Nervous system Flashcards
Inflammation of the spinal cord or brain
- Usually caused by a virus or bacteria
Meningitis
Vision - what lobe of the brain?
Occipital
PRIORITY during seizuresss!!
MAINTAIN PATENT AIRWAY + PROTECT FROM INJURY
assessment for stroke
B-E-F-A-S-T
Balance dizziness, headaches
Eyes blurry vision, abn pupil response, hemianopsia
Face unilateral facial drooping
Arms arm/leg weakness
Speech slurred
Time
Rapid acting anticonvulsant
lorazepam
examples of traumatic brain injury
fractures, bleeds, contusion
With the client placed
supine, passive flexion of
the neck causes
involuntary flexion of the
knee and hips.
Brudzinski’s sign
Damage to the spinal cord causes permanent changes in strength, sensation, and
other body functions below the site of the injury
spinal cord injury
Memory, understanding language - what lobe of the brain?
Temporal
With the client placed supine
and the hip flexed, the knee
cannot be completely
extended due to pain.
Kernig’s sign
Glasgow coma scale
eye opening =
verbal response =
motor response =
scores of min-max?
what GCS score do we intubate?
4, 5, 6
GCS 3-15
8!!!
Impairment in comprehension or production of language
Dysphasia / Aphasia
DURING SEEIIZURE***
DONT’S
leave the client,
forced clenched teeth apart,
place anything in mouth,
restrain movements
Weakness in muscles; Also called ‘incomplete paralysis’
Paresis
some causes for neuropathy
injuries, infections, toxin exposure, diabetes
s/sx of multiple sclerosis
optic neuritis, ataxia, nystagmus, hypotonia, dysdiadochokinesia, intentional tremors, spasticity
Complete inability to perform
purposeful or skilled motor acts
Apraxia
Weakness, numbness, and pain from nerve damage
Neuropathy
■ One side of the body
■ Only the legs
■ All four extremities
Hemi
Para
Quad
Normal ICP
5-15 mmHg
Tremors
Hyperkinesia
Isolation precautions
Viral:
Bacterial:
standard
droplet
Periorbital bruising
racoon eyes
CRANIAL NERVES
On, On, On, They Traveled And Found Voldemort Guarding Very Ancient Horcruxes.
Olfactory nerve (CN I)
Optic nerve (CN II)
Occulomotor nerve (CN III)
Trochlear nerve (CN IV)
Trigeminal nerve (CN V)
Abducens nerve (CN VI)
Facial nerve (CN VII)
Vestibulocochlear nerve (CN VIII)
Glossopharyngeal nerve (CN IX)
Vagus nerve (CN X)
Accessory nerve (CN XI)
Hypoglossal nerve (CN XII)
loss of consciousness, staring off into space
absence
types of strokes
hemorrhagic
ischemic (embolic, thrombotic)
PERRLA
Pupil Equal Round and Reactive to Light and Accommodation
Increased accumulation of cerebrospinal fluid
Hydrocephalus
sudden, brief, shock-like contractions of a muscle/group of muscles in extremities
Myoclonic
HR, BP, reflexes (swallowing, vomiting) are controlled by the?
Medulla
Bradykinesia: slow
Akinesia: Absence
Hypokinesia
Tx for bacterial meningitis
Antibiotics
Connective tissue covering the CNS
Layers: outer to inner
Meninges; Dura mater, Arachnoid mater, Pia mater
GABA
calming
assessment on Myasthenia gravis
PTOSIS (drooping eyelid) + weak muscles
Inflammation of the brain tissue
- due to viral infection
Encephalitis
Autoimmune disorder
- Communication between nerves and muscles destroyed
Myasthenia gravis
top complication of GBS
Respiratory arrest
Transmits and receives electrical and chemical impulses
Neuron
Acetylcholine
Learning
_____ Meningitis is
more dangerous
compared to _______
bacterial; viral
Serotonin
calming & sleep
Inability to swallow
Aphagia
Noradrenaline
Concentration
Damage to this area affects expressive language; CAN’T SPEAK yet can understand
Broca’s area
DURING SEEIIZURE***
DO’S
stay with client,
note time, duration & characteristics of seizure
remove harmful obj,
cushion client’s head,
loosen restrictive clothing,
assist to side lying
Seizure locations***
- limited to a specific area of the brain
- involves the entire brain
- no loss of consciousness
- impaired consciousness ranging from confusion to non responsive
Partial
Generalized
Simple
Complex
assessment for bacterial meningitis
Nuchal rigidity
Kernig’s sign
Photophobia
Brudzinski’s sign
autonomic dysreflexia Tx
Sit the client up to lower their BP + antihypertensives
posturing damage to deep brain structure pons; arms & legs straight out, toes pointed downward, neck & head arched back + rigid muscles
Decerebrate
A vessel ruptures and bleeds
into the brain
hemorrhagic stroke
Bruising over the mastoid
process
battle’s sign
This causes life-threatening descending flaccid paralysis
Botulism
Histamine
immunity
diagnosis for myasthenia gravis
Tensilon test (edrophonium)
Botulinum toxin released by _____ found in ______ & _____. This contaminates _____ and never be taken by children under ____ yr old
clostridium botulinum;
soil and dust
HONEY; 1 yr old
Tx for myasthenia gravis
Palliative***
Cholinesterase inhibitors
Corticosteroids
Immunosuppressants
Poor muscle control causes clumsy, voluntary movements
Ataxia
hematoma where dura is still attached to skull w venous blood, slow onset of symptoms
surg:
Subdural hematoma; craniotomy
Pain is often described as “_____________”, numbness, or weakness in neuropathy
pins and needles
There is a lack of oxygen to the brain and that causes damage!
