A Dedicated Institute for Nursing Competitive Exam

NERVOUS SYSTEM

Nervous System

 Nervous system body weight dk 3% Hkkx cukrk gsA

1. Parts of Nervous system :-
Nervous Control

CNS PNS

Brain Spinal Cord Cranial Nerves Spinal Nerves

(12pairs) (31pairs)

Sensory division Motor division

(Afferent) (Efferent)

Somatic nervous system Cardiac & smooth muscles &

Skeletal muscle gand (ANS)

SNS PNS

2. (A) NERVOUS TISSUE

 Nervous system vast number of cells ls cuk gksrk gSA ftUgs Neurones (nerve cells) dgrs gSA
 Neurones , Nervous system dh structural & functional unit gksrh gSA
 Neuron ,d special type of cells ls supported jgrk gs ftUgs Neuroglia dgrs gSA
 Brain esa 100 billion (1011 ) ds djhc Neuron ik;h tkrh gsA
 Spinal cord esa djhc 100 million Neuron ik;h tkrh gsA

(B)Neuron:-
 Each neuron consist of :-
A) Cell body
B) Dendrites
C) One axon.

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NERVOUS SYSTEM

A) Cell body:-
 Contain a nucleus surrounded by cytoplasm.
 okss neuronal cell body ftuesa free ribosome & prominent cluster of rough endoplasmic recticulam gskrs gS
mUgs Nissl bodies dgrs gSA (Protein synthesis dk dke djrh gSA )
B) Dendrites:- (little tree)
 ;s neuron dk input or receiving portion gksrk gSA
 ;s short tapering & highly branch gskrk gsA
C) Axons:- (axis)
 ;g long thin vkSj cylindrical projection gskrs gS tks cell body ls ,d cone shape elevation ij Join gksrs gs
ftls axon hillock (Small hill) dgrs gsA

Anatomical Classification
1. Multipolar neurons:- Brain & spinal cord esa most neuron blh type ds gksrs gSA
2. Bipolar neurons:- retina of eye, inner ear & olfactory area in the brain eas gskrs gSA
3. Unipolar neurons:- (Pseudounipolar neurons) PNS esa mostly ;gh neuron gksrs gSA bu neuron dh cell body
ganglia esa fLFkr gksrh gSA

Functional classification
1) Sensory or afferent neurons
2) Motor or efferent neurons
3) Interneurons or association neurons

(C) Neuroglia or glial cells

 Types of Neuroglia :- 6 gksrh gSA
1) Astrocytes
2) Oligodendrocytes CNS esa gksrh gSA
3) Microglial cells
4) Ependymal cells
5) Schwann cells
6) Satellite cells PNS esa gksrh gSA

3. NERVE:- Bundle of Axons in PNS.

 Depending upon structure:-

 Myelinated
 Nonmyelinated
 Depending upon distribution
 Somatic nerve fibers
 Visceral or autonomic nerve fibers
 Depending upon origin
 Crainal nerves
 Spinal nerves
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NERVOUS SYSTEM
 Depending upon function
 Sensory
 Motor
 Mixed
 Depending upon secretion of neuro transmitter
 Adrenergic
 Cholinergic
 Properties of nerve fibers:-
 Excitability
 Conductivity

4. NEURO TRANSMITTERS

5. SYNAPSE
 Electrical synapse
 Chemical synapse
 Area where nerve impulse is transmitted from one neuron to other neuron

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NERVOUS SYSTEM

6. Brain
 100 bilion neurons & 10 – 15 trillion neuroglia ls brain cuk gskrk gSA
 1.3 – 1.4 kg Wt. (1300gm) almost 3lb in adult
 Brain ectoderm ls mRiUu gksrk gSA

Major part of Brain

Fore brain Midbrain Hind brain

(Prosencephalon) (Messencephalon) (Rhombencephalon)

Telencephalon Diecephalon Myelencephalon Metencephalon

(Medulla oblongata) (Pons & Cerebellum)
Cerebrum Thalamus family
Basal ganglia Retina
Limbic system

7. BLOOD SUPPLY TO THE BRAIN:-

 By circulus arteriosus or circle of Willis }kjkA (Internal carotid arteries& vertebral arteries).
 1 or 2 min. blood flow esa ck/kk vkrh gS rks neuron ds function impaire gksrs gS but more than 4 min. vxj brain
dks O2 ugh feyrh gS rks permanent injury gks tkrh gSA

8. MENINGES:-
 Duramater:- Cranial duramater esa nks layer gksrh gSA tcfd spinal duramater esa 1 gh layer gksrh gSA
 Arachnoid mater:- Thin, Transperant gksrh gSA
 Pia mater
 Thin & Vascular gksrh gSA
 ;g brain stem ds pkjks vksj better difined gksrh gSA
 Telachoroidea :- choroid plexus
Note:-
 Duramater & SAS ends at the level of lower boarder of S2
 Pia mater extend upto tip of coccyx.

