Description:Limbic system is responsible for affect.

Description:The two-point discrimination test is a measure of tactile acuity, which is the ability to distinguish between two points that are close together. The test is performed by touching the skin with two points and asking the patient to say whether they feel one or two points. The smallest distance between the two points that the patient can still distinguish as two separate points is called the two-point threshold. The finger pads have the highest two-point threshold of any part of the body. This is because the finger pads are densely innervated with Meissner's corpuscles, which are specialized touch receptors. Meissner's corpuscles are very sensitive to fine touch, which is why we are able to feel small objects with our fingertips. The other options are not as sensitive to touch as the finger pads. The shin is relatively insensitive to touch, and the soles of the feet are only slightly more sensitive. The toes are somewhat more sensitive than the soles of the feet, but they are still not as sensitive as the finger pads. So, the two-point discrimination test exhibits maximum sensitivity in the finger pads.

Description:Testing the integrity of the 7th (facial) and 9th (glossopharyngeal) cranial nerves involves assessing various functions related to taste, palate, and tongue movement. The options listed can help evaluate these nerves as follows: a. Taste: The sense of taste is primarily mediated by the gustatory fibers of the facial nerve (7th cranial nerve). Assessing taste perception can help determine the integrity of this nerve. b. Palate symmetry: The elevation of the soft palate is controlled by the muscles innervated by the glossopharyngeal nerve (9th cranial nerve). By observing the symmetry of the palate during phonation or swallowing, we can assess the function of this nerve. c. Tongue protrusion: Tongue movement and protrusion are primarily controlled by the hypoglossal nerve (12th cranial nerve). While not directly related to the 7th and 9th nerves, testing tongue protrusion can provide additional information about overall cranial nerve function. d. Position of uvula: The uvula is not directly associated with the 7th or 9th cranial nerves. Its position is primarily determined by the action of the muscles innervated by the 10th (vagus) cranial nerve.

Description:Romberg test is used to asses neurological function for balance. The standing patient is asked to close eyes. It is positive if there is actual loss of balance and patient falls while the eyes are closed. Gait, posture and closing of eyes are observed during exam but the priority is to ensure the patient’s safety during examination.

Description:Babinski sign occurs when stimulation of lateral plantar aspect of the foot leads to extension (dorsiflexion or upward movement) of the big toe (hallux). Also, there may be fanning of other toes. Babinski reflex is an abnormal reflex action in adults while it is normal infants up to 2 years of age.

Description:Nurse should thoroughly asses for signs that could indicated increased intracranial pressures, fractures and bleeding. Bleeding from the ears occurs only with basal skull fractures that can easily lead to raise in intracranial pressure and brain herniation.

Description:Age-related degenerative changes in the elderly causes decreased sensory perception. This may result in altered pain perception in order persons. So it is essential to carefully asses any complaints of pain by elderly because pain has an impact on quality of life.

Description:• The client is advised to increased fluid intake to 3L (if not contraindicated) for 24-48 hours after the procedure (to facilitate CSF production). There is no instruction to increased fluid intake before the procedure. • Lumbar puncture involves insertion of a needle into spinal cord withdraw CSF or inject drugs into spinal cord. • Specimens obtained to be labeled. • Assessment of sensation in lower extremities after the procedure is important to rule out nerve injury.

Description:Angiography is imaging technique that uses an injection of a liquid dye to make the arteries easily visible on X-rays. During the procedure contrast (dye) is injected into the bloodstream to make blood vessels visible on X-rays. When the contrast is injected the client may feel flushing sensation, a salty or metallic taste in the mouth, nausea, and/or a brief headache. These nurse must inform about this to patient before undergoing the procedure. Also the nurse must apply a pressure dressing over the site of puncture to prevent bleeding. Keeping the extremity used as puncture site flexed will increase chance of thrombus formation so it is to be avoided.

Description:Checking airway, breathing and circulation is the priority assessment for the unconscious patient. At all levels of care, the ABC (Airway, Breathing and Circulation) protocol exist to remind the person delivering treatment of the importance of airways breathing, and circulation to the maintenance.

Description:A positron emission tomography (PET) an imaging test the helps reveal how the tissues and organs are functioning. A PET scan uses a radioactive drug (tracer) to show this activity. The tracer may be injected, swallowed or inhaled depending on which organ or tissues is being studied by the PET scan.

Description:The client is not given a radioisotope. Fluids are not pushed prior to the procedure. Tips: Use elimination techniques to eliminate inappropriate answers.

Description:An electroencephalogram (EEG) is a recording of the electrical activity of the brain. It is a non-invasive test that uses electrodes placed on the scalp to measure the electrical signals produced by brain cells. The EEG can be used to diagnose a variety of neurological disorders, including epilepsy, sleep disorders, and brain tumors. The other options are incorrect. Peristalsis is the wave-like contraction of the muscles in the digestive tract that helps to move food through the body. An EEG does not record peristalsis. Heart activity is recorded by an electrocardiogram (ECG). An ECG uses electrodes placed on the chest to measure the electrical signals produced by the heart. The ECG can be used to diagnose a variety of heart conditions, including heart arrhythmias and heart attacks. So, the correct answer is that an EEG is a recording of brain wave activity.

