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Med Surg Exam 8 > NEURO > Flashcards

NEURO Flashcards

1
Q

Dendrites

A

receive stimulation from other nerves

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2
Q

Cell body

A

(cont. nucleus) makes & delivers neurotransmitters to the axon

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3
Q

Axon

A

a nerve fiber. A bundle of axons is a nerve.

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4
Q

Myelin

A

is a lipid sheath that surrounds the axons of some nerves.
Myelin increases the velocity in which an impulse is transmitted down an axon.

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5
Q

Afferent or sensory neurons do what?

A

transmit information from the PNS to the CNS

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6
Q

Efferent or motor neurons do what?

A

carry information AWAY from the CNS

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7
Q

ACETYLCHOLINE
(major transmitter of the PNS)

A

Usually excitatory; parasympathetic effects sometimes inhibitory (stimulation of heart by vagal nerve)

Source: brain, ANS

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8
Q

SEROTONIN

A

Inhibitory, helps control mood and sleep; inhibits pain pathways

Source: brain stem, hypothalamus, dorsal horn of the spinal cord

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9
Q

DOPAMINE

A

Usually inhibitory; affects behavior (attention, emotions) and fine movement

Source: neurons on the substantia nigra and basal ganglia

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10
Q

NOREPINEPHRINE
(major transmitter of the SNS)

A

Usually excitatory; affects mood and overall activity

Source: brain stem; hypothalamus postganglionic neurons of the SNS

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11
Q

GAMMA-AMINOBUTYRIC ACID

A

Inhibitory

Source: nerve terminals of the spinal cord, cerebellum, basal ganglia, some cortical areas

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12
Q

ENDORPHIN, ENKEPHALIN

A

Excitatory; pleasurable sensation, inhibits pain transmission

Source: nerve terminals in the spine, brain stem, thalamus and hypothalamus, pituitary gland

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13
Q

frontal lobe

A

controls higher cognitive function, memory retention, voluntary eye movements, voluntary motor movements, and speech in Broca’s area

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14
Q

temporal lobe

A

integrates somatic, visual, and auditory data and contains Wernicke’s speech area, memory storage

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15
Q

parietal lobe

A

interprets spatial info and contains the sensory cortex

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16
Q

occipital lobe

A

processing of sight

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17
Q

Cerebrum

A

control center of the brain
takes up 85% of brain matter is known as gray matter
responsible for all voluntary conscious movement

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18
Q

Cerebrum is the site of:

A

learning, intelligence, and judgment

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19
Q

Cerebrum ridges & grooves

A

increase the surface area of the cerebrum.
RIDGES= gyri
GROOVES= sulcus

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20
Q

LEFT hemisphere

A

written & spoken language, reasoning, number skills, scientific knowledge, right hand control

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21
Q

RIGHT hemisphere

A

insight, 3-D art forms, imagination, music, awareness, left hand control

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22
Q

Midbrain

A

the smallest portion of the brain stem and is involved in hearing and vision

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23
Q

PONS

A

means “bridge” and provides the link between the cerebral cortex and the cerebellum

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24
Q

Medulla Oblongata

A

controls involuntary breathing, BP, HR, digestion, swallowing & coughing

contains reticular activating system (RAS) and alerts the cerebral cortex (alarm clock ex)