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NERVOUS SYSTEM

9. CSF:-
 Clear, Transparent, colorless gksrk gSA
 Specific gravity:- 1.005.
 Modified tissue Fluid gksrk gSA
 Brain ds ventricles, Spinal cord & brain ds pkjks vksj fLFkr SAS & center canal of spinal cord esa ik;k tkrk
gSA
 CSF replaces lymph in the CNS.
 Formation:- Choroid plexuses of lateral ventricles & 3rd & 4th ventricles.
 Total quantity = 80 – 150ml (3 – 5 oz)
 Rate of Production:- 0.3ml – 0.5 ml/min. (20ml/hour) & 480 – 720 ml/day average (500ml/day)
 Normal pressure of CSF:-
 Lateral recumbent position :- 10 – 18 cm of H2O (60 – 100 mm of CSF or H2O)
 Sitting position:- 30 cm of H2O,
Circulation

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NERVOUS SYSTEM

 Absorption in arachnoid villi & granulations and into dural venous sinuses.
 Rate of Absorption:- 20ml/hour (480ml/day)
 Rate of Absorption & Rate of production same gksrh gSA
Function
 Protection
 Nutrition
 Metabolism

10. Ventricles of the brain

 Brain esa 4 ventricles gskrs gs&

1) Lateral ventricles:-
 Rt. & Lt. cerebral hemisphere esa fLFkr gksrs gSA
 ;s 3rd ventricles ls interventricular foraman ;k foraman of Munro }kjk communicate jgrs gSA
2) Third ventricles:-
 ;g between two parts of thalamus esa fLFkr gksrk gSA
 ;s 3rd ventricle 4th ventricles ls cerebral aqueduct }kjk tqMk jgrk gSA
3) Fourth ventricles:-
 ;g between cerebellum & pons fLFkr gksrk gSA
 ;g uhps center canal of spinal cord ds lkFk continues gksrk gS o SAS ds lkFk foramina }kjk continues jgrk
gSA

“LOOK FOR SOMETHING POSITIVE IN EACH DAY,

EVEN IF SOME DAYS YOU HAVE TO LOOK A LITTLE HARDER ”

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NERVOUS SYSTEM

11. CEREBRUM
 Seat of intelligence

 Cerebral cortex:
 Folds=gyri or convolutions
 Deepest grooves b/w folds: - fissures.
 Shallower grooves b/w folds =sulci
 nksuks cerebral hemispheres vUnj ls corpus callosum }kjk connected jgrs gS tks fd white mater dk cuk gksrk
gSA

 Lobes of cerebram
 Frontal lobe
 Parietal
 Temporal
 Occipital

 Limbic system dks “emotional brain” Hkh dgrs gSA (Pleasure, pain, affection, fear & anger)
 Limbic system olfaction & memory dk dke Hkh djrk gSA
Note:- Aphasia :- Inability use or comprehend words. blesa O;fä words dks vfPN rjg ls use ugh dj ikrk A

12. Thalamus:-
 Function:- Relay station
13. Hypothalamus:-
 Control of ANS
 Production of Hormones
 Regulation of emotional & behaviour patterns
 Feeding center, satiety center, thirst center & thermoregulating center hypothalamus esa gh fLFkr gskrs gsA
 Circadian rhythms & conscious dks cuk;s j[krk gSA
14. Cerebellum
 Outer gray matter.
 Butter fly shape dk gskrk gSA
 Arbor vitae

Function:-
 Smooth & coordinates the contractions of skeletal muscles. (Anterior lobe & posterior lobe dk dk;Z gSA)
 Posture & balance. (Flocculonodular lobe dk dk;Z gSA)
 Ataxia:- disturbances of muscle coordination.

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NERVOUS SYSTEM

15. Brain Stem

 Brain stem esa Mid brain, Pons & medulla oblongata vkrs gSA

 Function of Reticular formation:-

 Consciousness dks maintain djuk A

 Pons:- (Bridge)
 Pons esa pneumotaxic & apneustic centers mifLFkr gksrs gSA

 Medulla oblongata:-
 ;g superior part of the spinal cord ds lkFk continues jgrk gSA
 Medula oblongata esa Cardiovascular center & vaso motor center & medullary rhythmicity area (control
breathing) mifLFkr gksrs gSA
 Medula oblongata esa Vomiting, Swallowing, sneezing, coughing & hiccupping (fgpdh) ds centers (dsUnz)
mifLFkr gksrs gSA

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NERVOUS SYSTEM

16. Cranial nerves

 Cranial nerve nose, eyes, inner ear, brain stem & spinal cord ls mRiUu (Originate) gksrh gSA
 Name:- According to their function & distribution.
 Number (roman no. I to XII):- in order of attachment to the brain.
 Mnemonic for Cranial Nerves
- Oh Oh Oh To Touch And Feel Very Green Vegetables AH

S.N. Number & name Type Function

1. Olfactory (I) nerve Sensory Smell
2. Optic (II) nerve Sensory Vision
3. Occulomotor (III) nerve Motor Movement of upper & eyeball. Accommodation of
lens for near vision & constriction of
pupil.
4. Trochlear (IV) nerve Motor Movement of eyeball

