NUR 634
NUR 634 Exam 3 Graded A 2025
Gray matter (define) - -Aggregations of neuronal cell bodies; it rims the surfaces of the
cerebral hemispheres, forming the cerebral cortex
White matter (define) - -Neuronal axons that are coated with myelin
Basal ganglia (define) - -Affect movement
Thalamus (define) - -Process sensory impulses and relays them to the cerebral cortex
Hypothalamus (define) - -**Maintains homeostasis & regulates temperature, HR, & BP
**Affects the endocrine system and governs emotional behaviors
Internal capsule (define) - -A white-matter structure where myelinated fibers converge
from all parts of the cerebral cortex and descend into the brainstem
Cerebellum (define) - -Coordinates all movement and helps maintain the body upright in
space
Somatic nervous system (define) - -Regulates muscle movements and response to
sensations of touch and pain
Autonomic nervous system (define) - -Connects to internal organs and generates
autonomic reflex responses
Sympathetic nervous system (define) - -Part of autonomic nervous system
**Mobilizes organs and their functions during times of stress and arousal**
Parasympathetic nervous system (define) - -Part of autonomic nervous system
**Conserves energy and resources during times of rest and relaxation**
Spinal nerves (classification) - -31 pairs total:
-8 cervical
-12 thoracic
-5 lumbar
-5 sacral
-1 coccygeal
Sensory fibers - -**AFFERENT**
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-Posterior (dorsal) root of nerve
Motor fibers - -**EFFERENT**
-Anterior (ventral) root of nerve
When upper motor neuron systems are damaged ABOVE their crossover in the
medulla, motor impairment develops on which side? - -***OPPOSITE /
CONTRALATERAL SIDE***
When upper motor neuron systems are damaged BELOW their crossover in the
medulla, motor impairment develops on which side? - -***SAME / IPSILATERAL
SIDE***
In upper motor neuron lesions, what happens to muscle tone and DTRs? - --Muscle
tone is increased
-DTRs are exaggerated
Damage to lower motor neuron systems cause what? - --Ipsilateral weakness and
paralysis
Damage to basal ganglia system produces changes in what? - --Muscle tone (most
often an increase)
-Disturbances in posture and gait
-Bradykinesia (slowness or lack of spontaneous movements)
-Various involuntary movements
Damage to cerebellum causes what? - --Impaired coordination, gait, & equilibrium
-Decreased muscle tone
Spinothalamic tract (define) - --Consists of smaller sensory neurons with unmyelinated
or thinly myelinated axons
-Registers pain, temperature, and crude touch
Posterior columns (define) - --Consist of larger neurons with heavily myelinated axons
-Transmit sensations of vibration, proprioception, kinesthesia, pressure, and fine touch
Diabetic patients with small-fiber neuropathy report what kind of sensation? - -Sharp,
burning, or shooting foot pain
Diabetic patients with large-fiber neuropathy report what kind of sensation? - -
Numbness & tingling, or no sensation at all
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Dermatome (define) - -The band of skin innervated by the sensory root of a single spinal
nerve
Biceps / Supinator (brachioradialis) reflexes - -Cervical 5, 6
Triceps reflex - -Cervical 6, 7
Knee reflex - -Lumbar 2, 3, 4
Ankle reflex - -Sacral 1
Upper abdominal reflex - -Thoracic 8, 9, 10
Lower abdominal reflex - -Thoracic 10, 11, 12
Cremasteric reflex - -Lumbar 1, 2
Plantar response - -Lumbar 5, Sacral 1
Anal reflex - -Sacral 2, 3, 4
Headache warning signs - --Progressively frequent or severe over a 3-month period
-Sudden onset like a "thunderclap" or "the worst headache of my life"
-New onset after age 50 years
-Aggravated or relieved by change in position
-Precipitated by Valsalva maneuver
-Associated symptoms of fever, night sweats, or weight loss
-Presence of cancer, HIV infection, or pregnancy
-Recent head trauma
-Associated papilledema, neck stiffness, or focal neurologic deficits
What classically presents as "the worse headache of my life"? - -**Subarachnoid
hemorrhage**
^instantaneous onset
Meningitis (S/S) - --Stiff neck
-Severe headache
Mass lesions from brain tumors or abscess (S/S) - -Dull headache increased by
coughing and sneezing
Migraines - associated S/S - -P- Pulsatile or throbbing
O- One-day duration / lasts 4-72 hours if untreated
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U- Unilateral
N- Nausea or vomiting
D- Disabling / causing disruption of daily activities
Vertigo (define) - -A spinning sensation within the patient or of the surroundings; often
reflects vestibular disease
Dysarthria (define) - -Difficulty forming words
Ataxia (define) - -Problems with gait or balance
^seen in cerebellar disease !!
