chapter 25: neurological system

the neurological system is responsible for

coordinating and regulating all the bodys functions

CNS (central nervous system)

brain and spinal cord

PNS (peripheral nervous system)

the sensory and motor neurons that connect the CNS to the rest of the body

subarachnoid space

a space in the meninges beneath the arachnoid membrane and above the pia mater that contains the cerebrospinal fluid

CSF (cerebral spinal fluid)

cushions the brain and spinal cords

nourishes CNS

removes waste materials

sensory and motor pathways

Most decussate (cross from one side to the other) from one side of CNS to other side

Most are made up of a chain of 2-3 neurons that contribute to successive tracts

Most exhibit body mapping (spatial arrangement)

All pathways are paired right and left

Cerebrum

Area of the brain responsible for all voluntary activities of the body

left and right hemispheres

largest part of brain

corpus callosum

the large band of neural fibers connecting the two brain hemispheres and carrying messages between them

Four lobes of the brain

frontal, parietal, occipital, temporal

gray matter

higher level functions like memory, perception, communication, etc

cerebral cortex

outer region of the cerebrum, containing sheets of nerve cells; gray matter of the brain

frontal lobe function

primary motor cortex

directs voluntary skeletal actions

talking and writing

emotions

judgement and behavior

frontal lobe contains that ______ which is used for speech

broca's area

parietal lobe function

touch

pain

temperature

shapes

two point touch descrimmination

occipital lobe function

influences ability to read with understanding

primary visual receptor

temporal lobe function

hearing and smell

the temporal lobe contains _________ which is responsible for interpreting auditory stimuli

wernicke's area

Midbrain

A small part of the brain above the pons that integrates sensory information and relays it upward.

Pons

A brain structure that relays information from the cerebellum to the rest of the brain

medulla oblongata

Part of the brainstem that controls vital life-sustaining functions such as heartbeat, breathing, blood pressure, and digestion.

Brainstem consists of

midbrain, pons, medulla oblongata

The pons links the cerebellum with the

brain stem, cerebrum, and spinal cord

cerebellum

the "little brain" at the rear of the brainstem

functions include processing sensory input and coordinating movement output and balance, coordination, smoothing of voluntary muscles movements, maintaining equilibrium, and maintaining muscle tone

spinal cord

Nerves that run up and down the length of the back and transmit most messages between the body and brain

the spinal cord is not as long as the

vertebral canal

white matter function

carry signals from one part of the CNS to another

afferent

sensory

efferent

motor

Synapse

the junction between the axon tip of the sending neuron and the dendrite or cell body of the receiving neuron

spinothalamic tract

nerve pathway from the spine to the thalamus along which pain impulses are carried to the brain

pain, temp, light tough

posterior column pathway

Carries sensations of highly localized ("fine") touch, pressure, vibration, and proprioception

dorsal root function

sensory

extrapyramidal tracts

group of tracts associated with balance and muscle tone

the peripheral nervous system consists of

12 pairs of cranial nerves and 31 pairs of spinal nerves

Somatic Nervous System (SNS)

the part of the peripheral nervous system that controls voluntary movement of skeletal muscles

31 nerves of the spine are composed of

8 cervical nerves

12 thoracic nerves

5 lumbar nerves

5 sacral nerves

1 coccygeal nerve

each nerve is attached to the spinal cord by

two nerve roots

sensory nerve fibers enter through the

dorsal rooots

motor nerve fibers enter through the

ventral roots

autonomic nervous system

the part of the peripheral nervous system that controls the glands and the muscles of the internal organs (such as the heart). Its sympathetic division arouses; its parasympathetic division calms.

sympathetic nervous system

the division of the autonomic nervous system that arouses the body, mobilizing its energy in stressful situations

parasympathetic nervous system

the division of the autonomic nervous system that calms the body, conserving its energy

paresthesia

abnormal sensation of numbness and tingling without objective cause

decrease in taste, smell, hearing, and vision is normal in

older patients

risk factors for stroke

High blood pressure

high cholesterol

Atherosclerosis

Heart disease

Smoking or tobacco use

Atrial fibrillation (Afib)

Diabetes

Overweight or Obesity

Blood disorders

Excessive alcohol

Certain medications

where do strokes occur

brain

strokes can occur at

any age

what is a stroke

Damage to the brain from interruption of its blood supply.

blood clot in the brain

mental status exam

a set of interview questions and observations designed to reveal the degree and nature of a client's abnormal functioning

cranial nerve exam

major section of the neurological exam that assesses sensory and motor functions of the cranial nerves and their associated central and peripheral structures

Cerebellar Examination

Assess for overall coordination of movement, balance, and equilibrium

Snellen chart

used to measure visual acuity

reflex hammer (percussion hammer)

test neurological reflexes and deep tendon reflexes, efferent neurons send message to the brain.

how do you rate reflexes

0-4

+4 is hyperactive

0 is no response

cranial nerve 1 test

Olfactory ( sensory) smell, have pt close eyes and smell substances one nostril at a time

cranial nerve 2 test

Snellen chart

cranial nerve 3 test

Pen Light Test- Stand 1 foot away from patient

Gently move pen light from outside of eye to center of eye for 1 second

Move the pen light away from center of eye and pay attention to pupil constriction and dilation.

PEARRL= Pupils Equal Round and Reactive to Light

cranial nerve 4 test

Trochlear (Motor) downard, internal rotation of the eye

6 positions of gaze and pupillary response

cranial nerve 5 test

-Touch to face (have patient close eyes and touch patient on random parts on face with cotton wisp)

-Muscles of mastication (place hands on patient's masseter and temporalis and ask them to bite down)

-Corneal reflex (have patient look up and in. Then touch the cornea with . cotton wisp and patient will blink and tear)

cranial nerve 6 test

Abducens (motor) lateral deviation of the eye

6 positions of gaze and pupillary response

cranial nerve 7 test

facial expressions

cranial nerve 8 test

Acoustic (Sensory) Hearing and balance

webber, rinne and gross hearing

cranial nerve 9 test

Swallows, tastes, salivates

cranial nerve 10 test

Swallows, tastes, talks

cranial nerve 11 test

Lift traps and you push down on them and tell patient to resist

Have patient turn head to side and you place hand on one side of face and you resist them pushing

cranial nerve 12 test

moves tongue

ptosis

drooping of eyes

dyskinesia

the distortion or impairment of voluntary movement such as in a tic or spasm

anesthesia

loss of feeling or sensation

hyperesthesia

increased sensitivity to stimulation such as touch or pain

analgeisa

inability to feel pain

hypalgesia

decreased sensitivity to pain

Hyperalgesia

increased sensitivity to pain

Two point descrimination test results:

fingertips- 6mm

dorsal hand- 15mm

chest- 45mm

forearm- 39

back-45

upper arm-40

Babinski reflex

Reflex in which a newborn fans out the toes when the sole of the foot is touched