5. Trigeminal (V) nerve Mixed Conveys impulses for touch, pain & temperature
Ophthalmic (smallest), sensations & proprioception
Maxillary &
mandibular
(Largest)
6. Abducens (VI) nerve Motor Movement of the eyeball (abduction of the eyeball)
7. Facial (VII) nerve Mixed Touch, pain & temp. sensation, proprioception &
test
8. Vestibulocochlear (VIII) nerve Sensory Conveys impulses related to equilibrium
9. Glossopharyngeal (IX) nerve Mixed Taste & somatic sensation (Touch, pain &
Temprature from tongue)
10. Vagus (X) nerve Mixed Taste & somatic sensation (Touch, pain & Temp.
from Epiglotis & pharynx), BP ,
swallowing, coughing, voice production,
GIT & CVS
11. Accessory (XI) nerve Motor Movement of head & pectoral girdle.
Cranial & spinal portion
12. Hypoglossal (XII) nerve Motor Movement of tongue during speech & swallowing

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NERVOUS SYSTEM
17. Brain Waves (EEG)

 Mainly neurons of cerebral cortex ds }kjk electrical impulses generate gksrs gS recording these electrical
impulses is electroencephalogram (EEG) dgk tkrk gSA
 Father of EEG:- Hans Berger
 EEG ls normal function of brain ,oa diseases dks Hkh diagnose fd;k tk ldrk gSA
1) Epilepsy
2) Tumor

 Type of Brain waves:-

1) α waves :- Awake & vka[ks can dj rest ds oäA sleep ds nkSjku xk;cA
2) β waves:- ;g mental activity ,oa nervous system dh activity ds nkSjku mRiUUk gksrh gSA
3) Theta waves:- ;g children esa normally gksrh gS o adult esa emotional stress ds nksjku mRiUUk gksrh gSA
4) Delta waves:- ;g deeps sleep ds nksjku mRiUUk gksrh gS

18. Spinal Cord & Spinal Nerves

 It is the continuation of the Medulla oblongata of brain. Spinal cord vertebral canal ds upper 2/3rd part
dks occupies djrh gSA (suspended in the V. canal)
 45 cm length (young adult male esa) (16 – 18ench)
 Elongated, almost cylindrical part of CNS gksrh gSA
 Surrounded by meninges & CSF & vertibreas.
 Thickness :- Little finger (2cm)
 C1 – L1 rd gskrh gsA
 Child esa C1 – L3 rd gskrh gsA
 Spinal cord ds center esa gray matter o periphery esa white matter gksrk gSA
 Spinal nerves:31 pairs (C8, T12, L5, S5,Co1)
 Plexus:-
 Cervical plexus:- C1 – C5
 Brachial plexus:- C5 – T1
 Lumbar Plexus :- L1 – L4
 Sacral Plexus:- L4 – S4

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NERVOUS SYSTEM

19. Autonomic Nervous System

 ;g Autonomous gskrk gsa ;kfu dh Lora= :Ik ls dk;Z djrk gSA
 ;g cardiac muscle, smooth muscle & glands dks supply djrk gSA
 ;g nks izdkj dk gksrk gS&
1) Sympathetic (Thoracolumbar):-
 T1 – L2 ls mRiUu gksrk gSA
 Fight or Flight response nsrs gsA
2) Parasympathetic (craniosacral outflow):-
 Cranial nerve 3, 7, 9, 10 parasympathetic gksrs gSA
 S2 – S4 ls mRiUu gksrs gSA
 Preganglionic & postganglionic neuron ACh release djrs gSA
 Rest & digest activity djrs gSA

20. GLASGO COMA SCALE(GCS)

It is done to assess the level of conscious. It is an important neurological tool. There are 3 parameters.
Motor Response Points:– 6
 Obeys a simple response = 6
 Localized painful stimuli = 5
 Withdrawal to pain = 4
 Abnormal flexion (decorticate posturing)=3
 Extensor response (decerebrate posturing) = 2
 No motor response to pain = 1
Verbal Response Points:– 5
 Fully Oriented = 5
 Confused conversation = 4
 Inappropriate words = 3
 Responds with incomprehensible sounds = 2
 No verbal response = 1
Eye Opening Points 4
 Spontaneous = 4
 In response to sounds = 3
 In response to pain = 2
 No response even to painful stimuli = 1
Interpretation Of Gcs
 Below 8 = coma
 9 to 12 = moderate injury
 13 to 15 = mild injury
 Best score =15.
 Worst score =3

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DISORDERS OF NERVOUS SYSTEM
Trigeminal Neuralgia
Definition:-
It is also known as tic doulourex. Trigeminal neuralgia is a sensory disorder to the trigeminal
It results in severe recurrent sharp facial pain along the course of trigeminal nerve.
Causes:-
Compression of trigeminal nerve by artery.
Clinical manifestations:-
1. Client has severe pain on the lips, gums or nose or across the checks.
2. Situations that stimulate symptoms include cold washing the face, chewing or food or fluids of
extreme temperatures.
Treatment:-
1. Instruct the client to avoid hot or cold foods and fluids.
2. Provide small feedings of liquid and soft foods.
3. Instruct the client to chew food on the unaffected side.

