Neurological exam
Help!
|
|
||||
|---|---|---|---|---|---|
| Two major types of cells that make up the nervous system | show 🗑
|
||||
| show | Neuron
🗑
|
||||
| show | glia cells
🗑
|
||||
| show | Motor/efferent, sensory/afferent, intermuncial
🗑
|
||||
| show | Motor/efferent
🗑
|
||||
| Neuron that transmits nerve impulses to the spinal cord or brain | show 🗑
|
||||
| Conducts impulses from sensory to motor neurons. | show 🗑
|
||||
| show | Internuncial
🗑
|
||||
| show | Dendrites
🗑
|
||||
| show | axon
🗑
|
||||
| Covers most fibers in the CNS, allows impulses to travel more smoothly and quickly. | show 🗑
|
||||
| show | neurilemma
🗑
|
||||
| Some of this cell forms the neurilemma, and also secretes mylin | show 🗑
|
||||
| show | Fibers
🗑
|
||||
| show | Mylin
🗑
|
||||
| show | Glia cell
🗑
|
||||
| show | Glia cells
neuroglia overgrowth
🗑
|
||||
| show | Nervous system, central- brain and spinal cord
🗑
|
||||
| show | Central brain/spinal cord
🗑
|
||||
| Links the CNS with the rest of the body | show 🗑
|
||||
| show | 1. Cerebrum
2. diencephalons (includes Thalmus/hypothal
3. cerebellum
4. medulla oblongata
5. pons
6. midbrain
🗑
|
||||
| Parkinsons is a degeneration of.... | show 🗑
|
||||
| S/S of...... decreased blink rate, absence of arm swing while waking, balance problems, cogwheel movement. Decreased dopamine | show 🗑
|
||||
| Two hemispheres make up the cerebrum, each is divided into two lobes... | show 🗑
|
||||
| Memory and reasoning are centered in the _________ cortex. | show 🗑
|
||||
| Which lobe? helps regulate personality and thought processes, contains motor speech area, written speech, controls voluntary muscle movement | show 🗑
|
||||
| Lobe that contains centers for hearing, taste and smell | show 🗑
|
||||
| Lobe that is the major area of perception. How we perceive things, distinguishes size, shape, distance. Hot, cold, pressure and pain | show 🗑
|
||||
| show | occipital
🗑
|
||||
| show | basal ganglia
🗑
|
||||
| This area includes the hypothalmus and thalmus | show 🗑
|
||||
| control center for appetite, temperature, water balance, BP, pituitary function and hormone balance. | show 🗑
|
||||
| show | Thalmus
🗑
|
||||
| Area of the brain responsible for coordinating voluntary muscle activity. Maintains posture, balance, muscle tone. | show 🗑
|
||||
| _____ system controls appetite, sexual activity, and aggression. | show 🗑
|
||||
| show | Gray
🗑
|
||||
| White matter | show 🗑
|
||||
| show | Nothing,she is correctly leaving out temperature because both senses come from the same area; parietal lobe. If one sense works, the others will also.
🗑
|
||||
| This area of the body is composed of the midbrain, pons, and medulla. | show 🗑
|
||||
| show | D. medulla
🗑
|
||||
| This area is the pathway between the brain stem and upper brain | show 🗑
|
||||
| show | Midbrain
🗑
|
||||
| Area that regulates our breathing; pneumotaxic center | show 🗑
|
||||
| show | medulla oblongata
🗑
|
||||
| meninges that lines skull, outermost layer of brain. Major vessels go underneath in the subarachnoid space. | show 🗑
|
||||
| show | Dura mater
🗑
|
||||
| show | Pia mater
🗑
|
||||
| middle layer of the meninges | show 🗑
|
||||
| show | Nerve fibers, forms tracts that take information to and from brain.
