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106 Cards in this Set
- Front
- Back
Interrelationships of nervous system permit?
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receiving sensory stimuli from environment...
identifying/integrating adaptative processes for maintenance... orchestrating changes for adaptation/survival... integrating responses of CNS/endocrine system... controlling cognitive/voluntary behavioral processes... controlling subconscious/involuntary functions |
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What are the divisions of the nervous system?
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central
peripheral |
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What are the functions of the nervous system?
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maintains/controls body functions
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What are nervous system responses?
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voluntary
autonomic |
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What are the mechanisms for nerve impulses?
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sodium
chloride potassium proteins function as gates |
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Factors affecting transmission of nerve impulses are?
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distance
lack of oxygen effects of hypnotics anesthetics pH of ECF (acidosis depresses nerve activity) alkalosis: excites nerve cell drugs can increase nerve activity: caffeine, theophylline (in tea and asthma drugs) and theorbromine (in cocoa) |
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Anatomy and Physiology CNS?
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Parts
brain spinal cord Function coordination control for body |
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Anatomy and Physiology: Peripheral?
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Parts
motor/sensory nerves ganglia outside CNS Function carries info to/from CNS |
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Brain and spinal cord are protected by?
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skull
vertebrae meninges CSF |
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Meninges produces and drains?
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CSF
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CSF circulates in/around brain as?
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shock absorber
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____ ____ can come from the spine, muscles, nerves or other structures in the back.
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Back pain
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Symptoms can include _____, _____ _____, dull ache, sharp pain and weakness in legs or feet.
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tingling
burning sensation |
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Anatomy and Physiology
Brain Circulation? |
arterial
internal carotids vertebral basilar venous jugular veins |
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The internal carotid arteries supply ____ and the vertebral basilar arteries supply ___
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80%
20% |
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Define medulla?
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contains nuclei for regulating blood pressure and breathing...
as well as nuclei for relaying information from the sense organs that comes in from the cranial nerves |
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Define pons?
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the pons contains nuclei that relay movement and position information from the cerebellum to the cortex...
it also contains nuclei that are involved in breathing taste and sleep |
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Define midbrain?
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contains nuclei that link the various sections of the brain involved in motor functions (cerebellum, basal ganglia, cerebral cortex), eye movements and auditory control. One portion, called the substantia nigra, involved in voluntary movements, when it does not function, you have the tremored movements of Parkinson's disease
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Define thalamus?
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the thalamus relays incoming sensory pathways to appropriate areas of the cortex, determines which sensory information actually reaches consciousness and participates in motor-information exchange between the cerebellum, basal ganglia and cortex
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Define hypothalamus?
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contains nuclei that controls hormonal secretions from the pituitary gland...these centers govern sexual reproduction, eating, drinking, growth, and maternal behavior such as lactation (milk-production in mammals). The hypothalamus is also involved in almost all aspects of behavior, including your biological "clock," which is linked to the daily light-dark cycle (circadian rhythms)
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frontal lobe
temporal lobe perception/interpretation of sounds integration of taste/smell/ balance limbic system mediates behavior patterns for survival |
voluntary skeletal movement
repetitive movement |
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parietal lobe
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processes sensory data
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occipital lobe
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interprets visual data
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temporal lobe
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perception/interpretation of
sounds integration of taste/smell/ balance |
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limbic system
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mediates behavior patterns
for survival |
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Anatomy and Physiology
Cerebellum Function? |
aids in integration of voluntary movement...
processes sensory information... uses sensory data for reflex control... uses sensory data for reflex control muscle tone equilibrium posture |
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Anatomy and Physiology
Basal Ganglia? Function? |
extrapyramidal pathway
processing station between motor cortex/upper brainstem gross intentional movement without conscious thought |
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Parts of the brainstem?
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medulla oblongata
medbrain pons diencephalon |
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Function of the brainstem?
