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Prods body into action during times of physiologic stress |
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functions in a complementary and counterbalancing manner to conserve body resources and maintain daily body functions such as digestion and elimination |
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Contains the motor cortex associated with voluntary skeletal movements and fine repetitive motor movements as well as control of eye movements. |
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primarily responsible for processing sensory data as it is received |
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Primary vision center and provides interpretation of visual data |
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Responsible for the perception and interpretation of sounds and determination of their source |
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Reception of speech and interpretation of speech |
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Trochlear downward and inward mvmt of eye |
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Trigeminal jaw, chewing, clenching Sensation to face |
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Abducens Lateral Eye movement |
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Facial facial expression muscles taste salive and tears |
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Glossopharyngeal swallowing and phonation |
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Vagus digestive enzymes, carotid reflex, involuntary action of heart, lungs, digestive tract sensation behind ear and external ear canal |
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Spinal Accessory turn head shrug shoulders |
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Hypoglossal sound articulation and swallowing |
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In infants and children motor control of the head and neck |
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develops first, followed by trunk and extremities |
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During 1st trimester in pregnancy |
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women increase nap time but may not feel rested with increased sleep |
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Risk Factors for Stroke (Brain attack or CVA) |
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HTN Obesity sedentary lifestyle smoking stress increased cholesterol/lipo/triglyc oral contraceptives in high risk women sickle cell anemia family hx of DM, CVD, HTN, increased cholesterol Congenital cerebral abnormalities |
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RF for falls in older adults |
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1+ falls in last year hx stroke neuro condition such as Parkinson dementia, peripheral neuropathy disorder of gait or balance lower extremity weakness or sensory loss impaired vision use of assistive device |
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Procedure for the neuro screening exam |
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the shorter screening is commonly used for health visits when no known neuro problem is apparent |
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Cranial Nerve Examination |
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CN 2-12 are routinely tested, however, taste and smell are not tested unless some aberration is found |
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Proprioception and cerebellar function |
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one test is administered for each of the following: rapid rhythmic alternating movements accuracy of movements balance gait heel-toe |
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superficial pain and touch at a distal point in each extremity are tested; vibration and position senses are assessed by testing the great toe. |
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all DTRs are tested, excluding the plantar reflex and the test for clonus |
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One nare at at time, eyes closed familiar smell |
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visual acuity and fields testing Snellen, rosenbaum ophthalmic exam of fundi |
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Oculomotor, Trochlear, and Abducens CN 3, 4, 6 tests |
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6 cardinal fields of gaze, pupil size, shape, response to light accommodation, opening of upper eyelids |
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Pt with severe unremitting headache |
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examine eye for presence or absence of lateral (temporal) gaze this 6th cranial nerve is commonly one of the 1st to lose function in the presence of increased ICP |
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observe face for muscle atrophy, deviation of jaw to one side or fasciculation 3 divisions of nerve are evaluated for sharp, dull, and light touch scalp, cheek and chin, non predictable pattern |
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If CN 5 test shows impairment use these tests |
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contact lens wearers may have diminished or absent reflex |
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Have pt make series of expressions raise eyebrows, squeeze eyes shut, wrinkle forehead, frown, smile, show teeth, purse lips, puff out cheeks |
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muscle weakness , flattened nasiolabial folds, problems with letters (B, M, P) asymmetry of expression |
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to distinguish between upper and lower neuron disease affecting the face, inspect face with emotional expression (laughing or crying) When upper neurons affected (CVA) voluntary movements are paralyzed, but emotional mvmts spared Lower motor neuron disorder Bells palsy, all facial mvmts on affected side are paralyzed |
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Vestibular fxn tested with Romberg test hearing evaluated with audiometer or weber/rinne test |
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Glossopharyngeal CN9 test |
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Gag reflex, simultaneously tested with Vagus |
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gag reflex evaluate uvula for symmetry swallow and sip water |
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Sternocleidomastoid CN 11 test |
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examine sixe, shape, strength or trapezius and SCM |
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tongue in out, side side, up down, letters (L T D N) |
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Proprioception and Cerebellar Function testing |
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Coordination and Fine Motor Skills assessment Balance assessment |
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