Unit 1: Care Of The Client With Neurologic Dysfunction

Front 1

-Acute confusional state
-An acute disorder of cognition
-May be seen postoperatively in the elderly
-Often an early indicator of various illnesses

Back 1

-Delirium

Front 2

Name the 5 components of a mental status examination:

Back 2

1.) General Appearance and Behavior: motor activity, body posture, dress and hygiene, facial expression, and speech

2.) State of Consciousness: orientation to time, place, person, and situation; memory, general knowledge, insight, judgement, problem solving, and calculation

3.) Mood and Affect: agitation, anger, depression, or euphoria

4.) Thought Content: illusions, hallucinations, delusions, or paranoia

5.) Intellectual Capacity: retardation, dementia, and intelligence

Front 3

Name the following cranial nerves:

-On Old Olympus Towering Tops A Fin And German Vend All Hops

Back 3

1.) Olfactory
2.) Optic
3.) Occulomotor
4.) Trochlear
5.) Trigeminal
6.) Abducens
7.) Facial
8.) Acoustic
9.) Glossopharyngeal
10.) Vagus
11.) Spinal Accessory
12.) Hypoglossal

Front 4

How is the olfactory nerve tested for efficiency?

Back 4

-Close one nostril, close both eyes, and sniff (repeat with other nostril)
-Often use a familiar scent such as coffee, spice, or soap
-(Generally not tested unless a noticed problem with sense of smell occurs)

Front 5

How is the optic nerve tested for efficiency?

Back 5

-Confrontation: examiner is positioned opposite the pt, askes the pt to close one eye, look directly at the bridge of the examiner's nose, and indicate when an object presented from the periphery of each of the 4 visual field quadrants is seen and repeated

-Snellen Chart

Front 6

How are the oculomotor, trochlear, and abducens nerves tested for efficiency?

Back 6

-Follow the examiner's fingers and traces a "H"

-Convergence: eyes turning inward

-Accommodation: pupils constricting with near vision

-Consensual: shine a light into the pupil or one eye and looks for symmetrical constriction of the same pupil and constriction

Front 7

Eyes do not move together:

Back 7

-Disconjugate gaze

Front 8

Fine, rapid jerking movements of the eyes:

Back 8

-Nystagmus

Front 9

How is the trigeminal nerve tested for efficiency?

Back 9

-Having the patient identify light touch and a pinprick in each of the 3 divisions (opthalmic, maxillary, and mandibular) of the nerve on both sides of the face
-Patient's eyes should be closed
-Motor component is tested by asking the pt to clench the teeth and palpating the masseter muscles just above the mandibular angle

Front 10

How is the facial nerve tested for efficiency?

Back 10

-Asking the pt to raise eyebrows, close the eyes tightly, purse the lips, draw back the corners of the mouth in an exaggerated smile, and frown

Front 11

How is the acoustic nerve tested for efficiency?

Back 11

-Have the pt close eyes and indicate when a tickling watch or the rustling of the examiner's fingertips is heard as the stimulus is brought closer to the ear
-Each ear is tested individually

Front 12

How are the glossopharyngeal and vagus nerves tested for efficiency?

Back 12

-Tested together
-Test for gag reflex
-Sensory component is mediated by glossopharyngeal nerve (CN IX) and the major motor component by the vagus nerve (CN X)

Front 13

How is the spinal accessory nerve tested for efficiency?

Back 13

-Shrug the shoulders against resistance and to turn the head to either side against resistance

Front 14

How is the hypoglossal nerve tested for efficiency?

