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NUR350 > Neurological Assessment > Flashcards

Neurological Assessment Flashcards

1
Q

Central Nervous System includes

A

Brain
Spinal Cord

  • Meninges (dura, arachnoid and pia mater) layers of membrane that protect CNS
  • Cerebrospinal fluid
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2
Q

Peripheral Nervous System includes

A 
cranial nerves (12 pairs)
spinal nerves (31 pairs)
and their branches

sensory (afferent) messages to CNS
motor (efferent) messages from CNS

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3
Q

Cerebral cortex

A

cerebrum’s outer folded layer of nerve cell bodies

  • lacks myelin
  • “grey matter”
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4
Q

Basal Ganglia

A

bands of grey matter buried deep within the two cerebral hemispheres

  • subcortical associated motor system
  • controls automatic movements (i.e. arm swing when walking)
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5
Q

Thalamus

A

Main relay system for the nervous system

  • sensory pathways of the spinal cord and brain stem form synapses on the way to cerebral cortex
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6
Q

Hypothalamus

A

Control centre for vitals

  • temperature
  • heart rate
  • blood pressure
  • regular sleep, anterior and posterior pituitary glad
  • emotional status
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7
Q

Cerebellum

A

Coiled structure under occipital lobe

  • Motor coordination of voluntary movements
  • Equilibrium (balance)
  • Muscle tone
  • smooths movement
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8
Q

Brain Stem

A

Mostly nerve fibres, connects to spinal cord

  • Midbrain
  • Pons
  • Medulla
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9
Q

Spinal Cord

A

Long cylindrical structure of nervous tissue down to L1/L2, main pathway for ascending and descending fibre tracts

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10
Q

Frontal Lobe

A
  • personality
  • behaviour
  • emotion
  • intellectual functions

Broca’s area: mediated motor speech
injury can cause expressive aphasia - can understand language but cannot talk

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11
Q

Temporal Lobe

A
  • hearing
  • taste
  • smell

Wernicke’s area: language comprehension
injury can cause receptive aphasia - hears words but cannot comprehend

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12
Q

Parietal Lobe

A
  • sensation
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13
Q

Occipital Lobe

A
  • visual receptor
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14
Q

Sensory Pathways

A

a. Spinothalamic tract
- pain
- temperature
- light touch

b. Posterior (dorsal) column
- proprioception (body position in relation to surrounding)
- vibration
- stereognosis (identify an object without visual input)

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15
Q

Crossed Representation

A

Right cerebral cortex controls left side of the body

Left cerebral cortex controls right side of the body

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16
Q

Motor Pathways

A

a. Corticospinal (pyramidal) tract
- skilled, purposeful voluntary movement
- higher order motor skills (writing, playing piano)

b. Extrapyramidal tract (primitive system)
- muscle tone
- gross body movements (walking)

c. Cerebellar system (on a subconscious level)
- coordinates movement (making them smoother)
- maintains equilibrium
- posture

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17
Q

Motor Neurons

A

Upper Motor Neurons

  • located in CNS, influence lower motor neurons
  • corticospinal or extrapyramidal tract
    i. e. of upper motor neuron disease: cerebral palsy

Lower Motor Neurons

  • located in PNS, final pathway
  • cranial and spinal nerves
    i. e. of lower motor neuron disease: spinal cord lesions
18
Q

Cranial Nerves

A

Exit from the brain

Mainly supply head and neck

19
Q

Spinal Nerves

A

Named by the region of the spine they exit

- all mixed nerves: both sensory and motor

20
Q

Dermatome

A

circumscribed skin area that is supplied mainly from one spinal cord segment through a particular spinal nerve

21
Q

Reflex Arc

A

Defence system of the PNS

- quick, involuntary and below level of conscious control

22
Q

Automatic Nervous System

A

A division of PNS

a. Sympathetic Nervous System
- fight or flight
b. Parasympathetic Nervous System
- rest or digest

23
Q

4 Types of Reflexes

A
  1. Deep Tendon Reflexes
    - knee jerk
  2. Superficial Reflexes
    - corneal reflex, abdominal reflex
  3. Visceral Reflexes
    - pupillary response
  4. Pathologic Reflexes
    - Babinski, pathologic because it should not be seen in adults
24
Q

Dev Considerations - Infants

A
  • dramatic growth and development of neurological system during 1st year of life
  • movement directed by primitive reflex
  • sensory and motor systems develop from myelinization (from proximal to distal)
25
Q

Dev Considerations - Older Adults

A

General atrophy
- impaired coordination and agility

Cranial/spinal nerves
- conduction reduces, slowed reaction

Motor system
- slowed movement, loss of balance

*Intellectual functioning change is person-dependent!

26
Q

Subjective Assessment of Neuro

A
  1. Headache
  2. Head injury
  3. Dizziness or vertigo
  4. Seizures
  5. Termors
  6. Weakness
  7. Incoordination
  8. Numbness or tingling
  9. Difficulty swallowing (dysphagia)
  10. Difficulty speaking
  11. Significant past history
  12. Environmental and occupational hazards
27
Q

Complete Neurological Exam

A
  1. Cranial Nerves
  2. Motor System
  3. Sensory System
  4. Reflexes
28
Q

Cranial Nerve I

A

Olfactory

sense of smell (smell test)

29
Q

Cranial Nerve II

A

Optic

visual acuity (snellen/jaegar)
visual fields (confrontation)
30
Q

Cranial Nerves III, IV, VI

A

Oculomotor
Trochlear
Abducens

movement (palpebral fissure, PERRLA, EOM)

31
Q

Cranial Nerve V

A

Trigeminal

sensory (light touch test)
motor (temporal, masseter and jaw)

32
Q

Cranial Nerve VII

A

Facial

motor (symmetry of expressions)
sensory
parasympathetic

33
Q

Cranial Nerve VIII

A

Acoustic (Vestibulocochlear)

hearing acuity (whispered voice test)

34
Q

Cranial Nerves IX and X

A

Glossopharyngeal
Vagus

motor (movement of pharynx - uvula, soft palate, tonsillar pillars)
sensory, taste

35
Q

Cranial Nerve XI

A

Spinal Accessory

motor (neck - head rotation and shrug)

36
Q

Cranial Nerve XII

A

Hypoglossal

motor (tongue and articulation)
“light, tight, dynamite”

37
Q

Motor System Assessment

A

a. Muscles
- size, tone, strength, involuntary movement

b. Balance Tests
- gait
- tandem walking (heel-to-toe)
- Romberg Test (stand with eyes closed)

c. Coordination & Skilled Movements
- rapid alternating movement
- finger to finger test
- finger to nose test
- heel to shin test

38
Q

Sensory System Assessment

A

a. Spinotholamic Tract
- pain
- temperature
- light touch

b. Posterior Column Tract
- vibration (tuning fork)
- position (passive movement)
- fine touch (tactile discrimination)
stereognosis - recognize object with eyes closed
graphesthesia - draw letter on hand
two-point discrimination

39
Q

Deep Tendon Reflex Testing

A

a. Biceps
b. Triceps
c. Brachioradialis (forearm)
d. Quadriceps (patellar)
e. Achilles (heel)

*grade on 4-point scale

40
Q

Superficial Reflex Testing

A

Plantar Reflex

NUR350 (27 decks)

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