CN VII - ANSWER- -facial
-assess mouth for taste
-assess the face for symmetrical movement
CNVIII - ANSWER- Vestibulocochlear (hearing and balance)
CN IX - ANSWER- Glossopharyngeal
-assess mouth for taste
-assess mouth for movement of soft palate and the gag reflex
-assess swallowing and speech
CN X - ANSWER- -vagus
-assess mouth for movement of soft palate and the gag reflex
-assess swallowing and speech
,CN XI - ANSWER- Accessory(spinal)-flexion and head rotation
CNXII - ANSWER- Hypoglossal (tongue movement)
Broca's area - ANSWER- Controls language expression - an area of the frontal lobe,
usually in the left hemisphere, that directs the muscle movements involved in speech.
Wernicke's area - ANSWER- controls language reception - a brain area involved in
language comprehension and expression; usually in the left temporal lobe
receptive aphasia - ANSWER- The inability to understand language (despite being able
to hear it and produce it) (wernicke's)
expressive aphasia - ANSWER- trouble communicating thoughts through speech or
writing(broca's)
global aphasia - ANSWER- When both production and understanding of language is
damaged
hyperkinesia - ANSWER- increase in muscle movement or activity
-tremors
dyskinesia - ANSWER- the distortion or impairment of voluntary movement such as in a
tic or spasm
Akinesia - ANSWER- inability to initiate movement
ataxia - ANSWER- lack of muscle coordination
Dyspraxia - ANSWER- partial inability to initiate coordinated voluntary motor acts
Apraxia - ANSWER- inability to perform particular purposive actions, as a result of brain
damage.
ICP range - ANSWER- 5-15 normal
Monroe-Kellie Hypothesis/Doctrine - ANSWER- -Cranial vault is a fixed space.
-3 intracranial components
-Blood
-Brain
-CSF
-Any increase in once component requires a decrease in another.
EARLY S/S of increased ICP - ANSWER- Early: Change in LOC, agitation, headache,
and vomiting.
Late: Pupillary dilation from CN III compression and loss of reflexes.
,LATE S/S of increased ICP - ANSWER- dilated, non reactive pupil, unresponsive,
posturing, widening pulse pressure, bradycarida, increased systolic b/p, changes in rr
and pattern.
Hirschsprung disease - ANSWER- Lack of ganglionic cells in segments of the colon
resulting in decreased motility and peristalsis.....causes megacolon
green/brown emesis
ribbon-like stool
delayed passage of meconium
treatment...remove part of colon without nerve cells
pyloric stenosis - ANSWER- projectile, non bilious emesis
olive shaped mass
intusseseption s/s - ANSWER- sausage like mass
green-billions emesis
red currant jelly stool
Kawasaki disease - ANSWER- (inflammation of blood vessles, hence the strawberry
tongue) causes coronary artery aneurysm and thrombosis
Strawberry tongue!!!!!!
rash
bilateral conjunctivitis
mucus membranes red ccracked
hands/feet red swollen
lymph nodes swollen
joints hurt
Elevated CPR, ESR, WBC, platelets
anemia
treatment
aspirin, IVIG
Reyes syndrome - ANSWER- acute encephalopathy after viral infection(flu or varicella),
assoc. with aspirin use during viral illness
-liver biopsy:cerebral edema and fatty liver changes
, s/s
viral illness, achy febrile, n/v
signs of liver dysfunction
high ammonia levels
altered mental status
MONITOR
-neuro status and ICP
-liver function
-I/O
-impaired coagulopathy
-rest and low stimulation
Phenylketonuria (PKU) - ANSWER- inherited disorder in which the infant lacks a liver
enzyme(phenylalanine)
normal phenylalanine(0-2)mg/dl
pku >20mg/dl
Asses:
-SCREENING:
newborn must be eating formula or treatmilk
heel stick 24-48 hours after birth
repeat test if positive
GI problems/vomiting
growth failure
behavioral difficulties
seizures
treatment:
avoid foods high in protein(high in phenylalanine)
Rickets - ANSWER- softening and weakening of bones; vitamin d deficiency
bow legs
developmental dysplasia - ANSWER- infant: Barlow(adduct hip with downward knee
pressure; pop(dislocated hip)=positive ) tests
then Ortolani test to confirm Barlow...
-flex knee and hip to 90degrees, index finger on anterior side of greater trochanter,
adduct with thumb....'clunk' femur replace back into joint
toddler:limb length differences
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