Chapter 23 Neurological System

includes brain and spinal cord

• includes the 12 pairs of cranial nerves
• 31 pairs of spinal nerves, and all of their branches

personality, behavior, emotions, and intellectual functions

primary center for sensation

primary visual receptor center

primary auditory reception center with functions of hearing, taste, and smell

• Temporal Lobe
• associated with language comprehension
• When damaged the person hears sound, but it has no meaning.

• frontal lobe
• mediates motor speech
• When injured the person cannot talk. The person can understand language, but can only produce a garbled sound.

the left cerebral cortex receives sensory information from and controls motor function to the right side of the body, and the right to the left side of the body

• 1. Spinothalmic Tract
• transmit sensations of pain, temperature, and crude or light touch.
• 2. Posterior Columns
• conduct the sensations of position, vibration, and finely localized touch.

• 1. Corticospinal or Pyramidal Tract
• a newer, "higher" motor system that permits humans to have very skilled and purposeful movements
• 2. Extrapyramidal Tracts
• older, "lower", motor system. Maintain muscle tome and control body movements, especially gross automatic movements such as walking.

• located completely within CNS
• Examples: corticospinal, corticobulbar, and extrapyramidal tracts
• UMN diseases: strokes, cerebral palsy, and MS

• located mostly in the PNS
• Examples: cranial nerves and spinal nerves
• LMN diseases: spinal cord lesions, poliomyelitis, and amyotrophic lateral sclerosis

• 1. Deep tendon (patellar)
• 2. Superficial (corneal, abdominal)
• 3. Visceral (pupillary)
• 4. Pathologic (Babinski)

circumscribed skin area that is supplied mainly from one spinal cord segment through a particular spinal nerve

• Thumb, middle finger, 5th finger= C6-8
• Axilla= T1
• Nipple= T4
• Umbilicus= T10
• Groin= L1
• Knee= L4

comes from a direct blow that causes the brain to shift rapidly back and forth inside the skull

a sudden loss of strength, a temporary loss of consciousness caused by lack of cerebral blood flow

rotational spinning caused by neurologic disease in the vestibular apparatus in the ear or the vestibular nuclei in the brainstem

occur with epilepsy--a disease characterized by altered or loss of consciousness, involuntary muscle movements, and sensory disturbances

a subjective sensation that precedes a seizure; it could be auditory, visual, or motor

involuntary shaking or trembling

a partial or incomplete paralysis

a loss of motor function caused by a lesion in the neurologic or muscular system or loss of sensory innervation

inability to control the distance, power, and speed of a muscular action

an abnormal sensation...burning, or tingling

difficulty forming words

difficulty with language comprehension or expression

• 1. Mental status
• 2. Cranial nerves
• 3. Motor system
• 4. Sensory system
• 5. Reflexes

decrease or loss of smell occurs bilaterally with tobacco smoking, allergic rhinitis, and cocaine use

unilateral loss of smell in the absence of nasal disease

• abnormally small muscle with a wasted appearance
• occurs with disuse, injury, LMN disease such as polio, diabetic neuropathy

• increased size and strength
• occurs with isometric exercise

clumsy movement with overshooting the mark and occurs with cerebellar disorders or acute alcohol intoxication

a constant deviation to one side

uncoordinated or unsteady gait

decreased pain sensation

absent pain sensation

increased pain sensation

decreased touch sensation

absent touch sensation

increased touch sensation

• inability to identify object correctly.
• occurs in sensory cortex lesions

a set of rapid, rhythmic contractions of the same muscle

• exaggerated reflex.
• occurs with UMN lesions (stroke)

• absence of reflex.
• occurs with interruption of sensory afferents or destruction of motor efferents (spinal cord injury)

reflexes that have a predictable timetable of appearance and departure

• 1. Level of consciousness
• 2. Motor function
• 3. Pupillary response
• 4. Vital signs

• F= Face drooping
• A= Arm Weakness
• S= Speech difficulty
• T= Time to call  9-1-1

• 1. Memory Loss
• 2. Losing Track
• 3. Forgetting Words
• 4. Getting Lost
• 5. Poor Judgement
• 6. Abstract Failing7. Losing Things
• 8. Mood Swings
• 9. Personality Change
• 10. Growing Passive