Neurologic system

Flashcard maker : Karen Combs
list the major functions of the 4 lobes in the cerebral cortex and the fn of wernicke’s area and Broca’s area
– frontal lobe = personality, behavior, emotions, and intellectual function.
-parietal lobe = postcentral gyrus is the primary center for sensation
– occipital lobe = primary visual receptor center
– temporal lobe = behind the ear and primary auditory reception center
– Wernicke’s = in the temporal lobe, language comprehension (damage = receptive aphasia = can hear bla bla bla)
– broca’s in frontal lobe, mediates motor speech (damage = expressive aphasia = can understand but can’t say it)
list the major functions of basal ganglia, thalamus, hypothalamus, and cerebellum
-basal ganglia = control automatic associated movements of the body, the arm swing alternating with the legs during walking
– thalamus = main relay station for the nervous system,
– hypothalamus = major control center with many vital functions: temp, HR, BP, sleep center, anterior and posterior pituitary gland regulator, and coordinator of autonomic nervous system activity and emotional status.
– cerebellum= concerned with motor coordination of Voluntary movements, equilibrium, and muscle tone (doesn’t initiate movement but smoothes it. coordinates many muscles piano, swim, juggle, like a autopilot. corrects voluntary movement under conscious level)
list the major functions of midbrain, pons, medulla, and spinal cord
-midbrain= merges into thalamus and hypothalamus. contains many motor neurons and tracts
-pons= the enlarged area containing ascending and descending fiber tract
-medulla= the spinal cord in the brain that contains all ascending and descending fiber tracts. it has vital autonomic venters: resp, heart, GI fn, as well as nuclei for cranial nerves VIII through XII. pyramidal decussation (crossing of the motor fibers) occurs here (gag, cough, hickupin, autonomic)
-spinal cord= main high way for ascending and descending fiber tracts that connect the brain to the spinal nerves, Mediates reflexes.
list the primary sensations mediated by the two major sensory pathways on the CNS
-spinothalamic tract= medaites pain temp, and crude or light touch (not precisely localized) (lateral spinothalmaic tract = pain, temp) (anterior spinothalamich tract= crude touch)
-posterior (dorsal) columns= sensation of position, vibration, and Fine localized touch (identify objects just by touch)
describe 3 major motor pathways in the CNS including the type of movements mediated by each
-corticospinal/pyramidal tract= \”higher\” motor system for purposefull and skilled movements (writing)
-extrapyramidal tracts= \”lower\” or primitive movemets (walking
-cerebellar system= coordinates movements, maintains equillibriam and helps maintain posture
differentiate an upper motor nuron from a lower motor neuron
-upper= located in CNS and are the descending fibers that influence/modify the lower motor neurons. conveys impulses form cerebral cortex to the lower…
-lower=located in the PNS cell body in gray matter of spinal cord, nerve fiber extends to directly connects to the muscles (the \”final common pathway\”)
list the 5 components of a deep tendon reflex arc.
1. an intact sensory nerve (afferent)
2. a functional synapse in the cord
3. an intact motor nerve fiber
4. the neuromuscular junction
5. a competent muscle
list the major symptom areas to assess when collecting a health hx for the neurologic system
HA, head injury, dizziness/verdigo, seizures, tremors, weakness, incoordination, numbness/tingling, difficulty swallowing, difficulty speaking, significant past history, and environmental/occupational hazards.
list the method of testing for each of the 12 cranial nerves (I-VII)
-I olfactory= identify familiar odor
-II optic= visual acuity, visual fields (confrontation), shine light in eye (light reflex test), direct inspection.
-III oculomotor= inspection, extraocular muscle movement, shine light in eye.
-IV trochlear= extraocular muscle movement (move eyes down or out ward)
-V trigeminal= superficial touch/sensory function (absent touch, pain, paresthesias), corneal reflex, clench teeth.
-VI Abducens= extraocular muscle movement to right and left sides
-VII Facial= wrinkle forehead, close eyes tightly, smile, puff cheeks identify tastes
list the method of testing for each of the 12 cranial nerves (VIII-XII)
-VIII acoustic= hearing acuity
-IX glossopharyngeal= gag reflex
-X Vagus= phonates \”ahh\”, gag reflex, note coice quality, and swallowing
-XI Spinal accessory= turn head, shrug shoulders against resistance
-XII Hypoglossal= protrude tongue wiggle tongue from side to side
list and describe 3 tests of cerebellar fn
-gait/ tandem walking
-rombers test – stand feet together with eye closed for 20 seconds.. or shallow knee bend.
-rapid alternating movements
describe the methods of testing the sensory system for pain, temperature, touch, vibration, and position.
