NR304 Neurologic System LabBook Work

Neurologic System

Lab Book Work

Vocabulary – define the following terms:

Agnosia

Agraphia

Amnesia

Analgesia

Aphasia

Apraxia

Ataxia

Athetosis

Chorea

Clonus

Coma

Decerebrate rigidity

Decorticate rigidity

Dysarthria

Dysphasia

Extinction

Fasciculation

Flaccidity

Graphesthesia

Hemiplegia

Lower motor neuron

Myoclonus

Nuchal rigidity

Nystagmus

Opisthotonos

Paralysis

Paraplegia

Paresthesia

Point localization

Proprioception

Spasticity

Stereognosis

Tic

Tremor

Two-point discrimination

Upper motor neuron

Study guide

1.       List the major functions of the following components of the central nervous system:

a.       Cerebral cortex – frontal lobe:

b.       Cerebral cortex – parietal lobe:

c.       Cerebral cortex – temporal lobe:

d.       Cerebral cortex – Wernicke’s area:

e.       Cerebral cortex – Broca’s area:

f.        Basal ganglia:

g.       Thalamus:

h.       Hypothalamus:

i.         Cerebellum:

j.         Midbrain:

k.       Pons:

l.         Medulla:

m.     Spinal cord:

2.       List the primary sensation mediated by the 2 major sensory pathways of the CNS.

3.       Describe 3 major pathways in the CNS, including the type of movements mediated by each.

4.       Differentiate an upper motor neuron from a lower motor neuron.

5.       List the 5 components of a deep tendon reflex arc:

6.       List the major symptom area to assess when collecting a health history for the neurologic system.

 7.       List and describe 3 tests of cerebellar function.

8.       Describe the method of testing the sensory system for pain, temperature, touch, vibration and position.

9.       Define the 4-point grading scale for deep tendon reflexes.

10.   Which vertebral level is assessed when eliciting each of these reflexes?

Biceps reflex __________                                            Quadriceps reflex __________

Triceps reflex __________                                           Achilles reflex __________

Brachioradialis reflex __________                          

11.   List the components of the neurologic recheck examination that are performed routinely on hospitalized persons being monitored for neurologic deficit.

12.   List the 3 areas of assessment on the Glasgow Coma Scale:

Fill in the labels:

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Review Questions:

1.       The medical record indicates that a person has an injury to Broca’s area. When meeting this person, you expect:

a.       Difficulty speaking

b.       Receptive aphasia

c.       Visual disturbances

d.       Emotional lability

2.       The control of body temperature is located in:

a.       Wernicke’s area

b.       Thalamus

c.       Cerebellum

d.       Hypothalamus

3.       To test for sterognosis, you would:

a.       Have the person close his or her eyes and then raise the person’s arm and ask the person to describe its location.

b.       Touch the person with a tuning fork.

c.       Place a coin in the person’s hand and ask him or her to identify it.

d.       Touch the person with a cold object.

4.       During the examination of an infant, use a cotton-tipped applicator to stimulate the anal sphincter. The absence of a response suggests a lesion of:

a.       L2

b.       T12

c.       S2

d.       C5

5.       During a neurologic examination, the tendon reflex fails to appear. Before striking the tendon again, you use the technique of:

a.       Two-point discrimination

b.       Reinforcement

c.       Vibration

d.       Graphesthesia

6.       Cerebellar function is assessed by which of the following:

a.       Muscle size and strength assessment

b.       Cranial nerve examination

c.       Coordination – hopping on one foot

d.       Spinothalamic test

7.       To elicit the Babinski reflex:

a.       Gently tap the Achilles tendon

b.       Stroke the lateral aspect of the sole of the foot from heel to across the ball

c.       Present a noxious odor for the person

d.       Observe the person walking heel to toe

8.       A positive Babinski sign is:

a.       Dorsiflexion of the big toe and fanning of all toes

b.       Plantar flexion of the big toe with fanning of all toes

c.       The expected response in healthy adults

d.       Withdrawal of the stimulated extremity from the stimulus

9.       Senile tremors may resemble parkinsonism, except that senile tremors do no include:

a.       Nodding the head as if responding yes or no

b.       Rigidity and weakness of voluntary movement

c.       Tremor of the hands

d.       Tongue protrusion

10.   Patients who have Parkinson disease usually have which of the following characteristic styles of speech?

a.       A garbled manner

b.       Loud, urgent

c.       Slow, monotonous

d.       Word confusion

11.   The Glasgow Coma Scale (GCS) is divided into 3 areas. They include:

a.       Pupillary response, a reflex test, and assessing pain

b.       Eye opening, motor response to stimuli, and verbal response

c.       Response to fine touch, sterognosis, and sense of position

d.       Orientation, rapid alternating movements, and the Romberg test

12.   The Landau reflex in the infant is seen when:

a.       The head is held and then flops forward as the baby is pulled to a sitting position by holding the wrists.

b.       The  infant’s toes curl down tightly in response to touch on the ball of his/her foot.

c.       The infant attempts to place his/her foot on the table while being held with the top of the foot touching the underside of the table.

d.       The baby raises his/her head and arches the back as in a swan dive.

13.   A 65-year-old man has noticed a change in his personality and his ability to understand. He also cries and becomes angry very easily. The cerebral lobe responsible for these behaviors is the __________ lobe.

a.       Frontal

b.       Parietal

c.       Occipital

d.       Temporal

Match column A to column B

Column A: Cranial Nerve                                               Column B: Function

14. ____ Olfactory                                                           a. Movement of the tongue

15. ____ Optic                                                                   b. Vision

16. ____ Oculomotor                                                     c. Lateral movement of the eyes

17. ____ Trochlear                                                          d. Hearing and equilibrium

18. ____ Trigeminal                                                        e. Talking, swallowing & sensory information from pharynx and carotid sinus

19. ____ Abducens                                                         f. Smell

20. ____ Facial                                                                  g. Extraocular movement, pupil constriction, down & inward movement of the eye

21. ____Acoustic                                                             h. Mastication & sensation of face, scalp, cornea

22. ____ Glossopharyngeal                                         i. Phonation, swallowing, tasting on the posterior third of the tongue

23. ____ Vagus                                                                 j. Movement of trapezius & sternomastoid muscles

24. ____ Spinal Accessory                                            k. Down & inward movement of the eye

25. ____ Hypoglossal                                                     l. Tasting on the anterior 2/3 of tongue, closing eyes