Winter Flascards Flashcards by Mercy Azanapo

doll eyes test
Normal (brain stem intact)

eyes move in the opposite direction of head movement
They stay fixed on a point (like a doll’s eyes)

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Abnormal (Brain stem Dysfunction) doll eye test

eyes move either the head
-> no compensatory movement
-> suggests brainstem injury

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GCS Comatose patient score

8 or less

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finger -to-Nose Test process

patient alternately touches their nose and the examiner’s finger

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what does the figure-to-nose process evaluates?

evaluates coordination and cerebellar function

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GCS Response (1-6)
Obeys commands
localize pains
withdraws from pain
Abnormal extension (Decorticate Postering)
Abnormal extension (decerebrate Postering)
No response

6
5
4
3
2
1

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GCS Verbal Response (1-5)

5
4
3
2
1

oriented
confused
inappropriate words
incomprehensible sounds
No response

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eye opening response (1-4)

spontaneous
to verbal stimule
to pain
no response

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arms extended by sides, wrists and fingers turned out

legs extended with feet turned inward

indicates more severe damage in the brian stem then decorticate posturing

Decerebrate posturing (extension)

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Flexion -> Arms bent twords check, wrists, and fingers bend inward.

legs extended and feet turned inward

indicates damage above the midbrain

Decorticate posturing and indication.

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Full consciousness
Decrease concentration
need continuous stimulation to arouse
reflexive positioning to pain stimuli
no response to stimulus
Coma

Progression of Dteriorating Brain Function.

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full consciousness

Alert, oriented to time, place, person

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coma

no response to any stimuli

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common causes of positive Bbinski in adults (4)

stroke, spinal cord injury, brain tumor, multiple slerosis

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babinski reflex assessed what type of motor neuron

Upper Motor neuron

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babinski reflex positive or negative in infant and why?

positive due to incomplete myelination of corticospinal tract

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what does a positive Babinski indicate in adults

Upper Motor neuron lesson

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positive Babinski sign in adults

Great toe dorsiflexes and other toes curl downward

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normal babinski response in adult

toes plantar reflex (curl outward)

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why does the babinski reflex test?

Neurological test of the corticospinal tract (upper Motor neuron pathway)

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causes contraction of skeletal muscle (e.g., pattelar reflex)

somatic reflexes

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CN exam order principle

test sensory and motor separately when applicable

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cause smooth muscles, cardiac muscles or glands to respond ( e.g diving reflex)

Autonomic reflexes

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Doll eyes reflex

Brainsterm integerity (oculocephalic tract),

CN VIII (vestibulocochlear),

CN III (oculomotor),

CN VI (abducens)

all intact

Oculocephalic reflex

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pupillary reflex nerves

CN II and III

Corneal reflex nerves

V1 (opthalmic branch sensory) and VII (motor)

If gag lost in unconscious patient

Brainstem compromise

If pupils change suddenly

Possible rising ICP

If LOC decreases first neuro sign Subtles

confusion

Nystagmus meaning

Involuntary rhythmic eye movement

Diplopia meaning

Double vision

Down and out eye position indicates

CN III palsy

Nonreactive dilated pupil

Blown pupil

Pinpoint pupils cause(2)

Opioids or pontine lesion

Fixed dilated pupil indicates

Severe brain injury or herniation

PERRLA meaning

Pupils equal round reactive to light and accommodation

Lower motor neuron damage ___ are visible, involuntary muscle twitches caused by spontaneous firing of a single motor unit. They look like a brief ripple or worm-like movement under the skin.