Bell’s Palsy (Facial Paralysis)

Definition:-
1. Bell’s palsy is caused lesion of the seventh cranial nerve.
2. It results in paralysis of one side of the face.
Signs and symptoms:-
1. Flaccid facial muscles
2. Inability to raise the eyebrows , smile, close the eyelids or puff out the checks.
3. Upward movement of the eye when attempting to close the eyelids..
4. Loss of taste.
Treatment:-
1. Facial exercises to prevent the loss of muscle tone.
2. Protect the eyes from dryness and prevent injury.
3. Promote frequent oral care.
4. Instruct the client to chew on the unaffected side.

Increased intracranial Pressure (ICP)

Definition:-
Normal ICP is 5 to 15 mm Hg. If pressure is increased and causes symptoms then it is known as
increased ICP.
Clinical manifestations:-
1. Altered level of consciousness which is the most sensitive and earliest indication of increasing ICP.
2. Late signs of increased ICP “CUSHING TRIAD”
 increased systolic blood pressure,
 widened pulse pressure and
 slowed heart rate.
 Irregular respiration.

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DISORDERS OF NERVOUS SYSTEM
Treatment:-
 Assess patency of the airway and keep an airway and emergency equipment at the bedside.
 Place the client in a semi fowler’s position.
 Change position of the client every 2 hours avoiding injury when turning.
 Avoid Trendelenburg’s position
 Initiate seizure precautions if necessary.

 A hypersomotic agent increases intravascular pressure by drawing fluid from the interstitial spaces and
from the brain cells.
 Limit fluid intake to 1200 ml/day
 Instruct the client to avoid straining activities, such as coughing and sneezing.
 Instruct the client to avoid Valsalva’s maneuvers.
 For the client with increased intracranial pressure elevate the head of the bed 30 to 40 degrees, avoid the
Trendelenburg position, and prevent flexion of the neck and hips.

Head injury or traumatic brain injury

Definition:-
Head injury is a trauma to the skull, resulting in mild to extensive damage to the brain.
Types of head injury:-
Concussion
 Concussion is a blowing of the brain within the skull with no loss of consciousness.
Contusion
 Contusion is a bruising type of injury to the brain tissue.
Contusion may occur along with other neurological injuries

Epidural Hematoma:-
 Results from arterial bleeding.
 Epidural hematoma forms between the dura and skull from a tear in the meningeal artery.
 It is associated with lucid period.
 Epidural hematoma is a surgical emergency.
Subdural Hematoma:-
 Results from a venous bleed.
 Subdural hematoma occurs under the duramater as a result of tears in the veins crossing the subdural
space.
Intracerebral Hemorrhage:-
 Intracerebral hemorrhage occurs when a blood vessel within the brain ruptures allowing blood to leak
inside the brain.

Subarachnoid Hemorrhage:-
 A subarachnoid hemorrhage is bleeding into the subarachnoid space.

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DISORDERS OF NERVOUS SYSTEM

Clinical sign and complications:-

Battle sign: bruising over the mastoid process.
 CSF drainage from the ears or nose

Spinal cord Injury

Definition:-
Trauma to the spinal cord causes partial or complete disruption of the nerve tracts and neurons.

Most frequently involved vertebrae:-

1. Cervical C5, C6 and C7
2. Thoracic – T 12
3. Lumbar – L1
Clinical manifestation of Spinal cord injuries:-
 Total sensory loss and motor paralysis below the level of injury.
 Loss of bladder and bowel control.
Specific spinal injuries:-
Cervical injuries:-
a) Involvement above C4 causes respiratory difficulty and paralysis of all four extremities.

Thoracic level injuries:-

a) Leg paralysis (paraplegia) may occur.
b) Autonomic dysreflexia with lesions or injuries above T6 and in cervical lesions may occur.

Tetraphlegia (Quadriplegia):-
 Injury occurring between C5 and C8

Paraplegia:-
 Injury occurring between T1 - L4 (below C8)
 Paralysis involving only the lower extremities

Seizures and epilepsy

Definition:-
 Seizures are an abnormal, sudden excessive discharge of electrical activity within the brain.
 Epilepsy is a disorder characterized by chronic seizure activity and indicates brain or CNS irritation.
Causes: -
 Genetic factors
 Trauma
 Tumors
 Circulatory or metabolic disorders
 Infections.

