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52 Cards in this Set

  • Front
  • Back
What are the four main divisions of the brain?
1. cerebrum
2. diencephalon
3. cerebellum
4. brain stem
What does the diencephalon have in it?
What is cognitive functioning?
The ability to use language, memory, judgement and make decisions.
Consciousness is the level of _________ of the _____ and the _____.


Arousal is controlled by what part of the brain?
RAS which is located in the brain stem. RAS activates the cerebral cortex (outermost part of the cerebrum)
Which part of the brain is responsible for interpreting the signals sent by the RAS and forming awareness, which is a higher level function?
cerebral cortex
What are the types of stimuli that effect the level of consciousness?
environmental stimuli
verbal stimuli
tactile stimuli
painful stimuli
What types of questions would assess the patients orientation?
This is an international method for grading neurological responses of the injured or severly ill patient.
Glasgow Coma Scale
What is the scale of GCS?
Highest score of responsivness is 15 and the lowest is 3. A score of 15 would indicate a fully alert, oriented individual.

**GCS is on test, even though she never talks about it
What are the three parameters of consciousness that the GCS assesses?
eye opening
verbal response
motor response
Assessment of cognitive function includes testing of these 9 things:
1) attention
2) memory
3) judgment
4) insight
5) spatial perception
6) calculation
7) abstract reasoning
8) thought processes
9) thought content
What is a test to assess attention?
Serial 7's
What is a test to assess memory?
triangle green 5
How do you assess judgment?
Would you go into a burning house?
How do you assess insight?
During health history if they can properly and realistically understand their what is their health status, symptoms, etc.
What is spatial perception?
The ability to recognize the relationships of objects in space. Tests include: drawing a clock, drawing things previously drawn, and identifying right from left body parts
How would you assess calculation?
serial 7's (just like you assessed attention)
How do you assess abstract reasoning?
the fables or metaphor test
What are the three types of sensory that you are looking for in a sensory assessment?
exteroceptive sensation

proprioceptive sensation

cortical sensation
Describe exteroceptive sensation.
It originates in the skin and mm. They are sensations to light touch, superficial pain and temperature.
How is proprioception tested?
motion and position

vibration sense
Where is proprioceptive sensation originating from?
deep sensations with sensory receptors in the muscles, joints, tendons and ligaments
What do cortical sensations require?
cerebral integrative and discriminative abilities
What are the components of cortical sensations?
two point discrimination
What is sterognosis?
the ability to identify objects by manipulating and touching them
What is graphesthesia?
the ability to identify numbers written on your hand
What is two point discrimination?
touching two part of the body simulatiously
What is extinction?
The ability to know when two points are stimulated at the same time, and if one is stopped, which one stopped, and what is still being felt.
What are the 12 cranial nerves?
spinal accessory
What is the CN1?

What does it do?

How do you test it?
olafactory nerve


smell test by occulding one nostril
What is CN2?

What does it do?

How do you test it?
optic nerve

visual acuity: distance vision & near vision & visual fields

Snellen chart/Close up reading/pirate patch pen out to side
What is CN3?

What does it do?

How do you test it?
oculomotor nerve

cardinal fields of gaze & pupil reactions

six point pen plus convergence/penlight pupil
What is CN4?

What does it do?

How do you test it?
trochlear nerve

moves eyeball up and down and around and around

cardinal fields of gaze test (6 point pen)
What is CN5?

What does it do?

How do you test it?
Trigeminal nerve

sensation in the face

cotton swab on the cheek..light touch
What does a neurological assessment include?
Assessment of:

-mental status
-cranial nerves
-motor function
-cerebellar function
What is CN6?

What does it do?

How do you test it?
Abducans Nerve CN VI

Moves eye outward

Cardinal Fields of Gaze ( 6 point pen test)
What is CN7?

What does it do?

How do you test it?
Facial Nerve

Moves the muscles in the face

Ask patient to frown, raise eye brown, wrinkle forehead while looking up
close eye tightly and resist you trying to open it, smile, show teeth, purse lips, puff out cheeks
What is CN8?

What does it do?

How do you test it?
Acoustic Nerve

Hearing & Balance

Voice Whisper test & Vertigo questions
What is CN9?

What does it do?

How do you test it?
Glossophnaryngeal Nerve

Gag reflex

Tested along with vagas nerve and hypoglossal nerve...put the stick in mouth, observe the uvula, ask to say ah, then put stick to back of tongue and gag...then move on to hypoglossal nerve with a tongue out and lalal
What nerves are tested together?
3,4,6 (Occulomotor, Trochlear & Abducans - all with cardinal fields of gaze - 6 point pen test)

9, 10, 12 (glossopharyngeal, vagas, hypoglossal (sticking stick in mouth, gag, uvula, ah, lalala)
What is CN10?

What does it do?

How do you test it?
vagas nerve

tons of stuff from speech to heart rate stimulation to sweating

With 9 and 12 when you use the stick, say ah, look at uvula, gag and lalala with tongue out up and down side to side
What is CN11?

What does it do?

How do you test it?
Spinal Accessory Nerve

provides movement to sternocleomastoid muscle (turning head side to side) and movement of trapezius muscles (shoulder shrug)

resistance to head turn & resistance to shrug test
What is CN12?

What does it do?

How do you test it?
Hypoglossal Nerve

Moves the tongue

ask patient to move tongue all around and say lalala
How do you test the motor system in a neurological assessment?
pronator drift test...done with romberg's test because of standing component
How do you test the cerebellar function in a neurological assessment?
1. test coordination (nose to finger, fingers to fingers, opposite finger to nose test, tap his feet)

2. test gait (walk straight line, heel toe, heel toe, note patient's ability to maintain balance)

3. Romberg's test (stand erect, feet together, arms at side, first with eyes open, then closed)
Describe glabellar, clonus, and babinski reflexes.
Glabellar - tap on forehead, hyperactive blinking

Clonus - rhythmic oscillation of involuntary muscle contraction...bending knee flexing foot and having sustained clonus

Babinski - fanned toes, they should be plantar if over 18 months

If the patient shows signs of nuchal rigidity, what should you suspect? What can you do to test this situation?

Kernig's sign (resistance to extension and pain of knee that is flexed due to spasm of hamstring)& Brudzinski's sign (neck to leg pop up)
What types of gerontological variations should you expect in regard to neurological assessment?
decreased oxygen supply to brain

neruonal changes..decreased nerve conduction rate

total brain weight decreased

sensory changes (vision, hearing, pain)

cognitive changes (decreased memory (short term))
Positive babinski is described as:
toes abduct and great toe dorsiflexes
slurred speech
Can't accurately perform finger tip to nose touch test