-pain= poke w/ dull or sharp tung blade. pt says dull/sharp
– temp= hot/cold water or tuning fork
-touch= touch pt with stretched out cotton ball, test bilaterally
– vibration= place tuning fork on toe/finger, if no, move up leg/arm
-position= move a finger up or down and pt will tell you the direction you moved their finger.
define the 4 point grading scale for deep tendon reflexes
4= very brisk, hyper active w/ clonus, indicative of disease
3= brisker han average, may indicate disease
2= average, normal
1= diminished, low normal
0= no response
state the vertebral level whose intactness is assessed when eliciting each of these reflexes
-biceps reflex C5-C6
-triceps reflex C7-C8
-bachioradialis reflex C5-C6
-quadricepts reflex L2-L4
-achilles reflex L5-S2
list the components of the neurologic recheck examination that are performed routinely on hospitalized persons being monitored for neurologic deficit
1. level of consciousness
2. motor function
3. pupillary response
4. vital signs
list the 3 areas of assessment on the Glasgow coma scale
-eye opening
-motor response
-verbal response
describe the gait patterns of spastic hemiparesis
arm is immobile against the body, with flexion of the shoulder, elbow, wrist, fingers, and adduction of shoulders. the leg is stiff and extended and circumducts with each step (drag toe in a semicircle)
describe the gait patterns of cerebellar ataxia
staggering, wide-based gait; difficult with turns; ncoordinated movement with positive rombergs sign
describe the gait patterns of parkinsonian
posture is stooped; trunk is pitched forward; elbows hips and knees are flexed. steps are short and shuffling. hesitation to begin walking, and difficult to stop suddenly.the person holds the body rigid. walks and turns body as one fixed unit. difficulty with any change in direction
describe the gait patterns of scissors
knees ross or are in contact, like holding an orange between the highs. the person uses short steps, and walking requires effort
describe the gait patterns of steppage
slapping quality- looks as if walking up stairs and finds no stair there. lifts knee and foot high and slaps it down hard and flat to compensate for foot drop
describe the gait patterns of waddling
weak hip muscles- when the person takes a step, the opposite hip drops, which allows compensatory lateral movement of pelvis. often the person also has marked lumbar lordosis and a protruding abdomen
state the type of reflex response you would expect to see with an upper motor neuron lesion versus a lower motor neuron lesion
– upper= hyperreflexia, ankle clonus; diminished or absent superficial abdominal reflexes; positive babinski sign
– lower= hyporeflexia or areflexia; no babinski’s sign, no pathologic reflexes
Describe the method of testing the type of reflexes that are also termed frontal release signs
snout = gently percuss oral region (bad= lips pucker)
sucking = touch oral region (Bad = sucking movement of lips, tongue,jaw, swallowing
grasp = touch palm with our fingers (bad = uncontrolled, forced grasping)
the medical record indicated that a person has an injury to broca’s area. when meeting the person you expec…
difficulty speaking
the control of body temperature is located in the…
hypothalamus
the test for stereognosis, you would…
place a coin in the person’s hand and ask him or her to identify it.
during the examination of an infant, use a cotton-tipped applicator to stimulate the anal sphincter. the absence of a response suggests a lesion of…
S2
during the neurologic examination, the tendon reflex fails to appear. before striking the tendon again, the examiner might use the technique of…
reinforcement
cerebellar function is assessed by which of the fallowing tests…
coordination- hop on one foot
to elicit a babinski reflex
stroke the lateral aspect of the sole of the foot from heel to the ball
a positive babinski sign is…
dorsiflextion of the big toe and fanning of all toes
the cremasteric response…
is positive when the ipsilateral testicle elevates upon stroking the inner aspect of the thigh
to examine for the function of the trigeminal nerve in a infant, you would..
offer the baby a bottle
senile tremors may resemble parkinsonism, except that senile tremors do not include…
rigidity and weakness of voluntary movement
people who have parkinson’s disease usually have which of the fallowing characteristic styles of speech…
slow, monotonous
oldfactory =?
I, smell
optic =
II, vision
oculomotor =
III, extraocular movement, pupil constriction, down and inward movement of the eye
trochlear =
IV, down and inward movement of the eye
trigeminal =
V, mastication and sensation of face, scalp, cornea.
abducens
VI, lateral movement of the eyes
facial
VII, taste anterior two thirds of tongue, close eyes
acoustic
VIII, dearing and equilibrium
glossopharyngeal
IX, phonation, swallowing, taste posterior third of tongue
vagus
X, talking, swallowing, carotid sinus, and carotid sinus, and carotid reflex
spinal
XI, movement of trapezius and sternomastoid muscles
hypoglossal
XII, movement of the tongue.

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