🗑
|
||||
| Csf is secreted by the _______ ______, which are networks of capillaries that project from the pia mater into the lateral ventricles of the brain. | show 🗑
|
||||
| show | subarachnoid
🗑
|
||||
| How many milliliters of CSF are in the body of an adult? | show 🗑
|
||||
| Pupils dilated, sympathetic or para? | show 🗑
|
||||
| show | Para
🗑
|
||||
| show | para
🗑
|
||||
| Increased HR sympathetic or para? | show 🗑
|
||||
| show | sympath
🗑
|
||||
| show | para
🗑
|
||||
| GU muscles, relaxed detrussor muscle sympathetic or para? | show 🗑
|
||||
| You are a man, a bear is chasing you, how would your penis react? sympathetic or para? | show 🗑
|
||||
| Skeletal muscle vessels how do their reactions between sympathetic or para differ? | show 🗑
|
||||
| show | Sympath, constriction occurs,
para, no effect
🗑
|
||||
| These drugs mimic sympathetic nervous system | show 🗑
|
||||
| these drugs mimic parasympathetic | show 🗑
|
||||
| show | 3- Ocular
4- trochlear
6- abducens
🗑
|
||||
| show | I. Olfactory/ Sensory; anterior ventral cerebrum
🗑
|
||||
| Nerve for vision where originated in brain? | show 🗑
|
||||
| show | III/. oculomotor/ Motor; midbrain
IV. trochlear; Motor
VI. abducens; Motor
🗑
|
||||
| show | IV. Trochlear- *according to tb- one eye movement muscle; superior oblique muscle. Motor; midbrain
🗑
|
||||
| show | V. trigeminal /Both;
pons
🗑
|
||||
| Nerve for Eye movement, origin? | show 🗑
|
||||
| show | VII. facial; both; pons/medulla junction
🗑
|
||||
| show | VIII. vestibulocochlear; sensory; junction of pons/medulla
🗑
|
||||
| show | IX. glossopharyngeal; both; medulla
🗑
|
||||
| show | X. Vagus; both; medulla
🗑
|
||||
| Nerve that allows shoulder shrug and turn of head. Origin? | show 🗑
|
||||
| allows movement of tongue. Origin? | show 🗑
|
||||
| show | II. optic
III. oculomotor
IV. trochlear
VI. abducens
X. Vagus
🗑
|
||||
| show | *tongue depressor on back of tongue, assess gag reflex.
*tell them to say ahh
*Offer them water, watch them swallow
*place something on the back 1/3 of tongue and see if they can taste it.
🗑
|
||||
| show | upper motor neuro damage, seen with cerebral hemisphere lesions.
🗑
|
||||
| show | *Change in LOC *Decreased sensory/motor response* Pupil changes, PERRLA 1.5-6mm is normal *VS changes are late *projectile vomiting not related to eating *HA r/t compression of arteries/veins and cranial nerves.
🗑
|
||||
| show | 0-15
🗑
|
||||
| show | *Mannitol most common given over 30minute. Very hypertonic, pulls fluid from brain tissue. assess fluid/electro close.
*Lasix, bumex, edecrin. Reduces blood volume. causes reduction in prod of CSF
*Mechanical vent; PaO2/Co2 remains in normal limits.
🗑
|
||||
| CO2 normal levels? | show 🗑
|
||||
| Mannitol administration? | show 🗑
|
||||
| IV fluids used with IICP? | show 🗑
|
||||
| show | *70-100
*50
*30
🗑
|
||||
| show | MAP= SBP + 2 dBP/3
🗑
|
||||
| show | CPP=MAP-ICP
🗑
|
||||
| show | *HOB at 30 degrees
*head in midline position no extreme rotataion/flexion of neck
*Avoid valsalva
*Hip flexion <60 degrees
*Avoid turn/suction/loud noises. Etc. allow 15-60 minutes between activity
*Conrol seizure quickly with Valium, Dilantin, or at
🗑
|
||||
| Nsg DX Ineffect breathing pattern; maintain airway to prevent hypoxia/hypercarbia Interventions? | show 🗑
|
||||
| show | *Watch Urine output
*Keep strict I&O
*IV fluids as ordered.
*Watch labs, Normal Na+ 135-145, very imp to brain
Less than 120/more than 150 causes changes, seizure
🗑
|
||||
| Normal ICP? | show 🗑
|
||||
| Patient undergoing Continuous ICP monitoring has an ICP of ___ to ___ They display symptoms. | show 🗑
|
||||
| show | 40 or more
🗑
|
||||
| show | 1 Ventricular Cath
2 Subarachnoid screw/bolt
3 Subdural or epidural placement.
🗑
|
||||
| The most common (70-80%) type of skull fX is..... treated by? | show 🗑
|
||||
| show | *Surgery may be done immediately to remove fragments.
*Cranioplasty maybe delayed for 6mo to allow postop swelling to subside
🗑
|
||||
| An inward depression of the bone fragment in the skull, can be seen/felt | show 🗑
|
||||
| Fracture that occurs at the base of the skull (over frontal/temporal lobes) S/S that indicate fracture? | show 🗑
|
||||
| show | false, dx by presence of Csf, raccoon eyes, blood behind eardrum, battles sign
🗑
|
||||
| show | Epidural
🗑
|
||||
| show | epidural
🗑
|
||||
| Contusion that occurs in the area of the brain opposite site of trauma | show 🗑
|
||||
| TX of basilar fx includes (select all that apply) A. Levaquin, given prophylactally B. Sterile cotton in nose or ear C. Bedrest D. Acetaminophen | show 🗑
|
||||
| show | Evacuation, prognosis better with early detect/tx.