Abrupt onset of motor and sensory deficits occurs in what? - -TIA or stroke
Strokes cause what type of motor changes? - -Spasticity // rate-dependent hypertonia
^tone increases with rapid movement and decreases with slow movement
Progressive subacute onset of lower extremity weakness/hypotonia occurs in what? - -
Guillain-Barre syndrome
Chronic, more gradual onset of lower extremity weakness occurs in what? - -Primary
and metastatic spinal cord tumors
Myasthenia gravis (S/S) - -Proximal, asymmetric weakness that gets worse with effort
and improves with rest
Monoparesis (define) - -Weakness in an extremity
Paraparesis (define) - -Weakness in both lower extremities
Hemiparesis (define) - -Weakness in one side of the body
Polyneuropathy (S/S) - -*Bilateral, distal weakness
*A pattern of stocking then glove sensory loss
Dyesthesias (define) - -Distorted sensations
^Ex. light touch or pinprick may cause a burning or irritating sensation
First question to ask when patient reports passing out? - -DID YOU LOSE
CONSCIOUSNESS ??
Vasovagal syncope (S/S) - -*Most common cause of syncope*
Prodrome:
~Nausea
~Diaphoresis
NUR 634
NUR 634 Exam 3 Graded A 2025
Gray matter (define) - -Aggregations of neuronal cell bodies; it rims the surfaces of the
cerebral hemispheres, forming the cerebral cortex
White matter (define) - -Neuronal axons that are coated with myelin
Basal ganglia (define) - -Affect movement
Thalamus (define) - -Process sensory impulses and relays them to the cerebral cortex
Hypothalamus (define) - -**Maintains homeostasis & regulates temperature, HR, & BP
**Affects the endocrine system and governs emotional behaviors
Internal capsule (define) - -A white-matter structure where myelinated fibers converge
from all parts of the cerebral cortex and descend into the brainstem
Cerebellum (define) - -Coordinates all movement and helps maintain the body upright in
space
Somatic nervous system (define) - -Regulates muscle movements and response to
sensations of touch and pain
Autonomic nervous system (define) - -Connects to internal organs and generates
autonomic reflex responses
Sympathetic nervous system (define) - -Part of autonomic nervous system
**Mobilizes organs and their functions during times of stress and arousal**
Parasympathetic nervous system (define) - -Part of autonomic nervous system
**Conserves energy and resources during times of rest and relaxation**
Spinal nerves (classification) - -31 pairs total:
-8 cervical
-12 thoracic
-5 lumbar
-5 sacral
-1 coccygeal
Sensory fibers - -**AFFERENT**
NUR 634
,NUR 634
-Posterior (dorsal) root of nerve
Motor fibers - -**EFFERENT**
-Anterior (ventral) root of nerve
When upper motor neuron systems are damaged ABOVE their crossover in the
medulla, motor impairment develops on which side? - -***OPPOSITE /
CONTRALATERAL SIDE***
When upper motor neuron systems are damaged BELOW their crossover in the
medulla, motor impairment develops on which side? - -***SAME / IPSILATERAL
SIDE***
In upper motor neuron lesions, what happens to muscle tone and DTRs? - --Muscle
tone is increased
-DTRs are exaggerated
Damage to lower motor neuron systems cause what? - --Ipsilateral weakness and
paralysis
Damage to basal ganglia system produces changes in what? - --Muscle tone (most
often an increase)
-Disturbances in posture and gait
-Bradykinesia (slowness or lack of spontaneous movements)
-Various involuntary movements
Damage to cerebellum causes what? - --Impaired coordination, gait, & equilibrium