Stroke
top sign of autonomic dysreflexia
sudden severe hypertension
Protrusion of an organ through a natural opening in a covering, muscle, or bone
There is SO much pressure, that the brain tissue pushes through the skull
Herniation
PD Tx
Palliative**
Carbidopa-levodopa (increase dopamine in brain)
reduce symptoms
Balance - what part of the brain is responsible for?
Cerebellum
Dopamine
Pleasure
Perception, math, spelling, logic - what lobe of the brain?
Parietal
“A neurological disorder marked by sudden recurrent episodes of sensory disturbance, loss of
consciousness, or convulsions, associated with abnormal electrical activity in the brain.”
Epilepsy
Damage to this area affects receptive language; CAN’T UNDERSTAND yet can speak
Wernicke’s area
The skull is a rigid container filled with: blood, brain, and CSF. If one of those three increases, another must decrease.
Monro-kellie hypothesis
Inability to move muscles
Paralysis
Shunt that drains extra CSF
from brain to the abdomen,
where it can then be excreted
as urine
VP Shunt
Open fracture → dura is
torn
The pressure inside of the skull
Intracranial pressure
posturing damage to the midbrain; arms pulled towards center w clenched fists + rigid muscles
Decorticate
Test drainage for CSF
halo test, glucose = cerebrospinal rhinorrhea
Tx for Hemorrhagic
- Control bleeding
*if caused by an aneurysm
COILING - IR
CLIPPING - OR
- Craniotomy
- EVD
Autoimmune disorder
- CNS inflammation
- Damages and degrades the myelin sheath surrounding neurons
Multiple sclerosis
A clear, odorless liquid found in your brain and spinal cord.
Cerebrospinal fluid (CSF)
Closed fracture → dura is
intact
Long acting anticonvulsant
Phenytoin
Seizure precautions***
oxygen & suctioning equipment,
side lying position w pillow under head,
all four side rails raised,
bed in lowest position,
padded side rails
Partial inability to perform purposeful or skilled motor acts
Dyspraxia
vaccines prevention for meningitis
Hib vaccine, Meningococcal conjugate/ MenACWY vaccines
GBS cause ____ weakness and paralysis
Ascending
Blood flow to the brain is blocked by a blood clot
Ischemic stroke
Spasms
Involuntary movements
Tardive dyskinesia
Dyskinesia
abrupt loss of muscle tone for a few seconds then confusion
atonic
Adrenaline
Fight or flight
Injuries at and above T6:
- Monitor for
autonomic dysreflexia
Tx for ISCHEMIC
- Permissive hypertension perfusion to brain
- Antithrombotic
*tPA (-ase)
only done quickly within 60 minutes!!! - Percutaneous thrombectomy
surgical removal of clot
Multiple sclerosis affects:
Myasthenia gravis affects:
CNS
PNS
NEVER _____ IN A CLIENT WITH A BASILAR SKULL FRACTURE
INSERT A NG TUBE
GBS Tx
Plasmapheresis
- Filter blood and remove antibodies attacking the nerves
Immunoglobulin therapy
- Stops the antibodies that are attacking the myelin sheath
a clot that’s formed elsewhere
(usually in the heart or neck arteries), travels in the bloodstream, and clogs a blood vessel in or leading to the brain. Sudden onset!
embolic
phases of tonic and clonic spasm, immediate loss of consciousness
Tonic-clonic
Progressive nervous system disorder
- Caused by degeneration of dopamine neurons
Parkinson’s disease
hematoma where dura peeled off skull, arterial blood, quick onset of symptoms
surg:
Epidural hematoma; burrhole
Alteration in brain function caused by an external source
Traumatic brain injury
hallmark signs of basilar skull fracture
battle’s sign, racoon eyes
Tx for multiple sclerosis
Palliative***
- corticosteroids (reduce inflammation)
- plasmapheresis
Difficulty swallowing
Dysphagia
Ask about a GI bug…. ____ is responsible for many GBS cases!
Campylobacter jejuni
Thinking, planning, organizing, problem
solving, emotions, behavioral control, personality - what lobe of the brain?
Frontal
a blood clot (thrombus) in an
artery going to the brain.
thrombotic
Immune system switches to attacking the nerves and de-myelinates peripheral nerves
Guillain-Barre Syndrome
Insulates and allows quick impulses
Myelin sheath
GBS peaks in about ____ weeks
2
top assessment for PD
Tremor, rigidity, mask-like faces, stooped posture, difficulty balancing, orthostatic hypotension, hypophonia, akinesia (absent of movements)
FALL RISK !!