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DISORDERS OF NERVOUS SYSTEM

Types of seizures:-
1. Generalized seizures
2. Partial seizures

Intervention and Seizure Precautions:-

1) If the client is having a seizure, maintain a patent airway. Do not force the jaws open of place anything
in the client’s mouth.
2) Bed rest in a semi fowler’s or a side lying position.
3) Maintain a darkened room (subdued lighting and avoid direct bright artificial lights) without stimulation
(a private room is optimal)
4) quiet environment (avoid activates or starting noises) a telephone in the room is not usually allowed.
5) Reading watching television and listening to music are permitted, provided that they do not over
stimulate the client limit visitors.
6) Maintain fluid restrictions.
7) Provide diet as prescribed, avoid stimulants in the diet.
8) Provide any activities that initiate the ValSalva maneuver (straining at stool coughing) provide stool
softeners to prevent straining.

 Assess behaviour at the onset of the seizure. If the client has experienced an aura, if a change in
facial expression occurred, or if a sound or cry occurred from the client.
 If the client is standing or sitting, place the client on the floor and protect the head and body.
 Administer oxygen.
 Prepare to suction secretions.
 Turn the client to the side to allow secretions to drain while maintaining the airway.
 Prevent injury during the seizure.
 Remain with the client.
 Do not restrain the client.
 Loosen restrictive do thing.

STATUS EPILEPTICS:- Involves a rapid succession of epileptic spasms without intervals of consciousness
it is a potential complication that can occur with any type of seizure and brain damage may result.
Cerebrovascular accident (CVA) or stroke

Definition:-
It is also known as brain attack. A stroke is a syndrome in which the cerebral circulation is deficiated,
causing neurological deficits.
Causes:-
 Thrombosis
 Embolism
 Hemorrhage from rupture of a cerebral vessel.

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DISORDERS OF NERVOUS SYSTEM

Clinical manifestations:-
 BY FAST acronym.
F: facial dropping
A: arm weakness
S: slurring of speech
T: tissue damage
Signs and symptoms of stroke:-
 Aphasia: inability to comprehend or use words in right context.
 Agnosia the inability to recognize familiar objects or persons.
 Apraxia:- Characterized by loss of ability to execute or carry out
skilled movements or gestures,
 Hemianopsia;- Blindness in half the visual field
 Neglect Syndrome (Unilateral Neglect):- Client Unaware of the existence of his or her paralyzed side.

Treatment of stroke:-
 Thrombotic stroke is treated by infusing tissue plasminogen activaters.
 Antihypertensive therapy
 Antiplatelet therapy
 Surgical management is by carotid endarterectomy.

Multiple Sclerosis(MS)

Definition:-
1) Multiple sclerosis is characterized by demyelination of the neurons in CNS.
2) It usually consists of periods of remissions and exacerbations.

Sign and symptoms: -

1.Fatigue and weakness
2.Blurred vision diplopic and transient blindness

Treatment:-
 Interferon therapy is used as a treatment modality.
 Steroids in high doses are given to reduce nerve edema.

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DISORDERS OF NERVOUS SYSTEM

Myasthenia Gravis (MG)

Definition:-
Myasthenia gravis is neuromuscular disease characterized by weakness and abnormal fatigue of the
voluntary muscles.
Causes:-
 Decreased secretion of acetylcholine
 Excessive secretion of cholinesterase
Sign and symptoms:-
Eye signs are earliest to occur mostly ptosis or dropping of upper eyelid occurs.
 Difficulty in chewing and swallowing
 Dysphagia.
 Diplopia
 Difficulty in breathing
Treatment:-
 Anticholinestrase medications are given.
(a) Myasthenia crisis:-
 The crisis is caused by inadequate amount of medication.

(b) Cholinergic crisis:-

 Cholinergic crisis results in is caused by overmedication with anticholonesterase.

Parkinson’s disease (PD)

Definition:-
Parkinsonism is a degenerative disease caused by the depletion of dopamine a dysfunction of the extra
pyramidal system.

Causes:-
 Lack of dopamine in substantia nigra.
Sign and symptoms:-
 Bradykinesia abnormal slowness of movement.
 Monotonous speech
 Tremors in hands and figures at rest (pill rolling)
 Tremors
 Rigidity
 Blank facial expression masklike faces
 Drooling of saliva.
 Loss of coordination and balance while walking
Treatment:-
 Carbidopa levadopa

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DISORDERS OF NERVOUS SYSTEM

Guillain Barre Syndrome(GBS)

Definition:-
Guillain Barre syndrome is characterized by ascending and symmetrical weakness. The syndrome usually
is preceded by a mild upper reparatory infection or gastroenteritis.

Causes :-
 Viral cause : EB virus
 Bacterial cause: campylobacter jejuni bacteria.
 Postvaccinial causes : after influenza vaccine.
Clinical manifestations:-
 Weakness of lower extremities.
 Gradual progressive weakness of the upper extremities and facial muscles.

Meningitis
Definition:-
Meningitis is inflammation of the meninges specially arachnoids and pia mater of the brain and spinal cord.

