Assessment of Nervous System

• Right:uses feeling
• "big picture" oriented
• imagination rules
• symbols and images
• present and future
• philosophy & religion
• can "get it" (i.e. meaning)
• believes
• appreciates
• spatial perception
• knows object function
• fantasy based
• presents possibilities
• impetuous
• risk taking

• Left: usu. dominant
• uses logic
• detail oriented
• facts rule
• words and language
• present and past
• math and science
• can comprehend
• knowing
• acknowledges
• order/pattern perception
• knows object name
• reality based
• forms strategies
• practical
• safe

• Divided into 4 lobes:
• - Frontal: associated with reasoning, planning, parts of speech, movement, emotions, and problem solving

- Temporal: associated with perception and recognition of auditory stimuli, memory, and speech

- Parietal: associated with movement, orientation, recognition, perception of stimuli

- Occipital: associated with visual processing

• Known as "the Little Brain"
• This structure is associated with regulation and coordination of movement, posture, and balance.

Medulla Oblongata: nerve impulses arise here for rythmically stimulate the intercostal muscles and diaphragm, regulate the heartbeat, regulate the diameter of arterioles adjusting blood flow

Pons: relay station from cerebral cortex to cerebellum; participates in reflexes that regulate breathing

Midbrain: only a small region

Thalmus: all sensory input (except olfactory) pass through here

Hypothalmus: The seat of the autonomic nervous system. Damage to the hypothalamus is quickly fatal as the normal homeostasis of body temperature, blood chemistry, etc. goes out of control. The source of 8 hormones, two of which pass into the posterior lobe of the pituitary gland.

Pituitary Gland: secretes hormones

- 31 pairs of spinal nerves (carry input btwn dermatones and spine)

- 12 cranial nerves

- Autonomic Nervous System (sympathetic/parasympathetic systems)

• breathing
• heart rate
• arousal and consciousness
• attention and concentration

• - Family story of memory loss
• - Orientation
• - General information, mood
• - Spelling (world or counting backwards)

• - Alert
• - Confused or lethargic
• - Semi-coma or stupor
• - Coma

• - Auditory/Receptive
• - Visual/Recpetive
• - Expressive/Speaking
• - Expressive/Writing

• - Intellect
• - Thought
• - Memory
• - Emotional Status
• - Perception (Agnosia: visual, auditory, tactile)
• - Motor Ability
• - Language (aphasia: deficiency in language)

• - Establish a database: assess risk for injury on admission
• - report any deviations that warrant immediate treatment
• - accuately record findings
• - explain and reassure the client when examiniations are needed and why
• - evaluate the client's response to all procedures

• - reflex hammer
• - penlight
• - tongue blade
• - safety pin
• - cotton swab
• - ophthalmoscope
• - eye chart
• - tuning fork
• - dermatone chart

- Central Nervous System

- Divided into four areas: Cervical, Thoracic, Lumbar and Sacral

- Sensory and motor tracts

• - Full Consciousness
• - Confusion
• - Lethargic
• - Obtundation
• - Stupor
• - Coma: light, deep
• - Delirium
• - Dementia