NEURO JAMES

What are the parts of the CNS?

brain and spinal cord

What are the parts of the PNS?

all nerve fibers outside of brain and spinal cord

What does the frontal lobe do?

personality, behavior, emotions, intellectual function

What does the Temporal lobe do?

Hearing, taste and smell

What does the cerebellum do? (basic)

Controls balance, equilibrium, and muscle coordination.

What does the occipital lobe do?

Visual reception

What does the parietal lobe do?

Sensation

What is the primary motor area of brain?

precentral gyrus

What is the primary sensory area in brain?

postcentral gyrus

What does Broca's area do?

Motor Speech/Speech Production

What does Wernicke's area do?

speech comprehension

What does the Basal Ganglia do?

Initiates and coordinates movement; controls automatic associated movements of body (extrapyramidal system)

What does the Thalamus do?

Main relay station where sensory pathways of spinal cord, cerebellum, and brain stem form synapses on their way to cerebral cortex

What does the hypothalamus do?

Major respiratory center with basic vital functions; pituitary gland regulator; coordinates autonomic nervous system and stress response - Four F's

What does the cerebellum do? (detailed)

Coiled structure under occipital lobe; coordinates voluntary movements, equilibrium, and muscle tone; does NOT initiate movement but smooths and coordinates it subconsciously

What is the 1st part of brainstem?

Midbrain - most anterior part of brainstem; contains many motor neurons and tracts

What is the 2nd part of the brainstem?

Pons - contains ascending sensory and descending motor tracts

What is the 3rd part of the brainstem?

Medulla - continuation of spinal cord; contains ascending and descending fiber tracts, autonomic centers, pyramidal decussation

What does the spinal cord do?

Main highway for ascending and descending fiber tracts connecting the brain to spinal nerves; mediates reflexes

What are the two sensory pathways?

Anterolateral tract and posterior (dorsal) columns

What does the anterolateral tract do?

Transmits sensations of pain, temperature, and crude/light touch

What do the posterior (dorsal) columns do?

Conduct sensations of position, vibration, and localized touch (proprioception and stereognosis)

What are the three motor pathways?

Corticospinal (pyramidal), extrapyramidal, cerebellar system

What does the corticospinal or pyramidal tract do?

Controls skilled, purposeful movements such as writing

What do the extrapyramidal tracts do?

Maintain muscle tone and control gross automatic movements like walking

What does the cerebellar system do?

Coordinates movement, maintains equilibrium and posture subconsciously

What are nerves?

Bundles of fibers outside the CNS; carry information to and from CNS

What do sensory (afferent) fibers do?

Carry input to CNS

What do motor (efferent) fibers do?

Deliver output from CNS

What are reflexes?

Basic defense mechanisms; involuntary and below conscious control

What are 3 types of reflexes?

Deep tendon, superficial, visceral

How many spinal nerves are there?

31 pairs

What is a dermatome?

Skin area supplied mainly by one spinal nerve

Where are the thumb, middle, and fifth finger dermatomes?

C6, C7, C8

Where is the axilla dermatome?

T1

Where is the nipple dermatome?

T4

Where is the umbilicus dermatome?

T10

Where is the groin dermatome?

L1

Where is the knee dermatome?

L4

What are aging considerations for neuro?

Decrease in brain weight, neuron loss, slower nerve conduction, slower movement, decreased cerebral blood flow and O₂ consumption

What are the 4 main headings of mental status assessment?

Appearance, Behavior, Cognition, Thought Processes

What are the four LOC?

Alert, Lethargic, Stupor, Coma

How do you test orientation?

Ask time, place, person

How do you test new learning?

Four unrelated words test

What tool screens anxiety?

GAD-7

What tool screens depression?

PHQ-9

How do you use the Mini-Cog exam?

Tests cognitive impairment by drawing and labeling a clock

What is delirium?

Acute, temporary loss of reality due to chemical imbalance

What is dementia?

Chronic decline from brain disease causing memory loss, personality change, and poor reasoning

How do you test cognitive function?

MMSE, MOCA

What are abnormal speech disorders?

Dysphonia, Dysarthria, Aphasia

What is dysphonia?

Difficulty or discomfort speaking with abnormal pitch or volume

What is dysarthria?

Neurologic speech disorder affecting muscle control of speech production

What is aphasia?

Loss of ability to understand or express speech

What are the 3 types of aphasia?

Broca, Wernicke, Global

What is Broca aphasia?

Expressive aphasia

What is Wernicke aphasia?

Receptive aphasia

What is global aphasia?

Most severe; affects both expression and comprehension

What is CN I and function?

Olfactory - smell (sensory)

What is CN II and function?

Optic - vision (sensory)

What is CN III and function?

Oculomotor - eye movement, pupil constriction (motor)

How do you test cerebellar function?

Rapid alternating movements, Romberg test

What is routine sensory screening?

Test superficial pain, light touch, vibration, stereognosis

What is complete sensory testing?

Done if neuro symptoms are present

What is stereognosis?

Recognizing objects by touch

What is graphesthesia?

Reading numbers traced on skin

What is extinction?

Touch both sides of body; normal = both felt

What is point location?

Touch skin then ask patient to point to location

How are DTRs graded?

0–4 scale

What does 2+ DTR mean?

Average, normal

What does 0 DTR mean?

No response

What does 1+ DTR mean?

Diminished, low normal

What does 4+ DTR mean?

Hyperactive with clonus, indicates disease

What is normal biceps reflex?

Flexion of forearm

What is normal triceps reflex?

Extension of forearm

What is normal brachioradialis reflex?

Flexion and supination of forearm

What is normal quadriceps reflex?

Extension of lower leg

What is normal Achilles reflex?

Foot plantar flexes

How do you test for clonus?

Briskly dorsiflex foot and hold; rhythmic contractions = clonus

What is a superficial reflex?

Response from skin stimulation causing localized muscle contraction

What is normal plantar reflex?

Plantar flexion of toes

Are senile tremors normal?

Yes

What are dyskinesias?

Repetitive movements of jaw, lips, or tongue

What is neuro recheck sequence?

LOC, Motor Function, Pupillary Response, Vital Signs