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pathway between cerebral cortex and spinal cord
controls many involuntary functions |
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Anatomy and Physiology:
Cranial Nerves? |
twelve nerves originate from
brain functions motor sensory parasympathetic |
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On Old Olympic Towering Tops A Finn And German Viewed Some Hops
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olfactory
optic oculomotor trochlear trigeminal abducens facial vestibulocochlear glossopharyngeal vagus accessory hypophyseal |
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olfactory
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smell
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optic
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vision
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oculomotor
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eyelid and eyeball movement;
via medial and laeral rectus and inferior oblique and superior rectus muscles; lid elevation via levator muscles; PARASYMPATHETIC-motor pupil constriction; ciliary muscles |
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trochlear
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innervates superior oblique
turns eye downward and laterally eye movement via superior oblique muscles |
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trigeminal
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chewing
face and mouth touch and pain sensation from skin of face and scalp and mucous membranes of mouth and nose; muscles of mastication (chewing) |
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abducens
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turns eye laterally via lateral rectus muscles
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facial
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controls most facial
expressions secretion of tears and saliva taste SENSORY: pain and temperature from ear area; deep sensations from the face; taste from anterior two thirds of the tongue MOTOR: muscles of face and scalp PARASYMPATHETIC - MOTOR lacrimal, submandibular, and sublingual salivary glands |
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vestibulocochlear (auditory)
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hearing
equilibrium sensation |
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glossopharyngeal
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taste
senses carotid blood pressure SENSORY: pain and temperature from ear; taste and sensations from posterior one-third of tongue and pharynx MOTOR: skeletal muscles of throat PARASYMPATHETIC MOTOR: parotid glands |
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vagus
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senses aortic blood pressure
slows heart rate stimulates digestive organs taste SENSORY: pain and temperature from ear; sensations from pharynx, larynx, thoracic, and abdominal viscera MOTOR: muscles of the soft palate, larynx, and pharynx PARASYMPATHETIC - MOTOR thoracic and abdominal viscera; cells of secretory glands; cardiac and smooth muscle innervation to the level of the splenic flexure |
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spinal accessory
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controls trapezius and
sternocleidomastoid controls swallowing movements MOTOR: skeletal muscles of the pharynx and larynx and sternocleidomastoid and trapezius muscles |
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hypoglossal
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controls skeletal muscles of tongue
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examination of olfactory cranial nerve
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occlude one nares
hold vial with aromatic substance under the nose, and ask the patient to deeply inspire patient should discriminate between odors |
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examination of trigeminal nerve for MOTOR function
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have patient tightly clench teeth, and then palpate the muscles over the jaw for tone
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examination of the trigeminal cranial nerve for SENSORY function
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touch each side of the face at the scalp, cheek, and chin areas alternately using no predictable pattern with, A, the pint and rounded edge of a paper clip and...(ask Jean)
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examination of the trigeminal cranial nerve for SENSORY function
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touch each side of the face at the scalp, cheek, and chin areas alternately using no predictable pattern with, B, a brush...ask the patient to discriminate between sensations
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examination of the facial cranial nerve for MOTOR fuction
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Ask the patient to:
puff out the cheeks smile wrinkle the forehead by raising the eyebrows purse the lips and blow out show the teeth squeeze the eyes shut |
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examination of the hypoglossal cranial nerve
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inspect the protruded tongue for size, shape, symmetry, and fasciculation..
observe movement of the tongue from side to side |
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examination of coordination with rapid alternating movements
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pat the knees with both hands, alternately using the palm and back of hand
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location of the taste bud regions tested for sensory function of the facial and glossopharyngeal cranial nerves
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lingual tonsil
palatine foramen caecum circumvillate papilae fungiform papilia cranial IX nerve: bilateral sour cranial VII nerve anterior two thirds: salty sweet |
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tracts of the spinal cord
(picture) |
pathway of spinal tracts from spinal cord to motor cortex
note DECUSSATION of the pyramids at the level of the medulla |
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nervous system
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whitish cords transmitting outgoing signals, from brain to organs
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cervical nerves (innervate neck and arms)
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cords conducting nerve impulses from neck and arms to cerebellum via spinal cord
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intercostal nerve
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cord conducting nerve impulses between ribs
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lumbar and sacral nerves (innervate legs and pelvic organs)
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nerves originating in lower back and extending into pelvis and legs
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sacral plexus
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network of nerves of sacrum
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spinal cord
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substance belonging to the nervous system, found in the holes of vertebrae
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brachial plexus
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network of nerves of the arm
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cerebrum
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seat of mental capacities
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Parts of spinal nerves
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31 pairs
ventral/dorsal roots |
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function of spinal nerves
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sensory/motor fibers supply/receive information
in dermatome reflex actions |
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dermatomes
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area of body surface innervated by particular spinal nerves
C1 usually has no cutaneous distribution |
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examples of nervous disorders?
