Nervous
Basic Anatomy
Brain
Cerebrum
Largest part of the brain, composed of 2
hemispheres and 4 lobes. Frontal, parietal,
temporal and occipital.
Cerebrum
Frontal
Cerebellum
Cerebellum-
Diencephalon
Area between cerebral hemispheres and
the brainstem it contains:
Thalamus relay station for the nervous
system, sorts out impulses and directs
them to the cerebral cortex
Hypothalamus maintains homeostasis
by controlling vital functions:
temperature, heart rate, BP, pituitary
regulator, emotions
Brain Stem
Brain
Cerebral Circulation
Originates
arteries.
Blood
Cerebrospinal
3 layers tissue
Dura mater
Arachnoid layer
Pia mater
Spaces:
Epidural
Subdural
Subarahnoid
Functional Divisions
Functional
CNS PATHWAYS
Crossed
representation:
Left cerebral cortex controls right side of body
and vice versa
Sensory pathways:
afferent pathways from peripheral to central
Motor pathways:
efferent pathways from central to peripheral
Cranial nerves (12 pairs) enter & exit brain
Spinal nerves (31 pairs) enter & exit spinal cord
Neurological Assessment
Subjective
Headaches
Paresthesia
(burning/numbness/tingling)
injury
Dysphagia (difficulty
Syncope (faint)
swallowing)
Dizziness
Dysphasia (difficulty speaking
Vertigo (rotational Significant past Hx
Environmental/occupational
spinning)
hazards
Seizures
Head
Tremors
Cognitive Assessment
Thought
process
Calculations
Current events
Response to proverbs
Judgment & problem solving ability
Communication abilities
Emotion- Mood and affect
Muscle
size
Involuntary movements?
Sensory Assessment
Sensory Function:
Perform all sensory testing with the
patients eyes closed and test bilaterally.
Spinothalamic
Posterior (Dorsal)
Columns position
(proprioception), vibration and tactile
discrimination (fine touch)
Sensory Assessment
Vibration
Cerebellar Function
Assessment
Posture
Cerebellar Function
Assessment
Rapid Alternating
Movements (RAM)
Hand movements- Tap finger to thumb, rapidly.
Tap each finger to thumb rapidly.
Pronate and supinate hands rapidly on knees
Finger to nose test Eyes closed touch finger to
nose alternating and increasing speed
Finger to finger test - Have pt. touch his fingertip
to your fingertip, alter position.
Heel to shin test While supine or sitting, have pt
run heel of one foot over the shin of opposite leg
DTR Assessment
Scale
0 - 4+
0 = absent,
1+ = diminished
2+ = average
3+ = brisk
4+ = hyperactive,
clonus.
DTR Assessment
Deep Tendon Reflexes (DTR)
Biceps
Clonus Testing
Perform
Superficial Cutaneous
Reflex Assessment
Abdominal
stimulus.
Cremasteric
Babisnki
Summary
Neurological
Mental
assessment includes:
status
Cognitive assessment
Cranial nerves
Motor Functions & Muscle tone
Sensory Function
Cerebellar Function
DTR & superficial cutaneous reflexes