Neuro Part 1 Flashcards
How does the cardiovascular system affect mobility ?
pumps oxygen through the blood to the muscles
- perfusion
What are some primary preventions for mobility issues ?
- physical activity
- healthy weight
- proper nutrition
What are some secondary preventions for mobility issues ?
- osteoporosis screening
- fall risk assessments
What is the function of the spinal cord ?
column of nerves between the brain and peripheral nervous system
What is the function of the brain stem ?
connects the brain to the spinal cord
What is the function of the brain ?
divided into 3 major parts
- the hindbrain (lower part)
- midbrain
- forebrain
What is the function of the CNS ?
the body’s master control unit
What is the function of the peripheral NS ?
body’s link to the outside world
What is the function of the autonomic nervous system ?
regulates involuntary bodily processes
- HR, RR, digestion, pupil contraction
- automatic without conscious direction
What is the function of the somatic nervous system ?
carries sensory info from sensory organs to the CNS and relays motor (movement) commands to muscles
- voluntary movements
What is the function of the Sympathetic NS ?
prepares the body for action and stress
- fight or flight
What is the function of the Parasympathetic NS ?
calms the body and helps the body to conserve energy
- rest and digest
What is the autonomic NS divided into ?
sympathetic and parasympathetic
What are the actions of the sympathetic NS ?
found in T1-L2
- dilate pupils
- dilate bronchi
- stimulates epinephrine and norepinephrine release
- inhibits peristalsis
What are the actions of the parasympathetic NS ?
found in brain stem & sacrum
- pupils constrict
- bronchi constrict
- HR decreases
- stimulates urination
- stimulate digestion
- promotes erection of genitals
What is the neurotransmitter for the Sympathetic NS ?
Epinephrine and Norepinephrine
What is the main neurotransmitter for the Parasympathetic NS ?
acetylcholine
What is the receptor for the parasympathetic NS ?
- muscarinic cholinergic receptors
- nicotinic cholinergic receptors
What is the receptors for the sympathetic NS ?
Alpha 1-2 and Beta 1-2 adrenergic receptors
Where are the adrenergic receptors found ?
blood vessels, heart, bronchiole walls, GI tract, bladder, ciliary muscles of the eye
What does the alpha 1 receptor do ?
vasoconstriction
- increased BP
What does the alpha 2 receptor do ?
inhibit release of Norepinephrine
- decrease BP
What does the beta 1 receptor do ?
increase cardiac contractility and HR
What does the beta 2 receptor do ?
bronchodilation, activations of glycogenolysis
Where are the nicotinic receptors found ?
in the muscle, somatic NS
Where are the muscarinic receptors found ?
in the CNS, salivary glands, heart, eye, lungs, GI
What do the M1 (+) receptors stimulate ?
brain, stomach (memory and increase acid)
What does the M2 (-) receptors stimulate ?
heart (bradycardia)
What does the M3 (+) receptors stimulate ?
glands, smooth muscle (saliva, broncho secretions, digestive enzymes, release insulin, miosis, bronchoconstriction, bladder)
- Miosis= pupil constriction
What are cholinomimetics ?
substances that mimic acetylcholine (cholinergic) receptors
What are some cholinergic reactions ?
- salivation
- lacrimation
- urination
- diaphoresis
- GI distress
- emesis
SLUDGE
What are some anti-cholinergic reactions ?
blocks cholinergic effects
- Hot as a Hare & Red as a Beet (can’t sweat and this is a cooling process)
- Dry as a Bone
- Blind as a Bat
- Mad as a Hatter
What are the functions of Acetylcholine (ACh) ?
- muscle contraction
- plays important role in memory
- dopamine inhibits this
What are the functions of Dopamine ?
- inhibits ACh
- give for shock and heart failure
- vasoconstriction
- increased HR, and myocardial contractility
- have to have dopamine to get to Epi and Norepinephrine to get to the ACh
What is the function of Serotonin ?
linked to mood
- found primarily in the brain stem
- poorly understood
What is the function of GABA ?
- decreases action potential of neurons
- prevents hyperexcitation caused by glutamate
- inhibitory neurotransmitter to glutamate
- Alcohol and Benzo’s increase GABA
What is the function of Glutamate ?