Fasciculations

Tongue deviation indicates

Lesion on same side

Normal CN XII finding

Tongue midline

Test CN XII

Stick out tongue move side to side

CN XII type

Motor

Hypoglossal nerve number

CN XII

Normal CN XI finding

Equal strength bilaterally

Shrug shoulders turn head against resistance

Test CN XI

CN XI controls

Sternocleidomastoid, trapezius

CN IV

Trochlear nerve

Accessory nerve number

CN XI

CN X part of reflex

Motor limb gag

Hoarseness suggests

Vagus nerve dysfunction

Test CN X

Assess voice quality, swallowing

CN X function(5)

Parasympathetic heart, lungs, GI, swallowing, voice

CN X type

Mixed

Vagus meaning

Wandering

Vagus nerve number

CN X

CN IX part of reflex

Sensory limb gag

CN IX function

Taste posterior third gag reflex swallowing

Mixed

Facial nerve CN IX

Glossopharyngeal nerve number

CN IX

Weber test lateralizes to

Affected ear conductive loss

Positive Romberg indicates

Posterior column or vestibular issue

Normal Romberg result

Minimal sway eyes closed

Test balance CN VIII

Romberg test

Vestibulocochlear type

Sensory

CN VIII

Vestibulocochlear nerve

Why forehead spared in stroke

Bilateral cortical innervation

Stroke facial pattern

Lower face droop forehead spared

Bell palsy pattern

Entire side facial paralysis

Test CN VII taste

Identify sweet salty on tongue tip

Normal CN VII finding

Symmetrical facial movement

Test CN VII motor

Smile frown puff cheeks close eyes

CN VII controls sensory

Taste anterior two thirds tongue

CN VII controls motor

Facial expression

Cranial nerve III Efferent limb meaning

Motor output from brain

CN VII

Facial nerve

CN VI palsy sign

Inability to abduct eye medial deviation

Test CN VI

Follow finger side to side

Lateral rectus function

Moves eye laterally

CN VI controls

Lateral rectus muscle

Motor nerve

Trochlear nerve Abducens nerve Accessory nerve Oculomotor nerve

CN VI

Abducens nerve

Absent corneal reflex suggests

Brainstem dysfunction

Blink bilaterally The corneal reflex is a protective brainstem reflex that causes both eyes to blink when the cornea is lightly touched. It assesses cranial nerve V1(sensory) and cranial nerve VII(motor).

Normal corneal reflex

Corneal reflex cranial nerves(2)

CN V sensory CN VII motor

Masseter muscle function

Jaw closure

Test CN V motor

Clench teeth, palpate masseter

Test CN V sensory(3)

Light touch forehead, cheeks, jaw

Trigeminal nerve: Mandibular branch function

Sensory jaw motor chewing

Trigeminal nerve: Maxillary branch function(2)

Sensory cheeks, upper lip

Trigeminal nerve: Ophthalmic branch function(3)

Sensory forehead, scalp, cornea

Three branches of CN V

Ophthalmic maxillary mandibular

CN V

Trigeminal nerve

Trigeminal nerve type

Mixed

CN IV damage sign(2)

Vertical diplopia, difficulty reading stairs

Function of superior oblique

Moves eye down and inward

CN IV controls

Superior oblique muscle

Ptosis meaning

Drooping eyelid

CN III abnormal finding

Ptosis dilated pupil eye deviates down and out

Normal accommodation response

Pupils constrict eyes converge

Most extraocular muscles, (parasympathetic)pupil constriction, eyelid elevation

CN III controls(3) Oculomotor nerve

Cranial nerve II Afferent limb meaning

Sensory input to brain

Optic disc swelling from increased ICP

Papilledema

Normal CN II finding(2)

Reads chart and intact peripheral vision

CN II also tests

Afferent limb of pupillary reflex

Optic nerve CN II olfactary

Sensory

Anosmia common causes(4)

Head trauma, frontal lobe lesion, COVID, sinus disease

Avoid testing CN I with

Irritants like ammonia

identify familiar scent with each nostril separately

Test for CN I

Pneumonic for cranial nerve names

Oh Oh Oh, To Touch And Feel Very Good Velvet, AH!

motor, or both, Some Say Marry Money, But My Brother Says Big Brains Matter More

Pneumonic for sensory

Winter Flascards Flashcards

(109 cards)