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NU 360 > Ch. 35 > Flashcards

Ch. 35 Flashcards

1
Q

the nervous system is made up of

A
  • the central nervous system
  • the peripheral nervous system
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2
Q

central nervous system consists of which body parts?

A
  • spinal cord
  • brain
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3
Q

the peripheral nervous system consists of what body parts?

A
  • 12 pairs of cranial nerves
  • 31 pairs of spinal nerves
  • autonomic nervous system
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4
Q

the autonomic nervous system is part of the ___

A

peripheral nervous system

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5
Q

the autonomic nervous system consists of which body parts?

A
  • sympathetic fibers
  • parasympathetic fibers
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6
Q

neurons

A

transmits info, impulses, messages
- mobility: purposeful movement
- sensory: experience sensation
- myelin sheaths: lipid covering, plays role in impulse conduction, think MS- impaired mobility d/t myelin sheath covering worn away

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7
Q

neuroglial cells

A
  • position, structure, and nutrition for neurons

people with glioblastoma: malignant tumor of glial cell; poor outcome

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8
Q

layers of the brain (out to in)

A
  • scalp
  • cranium: hard bone, protection
  • dura mater: “hard mother;” protection
  • arachnoid
  • subarachnoid space: underneath arachnoid
  • pia mater: right around brain
  • cerebral cortex: brain
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8
Q

cerebral circulation

A

blood flow in the brain that allows the brain to get its nutrients and oxygen even when the blood pressure in the body changes

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9
Q

frontal lobe

A

front of head
- voluntary movement, expressive language, managing higher level executive functions

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10
Q

cerebral cortex

A

all higher functions of the brain
- language, memory, reasoning, thought, learning, decision-making, emotion, intelligence, personality

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11
Q

parietal lobe

A

top back of head
- processes sense of touch, assembles input from other sense into a form you can use

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12
Q

occipital lobe

A

bottom part of the brain; where neck connects
- visuospatial processing, distance and depth perception, color determination, object and face recognition, memory function

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13
Q

cerebellum

A

controls voluntary movement; maintains equilibrium (posture and balance); spacial awareness; muscle tone; motor learning

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14
Q

temporal lobe

A

side of the brain
- helps senses understand and respond to the world around you

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15
Q

medulla

A
  • controls heart rate, breathing, blood pressure, etc; manages automatic responses
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16
Q

reticular formation

A
  • keeps brain awake/regulates consciousness
  • coordinates brain stems
  • controls muscles, reflexes, autonomic functions, feeding actions, bladder emptying, posture
  • modulates pain, biological rhythms
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17
Q

pons

A
  • relays and regulates the signals that give you the sensation of pain from anywhere in the body below the neck
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18
Q

midbrain

A
  • motor control, particularly eye movements and processing of vision and hearing
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19
Q

hypothalamus

A
  • manages body temperature, hunger and thirst, mood, sex drive, blood pressure, sleep
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20
Q

thalamus

A
  • information relay stations
  • all senses (EXCEPT SMELL) are processed through thalamus before sent to cerebral cortex
21
Q

subthalamic nucleus

A

regulates movement

22
Q

epithalamic nucleus

A

connects the limbic system to the brain
- secretion of melatonin, regulation of motor pathways and emotions

23
Q

circulation of the brain originates at

A

circulation of brain originates at both carotid and vertebral arteries
- forms ring at base of brain: circle of willis

24
Q

spinal cord: descending tracts

A
  • begin in brain, end in spinal cord
  • autonomic or non-voluntary movements
25
Q

spinal cord: ascending tracts

A
  • begin in spinal cord, end in brain
  • sensation pain, temperature, light touch/pressure
  • awareness of movement
26
Q

ANS: sympathetic

A
  • fight or flight
27
Q

neuro nursing assessment

A
  • Family history and genetic risk: stroke risk, hx of stroke in fam/pt,
  • Personal history: stroke, TIA, a-fb/clotting hx
  • Level of consciousness and orientation: A&O, GCS
  • Language and copying: difficulty
  • Cerebellar function: coordinated muscle movement
  • Memory: remember certain number of words (dementia, early s/sx)
  • Attention: participate in convo, engage; lose 1:1/eye contact; need redirection?
  • Cognition: what the patient is able to process/understand/think, carry on conversation/answer questions
  • Cranial nerves
  • Sensory function: touch: sharp, dull, pain, temperature, lack of sensation
  • Reflex activity: brisk or hypo-reflexive
27
Q