-Decreased muscle tone
Spinothalamic tract (define) - --Consists of smaller sensory neurons with unmyelinated
or thinly myelinated axons
-Registers pain, temperature, and crude touch
Posterior columns (define) - --Consist of larger neurons with heavily myelinated axons
-Transmit sensations of vibration, proprioception, kinesthesia, pressure, and fine touch
Diabetic patients with small-fiber neuropathy report what kind of sensation? - -Sharp,
burning, or shooting foot pain
Diabetic patients with large-fiber neuropathy report what kind of sensation? - -
Numbness & tingling, or no sensation at all
NUR 634
,NUR 634
Dermatome (define) - -The band of skin innervated by the sensory root of a single spinal
nerve
Biceps / Supinator (brachioradialis) reflexes - -Cervical 5, 6
Triceps reflex - -Cervical 6, 7
Knee reflex - -Lumbar 2, 3, 4
Ankle reflex - -Sacral 1
Upper abdominal reflex - -Thoracic 8, 9, 10
Lower abdominal reflex - -Thoracic 10, 11, 12
Cremasteric reflex - -Lumbar 1, 2
Plantar response - -Lumbar 5, Sacral 1
Anal reflex - -Sacral 2, 3, 4
Headache warning signs - --Progressively frequent or severe over a 3-month period
-Sudden onset like a "thunderclap" or "the worst headache of my life"
-New onset after age 50 years
-Aggravated or relieved by change in position
-Precipitated by Valsalva maneuver
-Associated symptoms of fever, night sweats, or weight loss
-Presence of cancer, HIV infection, or pregnancy
-Recent head trauma
-Associated papilledema, neck stiffness, or focal neurologic deficits
What classically presents as "the worse headache of my life"? - -**Subarachnoid
hemorrhage**
^instantaneous onset
Meningitis (S/S) - --Stiff neck
-Severe headache
Mass lesions from brain tumors or abscess (S/S) - -Dull headache increased by
coughing and sneezing
Migraines - associated S/S - -P- Pulsatile or throbbing
O- One-day duration / lasts 4-72 hours if untreated
NUR 634
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U- Unilateral
N- Nausea or vomiting
D- Disabling / causing disruption of daily activities
Vertigo (define) - -A spinning sensation within the patient or of the surroundings; often
reflects vestibular disease
Dysarthria (define) - -Difficulty forming words
Ataxia (define) - -Problems with gait or balance
^seen in cerebellar disease !!
Abrupt onset of motor and sensory deficits occurs in what? - -TIA or stroke
Strokes cause what type of motor changes? - -Spasticity // rate-dependent hypertonia
^tone increases with rapid movement and decreases with slow movement
Progressive subacute onset of lower extremity weakness/hypotonia occurs in what? - -
Guillain-Barre syndrome
Chronic, more gradual onset of lower extremity weakness occurs in what? - -Primary
and metastatic spinal cord tumors
Myasthenia gravis (S/S) - -Proximal, asymmetric weakness that gets worse with effort
and improves with rest
Monoparesis (define) - -Weakness in an extremity
Paraparesis (define) - -Weakness in both lower extremities
Hemiparesis (define) - -Weakness in one side of the body
Polyneuropathy (S/S) - -*Bilateral, distal weakness
*A pattern of stocking then glove sensory loss
Dyesthesias (define) - -Distorted sensations
^Ex. light touch or pinprick may cause a burning or irritating sensation
First question to ask when patient reports passing out? - -DID YOU LOSE
CONSCIOUSNESS ??
Vasovagal syncope (S/S) - -*Most common cause of syncope*
Prodrome:
~Nausea
~Diaphoresis
NUR 634