Causes:-
1) Bacteria : E. coli , Hemophilus influenzae.
2) Viral : Mumps Virus, Chicken pox, Herpes, HIV and Coxckie viruses.
3) Protozoal:
4) Fungal :Cryptococcal fungus.
Sign and symptoms:-
 Headache, High grade fever
 Nuchal rigidity : neck rigidity.
 Kerning sign: extension of knee beyond 135 degree causes pain in hamstring.
 Brudzinski’s sign: flexion of neck cause flexion knees and hips.
Other signs are:-
 Photophobia
 Red. Macular rash with meningococcal meningitis.
Diagnosis : BY CSF examination.
Treatments:-
According to causative organism.
Encephalitis
Definition:-
 Encephalitis is an inflammation of the brain parenchyma.
Causes:-
 Viral encephalitis most common.

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IMPORTANT NOTES

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 Nervous System
MCQ {CHO}
MCQs
Q.1 Body system that controls and Q.11 The part of brain, which is
coordinates all body activities: responsible for the co-ordination of
(a) Endocrine movement is:
(b) Musculoskeletal (a) Brain stem
(c) Nervous (b) Cerebellum
(d) Reproductive (c) Thalamus
Q.2 Nervous tissue: (d) Hypothalamus
(a) Covers body surfaces Q.12 Respiratory centre is situated at
(b) Specialized to contract which part of brain:
(c) Contains collagen fibers (a) Medulla (b) Pons
(d) Contain glial cells (c) Cerebellum (d) Thalamus
Q.3 Central Nervous System is consists of: Q.13 One of the functions of cerebellum is to:
(a) Brain (a) Serve as a passage between spinal
(b) Spinal cord cord and brain
(c) Brain and spinal cord (b) Maintain balance, coordination and
(d) Spine only muscular control
Q.4 Basic structural and functional unit of (c) Conduct nerve impulse
the nervous system is : (d) Maintain area of reason, thought,
(a) Nephron (b) Cytoplasm memory and sensation
(c) Proton (d) Neuron Q.14 Which part of the brain controls and
Q.5 Branched process of neurons is: integrates activities of the autonomic
(a) Axon nervous system?
(b) Myelin sheath (a) Midbrain (b) Thalamus
(c) Dendrites (c) Hypothalamus (d) Epithalamus
(d) Synapses Q.15 Temperature regulating centre is
Q.6 What is a specialised nerve cell? present in which part of the brain?
(a) Neuron (b) Axon (a) Thalamus
(c) Dendrites (d) Nucleus (b) Hypothalamus
Q.7 The supportive cells of the nervous (c) Medulla Oblongata
system are: (d) Cerebellum
(a) T cells (b) Stem cells Q.16 The heat regulatory centre is located
(c) Clial cells (d) Astrocytes in the:
Q.8 What is correct order of meanings (a) Thalamus
(from inside towards outside): (b) Hypothalamus
(a) Dura matter, arachnoid matter, pia (c) Limbic system
matter (d) Medulla
(b) Pia matter, arachoid matter, dura Q.17 All of the following statements are
matter true about functions of brain
(c) Arachnoid matter, dura matter, pia EXCEPT:
matter (a) Cerebrum or forebrain controls
(d) Arachnoid matter, pia matter, dura mental behavior and thoughts.
matter (b) Brainstem of mid brain controls
Q.9 Meninges are the coverings of : respiration and cardiovascular
(a) Brain and spinal cord system.
(b) Lungs (c) Cerebellum or hind brain regulates
(c) Kidneys muscle tone and posture.
(d) Heart (d) Cerebrum or forebrain helps in
Q.10 The middle layer of meninges is: interpretation of sensory impulses.
(a) Dura mater Q.18 Eating behavior regulated by:
(b) Pia mater (a) Hypothalamus
(c) Archnoid mater (b) Adrenal gland
(d) Choroid Plexus (c) Pancreas
(d) Thyroid gland
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MCQs
Q.19 The cylindrical part of the nervous Q.28 Site of transmission of message from
system located within the vertebral one neurone to another called:
canal is called: (a) Dendrite Synapse
(a) Cerebellum (b) Axon Node of ranver
(b) Corpus callosum Q.29 Which of the following brain area that
(c) Medulla oblongata regulates body temperature:
(d) Spinal cord (a) Cerebrum Cerebellum
Q.20 The spinal cord is made up of: (b) Hypothalamus Hippocampus
(a) Neurons Q.30 The temperature regulation centre is
(b) Cardiac muscles located in the:
(c) Smooth muscle (a) Cerebellum
(d) Striated muscle (b) Thalamus
Q.21 Heat regulating centre is located in : (c) Cerebrum
(a) Thalamus (d) Hypothalamus
(b) Hypothalamus Q.31 Inability to speak or understand the
(c) Medulla oblongata spoken words is called as:
(d) Cerebrum (a) Insomnia (b) Apraxia
