NCLEX Review: Neurological Module

Hey, This is Cindy from BrainyNurses.com. I would like to welcome you to this weeks Neurological NCLEX Review.

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This week, we will be covering the Neurological NCLEX Review from our Online Program. The topics covered in this review are Brain Physiology, The Cranial Nerves, Spinal Cord Syndromes, and Guillain-Barré.

Neurological NCLEX Review Sample Video

Straight from our course!

Brain Physiology

• Frontal lobe
  • Voluntary motor movement
  • Compare left and right for symmetry
  • Morals and emotions
  • Reasoning, judgment and concentration
  • Brocca’s area for motor speech (Left side)

• Parietal lobe
  • Spatial perception
  • Interpretation of senses
  • Language, reading and writing

• Temporal lobe
  • Auditory center and smell
  • Wernicke’s area for sensory and speech comprehension (Left side)

• Occipital lobe
  • Visual area

• Cerebellum
  • Balance, coordination and smooth movements
  • Gait assessment. Walk normally and then on heels and toes

• Limbic system
  • Emotional and visceral patterns for survival
  • Learning and memory

The Cranial Nerves

Cranial Nerves come off the brain stem

1. Olfactory
2. Optic
3. Oculomotor
4. Trochlear
5. Trigeminal
6. Abducens
7. Facial
8. Acoustic
9. Glossopharyngeal
10. Vagus
11. Spinal Accessory
12. Hypoglossal

“You have 1 nose and 2 eyes and CN 3, 4, and 6 make your eyes do tricks.”
“5 rhymes with Tri (Trigeminal nerve) and 7 is on your face.”
“8 is the shape of your earrings and 9 and 10 are under your chin.”
“11 with 1 on each shoulder to shrug them and 12 to stick out your tongue.”

For testing

• Oculomotor (CN III) for pupil reactions
• Trigeminal (CN V) affected in trigeminal neuralgia
• Facial (CN VII) used to smile
• Vagus (CN X) is parasympathetic activity
• Hypoglossal (CN XII) to stick out your tongue

 

Spinal Cord Syndromes

Cord Syndromes

• Central cord syndrome
  • Most common.
  • Cervical injury from hyperextension injury.
  • Greater motor loss in the upper extremities.
  • Loss of sensation below the level of injury is variable.
• Anterior cord syndrome
  • Flexion injury such as a violent impact to the back of the head.
  • Lose motor, pain and temperature sensation.
• Posterior cord
  • Extension injury such as a violent impact to the chin.
  • Lose proprioception, vibration, and light touch.
• Brown-Séquard
  • Penetrating or rotation-flexion injury.
  • Lose motor, proprioception, pressure, touch and vibration.
  • Lose ability to sweat on the site of the injury
  • Horner’s syndrome may occur. Ptosis and pupillary constriction.

Guillain-Barré

Guillain-Barré:  Acute disorder affecting the peripheral nervous system including the cranial nerves. Damages the myelin sheath and disrupts nerve conduction. Remyelinization occurs in opposite direction. Generally affects patients age 30-50 years.

Ascending paralysis from “ground to brain” (Guillain-Barré).  Initial symptoms will be seen and can lead to total paralysis, respiratory failure and the need for ventilator support.

Assessment

• Paresthesia and pain
• Muscle aches and cramping
• Night time pain
• Diplopia
• Difficulty with eye movements
• Difficulty speaking
• Dysphagia

Autonomic dysfunction

• Orthostatic hypotension
• Hypertension
• Changes in heart rate/bradycardia
• Deep vein thrombosis
• Bowel and bladder dysfunction
• Flushing
• Diaphoresis

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