Neuro

Dermatome

Area of skin supplied by nerves from a given spinal cord segment. Overlaps exist so that if one nerve is severed, sensation can still be transmitted above and below.

Upper motor neurons

A complex of all the descending motor fibers that can influence or modify the lower motor neurons. Located completely within the CNS. Ex// corticospinal, corticobulbar, and extrapyramidal tracts. Ex of diseases// CVA, cerebral palsy, and multiple sclerosis

Occipital lobe

A region of the cerebral cortex that processes visual information

Parietal lobe

A region of the cerebral cortex whose functions include processing information about touch.

Broca's area

A specialized area of the left frontal lobe that controls muscles involved in the production of speech and supplies this information to appropriate motor cortex areas

Phalen maneuver

A way to reproduce numbness and burning in a person with carpal tunnel syndrome

Superficial reflex

Abdominal, cremasteric, and corneal reflexes. Elicited with superficial subcutaneous touch.

Graphesthesia

Ability to read a number by having it traced on the skin

Peripheral Nervous System

All those nerves that lie outside the brain and spinal cord.

Parasthesia

An abnormal sensation such as burning or tingling

A The basal ganglia controls automatic associated movements of the body.

Automatic associated movements of the body are under the control and regulation of: A) the basal ganglia. B) the thalamus. C) the hypothalamus. D) Wernicke's area.

Medulla

Base of brainstem (is a continuation of the spinal cord); controls heartbeat and breathing

Reflexes

Basic defense mechanism of the nervous system. Involuntary actions

Central Nervous System

Brain and spinal cord. Consists of 12 pair of cranial nerves and 31 pair of spinal nerves

B The cerebellum controls motor coordination of voluntary movements, equilibrium, and muscle tone. Cerebellar function is tested by balance tests (e.g., gait, Romberg test) and coordination and skilled movements (e.g., rapid alternating movements, finger-to-finger test, finger-to-nose test, heel-to-shin test).

Cerebellar function is tested by: A) muscle strength assessment. B) performance of rapid alternating movements. C) the Phalen maneuver. D) superficial pain and touch assessment.

Cerebellum

Coordinates and smooths movements, controls balance. Operates on an unconscious level. Located under the occipital lobe

Olfactory nerve

Cranial nerve I. Test by presenting something with an obvious odor in one nostril then the other.

Optic nerve

Cranial nerve II. Test w/Smellen chart, visual fields confrontation, and inspection of optic disc w/Opthalmoscope

Oculomotor nerve

Cranial nerve III. Verify that palpebral fissures are equal, check papilary reactions to light

Trochear nerve

Cranial nerve IV. Test patient's pupils for accomodation, cardnial positions of gaze

Glossophyrngeal nerve

Cranial nerve IX. Elicit a gag reflex and have patient swallow

Trigeminal nerve

Cranial nerve V. Have patient clench teeth together, paplate masseter and muscles for equality. Push down on chin to test strenght. Sensation should be equal on forehead, cheeks and chin.

Abducens nerve

Cranial nerve VI. Assess eyes for lateral deviations

Facial nerve

Cranial nerve VII. Have patient smile, frown, show teeth, shut eyes, lift eyebrows. Puff cheeks and push them in to test symmetry.

Vestibochlear nerve

Cranial nerve VIII. Test by whispering in each ear and assessing patient's ability to hear normal conversation

Vagus nerve

Cranial nerve X. Test by depressing patient's tongue and have them say "ah". Vulva and soft pallet should be raised to mid-line and tonsils should move medially.

4 kinds of reflexes

Deep tendon Superficial Visceral Pathologic

Dysarthria

Difficulty forming words

Babinski reflex

Dorsiflexion of large toe and fanning of other toes with plantar stimulation. Present at birth but typically disappears by age 2.

C

During an assessment of an 80-year-old patient, the nurse notices the following: inability to identify vibrations at the ankle and to identify position of big toe, slower and more deliberate gait, and slightly impaired tactile sensation. All other neurologic findings are normal. The nurse should interpret that these findings indicate what? A) Cranial nerve dysfunction. B) Lesion in the cerebral cortex. C) Normal changes due to aging. D) Demyelinization of nerves due to a lesion.

C Nystagmus is a back-and-forth oscillation of the eyes. End-point nystagmus, a few beats of horizontal nystagmus at extreme lateral gaze, occurs normally.

During the assessment of extraocular movements, two back-and-forth oscillations of the eyes in the extreme lateral gaze occurs. This response indicates: A) that the individual needs to be referred for a more complete eye examination. B) a disease of the vestibular system and that should be evaluated. C) an expected movement of the eyes during this procedure. D) this assessment should be repeated in 15 minutes to allow the eyes to rest.

