NEURO Flashcards
CRANIAL NERVES
Cranial nerves responsible for eye movement
III - Occulomotor
IV - Tronchlear
VI - Abducens
CRANIAL NERVES
Responsible for facial movements and Anterior 2/3 of tongue
VII - Facial
CRANIAL NERVES
Responsible for hearing and taste of Posterior 1/3 of the tongue
VIII - Acoustic
CRANIAL NERVES
Responsible for Mastication
V - Trigeminal
CRANIAL NERVES
Responsible for Gag reflex and PNS activation
X - Vagus
CRANIAL NERVES
Responsible for tongue movement
XII - hypoglossal
CRANIAL NERVES
Neck and Shoulder movement
XI - Spinal Accessory
SPINAL NERVES
Number of Spinal nerves
CERVICAL - 8
THORACIC - 12
LUMBAR - 5
SACRAL - 5
COCCYGEAL - 1
SPINAL NERVES
What part of the body Cervical SN controls?
Diaphragm
Chest wall muscles
Shoulder
Upper Extremities
SPINAL NERVES
What part of the body thoracic SN controls?
Upper body
GI functions
SPINAL NERVES
What part of the body Lumbar, Sacral and coccygeal controls?
Lower body
Bowel and bladder movement
ANS
- FIGHT or FLIGHT response
- release of Norepinephrine
- Adrenergic response
Sympathetic Nervous System
ANS
SIGNS of SNS Response
- inc BP
- inc. HR
- bronchodilation
- inc. RR
- Dry mouth
- constipation
- urinary retention
ANS
- Rest and Digest
- inc in acetlycholine
- dec. in. body activity
- cholinergic response
PARASYMPATHETIC NERVOUS SYSTEM
ANS
Signs of PSNS response
- dec. HR
- dec. BP
- bronchoconstriction
- dec. RR
- inc. salivation
- diarrhea
- urinary frequency
CRANIAL NERVES
S/SX of dysfunctions in CN I?
- Anosmia
CRANIAL NERVES
S/SX of dysfunctions in CN II?
- blurring of vision/blindness
CRANIAL NERVES
S/SX of dysfunctions IN CN III, IV, VI?
- anisocoria (uneven pupils)
- nystagmus (Involuntary eye movement)
- diplopia
CRANIAL NERVES
S/SX of dysfunctions in CN V?
- Trigeminal Neurologia
- Tic Douloureux
CRANIAL NERVES
S/SX of dysfunctions in CN VII
- Bell’s Palsy
CRANIAL NERVES
S/SX of dysfunctions in CN VIII
- hearing loss
- tinnitus
- vertigo
CRANIAL NERVES
S/SX of dysfunctions in CN IX?
- Dysphagia
CRANIAL NERVES
S/SX of dysfunctions in CN X?
-Dysphagia
- inc. GI secretion
CRANIAL NERVES
S/SX of dysfunctions in CN XI?
- Unable to move
CRANIAL NERVES
S/SX of dysfunctions in CN XII?
- Tongue protrusion
- tongue deviation
Cranial Nerves
What is the longest, shortest and largest cranial nerves?
largest - abducens
smallest - tronchlear
longest - vagus
CRANIAL NERVES
Cranial nerves that are both sensory and movement nerves?
- Trigeminal
- Facial
- Glosspharyngeal
- Vagus
- Increased pressure in the skull
- compresses the brain and blood vessels
Increased Intracranial Pressure
Increased ICP
Predisposing factors of inc. ICP
- Stroke (hemorrhagic)
- Tumor
- Inflammation
- Trauma
- Cerebral Edema
- Hydrocephalus
Increased ICP
- its stated that the skull is a closed vault. An inc. in one component increases ICP.
Monro Kelle Hypothesis
Increased ICP
What is the normal ICP?
0 - 15 mmHg
Increased ICP
the hole in base of the brain that houses the medulla oblongata?
Foremen Magnum
Increased ICP
what happens in the medulla oblongata that causes respiratory arrest?
- Compression of the MO
Increased ICP
Early signs of inc. ICP
- vision changes
- severe headaches
- dec. in LOC
- Pupilary Changes
- Paresis (weakness)
Increased ICP
Late signs of inc. ICP?
- BP inc
- widen pulse pressure
- dec. RR
- CHAYNE STOKES
- Projectile vomiting
- Abn Posture
- (+) Babinski
- hemiplegia
- seizures
- coma
Increased ICP
Management
- HOB
- Evaluate neuro
- Check RR
- Avoid straining, coughing, comiting
- SAFETY
- Limit fluids
- prevent hypoxemia
Increased ICP
Med Management:
- Corticosteroids - prevent cerebral edema
- Diuretics - Mannitol and Loop
A chromic autoimmune disease that destroys the myelin sheath of the CNS
Multiple Sclerosis
MULTIPLE SCLEROSIS
What destroy the myelin sheaths?
