Nervous System Chapter 55 Quiz
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Questions and Answers

What is a lumbar puncture done for?

To aspirate cerebrospinal fluid

A patient's eye jerking while looking to the left could be caused by which of the following? (Select all that apply)

  • Lesions in the brainstem (correct)
  • Lesions in the cerebellum (correct)
  • Lower motor neuron lesions
  • Disorders of the basal ganglia
  • Upper motor neuron lesions

    • How should the nurse assess the most basic sense of touch? (Select all that apply)

  • Using a cotton wisp to touch the extremities (correct)
  • Applying tubes of warm and cold water to the skin
  • Simultaneously touching both sides of the body symmetrically (correct)
  • Applying a vibrating tuning fork to the fingernails
  • Touching the skin with a light pin prick (correct)

    • What is the nurse assessing when calling out a patient's name to arouse them from sleep?

    <p>Reticular activating system (RAS)</p> Signup and view all the answers

    Which findings should be considered during a cranial nerve assessment in a patient? (Select all that apply)

    <p>Facial movements full</p> Signup and view all the answers

    What can be used to test the function of the optic nerve (CN II) if a Snellen chart is not available?

    <p>Magazine or newspaper</p> Signup and view all the answers

    Which cranial nerve is assessed when eliciting the gag reflex? (Select all that apply)

    <p>Vagus nerve</p> Signup and view all the answers

    What manifestation is likely to be found in a patient with suspected lesions in Broca's area?

    <p>Irregular speech patterns</p> Signup and view all the answers

    What should the nurse ask the patient to do when assessing facial nerve (CN VII) integrity? (Select all that apply)

    <p>Purse lips together</p> Signup and view all the answers

    Which cranial nerves should be tested for blepharospasm?

    <p>Cranial nerve VII</p> Signup and view all the answers

    Which tests are used to assess the sensory system? (Select all that apply)

    <p>Intact gag reflex</p> Signup and view all the answers

    What instructions should the nurse give to assess the patient's accessory nerve?

    <p>Turn your head against resistance to either side.</p> Signup and view all the answers

    Which cranial nerve is affected in a patient with hemianopsia?

    <p>Optic nerve</p> Signup and view all the answers

    Which neurotransmitter may be responsible for alterations in mood, sleep, and emotions?

    <p>Serotonin</p> Signup and view all the answers

    What assessment finding is likely observed in a patient with a pyramidal tract dysfunction?

    <p>Impaired muscle movement</p> Signup and view all the answers

    What functional difficulties should be expected in a patient with frontal lobe dementia?

    <p>Higher cognitive function abnormalities</p> Signup and view all the answers

    What instructions should the nurse give to assess the facial nerve?

    <p>Raise the eyebrows</p> Signup and view all the answers

    Which nursing intervention should the nurse perform to prepare a patient for a skull x-ray?

    <p>Explain that the procedure is noninvasive.</p> Signup and view all the answers

    Which functions would be affected in a patient with basal ganglia injury? (Select all that apply)

    <p>Blinking</p> Signup and view all the answers

    What action is appropriate for a patient who reports severe headache after a lumbar puncture?

    <p>Increase fluid intake</p> Signup and view all the answers

    What could cause a patient to be unable to recognize the form of an object by touch?

    <p>Lesions in the parietal cortex</p> Signup and view all the answers

    What criteria should the nurse assess to judge a patient’s mental status? (Select all that apply)

    <p>Appropriate mood and affect</p> Signup and view all the answers

    What could cause a patient to demonstrate a lack of coordination in articulating speech? (Select all that apply)

    <p>Cranial nerve lesion</p> Signup and view all the answers

    Which diagnostic procedure confirms suspicion of cerebral death?

    <p>Cerebral angiography</p> Signup and view all the answers

    Match the following cranial nerves with their functions:

    <p>CN I = Olfactory function CN II = Optic function CN III = Oculomotor function CN VII = Facial expression and taste</p> Signup and view all the answers

    Which neurotransmitter is released by both preganglionic and postganglionic nerve endings of the sympathetic nervous system?

    <p>Acetylcholine</p> Signup and view all the answers

    What condition may result from the destruction of dopamine-secreting neurons?

    <p>Parkinson's disease</p> Signup and view all the answers

    What does compression of the nerve root cause?

    <p>cauda equina</p> Signup and view all the answers

    What condition puts Patient C at risk due to intracranial injury?

    <p>increased intracranial pressure</p> Signup and view all the answers

    What causes the expansion of brain tissue in Patient D?

