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289 Neuro

Nursing

QuestionAnswer
Brain parts cerebrum, dicenphalon, cerebellum, brainstem
Cerebrum Largest part of the brain, higher brain centers, (composed of frontal, parietal, temporal, occipital)
Frontal Motor, emotions and Broca's area
Parietal Sensory,
Temporal auditory, reception of speech
Occipital vision
Dicephalon thalmus, hypothalamus, pineal gland, pituitary, basal glands
Thalamus Relay
Hypothalamus homeostasis, temp, hunger, thirst, sleep, ANS
Pineal Gland Sexual development
Pituitary endocrine
Basal Ganglia automatic associated movement, primitive motor areas
Brainstem mid brain, pons, medulla
midbrain relay
pons relay and breathing,
medulla breathing, vomitting, cardiac, GI
Cerebellum balance, equillibrium, proprioception
dysphagia difficulty swallowing
Aphasia without voice, their words may be jumbled, or may be unable to respond
Parasthesia altered sensory preception, numbness, tingling
Examples of chronic diseases MS, myasthemia gravis, CVA, Parkinson's, ALS, any type of dementia
Equipment for physical examination for neuro includes penlight, vibratory tuning fork, tongue blade, percussion hammer, aromatic materials, vials of solutions, variety of materials for senory tactile assessment
components of neurological exam mini mental status, motor system, cranial nerves, proprioceptor and cerebellar function, sensory function, deep tendon reflexes and superficial reflexes
Mental status evaluate appearance, , MMSE, if not oriented, writing, IADL
If the person is not oriented we do... proceed to the mini mental status
Cranial nerve I olfactory
Cranial Nerve II Visual Acuity and Peripheral Vision
Cranial Nerve III, IV, VI Pupils
Cranial Nerve V TMJ and sensation
Cranial Nerve VII Facial movement
Cranial Nerve V and VI Corneal reflex
Cranial Nerves VIII ear and balance
Cranial Nerve IX gag, taste
cranial Nerve X Ahhhh
Cranial Nerve XI Shoulders and Neck
Cranial Nerve XII Tongue
I olefactory, not tested normally. patency, familiar non irritating arromatic substances (brownies), are nares symmetrical?
II Optic nerve, visual acuity and peripheral, near (newspaper) and distance (E chart), visual fields, internal exam
III, IV, VI Oculomotor, trochlear, Abducens, palpebral fissures, opening of upper lids, PERLA, Nystagmus, Extracocular movement...
V trigeminal nerve, motor function[ clenching teeth (TMJ)], Sensory Function [light touch on the face], Corneal Reflex (do not do in routine screening [ touch conjunctiva with cotton]
VII Facial Nerve, MotorFunction, symmetry of facial movement, sensory function, taste, not routinely screened, screening questions, Motor Efferent, Corneal reflex and Certain Speech Sounds
VIII hearing acuity and measurement, whispered voice, Reine, Weber
IX and X Glosspharyngeal, and vagus nerve, ahhhhhhhh, gag, voice sounds, swollowing, taste
When would a gag reflex be necessary to test? test dysphagia, surgical diagnostic exam, where they had spray administered. Checks to see before adminiswtering fluids
XI Spinal Accessory- stenoclomastoid, rotate head resistance, Trapezius- shrug shoulders against resistance
XII hypoglossal- movement of the tongue and speech sounds L,T,D,N (light tight dynomite)
If findings are normal for the cranial nerve you report cranial nerves I-XII are intact
Cerebellar tests for gait, balance, upper and lower extremities
Cerebellar tests for Balance include (Romberg, stand on one foot, walk in tandem, hop, knee bends, walk on toes, walk on heels)
Cerebellar Tests for upper Extremities alternating tapping, fingers to nose, thumb opposition, finger to nose, to nurse's finger
Cerebellar tests for lower Extremities heel up and down shin, plantar tap (place hands beneath feet and ask them to tap your hands)
Sensory function Suprise the client, Eyes closed, Fully Conscious, Distal to proximal, symmetrical
Primary Sensory Function Light touch, superficial pain, deep pressure, sharp/dull, hot/ cold, vibratory sense, kinesthetic sensation (moving Fingers, up and down)
Cortical Sensory Function Graphesthesia, two point discrimination, stereognosis, extinction (not as common)
Graphesthesia test by writing a letter or number on the hand
stereognosis ability to recognize familiar objects by feel
one point two point distinction is made on back of hand, back (over clothing)
Deep Tendon Reflexes Sites Triceps, Biceps, Brachioradial, patellar, achilles
To document a rating on a scale... include the highest level. EX: 2+/4+ on brachioradial reflex
Superficial Reflexes Plantar, abdominal, cremasteric
the order of higher function cerebrum initiates, basal ganglia refines, and cerebellum coordinates
Created by: Hoopster