NURS 5315 Neurologic System Core Knowledge Study Objective with Advanced Organizers
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NURS 5315 Neurologic System Core Knowledge Study Objective with Advanced Organizers/NURS 5315 Neurologic System Core Knowledge Study Objective with Advanced Organizers/NURS 5315 Neurologic System Core Knowledge Study Objective with Advanced Organizers
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Neurologic System
Core Knowledge Objectives with Advanced Organizers
1. Discuss the anatomy and physiology of the brain and brain stem.
a. Explain the function of the twelve cranial nerves
Cranial Nerve Function Sign of Dysfunction
I Olfactory Purely sensory; carries impulse for sense of smell Person is asked to sniff aromatic substances such as
Fibers arise from nasal olfactory epithelium and oil of closes vanilla and identify them
from synapses with olfactory bulbs that transmit Hyposmia-impared sense of smell and anosmia
impulses to temporal lobe
II optic Purely sensory, carries impulse for vision. Vision and visual field tested with an eye chart and
Fibers arise from retina of eye to form optic nerve by testing point at which person first sees an object
which passes through sphenoid bone: two optic moving into visual field, inside eye is viewed with
nerves form the form optic chiasma and eventually scope to observe blood vessels of eye interior.
end in occipital cortex
III oculomotor Contains motor fibers to interior oblique and Puplis examine for size shape and equality pupiliary
superior, inferior, and medial rectus extraocular reflex tested with a penlight ability to follow moving
muscles that direct eyeball; levator muscle of objects
eyelid, smooth muscle of iris and ciliary body; and
proprioception to brain from extraocular muscle
Fibers emerge from midbrain and exit from skull
and extend eye
IV trochlear Proprioceptor and motor fibers for superior Test common with cranial nerve III
obliques muscles of eye
Fiber emerges from posterior midbrain and exit
from skull to run to eye
V Trigeminal Both motor and sensory for face; conduct sensory Sensation of pain, touch, and temperature tested
impulses from mouth nose, surface of eye and with safety pin and hot and cold objects
dura mater; also contains motor fibers that
stimulate muscle to brain
Fibers emerge from pons and from three division
that exit from skull and run to face and cranial dura
mater
VI Abducent Contains motor fibers to lateral rectus muscle and Tested in common with cranial nerve III relative to
proprioceptor fibers from same muscle to brain move each eye laterally
Fiber leave interior pons and exit from skull and
extend to eye
VII facial Mixed: supplies motor fiber to muscle of facial Anterior 2/3 of tongue tested for ability to taste
expression and to lacrimal and salivary glands and sweet, salty, sour, and bitter substances; symmetry of
carries sensory fiber from tase buds of anterior face checked; ask to close eye, smile, whistle,
part of tongue
VIII vestibulocochlear Sensory: vestibular branch transmits impulses for Hearing checked with a tuning fork, vestibular tests;
sense of equilibrium; cochlear branch transmit barany and caloric test
impulse for sense of hearing
IX glossopharyngeal Mixed: motor fiber serve pharynx and salivary Gag and swallow reflexes checked; subject asked to
gland and sensory fibers carry impulses from speak and cough; posterior 1/3 of tongue may be
, 2
pharynx, posterior tongue, and pressure receptor tested for taste
of carotid artery
X vagus Fibers carry sensory and motor impulses for Same as test as cranial nerve IX
pharynx; a large part of this nerve is
parasympathetic motor fibers, which supply
smooth muscle of abdominal organs; receive
sensory impulse from viscera
XI spinal accessory Provides sensory and motor fibers for Checked for strength by asking subject to rotate head
sternocleidomastoid and trapezius muscle and and shrug shoulders against resistance
muscles of soft palat, pharynx, and layrnx
XII hypoglossal Carries more fibers to muscle of tongue and Subject asked to stick out tongue, and any position
sensory impulses from tongue to brain abnormalities are noted
b. Explain the function of the cerebrum, cerebellum, parietal lobe, frontal lobe, occipital lobe, temporal
lobe, brain stem, reticular formation reticular activating system, and limbic system.
Lobe Location Function Sign of Injury/Lesion / Disorder
Cerebrum Confusion, inability to speak or
is divided into the right and These hemispheres are connected by the understand, blurred vision
left hemispheres corpus callosum that is responsible for TBI
maintaining communication between the
two hemispheres. The cerebral cortex is
gray matter that covers the cerebrum.
