Neuro, breasts, and female GU
We have ___ cranial nerves and ____ spinal nerves.
What do afferent neurons do?
They transmit impulses from the senses and deliver them to the central nervous system (CNS)
What do efferent neurons do?
They conduct impulses from the central nervous system (CNS) to muscles & glands, using motor pathways
What function does the thalamus serve in the brain?
Sensory processing; all information goes through here and is filtered to other parts of the brain
What function does the brain stem serve?
Primal functions, like breathing & eating
What is the cerebral cortex of the brain?
It is the outer covering of the brain. It has patterns of sulci & fissures... every person is different, like a brain fingerprint!
NOTE: Damage to the L side affects the R side, and vice versa!
Name the four main lobes of the brain.
Frontal, occipital, temporal, parietal
What is the frontal lobe of the brain responsible for?
intellect, behavior, personality, voluntary motor information, judgment, and has BROCA'S AREA!
What is Broca's area of the brain responsible for?
What is the occipital lobe of the brain responsible for?
Vision, visual perceptions
What is the parietal lobe of the brain responsible for?
Sensory function; hot & cold
What is the temporal lobe of the brain responsible for?
Filters & senses auditory information, interprets speech, memory, and has WERNICKE'S AREA!
What is Wernicke's area of the brain responsible for?
Comprehension of speech
What is the autonomic nervous system (ANS) responsible for?
Regulates activities of visceral organs, different chemical transmissions regulate response, we have no control over it... autonomic = automatic!
What is the sympathetic nervous system (SNS) responsible for?
Fight or flight
What is the parasympathetic nervous system (PNS) responsible for?
Brings everything back to normal, for example: calming your body down after an episode of "fight or flight"
When gathering a patient's neurological health history, what type of things would we look for subjectively?
Their presenting problem "reason for seeking care", past history (i.e. Alzheimer's, MS, Huntington's), family history, lifestyle, and medications they're on. Again, we are ASSESSING for CHANGES.
When obtaining objective data during a neurological assessment, what will we look for?
We work from mental status and work DOWN towards more primitive things. For example: mental status & speech, cranial nerve function, motor function, sensory function, and reflexes.
When checking to see if a patient is alert and oriented (A&O), what will we check for?
If they know their name, the date, the time, their location, and situation (who's the current president?)
When assessing a person's mental status & speech, what is the MOST important thing?
Changes in level of consciousness
Inability to remember certain objects or certain people
Inability to perform simple motor tasks; for example, being unable to stack 5 blocks on top of one another
When using the Glasgow Coma Scale to assess baseline mental status, what are the three areas we assess?
1) Eye opening 2) Verbal response 3) Motor response
If a patient exhibits abnormal posturing, what can we assume?
Define: decorticate posturing
Feet flexed, hands "praying", has a better prognosis than decerebrate posturing... think "to the cord"!
Define: decerebrate posturing
Arms stiff to the side, feet move inward
Cranial nerve 1 is called ____ and we assess it by _____
Olfactory, ask the patient to close their eyes and smell something (like ground coffee or mint), each nostril is tested
Cranial nerve 2 is called ____ and we assess it by _____
Optic, we use the Snellen chart for visual acuity
Cranial nerve 3 is called ____ and we assess it by _____
Oculomotor, PERRLA (pupils are equal, react to light, and accommodate)
Cranial nerve 4 is called _____ and we assess it by
Trochlear, EOM's (CN's 3,4, and 6) -- have a patient follow a pen with their eyes in the six locations
Cranial nerve 5 is called ____ and we assess it by
Trigeminal (think tri = three), we assess chewing, corneal reflex [cotton ball to blinking eye], and facial sensation [reaction to soft items on the face]
Cranial nerve 7 is called ____ and we assess it by
Facial, asking the patient to smile & frown
Cranial nerve 8 is called ____ and we assess it by _____
Acoustic; Weber & Renee tests, whisper test
Cranial nerve 9 is called _____ and we assess it by _____
Glossopharyngeal, swallowing & gag reflex
Cranial nerve 10 is called _____ and we assess it by ______
Vagus, rise & fall of the uvula, gag reflex
Cranial nerve 11 is called ____ and we assess it by ____
Spinal accessory, shrugging & face turning side to side against our hands
Cranial nerve 12 is called _____ and we assess it by ____
Hypoglossal, sticking their tongue out and moving it from side to side
On the 0-4 reflex rating scale, what does each number mean?
0 = no response, 1+ = diminished, 2+ = NORMAL, 3+ = brisk, above normal, 4+ = hyperactive
Positive and negative results for the Plantar reflex (Babinski reflex) in an adult
Toes curl down = negative, normal finding
Toes fan out = positive, neurological impairment
What are the triad of symptoms for meningitis?
Fever, nuchal rigidity, and changes in level of consciousness
What is a positive Brudzinski neck sign?
The legs will lift when you raise their neck (chin to sternum)
Define: tandem walking
walking on a line, to test intoxication or cerebellar function
Define: Romberg test
person stands with their eyes closed... positive if they lose balance and fall to a side
Pt. closes their eyes and identifies an object in their hand
Pt. closes their eyes and identifies a letter or number you draw in their palm
Tanner stage 1 of breast development
Preadolescent. Only the nipple is raised above level of the breast, as in the child
Tanner stage 2 of breast development
Budding stages. Areola increased in diameter, surrounding area slightly elevated
Tanner stage 3 of breast development
Breast and areola enlarged. No contour separation
Tanner stage 4 of breast development
Areola forms a secondary elevation above that of the breast in half of girls
Tanner stage 5 of breast development
Areola is usually part of the general breast and contour and is strongly pigmented. Nipple usually projects.
Benign development of breast tissue in males and results in a tender, mobile knot under the areola. 1/3 of adolescent males
Form of milk produced in late pregnancy, contains antibodies to protect the newborn from disease
softening of the cervix related to the onset of pregnancy
due to increased vasculature, bluish discoloration of vagina and cervix related to the onset of pregnancy
no menstrual bleed, common in athletes
Define: gravida and pora
1) Gravida: # of pregnancies
2) Pora: # of births
bladder protrudes & leans on the vagina
rectum protrudes onto vagina
Define: uterine prolapse
uterus comes through vagina
Pediculosis Pubis (crab lice)
Nits are on and around roots of pubic hair and cause itching. The area is reddened and excoriated.
Herpes Simplex virus
Small vesicles appear on the genitalia and may spread to the inner thigh. Ulcers and PAINFUL and erupt upon rupture of the vesicles. The virus may be dormant for long periods.
Nontender solitary papule that gradually changes to a draining ulcer
Human Papillomavirus (HPV)
Wart-like, painless growths appear in clusters. These are seen on the vulva, inner vagina, cervix, or anal area.
Often asymptomatic. Characterized by purulent discharge with tenderness to movement of the cervix. If untreated, can cause sterility
Generally asymptomatic. One may see vaginal discharge or bleeding and abscesses in Bartholin's or Skene's glands.
(tri = think three symptoms) Painful urination, vulvular itching, and purulent vagina discharge. Vagina and vulva are reddened and the discharge is yellow and foul smelling.