    <p>acute hemorrhage</p> Signup and view all the answers

    Which glial cell could be the reason for increased intracranial pressure?

    <p>Ependymal cells</p> Signup and view all the answers

    Which cells constitute almost half of the brain and spinal cord mass?

    <p>Glial cells</p> Signup and view all the answers

    Which cranial nerve is responsible for pupillary constriction?

    <p>III</p> Signup and view all the answers

    What function is likely impaired if a patient has a damaged accessory nerve?

    <p>Raise the hand</p> Signup and view all the answers

    Which patient's findings may indicate Alzheimer's disease?

    <p>Patient A: Deficiency of acetylcholine-secreting neurons</p> Signup and view all the answers

    Where is the pia mater of the spinal cord located?

    <p>Pia mater</p> Signup and view all the answers

    In which situation is the assessment of temperature sensation conducted?

    <p>When the pain reflex is absent</p> Signup and view all the answers

    What age-related finding may an older adult patient who has diminished hearing and visual loss develop?

    <p>Perceptual confusion</p> Signup and view all the answers

    Which cranial nerves that innervate the pharynx are tested together?

    <p>IX and X</p> Signup and view all the answers

    Which type of nerve cell works to restore normal conditions after a brain injury?

    <p>Astrocytes</p> Signup and view all the answers

    Graphesthesia is a test for which integrative sensory function?

    <p>Cortical sensory</p> Signup and view all the answers

    An extensor plantar response is associated with which nervous system abnormality?

    <p>Upper motor neuron lesions</p> Signup and view all the answers

    What are the functions of the cerebellum?

    <p>Coordinating voluntary movement</p> Signup and view all the answers

    While assessing extraocular movements, if the eyes do not move together, how should this be documented?

    <p>Disconjugate</p> Signup and view all the answers

    What should the nurse ensure before a patient goes for a cerebral angiography?

    <p>Instruct that a contrast medium will be injected</p> Signup and view all the answers

    What is the priority intervention after a positive Romberg test?

    <p>Inform UAP that the patient will need assistance with activity</p> Signup and view all the answers

    Which instructions should the nurse give to test the functions of the accessory nerve?

    <p>Shrug the shoulders</p> Signup and view all the answers

    Which cranial nerve should be assessed during a patient's physical examination for altered taste?

    <p>Glossopharyngeal</p> Signup and view all the answers

    Which part of the spinal cord carries impulses for muscle movement?

    <p>Descending tract</p> Signup and view all the answers

    What is a normal response when testing the bicep reflex?

    <p>Flexion of the arm at the elbow</p> Signup and view all the answers

    What should the nurse prepare to assist with assessing the integrity of the brain stem?

    <p>Cranial nerves</p> Signup and view all the answers

    Which nerves should be evaluated if a patient has involuntary blinking?

    <p>Facial nerve (VII) and ocular motor nerve (III)</p> Signup and view all the answers

    What is the responsibility of the frontal lobe?

    <p>Higher-order processes such as judgment and reasoning.</p> Signup and view all the answers

    What does the postcentral gyrus do?

    <p>Responsible for sensory response from the opposite side of the body.</p> Signup and view all the answers

    Which statement made by a student indicates the need for further teaching regarding the effects of aging on the nervous system?

    <p>Cerebrospinal fluid production decreases due to constriction of ventricles.</p> Signup and view all the answers

    Which cranial nerve connects with the brain at the junction of the pons and the medulla?

    <p>Facial nerve</p> Signup and view all the answers

    Which activity is regulated by the Gamma-aminobutyric acid neurotransmitter?

    <p>Neuronal excitability</p> Signup and view all the answers

    Which division of the nervous system activates the 'fight or flight' response?

    <p>Sympathetic nervous system</p> Signup and view all the answers

    What assessment finding does the nurse anticipate observing in a patient with an upper motor neuron lesion?

    <p>Hyperreflexia</p> Signup and view all the answers

    Which area of the brain is affected in a patient with an inability to speak after experiencing an intracranial injury?

    <p>Broca's area</p> Signup and view all the answers

    What is the location of the visual area in the cerebrum?

    <p>Occipital lobe</p> Signup and view all the answers

    What type of age-related finding might a nurse determine in an older adult patient with diminished hearing and visual loss?

    <p>Perceptual confusion</p> Signup and view all the answers

    Which cranial nerve should the nurse assess for a patient with altered function of the lungs and digestive system?

    <p>Cranial nerve X</p> Signup and view all the answers

    Which cranial nerve should the nurse assess in a patient who has difficulty hearing?

