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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
Q

Cerebellum

A

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

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26
Q

Cerebellum 3 main functions

A
  1. patial orientation & equilibrium
  2. control of antigravity muscles
  3. self correction of voluntary movements
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27
Q

CSF - protection

A

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
Q

CSF - buoyancy

A

bc the brain is immersed in fluid, pressure at the base of the brain is reduced

29
Q

CSF - excretion of waste products

A

one way flow from the CSF to the blood takes potentially harmful metabolites, drugs, and other substances away from the brain

30
Q

CSF - endocrine medium for the brain

A

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
Q

cerebral arteries

A

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
Q

vertebral arteries

A

branch from the subclavian arteries to feed the spinal cord

33
Q

Autoregulation & BP

A

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
Q

Loss of autoregulation occurs when MAP is

A

> 150
or < 50

35
Q

Division of the Nervous System

A

CNS & PNS

36
Q

Division of PNS

A

motor neurons =

SNS (somatic nervous system) controls voluntary movements

& ANS (automatic nervous system) controls involuntary responses

37
Q

Division of ANS

A

sympathetic division (fight or flight) adrenergic

and parasympathetic division (rest or digest) cholinergic

38
Q

Upper Motor Neurons (UMNs)

A

Located: primary motor cortex

relay msgs to the skeletal muscles for the arms to extend

39
Q

Lower Motor Neurons (LMNs)

A

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
Q

Pyramidal system consists of:

A

upper motor neurons and lower motor neurons

41
Q

Neuro Assessment Consists Of:

A

Pt Hx
Family Hx
Physical Exam
Mental Status
Language and Speech
Perception
Cranial Nerve Function

42
Q

Affects of Aging on Nervous System

A

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
Q

THE 12 CRANIAL NERVES

A

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
Q

Cranial nerves originating in the cerebrum

A

Smell & Vision

45
Q

Cranial nerves originating in the pons

A

cranial nerves 5 - 8

46
Q

How to remember if cranial nerve function is SENSORY, MOTOR, or BOTH

A

Some
Say
Marry
Money
But
My
Brother
Says
Brilliant
Brains
Matter
More

47
Q

CN I ASSESSMENT

A

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
Q

CN II ASSESSMENT

A

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
Q

CN III, IV, VI ASSESSMENT

A

NORMAL: III = oculomotor
IV= trochlear
VI= abducens

ABNORMAL: bad accommodation, ptosis, nystagmus (invol mvmt of the eyes)

50
Q

NYSTAGMUS

A

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
Q

CN V ASSESSMENT

A

NORMAL: trigeminal
opthalmic, maxillary, mandibular

ABNORMAL: corneal reflex (touch cornea w/ wisp of cotton), chewing, sensation

52
Q

CN VII ASSESSMENT

A

NORMAL: facial nerve

ABNORMAL: muscles of facial expression

53
Q

CN VIII ASSESSMENT

A

NORMAL: vestibulocochlear, acoustic nerve, proprioception

ABNORMAL: hearing difficulty (weber, rinne)
dizziness, vertigo (romberg’s test)

54
Q

Oculocephalic Reflex

A

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
Q

Determination of brain death:

A

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
Q

CN IX & V ASSESSMENT

A

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
Q

CN XI ASSESSMENT

A

NORMAL: spinal accessory nerve

innervates the trapezius and sternocleidomastoid muscles

ABNORMAL: inability to turn head or shrug shoulders

58
Q

CN XII ASSESSMENT

A

NORMAL: hypoglossal
innervates tongue

ABNORMAL: mid-line deviation

59
Q

SPEECH - assessment abnormalities

A

aphasia (loss of ability to understand/express speech) , dysphagia, dysarthria (diff. speaking)

60
Q

EYES - assessment abnormalities

A

anisocoria (unequal pupil size), diplopia (double vision), homonymous hemianopsia (vision loss on same side for both eyes)

61
Q

CN - assessment abnormalities

A

dysphagia, ophthalmoplegia, papilledema (swelling of optic nerve)

62
Q

MOTOR SYSTEM - assessment abnormalities

A

apraxia (impaired purposeful mvmt) , ataxia (loss of bodily mvmt), dyskinesia (impairment of vol. mvmt), hemiplegia (paralysis of one side), nystagmus

63
Q

Diagnostic Tests

A
  1. lumbar puncture
  2. cerebral angiography
  3. CT scan
  4. EEG

RN Responsibilities:
-contraindications
-pre procedure preparation
-post procedure monitoring

64
Q

CSF Analysis

A

provides info about CNS diseases.

Normal CSF: clear, colorless, odorless, free of RBCs and contains little protein

65
Q

Lumbar Puncture

A

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
Q

CT Scan

A

N-Acetylcysteine prevents renal induced contrast nephropathy (RICN)

Med Surg Exam 8 (3 decks)

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