Hyperflexion

Exaggerated reflex seen with upper motor neuron lesions

Four lobes of the cerebral cortex

Frontal Parietal Occipital Temporal

Spinal cord

Highway for nerve fibers, mediates reflexes

Dysmetria

Inability to control the distance, power, and speed of a muscular action

Astrognosis

Inability to identify objects correctly. Occurs in sensory cortex lesions

Cerebral Cortex

Is the cerebrum's outer layer of nerve cell bodies which look like "gray matter" because it lacks myelin

mid-brain

Most anterior part of the brain stem. Contains many motor neurons and tracts

Wernicke's area

Part of the temporal lobe associated with language comprehension

Paresis

Partial or incomplete paralysis

Romberg test

Patient stands still with feet together and arms at side with eyes closed for 20 seconds.

clonus

Rapid, rhythmic contractions of the same muscle

Deep tendon reflex

Reveals the intactness of the reflex arc at specific spinal levels as well as the normal override on the reflex of the higher cortical levels. Graded 0 to +4. Ex knee jerk

Sensory pathways

Sensations of pain, temperature and light touch from skin, mucous membranes, muscles, tendons and vicera travel in afferent fibers > dorsal route > spinal cord.

Lower motor neuron diseases

Spinal cord lesions and polomylitis

Crossed representation

Term for the left cerebral cortex receiving sensory information from the right side of the body and the right cerebral cortex receiving information from the left side of the body.

C Measurement of the deep tendon reflexes reveals the intactness of the reflex arc at specific spinal levels.

Testing the deep tendon reflexes gives the examiner information regarding the intactness of the: A) corticospinal tract. B) medulla. C) reflex arc at specific levels in the spinal cord. D) upper motor and lower motor neuron synaptic junction.

Hyproflexia

The absence of a reflex which indicates a lower motor neuron problem

Brain Stem

The central core of the brain where cranial nerves III through XII originate. Consists of the mid brain, the pons, and the medulla

Lower motor neurons

These synapse directly onto muscle tissue at "neuromuscular junctions" and cause muscles to contract through action potentials

Glasgow Scale

This is an assessment tool used to determine consciousness in clients. The Score of 15 reveals a fully oriented person. 3 is deep coma., Used for head trauma- Score 3-15, based on Eye opening, Verbal response and Motor response.

Ataxia

Uncoordinated or unsteady gait

C

When performing a neurologic examination on a patient, the nurse knows that the area of the nervous system that is responsible for mediating reflexes is which of the following? A) Medulla. B) Cerebellum. C) Spinal cord. D) cerebral cortex.

Pathologic reflex

abnormal or aberrant (shouldn't be there but is) Example Babinski reflex

Motor pathways

corticospinal fibers mediate voluntary fine motor movement

Vertigo

sensation of rotational spinning caused by neruologic disease in the vestibular apparatus or vestibular nuclei (brain stem)

B The hypothalamus is a vital area with many important functions: temperature controller, sleep center, anterior and posterior pituitary gland regulator, and coordinator of autonomic nervous system activity and emotional status. The cerebellum controls motor coordination, equilibrium, and balance. The basal ganglia control autonomic movements of the body. The motor pathways of the spinal cord synapse in various areas of the spinal cord, not the thalamus.

After teaching a group of students about the areas of the brain, the instructor determines that the teaching has been effective when the students correctly identify which of these statements is true concerning the areas of the brain? A) The cerebellum is the center for speech and emotions. B) The hypothalamus controls temperature and regulates sleep. C) The basal ganglia are responsible for controlling voluntary movements. D) Motor pathways of the spinal cord and brainstem synapse in the thalamus.

Temporal lobe

An area on each hemisphere of the cerebral cortex near the temples that is the primary receiving area for auditory information

Pons

An area on the brainstem that acts as a bridge between the medulla and other structures. Coordinates with the respiratory center int he medulla to control breathing.

Visceral reflex

An unconscious, automatic, stereotyped responses to stimulation. Example pupillary response to light

Accesory nerve

Cranial nerve XI. Test by having patient rotate head left and right against your hand to check strength of traps and sternomastoid. Also have patient shrug shoulders against shoulders

Hypoglossal nerve

Cranial nerve XII. Test by having patient stick out tongue, should be mid-line. Then move tongue left and right, then say "light, tight, dynamite"

Dysphagia

Difficulty swallowing

Dysphasia

Difficulty with language comprehension or expression

Aphasia

Language disurbance - word choice, grammar or comprehension deficit

Basal Ganglia

Large clusters of neurons, located above the thalamus and under the cerebral cortex, that work with the cerebellum and the cerebral cortex to control and coordinate voluntary movements.

Paralysis

Loss of motor function due to a lesion in the neurolgoic or muscular system

B Superficial reflexes test the sensory receptor in the skin; the motor response is a localized muscle contraction. Superficial reflexes include abdominal, cremasteric, and plantar (or Babinski) reflexes.

The ______ reflex is an example of a _________ reflex. A) plantar; deep tendon B) abdominal; superficial C) quadriceps; pathologic D) corneal light; visceral

C The basal ganglia are large bands of gray matter buried deep within the two cerebral hemispheres that form the subcortical associated motor system (the extrapyramidal system). medulla.

The extrapyramidal system is located in the: A) hypothalamus. B) cerebellum. C) basal ganglia. D) medulla.

Frontal lobe

The lobe of the cerebral cortex controlling personality, behavior, and emotions

Thalmus

The main relay station where sensory pathways of the spinal cord, cerebellum and brain stem form synapses on their way to the cerebral cortex

Hypothalmus

The major respiratory center of the brain. Also responsible for basic functions like appetite, temp, blood pressure, heart rate, and emotional status