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Dillon Ch 21
Assessing the Sensory-Neurologic System
| Question | Answer |
|---|---|
| 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
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