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25
Cerebellum
located in the back of the skull and coordinates muscle movements, balance, posture, and coordination rcvs sensory impulses from the cerebral cortex, muscles, eyes, joints, and inner ear
26
Cerebellum 3 main functions
1. patial orientation & equilibrium 2. control of antigravity muscles 3. self correction of voluntary movements
27
CSF - protection
CSF protects the brain from damage by buffering the brain and separates the middle and inner meninges. Acts to cushion a blow to the head and lessen the impact
28
CSF - buoyancy
bc the brain is immersed in fluid, pressure at the base of the brain is reduced
29
CSF - excretion of waste products
one way flow from the CSF to the blood takes potentially harmful metabolites, drugs, and other substances away from the brain
30
CSF - endocrine medium for the brain
CSF serves to transport hormones to other areas of the brain. Hormones released into the CSF can be carried to remote sites of the brain where they can act
31
cerebral arteries
responsible for supplying the brain w/ oxygen- rich blood reduced blood flow in these arteries can cause cerebral ischemia, which can lead to strokes or TIAs 20% of resting CO is directed to cerebral blood flow
32
vertebral arteries
branch from the subclavian arteries to feed the spinal cord
33
Autoregulation & BP
Cerebral vessels constrict or dilate to maintain blood flow & prevent brain damage acidotic states & neuro hypoxia can lead to vasodilation elevated systemic BP & alkalosis can cause vasoconstriction
34
Loss of autoregulation occurs when MAP is
> 150 or < 50
35
Division of the Nervous System
CNS & PNS
36
Division of PNS
motor neurons = SNS (somatic nervous system) controls voluntary movements & ANS (automatic nervous system) controls involuntary responses
37
Division of ANS
sympathetic division (fight or flight) adrenergic and parasympathetic division (rest or digest) cholinergic
38
Upper Motor Neurons (UMNs)
Located: primary motor cortex relay msgs to the skeletal muscles for the arms to extend
39
Lower Motor Neurons (LMNs)
Located: anterior horn of the spinal cord which is cont. w/ the brainstem relay msgs to the skeletal muscles for the arms to flex
40
Pyramidal system consists of:
upper motor neurons and lower motor neurons
41
Neuro Assessment Consists Of:
Pt Hx Family Hx Physical Exam Mental Status Language and Speech Perception Cranial Nerve Function
42
Affects of Aging on Nervous System
CNS - loss of neurons, enlargement of ventricles, decrease in brain weight, cerebral blood flow, and CSF PNS - decrease in nerve conduction and coordinated neuromuscular activity Memory decreases Sensory/neuromuscular functions decrease
43
THE 12 CRANIAL NERVES
I olfactory II optic III oculomotor IV trochlear V trigeminal VI abducens VII facial VIII vestibulocochlear IX glossopharyngeal X vagus XI accessory XII hypoglossal
44
Cranial nerves originating in the cerebrum
Smell & Vision
45
Cranial nerves originating in the pons
cranial nerves 5 - 8
46
How to remember if cranial nerve function is SENSORY, MOTOR, or BOTH
Some Say Marry Money But My Brother Says Brilliant Brains Matter More
47
CN I ASSESSMENT
NORMAL: olfactory Affected by: chronic rhinitis, sinusitis, heavy smoking ABNORMAL: anosmia (loss of smell), hyposmia (decreased sensitivity to smell) often associated w/ complaints of a lack of taste
48
CN II ASSESSMENT
NORMAL: optic nerve, one of the first CNs to be affected by increased ICP ABNORMAL: decreased acuity (snellen chart), hemianopsia (blindness in half the field of vision)
49
CN III, IV, VI ASSESSMENT
NORMAL: III = oculomotor IV= trochlear VI= abducens ABNORMAL: bad accommodation, ptosis, nystagmus (invol mvmt of the eyes)
50
NYSTAGMUS
involuntary eye movement that an also indicate brain dysfunction at the brain stem or cerebellum Police do horizontal gaze nystagmus for field sobriety tests. Persons blood alcohol concent. can be estimated by subtracting angle of onset from 50 degrees. Ex. angle of 35 degrees would have a BAC of approx. 0.15%
51
CN V ASSESSMENT
NORMAL: trigeminal opthalmic, maxillary, mandibular ABNORMAL: corneal reflex (touch cornea w/ wisp of cotton), chewing, sensation
52
CN VII ASSESSMENT
NORMAL: facial nerve ABNORMAL: muscles of facial expression
53
CN VIII ASSESSMENT
NORMAL: vestibulocochlear, acoustic nerve, proprioception ABNORMAL: hearing difficulty (weber, rinne) dizziness, vertigo (romberg's test)
54
Oculocephalic Reflex
doll's eyes - tested only on unconscious pt and after a neck injury has been ruled out -normal = eyes move both directions -abnormal = eyes do not move, indicating brain stem dysfunction (negative dolls eyes) CN III, IV, and VI
55
Determination of brain death:
based on nonfunctioning brain stem. Use: test is contralateral when warm is applied and ipsilateral when cold is applied. Corneal reflex and gag are also used.
56
CN IX & V ASSESSMENT
NORMAL: IX= glossopharyngeal X= vagus both innervate the pharynx and muscles of the throat ABNORMAL: gag and cough reflex, aspiration, swallowing difficulties CN X ONLY = loss of parasympathetic innervation
57
CN XI ASSESSMENT
NORMAL: spinal accessory nerve innervates the trapezius and sternocleidomastoid muscles ABNORMAL: inability to turn head or shrug shoulders
58
CN XII ASSESSMENT
NORMAL: hypoglossal innervates tongue ABNORMAL: mid-line deviation
59
SPEECH - assessment abnormalities
aphasia (loss of ability to understand/express speech) , dysphagia, dysarthria (diff. speaking)
60
EYES - assessment abnormalities
anisocoria (unequal pupil size), diplopia (double vision), homonymous hemianopsia (vision loss on same side for both eyes)
61
CN - assessment abnormalities
dysphagia, ophthalmoplegia, papilledema (swelling of optic nerve)
62
MOTOR SYSTEM - assessment abnormalities
apraxia (impaired purposeful mvmt) , ataxia (loss of bodily mvmt), dyskinesia (impairment of vol. mvmt), hemiplegia (paralysis of one side), nystagmus
63
Diagnostic Tests
1. lumbar puncture 2. cerebral angiography 3. CT scan 4. EEG RN Responsibilities: -contraindications -pre procedure preparation -post procedure monitoring
64
CSF Analysis
provides info about CNS diseases. Normal CSF: clear, colorless, odorless, free of RBCs and contains little protein
65
Lumbar Puncture
CONTRAINDICATED: presence of increased ICP or infection at the site B4 PROCEDURE: pt must void. Pt is side lying, but may be seated. Inform pt sterile needle is used and passed between 1st and 2nd lumbar vertebrae. Temp pain felt radiating down the leg. POST PROCEDURE: monitor for HA intensity, meningeal irritation, s/s of local trauma (hematoma, pain)
66
CT Scan
N-Acetylcysteine prevents renal induced contrast nephropathy (RICN)

Med Surg Exam 8 (3 decks)

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