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Flashcards in Neuro Deck (27)
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1
Q

Neurological Assessment (5)

A
  • LOC
  • CN Function
  • Motor Function: muscle strength; cerebellar function; gait and balance
  • Peripheral Nerves/ Sensation
  • Reflexes (Babinski, DTRs)
2
Q

Assessment LOC and mental Stat
alert
not alert
other

A
  • Q4: person, place, time, situation
  • Glasgow Coma Scale (GCS)
  • ABCT: appearence, behavior, cognition, thought process
3
Q

GCS

A

Glasgow Coma Scale

  • eye opening
  • verbal responce
  • motor responce
4
Q

This is a type of flexed posturing and can indicate damage to the cerebral hemispheres.

There will be adduction and flexion of the arms and the hands will be closed shut (flexed). The legs will be rotated internally and feet flexed.

A

Decorticate

5
Q

This is a type of extended posturing and can indicate damage to the brain stem. Severe.

There will be adduction and extension of the arms and pronation of the hands and the fingers will be flexed along with extended legs and plantar flexion of the feet.

A

Decerebrate

6
Q
Assessment of CN I - XII, and abnormal finding
CN I- olfactory 
II- optic
III- ocularmotor
IV- Trochlear
V- Trigeminal
VI- Abducens
VII- Facial
VIII- Vestibulocochlear
IX- Glossopharyngeal
X- Vagus
XI- Accessory
XII- Hypoglossal
A

CN I- olfactory: Smell test. Abnormal- anosmia.
II- optic: Sullen eye chart, confrontation, ophthalmoscopic. Abnormal- visual field loss, papilledema.
III- ocularmotor, IV- Trochlear, VI- Abducens: EOMs, PERRLA. Abnormal- ptosis, nystagmus, strabismus, absence of PERRLA.
V- Trigeminal: muscles of mastication, light touch.

VII- Facial: facial symmetry, sweet/ salty taste.
VIII- Vestibulocochlear: whispered voice test.
IX- Glossopharyngeal: gag, sour/ bitter.
X- Vagus: gag “ahhhh”.
XI- Accessory: shoulder shrug, turn head against resistance.
XII- Hypoglossal: midline protrusion of tongue.

7
Q

Examine Muscles (4)

A
  • Size
  • Strength
  • Tone (assess via passive ROM)
  • ROM
8
Q

Muscle tone, 3 movements to note:

A

flaccidity
spasticity
rigidity

9
Q

paresis

A

weakness, eg: 1/5 strength

10
Q

Cerebellar Function Test (5)

A
  • RAMs
  • Finger-nose-finger
  • Heel-to-shin
  • Tandem walking
  • Romberg
11
Q
  • RAMs
  • Finger-nose-finger
  • Heel-to-shin
  • Tandem walking
  • Romberg
A

RAMs: Rapid alternating movements (pronation/ supination on thighs; touching each finger to thumb)

  • Finger-nose-finger: look for Dysmetira (tremmor or overshooting)
  • Heel-to-shin: tests lower extremity coordination
  • Tandem walking: Ataxia (uncoordinated unstready gait)
  • Romberg: pt stands with feet together, ares at sides, eyes closed for 20 seconds
12
Q

Assess Peripheral Sensation tests (5)

A
  • sharp vs dull
  • light touch
  • vibration
  • position (with pt eyes closed, move a finger or the big toe up or down and have the pt tell you which way it is moved)
  • Monofilament Test: platar side of foot, test 7 sites at random, have pt tell you when they feel the filament (test for neropothy associated with DM)
13
Q
Tactile Discrimination:
Stereognosis 
Graphesthesia
2 point discrimination
Point location

Abnormalities

A

Stereognosis: key in hand
Graphesthesia: number drawn on hand
2 point discrimination: 2-8mm on fingers
Point location: “put your finger where I touch you”

any abnormalities occur with parietal cortex lesions; or dermatome (spinal cord)

14
Q

DTRs

where is each reflex, what movement is triggered

A
Deep Tendon Reflex
Bicep: flexion
Tricep- extension
Brachioradialis: supination and flexion
Quadriceps (patellar): extension
Achelles: plantar flexion
15
Q

