316 Topic 6

Dysarthria

distorted/slurred speech

unintelligible

articulation and language is intact

Dysphonia

Difficulty talking and speech is at an abnormal pitch or volume

Neologism

Made up words that have no meaning

Echolalia

The uncontrollable and immediate repetition of words spoken by another person

Semi-coma

Lighter state of a coma, stirring, groaning, increased respiration, may open eyes in response to painful stimuli

Coma

state of profound unconsciousness, not responsive to touch or other stimuli

Lethargic

acting in an indifferent or slow, sluggish manner

Delirium

Hallucinations and clouding of consciousness

Receptive Aphasia

difficulty understanding language/spoken or written words

Expressive Aphasia

The inability to produce language ( despite being able to understand language)

What is the Patient Health Questionnaire-9 (PHQ-9) used to screen a pt for?

Depression

What is the Mini-Mental State Examination for?

To text cognitive functions within the mental status examination

Aphasia

Inability to comprehend or express verbal language. Usually caused by left hemisphere damage either to Broca's area (impairing speaking) or to Wernicke's area (impairing understanding).

Encephalitis

inflammation of the brain

What is Hypothalamic pituitary, thyroid axis

A crucial neuroendocrine system that regulates metabolism and stress response by controlling the production and release of thyroid hormones

causes the thyroid hormone to increase

Myxedema

a severe form of hypothyroidism, a condition where the thyroid gland does not produce enough thyroid hormones

Cachexia

loss of weight and generalized wasting that occurs during a chronic disease

Bell Palsy

paralysis on one side of the face

Stroke

Acute neurologic deficit caused by a blood clot in a cerebral vessel. It causes paralysis of the lower facial muscles.

Parkinson Syndrome

Dopamine levels are decreased, which lead to a face that is flat and expressionless

Meningitis

inflammation of the meninges of the brain and spinal cord

Clonus

rapidly alternating involuntary contraction and relaxation of a muscle in response to sudden stretch

Romberg Test

-ask client to stand with feet at comfortable distance apart, arms at sides, and eyes closed

-expected finding: client should be able to stand with minimal swaying for at least 10 seconds

What does the Glasgow Coma Scale consist of?

eye opening, verbal response, motor response

What is the highest score you can get on the Glasgow coma scale and what does that indicate?

15

Meaning the pt is fully awake and responsive

What is the lowest score you can get on the Glasgow coma scale and what does that indicate?

3

completely unresponsive

Glasgow Coma scale

7 or less=coma

stereognosis

inability to recognize objects by sense of touch

Nystagmus

Involuntary rapid eye movements

Strabismus

Eyes are not aligned with each other. Crossed eyes

Hemophilia

A hereditary disease where blood does not coagulate to stop bleeding

Graphesthesia

ability to recognize writing on the skin purely by the sensation of touch

Athetosis

Type of involuntary movement of the body, face, and extremities (cerebral palsy)

Familial Tremor

A type of intentional tremor that is common in older adult patients.

Hemianopsia

absence of vision in half of the visual field

Ptosis

drooping

paresthesias

numbness or tingling

diplopia

double vision

dysphagia

difficulty swallowing

Myoclonus

the sudden, involuntary jerking of a muscle or group of muscles

Chorea

sudden, rapid, jerky, purposeless movement involving limbs, trunk, or face

Fascicultation

rapid continuous twitching of resting muscle without movement of limb

Cerebral Palsy

paralysis caused by damage to the cerebral cortex, which is responsible for movement

Hemiplegia

paralysis of one side of the body

Multiple Sclerosis (MS)

disease of the central nervous system characterized by the demyelination (deterioration of the myelin sheath) of nerve fibers, with episodes of neurologic dysfunction (exacerbation) followed by recovery (remission)

peripheral neuropathy

damage to nerves in lower legs and hands as result of diabetes mellitus; symptoms include either extreme sensitivity or numbness and tingling

Spinal Cord Hemisection (Brown-Sequard Syndrome)

Loss of pain and temperature, contralateral side, loss of vibration and position discrimination on ipsilateral side

Reflex Response Grade Scale

What does the score of 4 indicate?

very brisk, hyperactive with clonus, indicative of disease

3 multiple choice options

Reflex Response Grade Scale

What does the score of 3 indicate?

brisker than average, may indicate disease

3 multiple choice options

Reflex Response Grade Scale

What does the score of 2 indicate?

Average, normal

3 multiple choice options

Reflex Response Grade Scale

What does the score of 1 indicate?

diminished, low normal, or occurs with reinforcement

3 multiple choice options

Reflex Response Grade Scale

What does the score of 0 indicate?

No response

3 multiple choice options

What is the nurses priority in a neurologic recheck?

Level of conciousness (LOC)

What are the components of a complete neurologic examination?

Mental Status

Cranial Nerves

Motor Function

Sensory Function

Reflexes

What is an abnormality in CN I?

Anosmia

What is an abnormality in CN II?

Defect or absent central vision

Defect in peripheral vision, hemianopsia

Absent light reflex

What is an abnormality in CN III?

Impaired eye movement, pupil abnormalities, or both

What is an abnormality in CN IV?

nerve palsy, characterized by vertical or torsional (tilted) double vision (diplopia) and an inability to move the eye down and in towards the nose

What is an abnormality in CN V?

a range of sensory and motor issues, including pain, numbness, and difficulties with chewing

What is an abnormality in CN VI?

weakness or paralysis of the lateral rectus muscle, which is responsible for outward eye movement

What is an abnormality in CN VII?

facial paralysis or weakness, known as facial palsy

What is an abnormality in CN VIII?

hearing loss, vertigo, and balance problems

What is an abnormality in CN IX?

difficulty swallowing (dysphagia), impaired taste on the posterior tongue, absent or diminished gag reflex, and pain in the throat

What is an abnormality in CN X?

difficulty swallowing (dysphagia), hoarseness or changes in voice (dysphonia), and even breathing difficulties (dyspnea)

What is an abnormality in CN XI?

weakness or paralysis of the sternocleidomastoid and/or trapezius muscles

What is an abnormality in CN XII?

weakness or paralysis of the tongue, leading to difficulties with speech, swallowing, and chewing

DTR Abdormalities

Clonus

Hypereflexia

Hyporeflexia