Intracranial Regulation Flashcards
2 parts of the Neurological System
- Central nervous system
2. Peripheral nervous system
Consist of the brain and the spinal cord
Central nervous system
What makes up the Peripheral nervous system?
Cranial nerves and the spinal nerves.
Processes that impact intracranial compensation and adaptive neurological function.
Intracranial regulation
What is a neuron? And what do they do?
The basic cell of the nervous system. They are highly specialized cells that send impulses throughout the body.
Cushions the brain and prevents injury to brain tissue.
Cerebrospinal fluid (CSF)
The largest part of the brain; it’s two hemispheres account for 60% of the brains weight. Composed of gray matter and has two hemispheres that are divided into four regions known as lobes.
Cerebrum
Control center of the nervous system, generating thought, emotion, and speech…
The brain
The brain is a sensitive organ covered by a protective coating of 3 connective tissue membranes, known as the _______________.
Meninges
The 4 lobes of the cerebrum
- The frontal lobe
- The parietal lobe
- The occipital lobe
- The temporal lobe
Regions of the brain
The cerebrum, the diencephalon, the brain stem, the cerebellum, the spinal cord, the pituitary gland
The ____________ lobe is involved with speech, thought, learning, emotion, and voluntary movement.
Frontal
The _________ cortex of the ________ lobe Controls more complicated cognitive processes, such as judgment, reasoning, and concern for others.
Prefrontal / frontal
The ____________ lobe processes all of the sensory information, including shapes, temperature, pain, and two point discrimination (ex: hot vs cold)
Parietal
The second largest part of the brain is the ____________. Made up of gray and white matter and is responsible for muscle movement and balance and control.
Cerebellum
The ___________ lobe, where the visual cortex is located, processes vision.
Occipital
The relay center for all signals coming to the brain. Takes all incoming nerve impulses and sends those signals to the correct region of the brain. Located within the diencephalon.
The thalamus
Located within the diencephalon, the ____________ is the autonomic control center, and is involved in regulating activities such as heart rate, blood pressure, respiratory rate and depth, pain, pleasure, and fear. Also controls body temperature, food and water intake and balance, sleep cycles, and digestive motility.
Hypothalamus
The diencephalon consists of what 3 structures?
The thalamus, hypothalamus, and epithalamus
The __________ lobe stores memory and interprets auditory stimuli. Also located in this lobe is the _________ cortex, which interprets smell.
Temporal lobe / olfactory cortex
Made up of the midbrain, pons, and medulla oblongata
Brain stem
Level of consciousness: stupor (5/8)
Unresponsive, may respond to inflicting painful stimuli
Controls reflexes and influences all basic functions including breathing, blood pressure, and heart rate.
The brainstem
What are the two different types of reflexes?
Somatic reflexes, which result in skeletal muscle contraction.
And
Autonomic reflexes which activate cardiac muscle, smooth muscle, and glands.
10 out of the 12 pairs of cranial nerves originate in the __________.
Brainstem
Reflexes are….
Rapid, involuntary, predictable motor responses to a stimulus.
Fully awake, alert, and oriented X3, responds appropriately, everything functioning
What is their level of consciousness?
Full consciousness (1/8)
Level of consciousness: confusion (2/8)
Impaired judgement, easily distracted, short attention span
Level of consciousness: disorientation (3/8)
Cannot answer one or more of person, place, or time.
Impaired judgment, easily distracted, short attention span….
What is their level of consciousness?
Level of consciousness: confusion
Can not answer one or more of person, place, time… What is their level of consciousness?
Level of consciousness: disorientation
Level of consciousness: semi-comatose (6/8)
Does not move spontaneously; unresponsive to stimuli, although vigorous or painful stimuli may result in stirring, moaning, or withdraw from the stimuli, without actual arousal
Unresponsive, may respond to painful stimuli… What is their level of consciousness?