Q.22 The length of the spinal cord in an (c) Agnosia (d) Aphasia
adult male is : Q.32 Aphasia refers to:
(a) 18 cm (b) 45cm (a) Increased rate of speech
(c) 50cm (d) 36cm (b) Inability to speak
Q.23 Part of brain that helps in (c) Loud speech
maintaining posture and equilibrium (d) High pitch speech
is: Q.33 Macrophage cells in the central
(a) Medulla nervous system are:
(b) Cerebellum (a) Microglia
(c) Cerebrum (b) Astrocytes
(d) Thalamus (c) Neuroglia
Q.24 Neurons that release acetylcholine are (d) Oligodendroglia
refers to as: Q.34 Which of the following is the largest
(a) Adrenergic part of the brain?
(b) Cholinergic (a) Cerebellum
(c) Pre-ganglionic (b) Cerebrum
(d) None of the above (c) Pons
Q.25 Forebrain consists of : (d) None of the above
(a) Cerebrum only Q.35 Broca‟s area controls:
(b) Diencephalon only (a) Sensory functions
(c) Cerebrum and diencephalon (b) Speech
(d) Crus cerebri (c) Emotions
Q.26 Which of the following value is (d) Motor functions
considered normal for intracranial Q.36 Which of these is an example of a
pressure (ICP)? neurotransmitter?
(a) 0 to 15 mm (a) Only dopamine
(b) 25mm Hg. (b) Only norepinephrine
(c) 35-45 mm Hg. (c) Only acetylcholine
(d) 120/80 mm Hg. (d) All of these
Q.27 Which called “gateway of pain” Q.37 Which division of the nervous system
according principal of pain sensation: initiate a response known as fight or
(a) Spinal cord flight?
(b) Brain stem (a) The parasympathetic nervous system
(c) Hypothalamus (b) The sympathetic nervous system
(d) Cranial nerve (c) The somatic nervous system
(d) None of these
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MCQs
Q.38 The thick collection of nerve fibers Q.48 Hemiplegia means:
that connects the two hemispheres of (a) Paralysis of both sides
the brain is called: (b) Paralysis in half body (right/left)
(a) Corpus callosum (c) Paralysis of both hands
(b) Hypothalamus (d) Paralysis of both legs
(c) Pons Q.49 Causes of Erb‟s palsy:
(d) Brain stem (a) C2’ C2 injury
Q.39 Temperature is controlled by: (b) T12 injury
(a) Pons (b) Hypothalamus (c) C5’ C6 injury
(c) Pituitary (d) Medulla (d) L1’ L2 injury
Q.40 The respiratory is located in the part Q.50 Which is the largest Nerve in human
of brain: body ?
(a) Medulla (b) Thalamus (a) Femoral Nerve
(c) Midbrain (d) Cerebellum (b) Sciatic Nerve
Q.41 As a part of the assessment of the (c) Pudendal Nerve
cranial nerves, the nurse asks the (d) Thoracic Nerve
patient to raise the eyebrows, smile Q.51 The 10th cranial nerve is:
and show the teeth, these actions (a) Abducent
provide information about which (b) Vagus
cranial nerve? (c) Facial
(a) Olfactory (b) Optic (d) Hypoglossal
(c) Facial (d) Vagus Q.52 The injury which nerve leads to
Q.42 Which nerve is responsible to detect “wrist drops”:
the smell: (a) Axillary nerve
(a) Optic (b) Oculomotor (b) Median nerve
(c) Olfactory (d) Facial (c) Radial nerve
Q.43 A nerve which helps in the process of (d) Ulnar nerve
smelling is: Q.53 The paralysis of both lower limbs is
(a) Optic nerve known as:
(b) Occulomotor nerve (a) Hemiplegia
(c) Olfactory nerve (b) Paraplegia
(d) Facial never (c) Monoplegia
Q.44 The nerve which innervates the (d) Quadriplegia
diaphragm is: Q.54 Seizures characterized by aura
(a) Intercostals never followed by abrupt fall with jerky
(b) Phrenic nerve movements of body and loss of
(c) Dorsal nerve consciousness is referred as:
(d) Vagus nerve (a) Partial seizure
Q.45 Total pairs of cranial nerves are: (b) Psychomotor seizure
(a) 22 (b) 20 (c) Focal seizure
(c) 12 (d) 14 (d) Generalized seizure
Q.46 Which cranial nerves have the highest Q.55 Intense headache, vomiting and stiff
number of branches: neck are initial symptoms of:
(a) Vagus nerve (a) Pneumonia
(b) Facial nerve (b) Meningococcal meningitis
(c) Trigeminal nerve (c) Acute respiratory syndrome
(d) None of these (d) Tuberculosis
Q.47 Nerve supply to jaw occurs by which Q.56 Nuchal rigidity occurs into:
nerve: (a) Meningitis
(a) Temporal nerve (b) Spinal cold injury
(b) Maxillary nerve (c) Myasthenia gravis
(c) Ophthalmic nerve (d) Brain abscess
(d) Zygomatic nerve
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MCQs
Q.57 Kernig‟s sign is a striking feature of: Q.66 Guillain – Barre‟ syndrome (GBS) is a
(a) Meningitis disease of:–
