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Dillon Ch 21

Assessing the Sensory-Neurologic System

Information going from the periphery of the body to the brain are transmitted through... afferent (ascending) pathways; they are sensory impulses
Information from the brain to the muscles are transmitted through... efferent (descending) pathways; they are motor impulses
largest part of the brain cerebrum
Cerebrum consists of: Frontal, temporal, pariental, & occipital lobes, cortex, limbic system
Diffuse network of hyper-excitable neurons in brainstem and cerebral cortex, screens and channels incoming sensory input RAS- reticular activating system
Connects the cerebrum to the brainstem and contains the thalamus and hypothalamus diencephalon
Includes the midbrain, medulla and pons; involuntary survival behaviors brainstem
Where emotional expression occurs, contains Broca's area Frontal lobe
Where hearing, taste, smell, memory, Wernike's are located Temporal lobe
Where emotions, sexual arousal,behavioral expression and recent memories are located Limbic system
Receives sensory input Parietal lobe
Vision and spatial relationships are integrated Occipital lobe
Clusters multiple sensory stimuli into a coherent whole before sending it to the cerebral cortex for perpecption thalamus
Controls autonomic nervous system and pituitary gland hypothalamus
regulates involuntary aspects of movement, ie coordination, muscle tone, kinesthetics, posture, equilibrium cerebellum
regulates visual, auditory, and other reflexes and controls eye movements, focusing and pupil dialation midbrain
regulates heart and respiratory rate, BP, and protective reflexes (ie swallowing, vomiting, sneezing, and coughing) medulla
helps control respiratory function, facial movement and sensation, and eye movement pons
3 layers that cover and protect the brain meninges- pia, arachnoid, and dura
Found in the ventricles, cushions the brain, delivers nutrients, and removes wastes CSF cerebral spinal fluid
Primitive reflexes that infants have palmar grasp, stepping reflex, and rooting reflex
within 24 hours after birth infants are screened for spina bifida and fetal alcohol syndrome
compulsive-obsessive disorder and hyperactivity are usually not apparent until... preschool years
folic acid deficiency in the first trimester is closely linked to spina bifida
Older adults may experience slower neural impulses, decreased sense of taste and touch, decreased reflexes
If the right side of the brain has a problem it will be manifested on the left side of the body, and visa versa
spacial perception problem where the patient doesn't see the affected side as a part of their body neglect
Glasgow Coma Scale- total of 15 pts possible- broken down into 3 areas... eye response- out of 4; motor response- out of 6; verbal response- out of 5
Know all 12 cranial nerves (and what they do) I Olfactory, II Optic, III Oculomotor, IV Trochlear, V Trigeminal, VI Abducens, VII Facial, VIII Vestibular/cochlear (acoustic), IX Glossopharyngeal, X Vagas, XI Spinal Accessory, XII Hypoglossal
Impaired lateral eye movement is due to which CN being damaged? CN VI
Impaired facial movement is due to which CN being damaged? CN VII
Which CN would impair motor function of the tongue? CN XII, protruded tongue will deviate towards the injured side
Two cerebellar tests for coordination and fine motor skills: rapid alternating movements and finger-to-nose or heel-to-shin tests
Two cerebellar tests for balance: Romberg and gait- heel-toe walking
If touch sensation is intact distally... touch sensation may or may not be intact proximally
If pain is intact... then temperature is intact
Using a tuning fork on a bony joint (great toe or distal interphalangeal) is used to test... deep sensations (vibratory sensations)
this test assesses the patient's peception of position sense kinesthetics
Ability to recognize the form of solid objects by touch sterognosis
Ability to recognize outlines, numbers, words, or symbols written on the skin graphestesia
Ability to differentiate between two points of simultaneous stimulation Two-point discrimination
Ability to sense and locate area being stimulated Point localization
Simultaneously touch both sides of patient's body, have patient point to where they were touched extinction
What is the scale for DTRs? And what are some locations? 0-4: 0= no response, 2= normal, 4= hyperactive; BICEPS, triceps, brachioradialis, PATELLAR, achilles
3 Meningeal signs Nuchal rigidity, Kernig's sign, & Brudzinski's sign
Pronounced neck stiffness nuchal rigidity
Patient in supine position, flexes knee,you apply pressure to knee while pt tries to extend leg, contraction and pain of hamstring muscles and resistance in extension are positive signs of meningitis Kernig's sign
Patient supine, flexes head to chest, flexion of hips is a positive sign of meningitis Brudzinski's sign
Created by: MEPN 2013