Stupor
Levels of consciousness in order from most conscious to least conscious
Full consciousness – alert; oriented to time, place, and person; comprehend spoken and written words
Confusion – unable to think rapidly and clearly; easily be Wilderwood, with poor memory and short attention span
Disorientation – not aware of or not oriented to time, place, or person (at least one of those)
Obtundation- lethargic, responds to verbal or painful stimuli but quickly drift back to sleep; hard to keep awake
Stupor – unresponsive, maybe briefly aroused by vigorous, repeated, or painful stimuli; may shrink away from or grab at the source of stimuli
Semi comatose – does not move spontaneously; unresponsive to stimuli, although vigorous or painful stimuli may result in stirring, moaning, or withdraw from the stimuli, without actual arousal
Coma- Unarousable; will not stir or moan in response to any stimulus; may exhibit non-purposeful response of area stimulated but makes no attempt to withdraw
Deep coma – completely unarousable and unresponsive to any kind of stimulus, including pain; absence of brainstem reflexes, corneal, papillary, and pharyngeal reflexes, and tendon and plantar reflex.
The ________ ______ is an extension of the brainstem, specifically the medulla oblongata, that transmits impulses to and from the brain.
Spinal cord
Consciousness is a condition in which The individual is aware of self and environment and is able to respond appropriately to stimuli. Full consciousness requires both normal __________ and full ___________.
Arousal / Cognition
Arousal -(or alertness) depends on the reticular activating system (RAS), a diffuse system of neurons in the Thalamus and upper brainstem.
Cognition- complex process by which an individual learns stores retrieves and uses information. Cognitive processing involves all mental activities controlled by the cerebral hemispheres, including thought processes, memory, perception, communication, problem solving, and emotion.
If the patient only opened eyes to verbal stimuli what score would they get in the eye-opening category of the Glasgow coma scale?
A 3 on The Glasgow coma scale for eye-opening
A period of abnormal electrical activity in the brain, may cause involuntary movement.
Seizures
3 things that can impede brain function:
- Ischemia- loss of blood flow to a specific area
- Hypoglycemia- Low blood sugar
- Masses- tumors, hematomas, hemorrhagic edema (swelling of the brain)
All 3 alter the amount of blood flow!
Increased intracranial pressure (IICP)
Sustained (more than 30 minutes) elevated pressure (15mmHg or higher in adults) in the cranial cavity. May cause severe headaches, change in mental status or tissue ischemia.
Level of consciousness: obtundation (4/8)
Lethargic, responds to verbal or stimulation, hard to keep awake
A more severe consequence of altered level of consciousness is a persistent vegetative state, defined by:
A permanent condition of complete unawareness of self and the environment and loss of all cognitive functions. Usually the result of severe brain trauma, this condition results from death of the cerebral hemispheres with continued function of the brainstem and cerebellum. Although the homeostatic regulatory functions of the brain continue, ability to respond meaningfully to the environment is lost. The client in a persistent vegetative state has sleep wake cycles and retains the ability to chew, swallow, and cough but cannot interact with the environment. When the person is awake, the eyes may wander back and forth across the room but they cannot track an object or an individual.
___________ ____________ is different from a persistent vegetative state in that the client is alert and fully aware of the environment and has intact cognitive abilities but is unable to communicate through speech or movement because of blocked efferent pathways from the brain.
Locked-in syndrome
When testing for brain death what three factors must be in place?
- Normal temperature
- No central nervous system drugs
- No alcohol in the body’s system
Glasgow coma scale for assessment of coma evaluates which 3 responses?
Eye opening – scale of 1 to 4 4– Spontaneous 3– To verbal stimuli 2– To pain 1– No response
Verbal response – scale of 1 to 5
5– Awake alert and oriented X3; uses appropriate words and phrases
4– Confused
3– Inappropriate words or verbal response
2– Incomprehensible words
1– No response
Motor response – scale of 1 to 6 6– Obeys commands 5– Localizes pain 4– Withdraws to pain 3– Flexion to pain 2– Extension to pain 1– No response
The higher the number the better the response.
On Glasgow coma scale a score of 4 for eye-opening would be…
Spontaneous
____________ is the largest division of brain, enables individuals to reason, function intellectually, express personality and mood, and interact with environment.
Cerebrum
When declaring somebody brain-dead they must perform an _______ test, where the ventilator is removed while oxygenation is maintained by tracheal cannula, allowing the CO2 to increase to 60 mmHg or higher. This level of carbon dioxide is high enough to stimulate respiration if the brainstem is functional.
Apnea
_________ __________ is this is cessation and irreversibility of all brain functions, including the brainstem.
Brain death
