBAR PUNCTURE
OFTEN USED WITH NEURO PATIENTS TO OBTAIN MEASURE PRESSURE OR TO OBTAIN SAMPLE OF CSF FOR DIAGNOSTIC TESTS.
WHERE IS THE LUMBAR PUNCTURE DONE?
SUBARACHNOID SPACE BELOW L3, L4 SO YOU DON'T MESS UP NERVES ABOVE.
LUMBAR PUNCTURE IS CONTRAINDICATED IN ...
INCREASE ICP AND INFECTION AT PUNCTURE SITE.
WHAT ARE NORMAL CHARACTERISTICS OF CSF?
CLEAR, COLORLESS, 0 RBCs, 0 ORGANISMS, FEW (<5) WBCs, SOME PROTEIN (<1% SERUM LEVEL-APPROX 60-80 mg/dl)NORMAL SERUM LEVEL IS 6-8 GM/dl); some glucose
Some protein in CSF is normal. What are these values?
<1% serum level - approx 60-80 mg/dl. (nomral serum level is 6-8 gm/dl)
Some glucose is normal in CSF. What are these values?
1/2 to 2/3 serum level - approx 50-80 mg/dl - (normal serum level is 70-120 mg/dl)
what is normal CSF pressure?
80-180 mm H2O
Is it important to know serum protein and glucose levels at same time as CSF levels of protein and glucose?
Yes
WHAT IS THE EXCEPTION TO CLEAR CSF?
NEWBORN - YELLOWISH WHICH REFLECTS BILLIRUBIN
What are the unique characteristics of neurons?
excitability: generate impulse
conductivity: pass through
transmission: pass on
What % of neurons are in the CNS?
15%
What are the parts of the neuron and can they regenerate?
cell body - cannot regenerate
dendrites - receive impulse(cannot regenerate)
axon - semds nerve impulse on - regeneration depends on presence of neurolema
cell body
metabolic center - most in CNS; some in PNS in ganglia
dendrites
receive impulse; extension of cell body
axon
only one - sends nerve impulse on
neurolglia
85% of cells in CNS
what are the functions of the neuroglia?
support
nourishment
protection
the action potential of a nerve impulse is a direct response of what?
Na+-K+ pump.
neurotransmitters
chemicals which affect the impulse crossing the synapse.
What chemicals are excitatory transmitters that aid the impulse crossing the synapse?
acetylcholine, norepinephrine,
seratonin, dopamine, histamine
inhibitory chemicals that interfere with impulse crossing the synapse are...
GABA, glycine