Description:The most common site of rupture of a cerebral aneurysm resulting in subarachnoid hemorrhage is the anterior communicating artery. The anterior communicating artery is a small artery located at the base of the brain, connecting the two anterior cerebral arteries. It lies in close proximity to the optic chiasm and is prone to the development of aneurysms. A cerebral aneurysm is a weak, bulging spot in the wall of a blood vessel in the brain. If the aneurysm ruptures, it can lead to bleeding into the subarachnoid space, causing subarachnoid hemorrhage. This type of hemorrhage can be life-threatening and requires immediate medical attention. While aneurysms can occur in other locations in the brain, the anterior communicating artery is the most common site of rupture. The other options listed (posterior communicating artery, middle cerebral artery, and internal carotid artery) are also potential sites for aneurysm formation, but they are less frequently involved compared to the anterior communicating artery.

Description:Cerebrospinal fluid (CSF) should be kept at room temperature (20-25°C) if there is a delay in transportation. This is because the components of CSF are unstable at lower temperatures and can be damaged if they are frozen. If the CSF sample cannot be transported to the laboratory within 4 hours, it should be refrigerated at 4°C. However, it is important to note that the quality of the sample will still deteriorate over time, so it is best to transport the sample as soon as possible. Do not keep CSF samples in ice buckets or at -20°C, as this will damage the components of the sample. Here are some additional tips for transporting CSF samples: Keep the sample in a sealed container. Transport the sample in a cool environment. Avoid shaking or jarring the sample. Label the sample with the patient's name, date, and time of collection.

Description:Lumbar puncture, also known as a spinal tap, is not typically performed as a routine investigation for brain tumors. A lumbar puncture involves inserting a needle into the spinal canal in the lower back to collect cerebrospinal fluid (CSF) for analysis. While it can be helpful in certain situations, such as suspected meningitis or intracranial pressure evaluation, it is not a primary investigation for brain tumors. On the other hand, options a, b, and c are commonly used investigations in the evaluation of brain tumors: a. CT scan (computed tomography): This imaging technique uses X-rays and computer processing to generate detailed cross-sectional images of the brain. It can help identify the presence of a tumor, its location, and provide initial information about its characteristics. b. MRI (magnetic resonance imaging): MRI is a more sensitive imaging modality for brain tumors compared to CT scan. It uses a strong magnetic field and radio waves to produce detailed images of the brain. MRI provides excellent visualization of the tumor's size, location, and surrounding structures, helping in diagnosis, treatment planning, and follow-up. c. Doppler: Doppler ultrasound is a non-invasive imaging technique that uses sound waves to evaluate blood flow in the arteries and veins. It can be useful in assessing the vascularity and blood supply to brain tumors. It's important to note that the specific investigations performed for a brain tumor may vary depending on the individual case and the judgment of the healthcare provider

Description:Suspected CNS infection (e.g., meningitis) is one of the indication for LP. All other conditions are contraindications of LP.

Description:Optic nerve damage can be assessed through various methods, but one of the most common and reliable tests is perimetry. Perimetry is a visual field test that measures the patient's ability to detect and identify visual stimuli in different areas of their visual field. This test can help identify any defects or loss of vision caused by optic nerve damage. Options a and b, ophthalmoscopy and slit lamp examination, are valuable techniques for examining the optic nerve and the structures of the eye, but they are more focused on assessing the optic disc and the health of the retina rather than directly evaluating optic nerve damage. A goniometer, mentioned in option d, is a tool used to measure angles and is not directly related to assessing optic nerve damage. Therefore, perimetry is the most appropriate and specific test for evaluating optic nerve damage and detecting any associated visual field defects

Description:A lethargic patient with fever, vomiting and headache may be the manifestations of injury or infection of brain or spinal cord which can only be confirmed by analyzing the CSF. CSF samples can be obtained by performing lumbar puncture. Lumbar puncture, also known as a spinal tap, is a medical procedure in which a needle is inserted into the spinal canal, most commonly to collect cerebrospinal fluid for diagnostic testing.

Description:a. Lumbar puncture is also known as a spinal tap. It is a procedure in which a needle is inserted into the subarachnoid space of the spinal canal to collect cerebrospinal fluid (CSF) for diagnostic or therapeutic purposes. b. The needle is typically passed between the 3rd and 4th or 4th and 5th lumbar vertebrae. The exact location depends on the patient's anatomy and the preference of the healthcare provider performing the procedure. c. The knee-chest position may be used during a lumbar puncture. This position involves the patient kneeling on the examination table and leaning forward with their chest resting on the table. It helps to open up the spaces between the vertebrae and facilitates the procedure.

Description:A lumbar puncture is a procedure in which a needle is inserted into the lower back to collect a sample of cerebrospinal fluid (CSF). The CSF is a clear fluid that surrounds the brain and spinal cord. It helps to protect the brain and spinal cord from injury and infection. The ideal site for a lumbar puncture is the L3-L4 interspace, which is the space between the third and fourth lumbar vertebrae. This is because the spinal cord typically terminates at the L1 vertebra, so there is less risk of damaging the spinal cord if the needle is inserted in this area. The other options are incorrect. The L1-L2 and L2-L3 interspaces are too high, and the L2-L4 interspace is too low. If the needle is inserted in either of these areas, there is a risk of damaging the spinal cord. So, the correct answer is that the site for a lumbar puncture is the L3-L4 interspace.

