Nervos And Sensory Flashcards
What is the nervous system?
controls, directs and coordinates body function
Two main divisions of Nervous System
CNS : the central nervous system_ brain & spinal cord
PNS : the peripheral nervous system_ nervous of rest body
2 type cell of NERVE tissue
Neuroglía- nourishes(provide necessary substance)/
protects
insulates (cover) neurons
neurons_ transmit information
Neurons work
Dendrites- receive messages
Nucleus- keeps cell alive
Axon- sends messages to axon terminals.
Myelin sheath- cover exon:enable to deliver impulse faster!
Neurotransmitters - chemical - allow message
Synapse- space between neurons
Is the neuron damaged easily?
Yes
How long take times to heal?
Long time
CNS covered by which bone & tissue?
Skull & meninges
Three main parts of CNS
1- cerebrum: largest part/ outer layer( cerebral cortex)
* thinking cap *
2-cerebellum: body movements
3- brainstem: control vital functioning in medulla
What is in the spinal column?
Spinal cord
What is the spinal cord contains?
The pathway that conduct message to & from brain
How long spinal cord?
18 inch
Dose the spinal cord extend?
Not extend
What is the meninges?
It is three layers connective tissue (covers & protects CNS)
Three layers of meninges
1- dura mater- out layer & next to the skull
2-arachnoid- middle layer
3-pie mater- inner layer
It the dura mater is damaged, which problem occurs?
Headache & memory issue because it is closed to the skull
What is the name of fluid to cushion the fragile tissue of CNS?
CSF: cerebral spinal fluid
It flows in the space
How many pairs of nervous system in PNS?
12 pair of cranial nerves & 31 pairs of spinal nerves
Which responsibility each of cranial & spinal?
1 crinal nerves - conduct impulses
* between brain and head-neck-chest- abdomen
2 spinal nerves - carry impulse
*from the skin-extremities-internal structure
; rest of cranial nerves parts
Is the Nervous system autonomic?
Yes.it controls involuntary muscles & body function automatically
Two part of control automatically
- Sympathetic- speed up
- Parasympathetic-slow down
If the brain is being symphatetic, what will happen in our body?
Metabolism
Heart rate Goes high
Blood pressure
Digestion
If the nervous system maintain parasympathetic controls?
Metabolism
Heart rate normal state/relaxed
Blood pressure
Digestion
What is the important between sympathetic & parasympathetic?
Balance
What is the 5 sensory in body?
Sight
Hearing
Taste
Smell
Touch
Each receptor’s name of 5 sensory
Eyes-
Nose- olfactory
Ears-
Tongue- tast buds
Skin in dermis layer -
When Hca observe or report or ask client, which sensor will use?
5 sensory
Which part should be checked first by staff?
Fingertips & toes
3 layers of the eye & optic nerve
3 layers
1. sclera- out layer
2. Choroid- second layer
3. Retina- inner Iayer : send message to optic nerve
Optic nerve: take image to brain
For interpretation(understand)
What is retinal detachment?
Loosing site
The back side of Eye will pain > report nurse & gohospital
What is the traumatic event with eyesight?
Temporary loose eyesight
If patient complains about eye hurt, what you ask to observe?
Can you see?
Can you follow my finger?
Something got it inside?
Do you feel dry?
Check redness & tearing
The front eye’s structure
- Cornea- transparent part(투명한 막)
- Iris- more to adjust the size of the pupil
- Pupil- a hole that light passes through to reach to retina
- Lens- behind pupil & reflect light and image onto retina
Which hairs protect eye from the injury?
Eyelashes: keep tears & protect as a shiled
Ears’ function?
Hearing & balancing
3 parts of ear
① external ear - called pinna or auricle
② middle ear
③ inner ear
What does external ear contain?
Auditory canal - sound waves travel through it
What is the cerumen?
It is the waxy substance secrete(emit)by glands in auditory canal
What part devides external & middle ear?
Eardrum(tympanic membrane)
Middle ear’s structure
① enstachian tube: allow pressure to be equal
② ossicles- three small bones- malleus/incus/stapes
Inner ear’s structure
① cochlea -having fluid that carries sound waves to nerves
② auditory nerves - carry the message to brain
③ 3 semicircular canal - balance of body
If patient ask you to clean her/his ear, what should you do? And why?
Clean only enter - don’t stick anything inside of eye
No Che tips
It is cause of HOH
If the patient look clearly, but break balance down, what you can suspect? And why?
Ear’s problem- 3 semi-circular canals related to balance
where can find taste receptor - taste buds?
Tongue/ soft palate입천장/ upper esophagus/ epiglottis
4 basic taste sensation & role
The role is relay(send)taste information to the brain
It patient refuse eat something twice, what should you do?
Don’t force
Leave them and just make report
Smell (olfactory)
Located on the roof of nasal cavity
The fluid in the mucous membrane stimulate
Send signal to the brain
Connected with taste
If patient complains cannot smell and taste, what should you do?
① suspect cause: depends on condition they can’t feel
caused by brain injury
② ask them: is this stiff also yesterday?
Did you do unusuall something today?