T - cells
MULTIPLE SCLEROSIS
TRIAD signs of:
- Dysarthia
- Nystagmus
- Intension tremor
Charcot’s Triad
MULTIPLE SCLEROSIS
Sign that heat makes s/sx of MS worse
Uhtoff’s Sign
MULTIPLE SCLEROSIS
Diagnostics in MS
- CSF analysis presence of oligoclonal bands (protein) in CSF
- MRI - CONFIRMATORY
- Lhermitte’s sign
MULTIPLE SCLEROSIS
Shock like sensation from the spine to the limbs when bending neck forward
Lhermitte’s Sign
MULTIPLE SCLEROSIS
Management of MS
Palliative
- prevent Uhtoff’s sign
- Assistive devices e.g. grab bars
- side rails up
- turn pt q 4hrs; q 1hr if elderly
- assist passive ROM q2 = prevent contractures
- avoid stress
- assist and plasmapharesis = removes t cells in the plasma
MULTIPLE SCLEROSIS
Medical Management
- Corticosteroids
- Corticotropin
- Baclofen and Dactrolene Na- muscle relaxant
- Propranolol - for tremors
for Chronic MS:
- Beta interferon - AVONEX, REBIF
idiopathic disease that causes atrophy of the brain due to deficiency of somatostatin, ACH, noreepinephrine with a initial sign of PROGRESSIVE MEMORY LOSS
Alzheimer’s Disease
ALZHEIMER’S DISEASE
5 A’s
Amnesia
Anomia
(-) ACH
Agnosia
Aphasia
ALZHEIMER’S DISEASE
Diagnostics
CT SCAN - progressive brain atrophy
AUTOPSY - CONFIRMATORY after death
ALZHEIMER’S DISEASE
MEDICATION
Arisept DOC
ALZHEIMER’S DISEASE
Management
Neuro Management
priority: SAFETY
- a degenerative disease
- movement disorder
- no weakness
- slow and progressive
- common in men
Parkinson’s Disease
PARKINSON’S DISEASE
What causes for the pt diagnosed of PD experiences resting tremors, akinesia and hypertonia
Decreased in dopamine
ALZHEIMER’S DISEASE
SIGNS of PD
- Pill rolling tremors
- progressive small handwritting
- stooped posture
- nuchal rigidity
- dysphagia
- antihistamines keeps tremors down
ALZHEIMER’S DISEASE
MEDICATION MANAGEMENT:
- LEVODOPA and CARBIDOPA
- ARTANE - improves rigidity
ALZHEIMER’S DISEASE
MANAGEMENT
- NEURO MANAGEMENT
- maintain good nutrition
- safety precaution
- inc. fluid and fiber intake
ALZHEIMER’S DISEASE
NURSING CONSIDERATIONS
- DEC CHON - AM
- INC CHON - PM (induces sleep)
- meds are taken before meals - inc absorption
- inform pt discoloration of body fluids due to meds
Spinal shock
- Inflamed __
- all VS are __
- tetraplegia/quadreplegia or paraplegia
- DOC: __
- position?
- ✅catheter kasi ❌__
Spinal shock
- Inflamed SC
- all VS are ⬇️
- tetraplegia/quadreplegia
- DOC: IV steroids
- ✅flat on bed
- ✅catheter kasi ❌full bladder
Autonomic dysreflexia
- Affects only __
- happens if ___
- ano vs ang mataas at mababa
- with ___ ✅HIGH FOWLERS
- ❌____ nakaka ⬆️kasi bp
- ✅catheterize and anti ___
Autonomic dysreflexia
- Affects only C1-T6
- happens if FULL BLADDER
- HPN w throbbing headache but ⬇️HR
- Nasal congestion ✅HIGH FOWLERS
- ❌constrictive clothing nakaka ⬆️kasi bp
- ✅catheterize and anti HPN
Phenytoin (Dilantin) AE ha not SE
Agranulocytosis (⬇️WBC) —sore throat & fever— refer!
Any form of infxn is __
Report to MD
Inc ICP position unconscious and conscious
- Conscious: S. fowler head midline
- unconscious: S. fowler head on side
Parkinson’s cardinal sx TRB
TREMORS (initial sx) RIGIDITY BRADYKINESIA
GIVE THE MNGT
PILL ROLLING
Cogwheel rigidity Pitik2x shoulder
Bradykinesia
✅movt of fingers—PILL ROLLING
✅passive ROM—Cogwheel rigidity
Pitik2x shoulder
✅walker —Bradykinesia
Levodopa given 30-45 before meals avoid?
Vit B6 (antidote) or ⬇️CHON
(levodopa at carbidopa)
Sinemet
Doc of trigeminal neuralgia, bawal mag?
Tegretol anti convul
❌toothbrush ✅mouthwash
Bacteria at Virus causative agent of GBS
DOC
Campilobacter jejuni
Epstein barr virus
Erythromycin