Back 14

-Ask the pt to protrude the tongue (should stay midline)

Front 15

Third cranial nerve:

Back 15

-oculomotor

Front 16

-Loss of one's sense of direction, position, or relationship with one's surroundings
-Mental confusion or impaired awareness, especially regarding place, time, or personal identity:

Back 16

-disorientation

Front 17

When the eyes stay centered as the head moves instead on focusing and moving as head is turned:

Back 17

-doll's eyes

Front 18

Failure of the eyes to turn together in the same direction:

Back 18

-dysconjugate gaze

Front 19

Relaxed, flabby, or without tone:

Back 19

-flaccid

Front 20

Relating to a localized area:

Back 20

-focal

Front 21

The large opening in the basal part of the occipital bone through which the spinal cord becomes continuous with the medulla oblongata:

Back 21

-foramen magnum

Front 22

Paralysis of one side of the body:

Back 22

-hemiplegia

Front 23

Loss of vision for one half of the visual field of one or both eyes:

Back 23

-hemianopsia or hemianopia

Front 24

Pain of a severe, throbbing, or stabbing character in the course or distribution of a nerve:

Back 24

-neuralgia

Front 25

Resistance to flexion of the neck:

Back 25

-nuchal rigidity

Front 26

An abnormal involuntary repetitive movement of the eyes:

Back 26

-nystagmus

Front 27

Mentally dulled:

Back 27

-obtunded

Front 28

Congenital or acquired weakness of the arterial wall resulting in dilation and ballooning of the vessel:

Back 28

-aneurysm

Front 29

Profound state of unconsciousness:

Back 29

-coma

Front 30

The blink that occurs with irritation of the eye:

Back 30

-corneal reflex

Front 31

The reaction of both pupils when only one eye is exposed to a change in light intensity:

Back 31

-consensual eye reflex

Front 32

A state of temporary but acute mental confusion:

Back 32

-delirium

Front 33

Double vision:

Back 33

-diplopia

Front 34

Drainage from the ear:

Back 34

-otorrhea

Front 35

Paralysis characterized by motor and/or sensory loss in the lower limbs and trunk:

Back 35

-paraplegia

Front 36

Paralysis of all four limbs, both arms and both legs, as from a high spinal cord accident or stroke:

Back 36

-quadraplegia

Front 37

Medical term for a runny nose:

Back 37

-rhinorrhea

Front 38

A state of increased tone of a muscle (and an increase in the deep tendon reflexes):

Back 38

-spasticity

Front 39

Sleepiness:

Back 39

-stupor

Front 40

The protrusion of brain tissue into the tentorial notch, caused by increased intracranial pressure resulting from edema, hemorrhage, or a tumor. Characteristic signs are severe headache, fever, flushing, sweating, abnormal pupillary reflex, drowsiness, hypotension, and loss of consciousness:

Back 40

-tentorial herniation

Front 41

Increased accumulation of fluid in the extravascular spaces of brain tissue:

Back 41

-cerebral edema

Front 42

Name the 3 types of cerebral edema:

Back 42

1.) Vasogenic Cerebral Edema
2.) Cytotoxic Cerebral Edema
3.) Interstitial Cerebral Edema

Front 43

Occurs when a mass lesion in the cerebrum forces the brain to herniate downward through the opening created by the brainstem:

Back 43

-tentorial herniation

Front 44

Occurs when there is lateral and downward herniation:

Back 44

-uncal herniation

Front 45

Occurs when there is lateral displacement of brain tissue beneath the falx cerebri:

Back 45

-cingulate herniation

Front 46

Opening into the cranium with a drill; used to remove localized fluid and blood beneath the dura:

Back 46

-Burr hole

Front 47

Opening into the cranium with removal of a bone flap and opening the dura to remove a lesion, repair a damaged area, drain blood, or relieve increased ICP:

Back 47

-Craniotomy

Front 48

Excision into the cranium to cut away a bone flap:

Back 48

-Craniectomy

Front 49

Repair of a cranial defect resulting from trauma, malformation, or previous surgical procedure; artificial material used to replace damaged or lost bone:

Back 49

-Cranioplasty

Front 50

Precision localization of a specific area of the brain using a frame or a frameless system based on 3-dimensional coordinates; procedure is used for biopsy, radiosurgery, or dissection:

Back 50

-Stereotaxis

Front 51

Alternate pathway to redirect CSF from one area to another using a tube or implanted device:

Back 51

-Shunt procedures