Health Assessment for Stroke and Neurological Conditions

Neurological System Notes

• The nervous system is a complex network of nerves and cells that transmits signals throughout the body.
• It is divided into the central nervous system (CNS) and peripheral nervous system (PNS).
• The CNS consists of the brain and spinal cord.
• The PNS consists of the cranial nerves and spinal nerves.

Central Nervous System (CNS)

• The CNS is responsible for processing information and coordinating body functions.
• It includes the cerebral cortex, hypothalamus, cerebellum, brainstem, midbrain, pons, medulla, and spinal cord.

Cerebral Cortex

• The cerebral cortex is the outer layer of the brain.
• It is responsible for higher-level cognitive functions, such as thought, language, and memory.
• It is divided into four lobes: frontal, parietal, occipital, and temporal.

Lobes of the Cerebral Cortex

• Frontal lobe: Personality, voluntary movement, and higher-level cognitive functions.
• Parietal lobe: Sensation, perception, and spatial awareness.
• Occipital lobe: Visual processing.
• Temporal lobe: Auditory processing, language comprehension, and memory.

Other CNS Structures

• Hypothalamus: Controls body temperature, hunger, thirst, and sleep.
• Cerebellum: Coordinates movement and balance.
• Brainstem: Connects the brain to the spinal cord and controls basic life functions.
  • Midbrain: Contains centers for eye movement and auditory reflexes.
  • Pons: Relays signals between different parts of the brain.
  • Medulla: Controls vital functions, such as breathing and heart rate.
• Spinal cord: Carries signals between the brain and the rest of the body.

Structures of significance

• Wernicke's area: Language comprehension
• Broca's area: Motor speech
• Basal ganglia: Movement, posture, and other functions
• Thalamus: Relays sensory information to the cerebral cortex.

Pathways of the CNS

• Sensory pathways transmit information from the body to the brain.
  • Spinothalamic tract: Pain, temperature, and crude touch.
  • Posterior column: Proprioception, vibration, and fine touch.
• Motor pathways transmit information from the brain to the muscles.
  • Corticospinal tract: Voluntary movement.
  • Extrapyramidal tracts: Involuntary movement.
• Upper motor neurons: Located in the brain.
• Lower motor neurons: Located in the spinal cord and brainstem.
• Cerebellar system: Coordinates movement and posture.

Peripheral Nervous System (PNS)

• The PNS transmits signals between the CNS and the rest of the body.
• It includes the cranial nerves, spinal nerves, and autonomic nervous system.
• Cranial nerves: 12 pairs of nerves that originate from the brain.
• Spinal nerves: 31 pairs of nerves that originate from the spinal cord.
• Reflex arc: Simple nerve pathway that controls automatic actions.
• Autonomic nervous system: Controls involuntary functions, such as heart rate and digestion.

Neurological Exam

• Subjective data: Includes patient history of symptoms.
• Objective data: Includes physical exam to assess neurological function.
• Motor function: Ability to follow commands, muscle tone, strength, coordination, balance, and posture, and reflexes.
• Sensory function: Tactile sensation, pain, temperature, vibratory, and tactile discrimination.
• Cranial nerves: Assessing specific cranial nerve functions.
• Vital signs: Heart rate, blood pressure, respiration rate, and temperature.
• Level of consciousness: Assessing alertness and the person's orientation to their surroundings (person, place, and time).
• Pupillary response: Reaction of pupils to light and accommodation.
• Glasgow Coma Scale (GCS): Scoring system to assess the level of consciousness.
• Speech and hearing: Clarity and appropriateness of speech and hearing function.

Health History Questions for Neurological Exam

• Headache
• Head injury
• Dizziness/vertigo
• Seizures
• Tremors
• Weakness
• Questions specific to infants and children: health during pregnancy, neonatal period, reflexes, weakness, balance issues, seizures, physical development, environmental factors, cognitive development, family history

Additional Health History Questions to consider for Older Adults

• Risk for falls
• Cognitive function
• Tremor
• Vision

Promoting Health: Stroke Prevention

• Early recognition of symptoms: Sudden weakness in the face, arms, or legs, confusion, difficulty speaking, sudden changes in vision, trouble walking, severe headache with no cause, sudden nausea, or vomiting, brief loss of consciousness.
• Modifiable Risk Factors: Cardiovascular disease (coronary heart disease, heart failure, peripheral artery disease), hypertension, smoking/secondhand smoke exposure, diabetes, atrial fibrillation, other cardiac conditions, Dyslipidemia, Asymptomatic carotid stenosis, Sickle cell disease, Postmenopausal hormone therapy.
• Nonmodifiable Risk Factors: Age, gender, low birth weight, genetic factors, ethnic background.
• Prevention: Limit sodium intake in diet, maintain healthy weight, exercise moderately, stop smoking, limit alcohol intake, manage underlying medical conditions.

Sample Charting

• Subjective data examples
• Objective data examples
• Specific details related to different parts of the Neurological Assessment.

Abnormal Findings in Neurological Examination

• Abnormalities in muscle tone: Flaccidity, Spasticity, Rigidity, and Paralysis
• Abnormal posturing: Decorticate rigidity, Decerebrate rigidity, and Flaccid quadriplegia.
• Abnormal findings in the cranial nerves: Dysphonia, Dysarthria, Aphasia, Global aphasia, Broca's aphasia and Wernicke's aphasia
• Abnormal gaits: Spastic hemiparesis, Cerebellar ataxia, Parkinsonian (festinating), Scissors, Steppage or footdrop, Waddling, and Short leg
• Common patterns of sensory loss: Peripheral neuropathy, Individual nerves or roots, Complete transection of spinal cord, Thalamus, and Cortex
• Patterns of motor system dysfunction: Cerebral palsy, Muscular dystrophy, Hemiplegia, Parkinsonism, Cerebellar, Paraplegia, and Multiple sclerosis

This quiz covers essential topics related to stroke risk factors, symptoms, and prevention strategies, as well as neurological conditions like Parkinson's disease. Assess your knowledge of how health history and dietary changes can impact stroke risk and overall health in older adults. Perfect for students in health sciences or anyone interested in medical knowledge.