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carpal tunnel syndrome
cubital tunnel syndrome |
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carpal tunnel syndrome?
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compression of the median nerve, which runs through the wrist, causing pain, numbness and tingling in first 3 fingers and base of thumb
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cubital tunnel syndrome?
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compression of ulnar nerve, which runs over the elbow, causing pain, numbness and tingling in ring finger and little finger
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anatomy and physiology of infants and children
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major brain growth/myelinization in first year of life
primitive reflexes present in neewborn motor maturation in cephalocaudal direction brain growth continues until 12-15 years of age |
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anatomy and physiology of pregnant women
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hypothalamic-pituitary
neurohormonal changes common alterations headaches numbness/tingling of hands no rest after sleep inability to sleep |
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anatomy and physiology of older adults
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changes physiologic rather than anatomic
cerebral neurons decrease velocity of nerve impulse conduction declines slowed response time diminished touch/pain perception seizures or convulsions sequence of events character of symptoms aura automatism muscle tone postictal behavior relationship of seizure to other events frequency of seizure medication |
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related history: present problem
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pain
onset quality location associated manifestations efforts to treat medications |
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related history: present problem
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gait coordination
balance falling legs simply give way associated problems medications weakness/paresthesia onset character associated symmptoms concurrent chronic illness (HIV, nutritional/vitamin deficiency) medications |
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related history: past medical history
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trauma
meningitis encephalitis plumbism deformities congenital anomalies cardiovascular/circulatory problem neurologic disorder/brain surgery/residual effects |
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Related history: family history
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hereditary disease
medical/metabolic disorder alcoholism mental retardation epilepsy or seizure disorder/ headaches Alzheimer disease learning disorders weakness/gait disorders |
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Related history: personal/social history
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environmental/occupational
hazards hand, eye, foot dominance ability to care for self sleeping/eating patterns use of alcohol/drugs |
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related history: infants
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prenatal history
birth history respiratory status at birth neonatal health congenital anomalies multiple handicapping conditions |
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related history: children
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developmental milestones
age attained loss of previously achieved function performance of self-care activities health problems headaches seizure activity clumsiness/unsteady gait muscular weakness/failing |
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related history: pregnant
women |
weeks of gestation or EDC
convulsions/headache seizure activity headache nutritional status |
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related history: older adults
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increased stumbling/falls
decreased agility safety modification at home interference with performance of ADLs hearing loss, vision deficit, or anosmia development of tremor fecal/urinary incontinence transient neurologic deficits |
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exam and findings: equipment
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penlight
tongue blades sterile needles tuning forks familiar objects cotton wisp monofilament reflex hammer vials of aromatic substances vials of solutions test tubes of hot/cold water Denver II |
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exam and findings: screening exam
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components
cranial nerves proprioception/cerebellar function sensory function DTRs |
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Olfactory (I)
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sensory / smell
test for odor id |
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Optic (II)
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sensory/visual acuity
test for visual acuity test visual fields perform ophthalmologic exam |
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exam and findings: cranial nerves
oculomotor, trochlear, abducens (III, IV, VI) |
inspect eyelids for drooping..