DX by CT
🗑
|
||||
| S/S of what serious disorder? Irritable, motor weakness, ipsolateral pupil dilation | show 🗑
|
||||
| which hematoma? Bleed between the dura and arachnoid in the subdural space. | show 🗑
|
||||
| show | Chronic subdural hematoma
🗑
|
||||
| 1. Test which includes placing ice cold water in ear. Why is it done? | show 🗑
|
||||
| Known as Doll’s eyes occulocephalic reflex | show 🗑
|
||||
| show | Corneal reflex
🗑
|
||||
| Patient is 56 years old, says her doc diagnosed her with a primary tumor. She Has had a history of liver problems and assumed that is where this tumor came from. She asks you if this tumor will spread to her brain. What do you tell her? Teaching? | show 🗑
|
||||
| show | secondary/metastatic
🗑
|
||||
| CNS tumor patient, can they donate their organs? | show 🗑
|
||||
| Most common brain tumor, accounts for 65% | show 🗑
|
||||
| show | astrocytoma
🗑
|
||||
| show | Glioblastoma
Think "Glee"+ "jazz hands"=feelers
🗑
|
||||
| show | Medulloblastoma
🗑
|
||||
| Why are the gliomas difficult to remove? | show 🗑
|
||||
| Arise from meninges, most common in African American | show 🗑
|
||||
| Tumor within the frontal lobe (localized) would cause what manifestations? | show 🗑
|
||||
| Location of tumor that would cause visual changes? | show 🗑
|
||||
| Tumor location that affects perception, heat/cold. | show 🗑
|
||||
| What signs would you expect to see in a patient with a tumor On their temporal lobe? | show 🗑
|
||||
| Signs/symptoms of generalized tumor? | show 🗑
|
||||
| show | Optic disk blurred, not sharply defined.
🗑
|
||||
| show |
Stereotactic (3D image)
🗑
|
||||
| show | Gamma knife
🗑
|
||||
| show | *Mtn neck in straight alignment
*Avoid flexing neck, prevents tear of suture line
*Position on either side, or kept flat, may be at an elevation of 10-15 degree
🗑
|
||||
| Cranial surgery on the anterior /mid fossa. Nsg considerations? | show 🗑
|
||||
| Reasons for cranial surgery to be done | show 🗑
|
||||
| Post op care for cranial surgery Monitor for edema, pain, monitor ICP are main goals. what is the major complication? | show 🗑
|
||||
| Assess saturation of dressings or leaking from ear/nose indicates what abnormality after Cranial surgery? | show 🗑
|
||||
| postop cranial surgery, what expectations may you see relating to body temperature? | show 🗑
|
||||
| show | too little adh can occur due to injury of the hypthalmus or in edema.
SiADH may occur due to excess ADH secretion= low NA level
🗑
|
||||
| show | C. Dsg won't be changed for up to 3 days and will be done by the surgeon the first time.
🗑
|
||||
| Patient with meningitis has cloudy CSF, what is likely the cause of their case of meningitis? | show 🗑
|
||||
| show | almost always related to a viral infection outside of the CNS (respiratory or GI) Virus enters body replicates and spreads to brain via the blood.
🗑
|
||||
| show | 3. oculomotor
4. trochlear
6. abducens
7. facial
8. acoustic
**Hearing may not return**
🗑
|
||||
| show | C- 8-10 days, 4-6x per day.
🗑
|
||||
| Isolation required for the bacterial meningitis patient for how many days? | show 🗑
|
||||
| Stiff painful neck R/T irritated meninges, seen with meningitis | show 🗑
|
||||
| How do you test for kernig sign? | show 🗑
|
||||
| show | Positive brudzinski
🗑
|
||||
| show | B
🗑
|
||||
| show | A- ARBO virus carried by mosquito would be epidemic
B,
C. most common non epidemic
🗑
|
||||
| S/S of which illness? *H/A *malaise *dizziness *NV *restless *irritable *stiff neck, tremor, convulsions | show 🗑
|
||||
| show | Given for seizure prevention or migraine
teach
: *don't abruptly discontinue, may cause seizure
*avoid tasks that require alertness until response to drug is known
*take adequate fluid to decrease r/f renal stone devel.
🗑
|
||||
| show | Serotonin
🗑
|
||||
| Teaching for patient prescribed Sumatriptan (Imitrex) | show 🗑
|
||||
| show | *Hypoglycemia
*parasthesia
*weight loss
*cognitive change
Must be taken 2-3 months to determine effectiveness
🗑
|
||||
| Lobe of brain which controls voluntary muscle movement | show 🗑
|
||||
| Pressure needed to insure blood flow to the brain | show 🗑
|
||||
| Type of vascular headache tx with prednisone and lithium | show 🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Created by:
purpleapple87
Popular Nursing sets