    <p>CN VIII</p> Signup and view all the answers

    What is the function of the spinocerebellar tracts?

    <p>To carry information about muscle tension</p> Signup and view all the answers

    Which functions can the nurse assess in an unconscious patient during a pupillary assessment?

    <p>Shape</p> Signup and view all the answers

    What is an expected finding in a geriatric patient related to changes in the reticular activating system?

    <p>Decrease in stage 4 sleep</p> Signup and view all the answers

    Which glial cell could cause gliosis in the central nervous system?

    <p>Astrocytes</p> Signup and view all the answers

    Which component of the neurologic system is responsible for blood pressure changes in older adults?

    <p>Autonomic nervous system (ANS)</p> Signup and view all the answers

    Which cells constitute almost half of the brain and spinal cord mass?

    <p>Glial cells</p> Signup and view all the answers

    How will the nurse document weakness or paralysis of an eye muscle resulting in eyes not moving together?

    <p>Disconjugate gaze</p> Signup and view all the answers

    What is the result of lesions involving motor pathways of cranial nerves IX and X?

    <p>Dysphagia</p> Signup and view all the answers

    Which lobe of the cerebrum helps integrate somatic and sensory input?

    <p>Parietal lobe</p> Signup and view all the answers

    What part of the cerebrum is damaged in a patient who does not understand spoken words?

    <p>Wernicke's area</p> Signup and view all the answers

    Which patient is susceptible to Parkinson's disease?

    <p>Patient A: Deficiency of dopamine</p> Signup and view all the answers

    Which patient is likely to have an inability to sense taste, as identified by the nurse during assessment of a group of four patients?

    <p>Patient B: Damaged facial nerve</p> Signup and view all the answers

    Which area depicted in the figure is used to obtain cerebrospinal fluid (CSF) during a lumbar puncture?

    <p>B: Lumbar vertebrae</p> Signup and view all the answers

    Which glial cells are most abundant, primarily found in the gray matter, and provide structural support to neurons?

    <p>Astrocytes</p> Signup and view all the answers

    What is the rating on the muscle response scale of 0 to 5 when an elicited patellar reflex is brisk?

    <p>3</p> Signup and view all the answers

    Which part of the central nervous system (CNS) is responsible for sleep-wake transitions causing extreme fatigue?

    <p>Brain stem</p> Signup and view all the answers

    What part of the cerebrum is recognized as damaged if there are language comprehension issues?

    <p>Wernicke's area</p> Signup and view all the answers

    Which neurotransmitter is released by the preganglionic and postganglionic fibers during the parasympathetic response?

    <p>Acetylcholine</p> Signup and view all the answers

    Which division of the central nervous system has been affected if there is increased intracranial pressure with suspected herniation?

    <p>Pons</p> Signup and view all the answers

    Which condition does the nurse recognize is associated with an optic nerve injury?

    <p>Anisocoria</p> Signup and view all the answers

    Which are components of the central nervous system (CNS)? Select all that apply.

    <p>Brainstem</p> Signup and view all the answers

    Which diagnostic study is used to obtain cerebrospinal fluid (CSF)?

    <p>Lumbar puncture</p> Signup and view all the answers

    Which part of the central nervous system carries specific sensory information to higher levels?

    <p>Ascending tracts</p> Signup and view all the answers

    Which is the primary functional unit of the nervous system?

    <p>Neuron</p> Signup and view all the answers

    Which cells of the nervous system are characterized by excitability, conductivity, and influence?

    <p>Neurons</p> Signup and view all the answers

    What statement by the student nurse demonstrates further instruction is required about neurologic assessment techniques?

    <p>Decreased oxygen supply results in a decreased risk of postural hypotension.</p> Signup and view all the answers

    What portion of the ascending spinal cord tract carries information regarding pain and temperature sensation?

    <p>Spinothalamic tracts</p> Signup and view all the answers

    Which cells help in restoring the neurochemical milieu after brain injury?

    <p>Astrocyte cells</p> Signup and view all the answers

    Which part of the cerebrum has the potential for impaired functioning related to decreased libido?

    <p>Limbic system</p> Signup and view all the answers

    Which neurotransmitters inhibit the transmission of impulses across the synaptic cleft? Select all that apply.

    <p>Serotonin</p> Signup and view all the answers

    Which cranial nerve is assessed when the nurse requests a patient to shrug the shoulders and turn the head against resistance?

    <p>XI</p> Signup and view all the answers

    Which cranial nerve is assessed while evaluating the innervation of the lateral rectus of the eye?