inspect pupils for size/equality... test consensual response/accommodation... test extraocular eye movements.... |
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exam and findings: cranial nerves
trigeminal V |
mixed/muscle tone, sensation
inspect face for atrophy/tremors... palpate jaw for tone/strength... test for pain/sensation... test corneal reflex |
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exam and findings: cranial nerves
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facial (VII) mixed/facial expressions, taste
inspect facial symmetry test tongue for salt/sweet acoustic (VIII) - sensory and hearing, balance test hearing compare bone/air conduction test for sound lateraliza- tion |
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exam and findings: cranial nerves
glossopharyngeal IX |
mixed/taste/swallowing
test tongue for sour/bitter test gag reflex/swallow |
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Exam and findings: cranial nerves
vagus (X) |
mixed/swallowing/speech
inspect palate/uvula for symmetry inspect for swallow difficulty evaluate guttural speech sounds |
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exam and findings: cranial nerves
spinal accessory (XI) |
motor/muscle strength
test trapezius/sternocleidomastoid muscle strength hypoglossal (XII) motor/tongue strength inspect tongue for symmetry/tremors/atrophy test tongue movement test tongue strength evaluate lingual speech sounds |
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exam and findings
coordination/fine motor skills |
test rapid rhythmic alternating movements
evaluate rhythm/flow/speed test accuracy of movements evaluate accuracy/speed/ rhythm test balance evaluate equilibrium observe gait |
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exam and findings: gait patterns
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spastic hemiparesis
spastic diplegia steppage waddling tabetic cerebellar sensory ataxia Parkinsonian ataxia analgic limp |
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Exam and findings: sensory function
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types
primary cortical primary functions superficial ttough superficial pain temperature deep pressure vibration joint position cortical functions stereognosis two-point discrimination extencition phenomenon graphesthesia point location observe all sensory fucntion tests for: side-to-side differences interpretation of sensation discrimination location If impairment found, map boundaries by DERMATOME |
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Exam and findings..
types of reflexes |
superficial
deep |
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exam and findings...superficial reflexes
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upper abdominal
lower abdominal cremasteric plantar |
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exam and findings: reflexes
deep reflexes? |
biceps
brachioradial triceps patellar achilles |
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exam and findings: reflexes
observe superficial reflex tests for? |
abdominals - equal movement of umbilicus
cremasteric - rising of testicle/scrotum plantar - fanning of toes/dorsiflexion of great toe |
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exam and findings: reflexes
observe deep tendon reflex test for? |
bicpes - elbow flexion
brachioradial - forearm pronation/elbow flexion patellar - lower leg extension achilles - foot flexion clonus triceps - elbow extension |
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Exam and findings
Additional procedures |
monofilament test
protective sensation on foot meningeal signs nuchal rigidity brudzinski kernig |
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Exam and findings: Infants
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cranial nerves indirectly
tested cranial nerves II, III, IV, VI optical blink reflex gaze/tracking doll's eye CN V rooting sucking CN VII facial expressions forehead wrinkling smile CN VIII acoustic blink reflex doll's eye maneuver CN IX, X swallowing reflex CN XII sucking/swallowing ability tongue position with pinch test Observe movement spontaneity symmetry |
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Exam and findings: infants
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evaluate primitive reflexes
palmar plantar moro placing stepping asymmetric tonic neck inspect/palpate muscle strength/tone |
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Exam and findings: children
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observe neuromuscular development progress/skills displayed during PE
evaluate developmental level CN exam modified according to age observe at play gait/fine motor coordination heel-to-toe walking, hopping, jumping DTRs not routinely tested in young children soft signs unexpected findings in school-age child considered normal in younger child may be gross/fine motor, sensory, reflex |
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exam and findings: pregnant women
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same as for adult
DTRs on initial exam serve as baseline |
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exam and findings: older adult
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exam same as adult
meds can impair CNS function slowed reaction time/ tremors/anxiety test gait for decreases in speed/balance/grace check tactile/vibratory sense for impairment check DTRs for diminished response |
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Common abnormalities: CNS
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AIDS dementia complex
multiple sclerosis generalized seizure disorder meningitis |
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Common Abnormalities: CNS
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encephalitis
Lyme disease intracranial tumors CVA |
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Common Abnormalities:
Peripheral Nervous System |
myasthenia gravis
Guillain-Barre Peripheral neuropathy |
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Common Abnormalities
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Pregnant women
maternal obstetric palsy Older adults Parkinsons Normal-pressure hydrocepha- lus |