③ check Hx of allergy
④ diagnosis ‘is it Covid symptom’
⑤ isolation-if helshe is Covid
Can Nervous system disorders affect mental & physical function ?
Yes, it affect thinking, reasoning, understanding, remembering, reading and problem solving.
Type of nervous system disorder
① Epilepsy
② Stoke_ CVA
③Aneurysm and acquired brain injuries
④ Parkinson’s Disease
⑤ Huntington’s Disease
⑥ Multiple Sclerosis
⑦ Amyotrophic Lateral Sclerosis
⑧ Spinal Cord Injuries
① epilepsy: what is epilepsy
Chronic disorder involving seizures
A group of neurological disorder(sensory, consciousness, convulsions suddenly
and abnormal electrical activity in the brain
What is seizure
발작
It involves violent & sudden contractions muscle
caused uncontrolled movement
Single seizure is also epilepsy?
No, epilepsy is more than two type of seizures
Epilepsy is violent?
Yes, it maked bruise, scratch or even bite
so don’t put anything in the month during the time
Can be bite or they can swallow it
Type of epilepsy
① petit mal seizure-involuntary movement(mild)
brief one without loss of posture
② grand mal seizure- violent contractions
common symptom (‘간질’하면 떠오르는)
Causes of epilepsy from infant to elderly
① brain injury or head trauma
② lack of oxygen
③ problems with brain development
④ during pregnancy, mother having injury or infection
⑤ chemical imbalance
⑥ Brain tumor
⑦ childhood fever
⑧ poisons - alcohol
⑨ single seizure(it can develop to epilepsy)
Seizure intervention
① aura
② yell for help
③ don’t restrain & put anything in mouth
④ protect from injury: remove chair/table
⑤ maintain airway
⑥ observe, assume recovery position(on the side head leg)
⑦ after done, leave them sleep
** don’t leave them alone & if it’s maintaining over 30 min call nurse/ 911*
What is Stroke- CVA
It is a disease that affects the arteries supplying blood to the brain
When does the stroke occur ?
①brain blood vessel burst & bleed - cerebral hemorrhage
② blood clot blocks blood to the brain
How often it occurs In Canada?
4th cause of the death
Warning sign of the stroke
Tia - transient ischemic attack: lasts a few minutes
Storke cause
① Hemorrhage
② Thrombus - blood clot
③ Embolus- starts in artery/ breaks loose/travel to brain
Weakness people from the stroke
① age: over 65
② family history (hereditage)
③ gender: risk is higher men than women
death rate is more women than men
④ Hypertension
⑤ heart disease
⑥ smoking
Risk factor of stroke
① atherosclerosis동맥경화 / high blood cholesterol
② TIA
③ lifestyle causes: lack of exercise / high alcohol intake
④ diabetes
Does the store occur suddenly?
Yes
Warning signs of stroke
Suddenly
① weakness, numbness, tingling especially on one sidebody
② vision problem in especially one eye
③ loss of speech or understanding
④ severe headache with no cause
⑤ dizziness
When you saw stroke sign , what should you do?
Test F.A.S.T r
F: face- ask smile. One side droop?
A: arms- when raised, only one side drift down?
S: speech- stroke person repeat sentence or slur(mumble) word
T: time is critical
Stroke across connect
① left side brain- right side paralysis
* aphasia: difficulty of speech
* personality change- lethargic(sleepy), slow, anxious
② right side brain- left side paralysis
*problem ofspatial(sense of space) or
perceptual(sense of awarness)
*personality change - impulsive(No control),
become radical(angry)
Post stroke care
Maintain ability that remains
Prevent complications from lack of mobility(lack of moving)
-① pneumonia 폐렴 : can’t breath good > increase HOB
-② blood clots > redness: tell nurse ASAP
-③ decubitus 욕창 - pressure sore
> q2h repositioning > using pillow
-④ contractures : ROM
Regain functional abilities
- therapy to regain skills
③ aneurysm; what is this?
동맥류
Weakened area in an artery wall
It is risk of rupture. Then what is rupture?
It is break down
Why rupture is the risk?
It can lead to internal bleeding or hemorrhage
Symptom of aneurysm
No symptoms at all > suddenly die
→ Surgery complications
④ ABI ( acquired brain injury ): what is it?
Disease, medical condition, accident or violence cause damage of brain tissue
Mostly caused by car accident
Only some are by a lack of oxygen
Sign of ABI
Severe neck pain, nausea메스꺼움, vomit
⑤ Parkinson’s disease - what is it?
Slow, progressive disorder
No cure
The brain part of controlling muscle movement affected
Age of the Parkinson’s disease
Over the 50
Sign of Parkinson’s disease
① tremors(shaking)
② rigid, stiff muscles in arms, legs, neck, trunk
③ slow movement
④ stooped posture
⑤ imbalance
⑥ mask-like expression
Treatment of Parkinson’s disease
① drug - treat & control
② exercise & physi therapy
③ speech & swallowing therapy
• help eating& self care
• normal elimination (destruction) is a goal
• prevent falls & injury
⑥ Huntington’s Disease: what is it?