Description:Lumbar puncture (also known as a spinal tap) can be used as a diagnostic procedure for various conditions, including the indications mentioned in the options: a. Intra cranial infection: Lumbar puncture can help diagnose intra cranial infections, such as meningitis or encephalitis. By collecting a sample of cerebrospinal fluid (CSF) through the procedure, the CSF can be analyzed for signs of infection, such as abnormal cell counts, presence of bacteria or viruses, and increased protein or glucose levels. b. Meningeal leukemia: Lumbar puncture can also be used to diagnose meningeal leukemia, a condition where cancer cells infiltrate the meninges (the protective membranes surrounding the brain and spinal cord). By analyzing the CSF obtained from a lumbar puncture, cancer cells or abnormal cell counts can be detected, aiding in the diagnosis and management of meningeal leukemia. c. Neoplasms of brain: Lumbar puncture can provide important diagnostic information in cases of suspected brain tumors or neoplasms. While it cannot directly visualize the brain tumors, the analysis of CSF obtained from the lumbar puncture can reveal cancerous cells or markers associated with brain tumors, aiding in the diagnosis and treatment planning. Therefore, the correct answer is d. All of these. Lumbar puncture can be a valuable diagnostic tool for intra cranial infections, meningeal leukemia, and neoplasms of the brain. It is important to note that lumbar puncture should be performed based on the specific clinical scenario and with the guidance of a healthcare professional.

Description:Lumbar puncture (LP) is a relatively safe procedure, but it can have some complications. The most common complications of LP are: Infection: The risk of infection after LP is very low, but it can occur. The infection can be caused by bacteria, viruses, or fungi that are present on the skin or in the bloodstream. Brainstem herniation: Brainstem herniation is a rare but serious complication of LP. It occurs when the pressure in the brain decreases too quickly after LP, and the brainstem is pushed down through the opening at the base of the skull. This can cause serious brain damage or death. Hematoma: A hematoma is a collection of blood that can occur under the skin or in the spinal canal after LP. Hematomas are usually small and harmless, but they can sometimes cause pain or pressure. Other, less common complications of LP include: Headache: A headache is the most common complication of LP. It usually occurs within 24-48 hours after the procedure and is caused by leakage of CSF from the puncture site. Back pain: Back pain can also occur after LP. It is usually mild and goes away on its own within a few days. Nerve damage: Nerve damage is a rare complication of LP. It can cause numbness, tingling, or weakness in the legs.

Description:The Trendelenburg test is used to assess the function of the hip abductor muscles, specifically the gluteus medius and gluteus minimus. These muscles are innervated by the superior gluteal nerve. When there is an injury or dysfunction of the superior gluteal nerve, the hip abductor muscles weaken or become paralyzed, resulting in a positive Trendelenburg sign. During the Trendelenburg test, the patient stands on one leg while the examiner observes the level of the opposite hip. In a positive Trendelenburg sign, the pelvis on the unsupported side drops or tilts downward because of the inability of the weakened hip abductor muscles to maintain proper alignment and support. This is often seen when there is an injury or compression of the superior gluteal nerve. The other nerves listed in options a, b, and d (obturator, sciatic, and inferior gluteal) are not directly associated with the Trendelenburg test. The obturator nerve innervates the hip adductor muscles, the sciatic nerve innervates the muscles of the posterior thigh and leg, and the inferior gluteal nerve innervates the gluteus maximus muscle.

Description:Unilateral trigeminal nerve injury can be assessed by evaluating the ability to perform certain movements involving the jaw. The trigeminal nerve (cranial nerve V) is responsible for the motor control of the muscles involved in chewing, including the temporalis, masseter, and medial and lateral pterygoids. Option a, elevation and lowering of the jaw, is a specific test for assessing the function of the trigeminal nerve. The patient is asked to open and close their mouth, demonstrating the ability to elevate and lower the jaw properly. In the case of a unilateral trigeminal nerve injury, weakness or paralysis of the muscles on one side may be observed, resulting in an asymmetric or limited movement of the jaw. Options b, c, and d are not specific tests for evaluating unilateral trigeminal nerve injury: b. Inability to tense the jaw: This symptom is not specific to trigeminal nerve injury and can be caused by various other conditions affecting the muscles involved in jaw movement. c. Blinking of the eye: Blinking of the eye is controlled by the facial nerve (cranial nerve VII), not the trigeminal nerve. Unilateral trigeminal nerve injury does not directly affect eye blinking. d. Corneal reflex: The corneal reflex, which involves the blinking response when the cornea is touched, is mediated by the trigeminal nerve (sensory division, ophthalmic branch) and the facial nerve (motor division). However, the corneal reflex is not a specific test for evaluating unilateral trigeminal nerve injury, as it assesses the sensory and motor components of multiple cranial nerves.