    <p>CN VI</p> Signup and view all the answers

    With which neurologic component does the nurse document findings of memory loss and dizziness?

    <p>Cognitive perceptual</p> Signup and view all the answers

    Where does a nurse suspect a lesion may be located in a patient with spasticity, hyperreflexia, weakness, and paralysis in the lower extremities?

    <p>Upper motor neurons</p> Signup and view all the answers

    What is the function of the area depicted in the figure related to saltatory conduction?

    <p>Saltatory conduction</p> Signup and view all the answers

    What is the function of the area depicted in the figure regarding dendrites?

    <p>To conduct impulses toward the cell body</p> Signup and view all the answers

    Which cerebral lobes can cause blurred vision because of the presence of lesions? Select all that apply.

    <p>Parietal</p> Signup and view all the answers

    Study Notes

    Nervous System: Key Concepts and Functions

    • Patient with a damaged facial nerve (Patient B) may experience taste sensation loss as this nerve controls taste in the anterior two-thirds of the tongue.
    • Lumbar vertebrae are the site used for obtaining cerebrospinal fluid (CSF) during a lumbar puncture, specifically in the third and fourth vertebrae.
    • Astrocytes are the most abundant glial cells in the nervous system, primarily found in gray matter, providing structural support to neurons.
    • A brisk patellar reflex is rated a 3 on the muscle response scale, where 0 indicates absent reflex and 2 indicates a normal response.
    • The brainstem, particularly the reticular activating system (RAS), regulates sleep-wake transitions, impacting fatigue.
    • Wernicke's area in the cerebrum is crucial for language comprehension; damage here can affect language processing.
    • During a parasympathetic response, both preganglionic and postganglionic fibers release acetylcholine.
    • Increased intracranial pressure that leads to herniation is associated with the pons, part of the brainstem.
    • Anisocoria, the condition of unequal pupil sizes, can result from optic nerve injury.
    • Key components of the central nervous system (CNS) include the cerebrum, brainstem, spinal cord, and cerebellum; spinal and cranial nerves belong to the peripheral nervous system.
    • Lumbar puncture is the diagnostic procedure used to collect cerebrospinal fluid (CSF).
    • Ascending tracts in the spinal cord carry sensory information to higher CNS levels.
    • Neurons serve as the primary functional units in the nervous system, responsible for transmitting signals.
    • Neurons exhibit properties of excitability, conductivity, and influence, essential for nervous system function.
    • An older adult may show diminished strength, agility, and average reflex scores due to changes associated with aging, including hypothalamic function affecting sleep patterns.
    • The spinothalamic tracts carry sensations of pain and temperature to the thalamus in the CNS.
    • Astrocytes play a significant role in restoring the neurochemical balance after brain injuries.
    • The limbic system controls emotions and sexuality; impairment may lead to decreased libido.
    • Neurotransmitters that inhibit impulse transmission include GABA, serotonin, and dopamine.
    • Assessing a patient’s ability to shrug shoulders tests cranial nerve XI (accessory nerve).
    • The abducens nerve (CN VI) is responsible for lateral eye movement through the lateral rectus muscle.
    • The cognitive perceptual section of health assessments includes inquiries about memory loss and dizziness.
    • A lesion in upper motor neurons can result in spasticity and hyperreflexia in lower extremities.
    • Saltatory conduction occurs rapidly at the nodes of Ranvier, allowing quicker signal transmission in myelinated nerves.
    • Dendrites conduct impulses toward the neuron's cell body, receiving signals from other neurons.
    • Blurred vision can be linked to lesions in the parietal, occipital, or temporal lobes, which are involved in visual processing.
    • Aging impacts cerebrospinal fluid production due to enlarged ventricles, leading to decreased brain weight and blood flow.
    • The facial nerve connects at the pons and medulla junction in the brainstem.
    • Gamma-aminobutyric acid (GABA) regulates neuronal excitability and plays a role in inhibiting neural activity.### Neuronal Excitability and the Nervous System
    • Neuronal excitability is influenced by neurotransmitters such as GABA, serotonin, dopamine, and norepinephrine.
    • GABA regulates neuronal excitability.
    • Serotonin is vital for sleep cycle regulation.
    • Dopamine regulates motor control.
    • Norepinephrine is key in activating the "fight or flight" response.

    Fight or Flight Response

    • Activated by the sympathetic nervous system, a division of the autonomic nervous system.
    • This response occurs during stressful situations, preparing the body for rapid action.
    • The central nervous system (CNS) integrates and coordinates responses, while the peripheral nervous system (PNS) relays information from the body to the CNS.

