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