105 Neuro
what Glasgow score indicates severe neurological issues?
8 or less
How many cervical nerves are there and what do they control?
8- controls diaphragm, chest wall muscles, arms, shoulders *think breakfast at 8
What are some reflexes of the cranial nerves that you would assess in a near assessment?
corneal- blink gag cough pupillary- constriction PERRLA
What is presbyopia?
normal near vision loss from aging
function of the frontal lobe
executive function problem solving concentration planning/organizing reasoning personality, behavior, mood two parts: motor cortex- controls voluntary movements Broca's area- expressive speech
What does the CNS consist of and what does it do?
brain, spinal cord, nerve impulse transmission (sensory and motor)
medulla oblongata function
breathing, heart, respiration
purpose of dopamine
"feel good", has memory, movement, attention *think of Parkinson's is memory and movement, ADHD is attention
What does the ANS consist of?
(part of the ANS) 12 cranial nerves 31 pairs of spinal nerves
purpose of acetylcholine
(stimulates PNS-rest and digest- response)- decreases BP, HR, vasodilates -stimulates GI tract
how do you assess motor in a neurological assessment?
*always compare the left to the right, upper and lower extremities and do them at the same time -grasp hands and squeeze -biceps and triceps- grab wrists and tell them to pull you towards them and then push you away -quads- lift legs against gravity and against resistance -flex and dorsiflex feet -pronator drift
function of occipital lobe
*think optic processes visual info perception of shapes and sizes
What are some normal neurological age related changes?
-less neurotransmitters -less functional voluntary movement -old age memory loss -less aware of touch, smell, temperature and pain -presbyopia -presbycusis
How many thoracic nerves are there and what do they control?
12- controls upper body, GI function *think lunch at 12
How many points are there for eye response the the GCS? What are they?
4 possible 4- Spontaneously 3- to speech 2- to pain 1- no response
how many lumbar and sacral nerves are there and what do they control?
5 and 5 - controls lower body, bowel and bladder *think dinner at 5
How many points are there for verbal response in the GCS? What are they?
5 possible 5- oriented to time, place, person 4- confused 3- inappropriate words 2- incomprehensible sounds 1- no response
How many points are there for motor response in the GCS? What are they?
6 possible 6- obeys commands 5- purposeful movement to pain 4- withdraws from painful stimuli 3- flexion in response to pain 2- extension in response to pain 1- no response to pain
Cerebellum function
Balance and coordination
What is the MMSE and how is it scored?
Mini Mental Status Examination assesses cognitive function: orientation, attention, calculation, memory, language ability -30 points possible, under 20 is impairment
What is presbycusis?
age related hearing loss
how do you assess the sensory system?
ask pt to identify different stimuli like sharp vs dull and check left vs right
function of serotonin
found in the gut (nausea), mood, anxiety, sleep
what is something that CSF brings to the brain that it cannot store itself?
glucose
function of temporal lobe
hearing and attention long term memory Wernicke's area- receptive speech
function of parietal lobe
helps us make sense of the world- interprets sensation/perception spacial awareness, body position, arithmetic, spelling
what is Broca's area and which lobe is it in?
it's responsible for expressive speech and it's in the frontal lobe
What is the first thing you assess in a neuro patient?
level of consciousness
What are the three areas that the Glasgow Coma Scale measures?
motor response verbal response eye opening response
What is pronator drift?
pt holds both arms out in front of body, turn palms upward and close eyes -if one starts to go down, it's a sign of weakness
What is Wernicke's area?
receptive speech, controls language comprehension
what is the main area of the parietal lobe?
sensory area- processes sensory information -temp -pressure/touch -smell, pain, taste -integrates visual information
What should you do when trying to get a response for GCS?
start from central to peripheral First- call pt by name No response- louder No response- gently shake pt No response- sternal rub No response- painful stimulus Pinch to inner arm or nailbed pressure
What is the difference between cerebral angiography and CT angiography?
the CT is less invasive because the dye is injected into a vein and not the artery
What happens if Wernicke's area is damaged?
think Wernicke is crappy unable to understand and respond to what people are saying
What happens if Broca's area is damaged?
think broken- they can understand but their speech is disjointed