    Upper Motor Neuron Lesion Assessment

    • Hyperreflexia is anticipated in patients with upper motor neuron (UMN) lesions.
    • Areflexia, denervation atrophy, and decreased muscle tone are associated with lower motor neuron (LMN) lesions.

    Language and Speech

    • Damage to Broca's area leads to speech inability, crucial for verbal expression.
    • The occipital lobe is the visual area responsible for processing visual images.

    Aging and Sensory Changes

    • Older adults may experience perceptual confusion due to diminished hearing and vision.
    • Changes in nerve conduction and neurotransmitter levels can also affect response times and sensations.

    Cranial Nerve Functions

    • Cranial nerve X (vagus nerve) is crucial for lung and digestive system function.
    • Cranial nerve VIII (vestibulocochlear) is responsible for hearing; assessment is essential for patients with hearing difficulties.
    • Pupillary constriction is controlled by cranial nerve III (oculomotor).

    Disorders and Symptoms

    • Dysphagia results from lesions affecting cranial nerves IX and X.
    • Parietal lobe integrates sensory input and is involved in spatial awareness.
    • Wernicke's area damage leads to difficulties in understanding spoken words.

    Neurological System and Aging

    • The autonomic nervous system (ANS) regulates blood pressure and may lead to orthostatic hypotension in older adults.
    • Glial cells, constituting almost half of the brain mass, support neuron function.

    Intracranial Pressure and Glial Cells

    • Ependymal cells assist cerebrospinal fluid (CSF) secretion, impacting intracranial pressure.
    • Increased intra-cranial pressure can lead to severe complications if not managed.

    Alzheimer's Disease

    • Alzheimer's is characterized by a deficiency in acetylcholine-secreting neurons.
    • Progressive mental deterioration is linked to generalized brain degeneration.

    Anatomy of the Spinal Cord

    • The pia mater is the delicate innermost layer of protective membranes (meninges) surrounding the brain and spinal cord.

    Assessment Techniques

    • Pupil size, shape, and reactivity can be assessed in unconscious patients.
    • Disconjugate gaze indicates issues with eye muscle coordination and may suggest neurological problems.

    Additional Notes

    • Understanding the structure and functions of cranial nerves is critical in diagnosing and managing neurological disorders.
    • Monitoring age-related neurological changes enhances patient care and intervention strategies.### Sensory Testing and Assessment
    • The pain reflex must be intact when assessing temperature sensation; if pain is absent, testing for temperature is still needed.
    • The pronator drift test evaluates motor system function, while extinction assessment tests for symmetrical sensation.
    • Sensory system assessment includes pain, temperature, touch, and proprioception evaluations.
    • Perceptual confusion occurs in older adults with diminished hearing and vision.
    • Sensory changes include decreased taste and smell perceptions due to aging.
    • Decreased nerve conduction results from changes in myelin, impacting neuromuscular coordination.

    Cranial Nerve Assessments

    • Cranial nerves IX (glossopharyngeal) and X (vagus) are tested together; they innervate the pharynx.
    • Accessory nerve (CN XI) is assessed through shoulder shrugging and head turning against resistance.
    • Altered taste suggests potential damage to the glossopharyngeal nerve.

    Brain Injury Recovery

    • Astrocytes clear neuronal debris and restore neurochemical balance after brain injury.
    • Microglia perform inflammation roles, while ependymal cells and oligodendrocytes have distinct functions.

    Neurological Responses and Reflexes

    • An extensor plantar response indicates an upper motor neuron lesion.
    • The bicep reflex normally results in bicep contraction and arm flexion, with abnormal results indicating dysfunction.

    Additional Neurological Tests

    • Graphesthesia tests cortical sensory function.
    • Cerebral angiography requires assessing stroke risk and informing about the usage of contrast medium.
    • A positive Romberg test indicates balance issues, necessitating additional fall precautions.

    Neurotransmitter Functions

    • Serotonin significantly influences mood, sleep, and emotions, with low levels contributing to mood disorders.
    • Other neurotransmitters like norepinephrine and acetylcholine play different roles in neurological function and disease.

    Considerations in Patient Management

    • During assessments, ensure patient safety with appropriate support based on test results (e.g., Romberg test).
    • Familiarity with cranial nerve functions facilitates accurate assessments and identification of neurological injuries.

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    Description

    Test your knowledge of the nervous system with this quiz based on Chapter 55. Explore various patient scenarios involving nerve damage and their effects on sensory functions, particularly taste. Gain a better understanding of the role of the facial nerve and its implications in patient assessments.

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