Nervous system Flashcards
Brain
controls
generates
CNS
controls center of nervous system-
generates thoughts, emotions and speech
Hemispheres-
what kinds/lobes
each hemisphere
ie
CNS
Left & Right & 4 lobes-
each hemisphere receives sensory and motor impulse from opposite side of body
(Ie right hemisphere receivers impulse from left side of body
Left hemisphere controls what
CNS
Left side controls language
Right hemisphere controls what
CNS
non verbal perceptual function
Brainstem consists of:
CNS
midbrain
pons
medulla oblongata
Midbrain function
CNS
center for auditory and visual reflexes
Pons function
CNS
controls respirations
Medulla oblongata-
important role in
CNS
important role in cardiac rate, blood pressure, respirations and swallowing
CSF
liquid/derived from where
forms
helps
CNS
- CSF is a clear colorless liquid derived from blood plasma
, forms a cushion for brain tissue and protects the brain and spinal cord from trauma.
Helps nourish brain and remove waste products
Spinal Cord-
protected by
serves as
CNS
protected by vertebrae,
serves as center for conducting messages to and from brain
Meninges-
protective
covers
CNS
protective tissue membrane
covers the brain and spinal cord
Peripheral nervous system
links
consists. of
Links the central nervous system with rest of body
Consists of Nerves, sensory receptors, motor receptors
Spinal nerves
contain
31 pairs-
C
T
L
S
C
contain both sensory and motor fibers
31 pairs- named by locations-
cervical (8)
, thoracic (12)
lumbar (5),
sacral (5)
, coccygeal 1
Reflexes-what are they
rapid, involuntary motor responses to a stimulus
Olfactory nerve #
function
1
sense of smell
Optic nerve #
function
2
vision
Oculomotor nerve #
function
3
eyeball movement
raining of upper eyelid
contraction of pupil
proprioception
trochlear nerve #
function
4
eyeball movement
Trigeminal nerve #
function
5
sensation of upper scalp, upper eyelid, nose, nasal cavity, cornea and lacrimal galena
sensation of palate, upper teeth, check, top lip, lower eyelid
chewing
Abducens nerve #
function
6
lateral movement of eyeball
Facial nerve #
function
7
movement of facial muscles
secretions of lacrimal,, nasal, submandibual and sublingual glands
sensation of taste
acoustic nerve #
function
8
sensation of equilibrium
sensation of taste
glossopharngyleal nerve #
function
9
swallowing
gagreflex
sensation of taste
vagus nerve #
function
10
swallowing
regulation of cardiac rate
regulation of respirations
digestion
sense of taste
accessory nerve #
function
11
movement of head and neck
hypoglossal nerve #
function
12
movement of tongue for speech and swallowing
autonomic nervous system regulates what
internal environment of the body
sympathetic division
what is primary trasnmitter
prepares for what
autonomic nervous system
norepinephrine is primary neurotransmitter of sympathetic division-
prepares the body to handle harmful or stressful situations
sympathetic division
how will body present
autonomic nervous system
dilated pupils,
increased heart rate/force of heart contraction,
increased glucose release
diaphoresis
Parasympathetic Division-
what is primary trasmitter
operates when
autonomic nervous system
acetylcholine is primary transmitter,
operates during non stressful situations,
Parasympathetic Division-
what happens when stimulated
autonomic nervous system
constriction of pupils,
decreased heart rate
vasoconstriction of coronary arteries
What do diagnostic tests of nervous system used for
nurse is responsible for-(explain/ assess/ signed/ sup)
Help to support diagnosis of specific disease or injury
Nurse is responsible for :
Explaining procedure & special considerations
Assessing medications
Signed consent
Supporting patient
Diagnostic Tests of the Neurologic System
Carotid Duplex
CT Scan –used for suspected stroke or looking for blockage/ hemorrhage
EEG
Lumbar Puncture –regularly address dressing site, encourage inc of oral fluids, encourage acetaminophen for back/headaches
MRI
Myelogram
PET scan
Health Assessment Interview
consider what-
interview-questions?