ANS: parasympathetic

A
  • rest and digest
  • can slow body function when needed
28
Q

assessment of mental status includes

A
  • consciousness: LOC
  • cognition: test of memory and attention
29
Q

GLASCOW coma scale: eye

A

4- open spontaneously
3- open to verbal command
2- open to pain
1- no eye opening

30
Q

GLASCOW coma scale: verbal

A

5- oriented
4- confused
3- inappropriate words
2- incomprehensible sounds
1- no verbal response

31
Q

GLASCOW coma scale: motor

A

6- obeys commands
5- localising pain (crosses the midline to site of pain)
4- withdrawal from pain (away from pain)
3- flexion to pain (decorticate; posturing reflex)
2- extension to pain (decerebrate; posturing reflex)
1- no motor response

32
Q

“posturing” includes

A

decorticate and decerebrate

33
Q

decorticate

A
  • curl in; internal rotation; turning into core
  • stimulate patient and get abnormal pulling in of body
  • arms to chest, toes point in
  • injury to the lower brain; trauma or lack of oxygen
  • a little better than decerebrate
34
Q

decerebrate

A
  • curl out; external rotation
  • stimulate patient and get abnormal pulling out of body
  • toes point out
  • extension of body
  • rigid
  • WORSE than decorticate
  • dysfunction in the brainstem
35
Q

physical assessment: pupils

A

PERRLA: pupils, equal, round, reactive to light, accommodating
- brisk
- sluggish
- fixed: pupils don’t constrict with light; happens with cardiac arrest; artificial eye*
- dilated: big; from uppers: meth, cocaine, adderall, focalin
- pinpoint: small; from opioids

36
Q

physical assessment: muscle strength

A
  • hands & feet
  • should be equal
  • move with resistance vs gravity
  • dominant can be slightly stronger- normal
  • know patients history (hx of stroke)
37
Q

diagnostic assessment techniques

A

Laboratory assessment
Skull and spine x-rays
Cerebral angiography (arteriography)
Computed tomography (CT) scan
Magnetic resonance imaging (MRI)
Positron emission tomography (PET)
Single-photon emission CT (SPECT)
Magnetoencephalography (MEG)

38
Q

electromyography (EMG)

A

Used to identify nerve and muscle disorders, as well as spinal cord disease

39
Q

lumbar puncture

A
  • Insertion of spinal needle into the subarachnoid space (between the third and fourth lumbar vertebrae)
  • taking out CSF to test
  • Empty bladder
  • Position: side-lying
  • Spinal headache possible from spinal tap
40
Q

lumbar puncture is contraindicated in patients with

A

Contraindicated in patients with increased intracranial pressure

41
Q

what do we want/not want cerebrospinal fluid (CSF) to look like?

A
  • want to see clear
  • bloody, sediment: do not want to see
42
Q

electroencephalography (EEG)

A
  • for undiagnosed seizure activity; to check brain activity
  • Graphically records the electrical activity of the cerebral hemispheres
  • want to cause a seizure: Sleep deprivation requirement; Anticonvulsants possibly withheld; hyperventilate; flashing lights
  • can do it as a sleep study- depends on what provider orders
43
Q

nursing management of electroencephalography (EEG)

A
  • clean hair, may have to cut hair
  • no lotion
  • sleep deprivation
  • no anticonvulsants
  • not painful to pt!
44
Q

carotid blockages

A
  • carotid blockage causes: lack of perfusion to brain
  • don’t massage both carotids at the same time bc will cut off blood flow
45
Q

cranial nerves: name in order (HINT: on occasion our trusty truck acts funny very good vehicle any how)

A

olfactory
optic
oculomotor
trochlear
trigeminal
abducens
facial
vestibulocochlear
glossopharyngeal
vagus
accessary
hypoglossal

46
Q

cranial nerves: sensory vs motor (HINT: some say marry money but my brother says big brains matter more)

A

sensory
sensory
motor
motor
both
motor
both
sensory
both
both
motor
motor

47
Q

blown pupil

A
  • profoundly impacts mental status and cognition
  • one pupil normal, one pupil hugely dilated
  • could be caused by pressure in brain from injury, brain bleed
48
Q

anasychoria

A
  • born with unequal sized pupils
  • normal, not concerning
49
Q

highest possible GCS score

A

15

50
Q

lowest possible GCS score (patient is dead)

A

3

NU 360 (12 decks)

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