Destroys brain cells
It is inherited neurological disorder
Cause of Huntington’s disease
Uncontrolling movement, emotional disturbances, cognitive losses
Symptom of Huntington’s disease
Begin with twitching(vibration of eye muscle), fidgeting( continuous small movement 꼼지락대는), clumsiness( 서툰)
Difficulty eating, swallowing, ADL
What age is mostly affected by Hontington’s disease?
Between 20 - 60
No cure
⑥MS (multiple sclerosis): what is it?
Multiple arteries is chronic disease
The myelin sheath in brain & spinal cord neuron is destroyed > impulses can not sent to brain
Sign of symptoms of MS (multiple sclerosis)
① tremors(shaking)
② Dizziness
③ bad concentration, attention, memory, judgment
④ depression
⑤ bowel & bladder problems
⑥bad sexual function
⑦ hearing loss
⑧ fatigue (exhausted)
⑨poor coordination & clumsiness(서툰)
Depend on damage
•Vision problems
•Muscle weakness in the arms and legs
•Balance problems that affect standing and walking
•Tingling, prickling, or numb sensations
•Partial or complete paralysis
•Pain
•Speech problems
Which age & gender affected by multiple sclerosis?
Female(20-40 age)/ No cure
Is it also affected by family history?
Yes, risk increases
⑦ ALS ( amyotrophic lateral sclerosis ):what is it?
It attacks nerve cells of control volutory muscles( face muscle)
Motor nerve cells in the brain, brainstem, spinal cord are affected
It it is rapidly progressive and fatal (die), what is it called?
Lou Gehrig’s disease
Symptoms of amyotrophic lateral sclerosis
① Brain became automatic ( involuntary) > can’t control
② not affect emotion (mind), intelligence (memory)
③ not affect to 5 sensory
Amyotrophic lateral sclerosis’s treatment
No cure
Drug can make slow down
Keep active
Which age & gender affected relatively more by ALS?
Male ( 40-60 age)
⑧ spinal cord injuries: is it permanent damage?
Yes, the higher position of spinal cord damage, the more function lost
Common cause of the spinal cord injuries
① stab or gunshot wounds
② motor vehicle crashed
③ falls
@ sports injury
Is the spinal cord injury common in old group?
No, Young adult men have the highest risk
Paraplegia VS tetraplegia
Paraplegia - lumbar(leg)/ thoracic(below chest) injuries
Tetraplegía- cervical injuries( under neck lose sense)
Rehabilitation of spinal cord injuries
① Learn body function
② Learn using self-helf, devicesJ
Patient with spinal cord injuries can be back home?
Some of them return home
Others need to long-term or home care with assistive living setting
Speech & language disorder
① aphasia
Loss of speech & language skill
Causes of aphasia
CVA
Head injury
Brain infections
Cancer
3 types of aphasia
① receptive aphasia: difficulty listening & reading )
② expressive aphasia: difficulty speaking & writing
③ both of aphasia_ worst: difficulty speaking & understanding language
Receptive aphasia
- Client can’t understand own word
- speech mixup or muddle
- client can’t aware of their mistakes
> using gesture & represent them what they will going to do by your action
Expressive aphasia
Can understand spoken & written words
Speech is difficult to understand
Think one but say another
Very aware of making mistakes > patient canbe embarrassed. > it could be lead them to frustration or depression
How to deal with expressive aphasia
① be polite
② Keep time until they say
Expressive- receptive aphasia
Global aphasia
Say “yes” or “No”
Use body language _ thumbs up/ shake head
Apraxia
Asia: The muscles use for speech
Can’t use the speech muscles
Is the patient with apraxia has cognitive problem?
No, it’s just that muscle is not working
Client understand speech & know what other say
Just the brain can’t coordinate the speech mused
What is the speech muscle?
Jaw, lip. Tongue movements
Causes of apraxia
Damage to motor speech area in brain
• speech is usually slow
• inconsistent speech
• difficult to put words in the right order
Dysarthria
It’s difficulty of speaking clearly
Because speaking muscles are weakness or paralysis
Causes of dysarthria
Cerebral palsy(중풍)
Multiple sclerosis
Head injury
Tumor
Infection
Emotional effect of speech & language disorder
Avoiding social situation
Avoiding friends & family
Extreme stress
Loss of employment
Difficulties doing routine tasks
Treatment of speech disorders
① meet a speech therapist
② remember the goal- “improving ability to communicates
Improvement for speech disorders
① depends on Brain damage
② age & health
③willingness & ability to learn
SLP role
① improve language skill
② Use remaining abilities
③ Restore language abilities to the best extent possible
④ learn other methods of communicating
⑤ strengthen speech muscles
Communication aids
① communication board - what’s in there?
Picture or words to show function or task(can pointing)
Related activities of daily living
Communication aids
②mechanical & electronic devices
Aren’t torches the picture
Voice message or printed message on the screen
Communication aids
③ using Computer
Using electronic devices
- can speak
- can type
- identify symbols
-Speech synthesizer
Guideline for handling speech disorder patients
① check & follow care plan
② communication method use
③ Care your facial muscle
④ be aware of the fatigue sign
⑤ try to include client