what testing
Consider genetic influences-many neurologic diseases have a genetic component due to inheritance of a gene or gene mutation,
Interview- questions to ask?— ask about family history, health problems related to neurological disorders, history of disorders like- seizures, ALS,MS, Parkinson, tremors, past history of dizziness, headaches, trauma, or injury
Genetic testing, counseling if data collected indicates risk factors or alterations
Neurological Physical Assessment
Mental Status,
cranial nerve assessment,
sensory assessment,
motor function,
reflexes
Vitals,
assesses level of consciousness,
pupillary response,
strength,
sense
pain/touch
Glasgow Coma Scale
what is it
assessment of what
score of 15 is what
–objective tool used to describe extend of impaired consciousness,
Assessment of eyes open, best motor response, best verbal response
Score of 15 indicates patient is alert and oriented; highest level of functioning
Decorticate
manifestations
arms
wrists
legs
feet
you will see upper arms are close to sides,
wrists and fingers are flexed,
legs internally rotated
feet plantar flexed
Decorticate
cause
posture that occurs with lesions of cortical spinal tract
Decerebrate manifestaitons
arms
wrists
feet
arms pronated and extended,
wrists that are flexed
feet plantar flexed,
Decerebrate cause
posture that occurs with lesions/injures to brain stem-midbrain or pons
Aphasia-
defective/ absent language function
Dysphonia –
change in tone of voice
Dysarthria
–difficulty speaking
Dysphagia
–difficulty swallowing
Anosmia
– inability to smell
Nystagmus
involuntary eye movement
Ataxia
lack of coordination/ clumsiness
Flaccidity
muscle tone is decreased or absent causing extremities to drift in strokes or loss of tone d/t consequences of stroke
Spasticity
–muscle tone increased- tightening of muscles-seen in MS and cerebral palsy
Consciousness
individual is aware of self/environment and they respond appropriately
altered level of consciousness
looking at
Level of consciousness
Pupillary response
Oculomotor response
Motor response
Breathing
AEIOU
altered loc
alcohol,
epilepsy,
insulin,
opium,
uremia(high levels of urate in blood)
T-I-P-S-S
what causes altered loc
tumor,
injury,
psych,
stroke,
sepsis
Full consciousness-
Decreased LOC
alert and orientated, can comprehend
Confusion-
Decreased LOC
patients are unable to think rapidly or quickly
Disorientation-
Decreased LOC
not aware, nor orientated to time place or person,
Obtunded
Decreased LOC
- lethargic but react to stimuli and drift back to sleep
Stupor-
Decreased LOC
briefly affected by painful stimuli
Semicomtatose-
Decreased LOC
do not move spontaneously, stimuli may cause moaning, but withdrawal right away
Coma
Decreased LOC
- unarousable, make no attempt to withdrawal
Deep coma
Decreased LOC
- absence of reflexes
what is a seizure
abnormal
may result
Its an Abnormal electrical activity
may result in abrupt altered stated of function
epilepsy
partial seizure
generalized seizure
Epilepsy- seizure disorder, chronic
Partial Seizure may affect only part of brain
Generalized Seizure affects all of brain
MRI & CT-
Seizures- Diagnosis
Abnormalities in brain
EEG-
Seizures- Diagnosis
helps to localize any brain lesions and confirm diagnosis
Lumbar Puncture-
nursing considerations
assess
encourage
backpain/headahce
Seizures- Diagnosis
assess spinal fluid for CNS infections
Nursing Considerations??
assess dressing site
encourage increase of oral fluids
acetaminophen for back pain/ headache
labs
Seizures- Diagnosis
Look at
Blood count,
electrolytes,
blood urea,
glucose
Antiepileptic drugs
dont cure-rather they
limits
Seizures- Medications
- don’t cure; rather they: reduce/ control activity- it will raise the seizure threshold,
which limits the spread of abnormal activity in the brain
Goal->seizure meds
protect
reduce
allow
focus
need
protect from harm,
reduce/prevent activity-will be lethargic
, allow pt to rest,
focus on safety and positioning if another seizure,
need to lay on side
Seizures- Medications
Phenytoin
phenobarbital,
valproic acid
lamotrigine
gabapentin
Seizures- Medications
considerations:
minimum
dosing
not always
frequent
Pt will be on for minimum of three years – if Seizure free, withdrawal may be considered by reducing one drug at a time over several weeks/months
Dosing-need to take exact dose
Not always well tolerated-ca cause decreased alertness, headache, dizziness,
Frequent blood monitoring-make sure they have decreased blood levels, need to do liver function test
health promotion seizures
what care
stress importance of
vehicles
family teaching
Follow up care,
Stress importance of taking, scheduling, considering and continuing medications even if no seizure activity
Vehicles –may be prohibited and reinstated after prover has cleared them
Family teaching-first aid
positioning during episode
positioning after episode
Positioning during episode cushion- head if seizure, loosen anything tight around neck, turn head and body to side and call for assistance
Positioning after episode –let them rest, but lay on side in case of another seizure
ineffective airway clearence-seizures
what happens
what pools
pt airway interventions-clothing/ turn/ dont put/ may need
Tongue falls back, obstruct airway –Gag reflex depressed
Secretions pool
Patent airway interventions: risk for aspiration- loosen clothing, turn to side, do not put anything in mouth and may need oxygen