(b) Nephritis (a) Brain
(c) Neuritis (b) Spinal cord
(d) Dendritis (c) Distal nerves
Q.58 Abnormal Sensitivity to light is (d) all of above
known as: Q.67 When helping a stroke patient surse
(a) Hydrophobia should assist:–
(b) Diplopia (a) On weak side
(c) Aphasia (b) On strong side
(d) Photophobia (c) From behind
Q.59 Fever, headache and nuchal rigidity (d) From back
are classic symptoms seen in: Q.68 “Mask like face” is related to which
(a) Parkinson’s disease disease:
(b) Alzheimer’s disease (a) Tetanus
(c) Brain abscess (b) Hypothyroidism
(d) Meningitis (c) Parkinson’s disease
Q.60 Which of the following is a specific (d) Down’s syndrome
investigation of detect scizures? Q.69 Which drug used to decrease ICP?
(a) CT scan (b) MRI scan (a) IV mannitol
(c) EEG (d) X–ray (b) IV Phenytoin
Q.61 To diagnosis meningitis which type of (c) IV diazepam
sample is collected? (d) IV nitro– glycerin
(a) Urine Q.70 Position given to a patient with head
(b) CSF injury is :
(c) Bone marrow (a)Tredelenburg position
(d) Stool (b) Head elevation
Q.62 Simple or cynical febrile seizures (c)Prone position
occur in: (d) Side lying position
(a) Infants below 3 months of age Q.71 During head injury what is the cause
(b) 3 months – 5 years of increase in body temperature :
(c) 3 years – 8 years (a)Pons injury
(d) Preadolescents (b) Hypothalamus injury
Q.63 First aid treatments for a patient of (c)Cerebellum injury
epilepsy is: (d) Medulla injury
(a) To project the patient Q.72 Lucid interval is seen in :
(b) To clean the airway (a) Intra cerebral haemorrhage
(c) To provide rest and comfort (b) Extra-dural haemorrhage
(d) To give medicine (c) Acute subdural haemorrhage
Q.64 Guillian Bare‟ is not linked to which (d) Chronic subdural haemorrhage
of the following statements? Q.73 The following device is used in
(a) Infections often present cervical spinal cord injuries:
(b) Greater initial upper extremity (a) Halo vest
deficits (b) Milwaukee brace
(c) Increased CSF protein levels (c) Buck’s extension traction
(d) Hypertension (d) Ilizarov device
Q.65 Guillian Barre‟ syndrome is a disease Q.74 The patient who is immobilized
of which of the following? because of spinal cord injuries should
(a) Brain have a diet rich in :
(b) Spinal cord (a) Calories
(c) Peripheral nerve (b) Carbohydrates
(d) All of the above (c) Fats
(d) Proteins
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MCQs
Q.75 Bell‟s palsy is due to the injury of
which cranial nerve:
(a) Trigeminal
(b) Facial
(c) Trochlear
(d) Hypoglossal
Q.76 Myasthenia gravis is a disease of :
(a) Neuro-muscular junction
(b) Anterior horn cells
(c) Skeletal muscle
(d) Spinal cord
Q.77 Symptoms of trigeminal neuralgia
may include all of the following
except:
(a) Extreme, intermittent facial pain in
the jaw or cheek
(b) Tingling or numbness on one side of
the face
(c) Pain triggered by contact with the
face or facial movements
(d) Inability to swallow.
Q.78 Which of the following is fourth
cranial nerve?
(a) Abducens
(b) Trochlear
(c) Trigeminal
(d) Facial
Q.79 Which of the parts controls eating
behavior?
(a) Hypothalamus
(b) Pituitary gland
(c) Pineal gland
(d) Pancreas
Q.80 Which of the following is used to
assess the level of consciousness
(a) Apgar score
(b) Braden scale
(c) Glassgow coma scale
(d) Snellen’s chart
Q.81 „Movement of eyeballs‟ is the function
of which of the following cranial
nerves?
(a) Olfactory
(b) Accessory
(c) Oculomotor
(d) Optic
Q.82 What should the nurse do first when a
male client is having a tonic-clonic
seizure?
(a) Elevate the head of the bed
(b) Take measures to prevent injury
(c) Restrain the client’s arms and legs
(d) Place a tongue blade in the client’s
month

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MCQs

Gurjar Ki Thadi, opp. Metro Pillar No. 67 New Sanganer Road, Jaipur. Mb. 7426955591, 7426955593 47
MCQs

1 C 16 B 31 D 46 A 61 B 76 A
2 D 17 B 32 B 47 B 62 B 77 D
3 C 18 A 33 A 48 B 63 B 78 B
4 D 19 D 34 B 49 C 64 B 79 A
5 C 20 A 35 B 50 B 65 C 80 C
6 A 21 B 36 D 51 B 66 C 81 C
7 C 22 B 37 B 52 C 67 A 82 B
8 B 23 B 38 A 53 B 68 C
9 A 24 B 39 B 54 D 69 A
10 C 25 C 40 A 55 B 70 B
11 B 26 A 41 C 56 A 71 B
12 A 27 B 42 C 57 A 72 B
13 B 28 B 43 C 58 D 73 A
14 C 29 C 44 B 59 D 74 D
15 B 30 D 45 C 60 C 75 B

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