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Ch. 41: Assessing the Nervous SystemGeneral Functions of the Four Regions of the Brain

Region Functions

Cerebrum Interprets sensory input

Controls skeletal muscle activityProcesses intellect and emotions

Contains skills memory

Diencephalon Conducts sensory and motor impulsesRegulates autonomic nervous system

Regulates and produces hormonesMediates emotional responses

Brainstem Severs as conduction pathway

Serves as site of decussation of tractsContains respiratory nuclei

elps regulate skeletal muscles

Cerebellum Processes information necessary for balance! posture!

and coordinated muscle movement

Functions of Loes of the Cererum an! Areas of the Cereral Corte"Area Functions

Parietal lobe "somatic sensory area of cerebral corte#$ Promotes recognition of pain! coldness! and light

touch%

&ccipital lobe Receives and interprets visual stimuli

'emporal lobe Receives and interprets olfactory and auditory stimuli

(rontal lobe Controls movements of voluntary muscles

Primary motor area (acilitates voluntary movement of skeletal muscles

Speech area Promotes understanding of spoken and written words

Motor speech "Broca)s area$ Promotes vocali*ation of words

Normal Laoratory #alues for Cereros$inal Flui!

Com$onent Normal #alue

+ppearance Clear and colorless

p ,%-.

Specific gravity /%00,

1BCs 023

Protein /.24.

5lucose 40230

Chloride //32/-6

Pressure 7600

Cranial Nerves

Name Function

I2&lfactory Sense of smell

II2&ptic 8ision

III2&culomotor 9yeball movement

Raising of upper eyelid

Constriction of pupilProprioception

I82'rochlear 9yeball movement

82 'rigeminal Sensation of the upper scalp! upper eyelid! nose! nasal

8/9/2019 Ch 41 Assessing the NS

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8/9/2019 Ch 41 Assessing the NS

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o Place pt% on side in the fetal position with back bowed! head fle#ed on the chest! and knees

drawn up to the abdomen

o Instruct pt% to lie flat in bed in prone or supine prior testing for 423 hrs%

o Monitor site for leakage of CS( or hematoma formation

o 9ncourage increased fluid intake

Areviate! Neuro Assessment

:&C "response to auditory and@or tactile stimulus$

8S "BP! P! RR$ Pupillary response to light

+ssess strength of hand grip and movement of e#tremities bilaterally

Determine ability to sense touch@pain in e#tremities

Glasgo' Coma Scale

Assessment Res$onse Score

9yes &pen

"record C if eyes are closed by

swelling$

Spontaneously

'o speech

'o pain

?o response

4

-

6

/

Best Motor Response"record best upper arm response$ &beys commands:ocali*es pain

(le#ion2withdrawal

+bnormal fle#ion

+bnormal e#tension

?o response

A.

4

-

6

/

Best 8erbal Response

"record ' if an endotracheal or

tracheostomy tube is in place$

&riented

Confused

Inappropriate words

Incomprehensible sounds

?o response

.

4

-

6

/'otal Score a higher score indicates a higher level of functioning

Anormal Neuro Fin!ings

+phasia2 defective of absent language function

Dysphonia2 change in the tone of the voice common in strokes

Dysarthia2 difficulty speaking

+nosmia2 inability to smell

?ystagmus2 involuntary eye movements

Ptosis2 aka orner syndrome drooping eyelids

(asiculations2 twitches

+ta#ia2 lack of coordination and a clumsiness of movements