[Exam 4] Chapter 65: Assessent of Neurologic Function (Page 1946-1962) Flashcards
Function of the Nervous System?
To control all motor, sensory, autonomic, cognitive, and behavioral activites
What does the CNS include?
Brain and spinal cord
What does the Peripheral Nervous System include?
Cranial and Spinal Nerves
Autonomic (Sympathetic and Parasympathetic Systems) and Somatic Systems
What is the basic functional unit in the nervous system?
Neurons
What are neurons composed of?
Dendrites, cell body, and axon.
What do Myelin Sheaths do?
That nerve impulses transfer quickly and do not get off of their path
What do dendrites do?
Structures that receive electrochemical messages
What is an axon?
Long projection that carries electrical impulses away from the cell body
What do Synaptic Terminals do?
They are terminals that have neurotransmitters present .
What is the Autonomic System?
It is involuntary, it is automatic. Body automatically does it.
What is the Autonomic System broken down into?
Sympathetic and Parasympathetic Systems
What does the Sympathetic system do? (simple)
Speeds up nerve impulses. S&S is a good way to remember this
What does the Parasympathetic system do? (simple)
Slows down nerve impulses. (This is Pokey)
What is more strongly controlled by the parasympathetic system?
GI System
What is more strongly controlled by the sympathetic system?
Fight or flight response
What does the Somatic System control?
Voluntarily movements. Helps you move, or do things that require nerve impulses that we control by thinking about
What nerves controlled by Somatic System?
Afferent and Efferent Nerves of Skeletal System
Functions of Autonomic System? (4)
Regulates activities of internal organs to maintain homeostasis
Regulated by centers in the spinal cord, brain stem and hypothalamus
Sympathetic
Parasympathetic
What does the Sympathetic System control ? (3)
Flight or Fight Response
Norepinepherine
Stimulation causes dilated blood vessels, bronchioles, and pupils and sweating
What does the Parasympathetic System control? (2)
Controls visceral organs (GI and Bladder)
Stimulation causes a reaction of visceral organs (peristalsis and bladder constriction)
What is the Somatic System Responsible for?
Carrying motor and sensory information both to and from CNS
What is the Somatic System made up of?
Nerves that connect to the skin, sensory organs, and all skeletal muscles
Neurotransmitters: Communicate messages how?
From one neuron to another or to a specific target tissue
Neurotransmitters: What can they do to a target cell?
Excite (Acetycholine) or inhibit (dopamine)
Neurotransmitters: Many neurologic disorders are caused by
an imbalance in neurotransmitters
What does Acetycholine do?
Excites or speed up transmissions
What does Dopamine do?
Inhibits or slows down the nerve impulses
What are the sensory nerves?
I, II, VII
What are teh motor nerves?
III, IV, VI, XI, XII
What are teh mixed sensory and motor nerves?
V, VII, IX, X
The Autonomic Nervous system functions to regulate…
activites of internal organs and to maintain and restore internal homeostasis
Main neurotrnsmitter in Sympathetic Nervous System is?
Norepinephrine
What is the Autonomic Nervous System regulated by?
Centers in the spinal cord, brainstem, and hypothalamus
What does the Sympathetic Nervous system do to body organs? (Specifics)
Stimulation causes dilated blood vessels in the heart and skeletal muscles, dilated bronchioles, and increased sweat production and dilated pupils
What does the Parasympathetic Nervous System do to body organs? (Specifics)
Stimulation causes a reaction of visceral organs, such as peristalsis or bladder contraction
What are the requirements for an accurate assessment?
Knowledge of anatomy and physiology or neuro system
Knowledge of diagnostic tests
Knowledge of nursing interventions for diagnostic tests and assessment procedures
Neurologic Assessment: What Health History poritons would you look at? (6)
Pain
Seizures
Dizziness (abnormal sensation of imbalance) / Vertigo (illusion of movement, usually rotation)
Visual Disturbances (Are they seeing double? Halos around light?)
Weakness
Abnormal Sensations (Paresthesia)
Neurologic Assessment: What would you look at for cerebral function? (7)
Mental status,
intellectual function,
thought content,
emotional status, (Labial mode)
perception,
motor ability,
language ability
Neurologic Assessment: Cerebral function, make sure to note what impact?
Impact of any neurologic impairments on lifestyle and patient abilities and limitations
Neurologic Assessment: Motor system, what is assessed? ($)
Posture,
Gait, (Assess when they aren’t paying attention)
Muscle Tone and Strength
Coordination and Balance
Neurologic Assessment: Sensory System parts (4)
Tactile Sensation
Superficial Pain
Vibration
Position Sense (Tell them to close eyes and tell us what position their hand is in)
What is Ataxia?
Incoordination of voluntary muscle action, particularly of the muscle groups used in activities such as walking or reaching
Neurologic Assessment & Gerontologic Considerations: Its important to distinguish what?
Normal aging changes from abnormal changes
Neurologic Assessment & Gerontologic Considerations: What should you do first?
Determine previous mental status for comparison. Assess mental status carefuly to distinguish delirium from dementia
Neurologic Assessment & Gerontologic Considerations: Normal changes of the body icncludes what? (8)
Loss in Strength/Agility
Change in Gait, posture, and balance
Slowed Recaction Time and Decrease Reflex
Visual/Hearing Alterations
Decreased sense of smell/taste
Dulling of tactile sesnations
Decreased temperature
REduction of cerebral blood flow
What Diagnostic Tests can be performed? (8)
CT, PET, MRI, SPECT
Cerebral Angiography (Look at blood flow through brain)/Myelography (Uses Dye)
Noninvasice Carotid Flow Studies (Ultrasound Carotid Artery)
Transcranial Doppler
Electroencephalography (EEG) (Electrodes placed to study activity)
Electromyography (EMG) (electrodes placed to study activity)
Nerve Conduction Studies/Evoked Potential Studies
Lumbar Puncture and Analysis of Fluid
Diagnostic Evaluation & CT: How is the test first initially performed?
Without IV dye, and then with IV
Diagnostic Evaluation & CT: What does the patient do
Lies on table with head in heatrest while scanning system roates around heat
Diagnostic Evaluation & CT: Nursing Intervention for this?
Tell pt about need to lie still.
Fasting for 4 hours if contast needed
Diagnostic Evaluation & MRI: Useful in what situations?
Diagnosis of brain tumor, strokes, and multiple sclerosis and does not involve ionizing radiation