DTRs
hyper/hyopflexion meaning
Clonus
Babinski

A

-Hyperflexion: LMN lesion
-Hypoflexion: UMN lesion
-Clonus: raipd rhythmic contractions of the same muscle (briskly dorsiflex the foot and hold; + = rapid tapping motion)
-Babinski: “J” drawn from heel across ball of foot. Toe curling= plantar reflex present, normal
Toe fanning= + Babinski, abnormal (unless <24 months old)

16
Q
Developmental Competence: Infants
shrill cry
When should the following stop?
Rooting
Sucking
Palmar grasp
Babinski
Tonic Neck
Moro
Placing and stepping
A
  • shrill cry: CNS damage
  • Rooting: baby turns head towards touch; 4mo
  • Sucking: 12mo
  • Palmar grasp: 4mo
    • Babinski: 24 mo
  • Tonic Neck: fencing position; 6mo
  • Moro: startle; 4mo
  • Placing and stepping: tries to place foot on table and step; 4 days walking
17
Q

Cushing’s Triad

A

increased SBP, widening PP, decreased HR

18
Q

Neuro Checks (4)
when is it used
normal vs abnormal

A

-Used when doing frequent checks on pt with CVA or brain trauma (usually q1-q2). Assess neuro decline and ICP

  • LOC/ GCS
  • Motor function (upper and lower strength; facial movement; pronator drift- pt holds arms out w/ eyes closed)
  • PERRLA
  • Vitals (crushing’s triad)
19
Q

Motor System Dysfunction
what is this
causes
s/s

A

UMN/ LMN lesions resulting in paresis or paralyzation.

  • UMN Lesions: problems in CNS; eg: CVA, cerebral palsy. MS
  • LMN Lesions: problems in the PNS; eg: spinal cord injury, herniated disk, polio, Guillain-Barre

-muscle weakness, paralyzation, site of transection will affect the site bellow the injury (quadriplegia: LMN at cervical vert., paraplegia: LMN at lumbar vert., hemiplegia/ hemiparesis: UMN: stroke)

20
Q
MS
what it is
cause
s/s
average age of diagnosis
A

Multiple Sclerosis
-Autoimmune disorder

  • Progressive demyelination of brain and spinal cord
  • vary depending on location of demyelination: nystagmus, diplopia, fatigue, weakness, spasticity, loss of balance, hyperreflexia, +Babinski

-average age of diagnosis is 32

21
Q

Parkinson’s Disease
what it is
cause
s/s

A
  • A disorder of the CNS that affects movement can causes tremors.
  • Degeneration of dopamine producing neurons in the basal ganglia causing over activation of ATP

-Findings: Rest tremor, rigidity, flat affect, shuffling gait

22
Q

CVA
what it is (types)
cause
s/s

A

Cerebral Vascular Accident

  • ischemia to the brain
  • HTN, smoking, obesity, DM

-Findings: relates to what part of the brain is affected and the extent of the ischemia

23
Q

AD
what it is
cause
s/s

A

Alzheimer’s Disease

  • incurable degenerative neurologic disorder
  • unknown (poss: toxins, autoimmune, virus, hx of CVA)

-Findings: *recent memory loss, personality changes, getting lost in familiar places

24
Q

Guillain-Barre Syndrome
what it is
cause
s/s

A

-widespread demyelination of PNS
-unknown
-Findings: Ascending Paralysis (weakness in the lower extremities; ascends to upper extremities and face)
DTRs absent

25
Q

ischemia

A

an inadequate blood supply to an organ or part of the body

26
Q

BE FAST

A

Balance decrease, Eye (blurred vision), Facial drooping, Arm weakness, Speech different, Time to call 911

27
Q
Types of CVA:
Transient Ischemic 
Hemorrhagic 
Embolic
Thrombotic
A

Transient Ischemic: loss of blood a portion of the brain symptoms lasting <1hr
Hemorrhagic: ruptured blood vessel
Embolic: a clot that travels to the brain a blocks blood flow
Thrombotic: clot formed in the blood vessels of the brain leading to a blockage