The white matter lies beneath the
cerebral cortex and is composed of the
myelinated axons of the CNS.
Frontal Central sulci and borders Falling, weakness on one side of body or
the inferiorly on the It is responsible for communication face, reduced creativity, impaired
lacteral sulcus (talking, writing), emotions, intellect, judgement, reduced sense of taste or
reasoning, judgment and behavior. It smell
contains the Broca’s area: responsible for
speech.
Temporal Lies inferior to the lateral Disturbance of auditory sensation and
fissure and is composed of interprets impulses from the ear. It perception, disorder of visual perception,
the superior, middle, and contains Wernicke’s area (interprets the language comprehension
inferior temporal gyri auditory stimuli
Parietal Borders the central, Difficulty with writing (agaphia) difficulty
parietooccipital, and lateral interprets tactile sensation such as touch, with math (acalculia) inability to perceive
sulci pain, temperature, shapes and 2-point objects normally (agnosia)
discrimination.
Occipital Lies caudal to the Defects in vision, difficulty with locating
parietooccipital sulci and lobe houses the ability to read with objects in environment, difficulty with
superior to the cerebellum comprehension and is the primary visual identifying color, production of
receptor center. hallucination, visual illusions, word
blindness
Cerebellu Hindbrain Is responsible for reflexive, involuntary Loss of coordination (asynergia) inability
m fine tuning of motor control and for to judge distance and when to stop
maintaining balance and posture through (dysmetria) inability to perform rapid
extensive neural connection with medulla alternating movements, tremors
and with midbrain staggering, wide based walking (ataxic
, 3
gait)
Brain Stem Midbrain, medulla, and Connects the hemispheres of the brain, Dizziness, insomnia, abnormal sleeping
pons cerebellum, and spinal cord pattern, balance issues, inability to cough
or gag, difficulty eating, drinking, or
swallowing, slurred speech
Reticular brainstem Collection of nuclei within the brainstem Is serious can lead to coma or death, less
Formation collectively constitute the reticular damage can cause fatigue, change in
& Reticular formation. Is a large network of diffuse sexual arousal and disturded sleep pattern
Activating nuclei that connect the brainstem to the
System cortex and control vital reflexes, such as
cardiovascular function and respiration. It
is essential for maintaining wakefulness
and attention which is referred to as
reticular activating system.
Limbic Group of interconnected Involved in primitive behavioral Hormonal system imbalance, inability to
System structures located between responses, visceral reaction to emotion, perceive hunger or feeling of satiety is
the telecephalon and motivation, mood, feeding behavior, reduced and emotional reactions can
diencephalon and biologic rhythm and sense of smell. change
surrounding the corpes
collosum
c. Identify which area of the brain is impacted by a disorder based on the clinical manifestation.
d. Discuss the function and location of the Wernicke and Broca’s areas of the cerebrum and describe a
sign which would manifest as a result of a lesion, injury or defect in each area.
Lobe Location Function Sign of Injury
Wernicke Area Temporal lobe interprets the auditory stimuli Dysfunction may result in receptive aphaisa or
dysphasia
Broca’s Area Frontal lobe responsible for speech Difficulty forming or inability to form words
e. Explain the difference between supratentorial and infratentorial.
Location Definition
Supratentorial Produce changes in arousal by either diffuse or localized dysfunction. Diffuse dysfunction may be caused by
disease process affecting the cerebral cortex or the underlying subcortical white matter.
Infratentorial Produce a decline in arousal by direct destruction of the reticular activation system and its pathway or the
brainstem may destroy either the direct invasion by indirect impairment of blood supply. Most common cause
is cerebralvascular disease.
f. Discuss the cerebral artery anatomy and identify which artery provides blood to which part of the
brain.
Cerebral blood flow (CBF) is normally regulated to meet the metabolic needs of the brain. It
keeps the brain well oxygenated and is approximately 20% of the cardiac output. This is 750-
900ml of blood per minute. Cerebral blood flow is altered by the concentration of carbon dioxide
and oxygen. CBF decreases when CO2 decreases, and it increases when the PaO2 is < 50mmHg.
When the PaO2 is at levels > 80mmHg, CBF is not altered - it is simply maintained.
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