- increases action potential of neurons
- excitatory neurotransmitter
- Cocaine, nicotine increases glutamate
- ketamine is a glutamate antagonist
What is Parkinson’s disease ?
chronic progressive neurodegenerative disease characterized by initiation and execution of movement, increased muscle tone, tremor at rest, and gait disturbances
- idiopathic (don’t know why)
What degenerates in Parkinson’s diseases ?
dopamine-producing neurons in substantia nigra in the midbrain
- decrease in dopamine but normal amount of ACh
- gets less of fight or flight reaction but the same rest and digest
What are the classic signs of Parkinson’s ?
tremors (often 1st sign), rigidity (2nd sign), bradykinesia
- can have desire to move but can’t get NS to do it
What is bradykinesia in Parkinson’s ?
- loss of autonomic movements
- stooped posture
- masked face
- drooling of saliva
- shuffling gait
What are some onset symptoms of Parkinson’s ?
- symptoms of unilateral (arms won’t swing at the same time)
- mild tremor
- slight limp or decreased arm swing
What are some later symptoms of Parkinson’s ?
- shuffling
- propulsive gait with arms flexed and loss of postural reflexes
- face stays in the same expression
What are some non-motor signs of Parkinson’s ?
- depression
- anxiety
- apathy
- fatigue
- pain
- constipation
- short term memory impairment
- sleep disturbances
What is Dyskinesia ?
difficulty performing voluntary movements
What is Akinesia ?
loss of normal motor function
What do Antiparkinson’s drugs do ?
- increase dopamine levels
- stimulate dopamine sites
- extend the action of dopamine in the brain
- prevent the activation of cholinergic receptors
- Needs to increase dopamine levels/last longer in brain or inhibit cholinergic receptors
What is the goal of Parkinson’s medications ?
restore the balance between dopamine and Acetylcholine
What is the main problem with Levodopa ?
- only about 1% of the drug is converted into dopamine
- needs VERY HIGH doses to achieve therapeutic effect (lots of side effects)
Which receptors do anticholinergics block ?
muscarinic receptors
What are muscle spasms ?
sudden, violent involuntary contraction of a muscle or group of muscles
- localized muscle injury or an imbalance in electrolytes
- short term contractions that will eventually relax
What are spasticity ?
certain muscles are continuously contracted
- causes stiffness or tightness of the muscles
- associated with spinal cord injury
- long term contractions that will never relax
What is cerebral palsy ?
lack of oxygen to the brain causing permanent issues with muscle contraction that occurred in the developing fetal or infant brain
- spasticity
- damage doesn’t get worse but it doesn’t get better
What are Seizures ?
abnormal, sudden, excessive, uncontrolled electrical discharge of neurons within the brain
- imbalance of glutamine or imbalance of electrolytes
What is Epilepsy ?
condition in which a person has spontaneously recurring seizures, a brain disorder
- seizures that happen across their lifespan
- episodes but have breaks in between seizures
What is Status Epilepticus ?
state of continuous seizure activity
- seizures greater then 10 mins
- emergency situation that can cause death
- no stopping/breaks in between seizures
Why are infants more at risk for seizures ?
within their first year
- preemie babies are more at risk for imbalances because they’re small which puts them at risk
What can cause acute symptomatic epilepsy ?
had trauma or meningitis
What can cause remote symptomatic epilepsy ?
prior brain injury such as encephalitis or stroke
Why is Status Epilepticus so dangerous ?
if you can’t get brain to calm down then the brain keeps firing, and the heart will stop beating
How does a Ketogenic Diet help control seizures ?
the high fat diet induces ketone production which gets you into metabolic acidosis
- ketone bodies enhance GABA system
- helps the brain calm down
- body isn’t made to be in acidosis for long so this has side effects
- can’t have a cheat day because not being consistent can ruin years of consistency
What does a RN do when a patient is having a seizure ?
- Position: lay them on in a left lying recovery position
- Document: time, duration, and body part involved
- if longer than 5 mins then you give the pt their recovery med
- Stay: with client and assess for postictal signs following seizures
- ## have suction available and ready
How do antiepileptic drugs work ?
- increase the threshold of activity
- limit the spread of a seizure discharge from its origin
- decrease the speed of nerve impulse conduction
- decrease the rate that sodium flows into cell
- inhibit calcium flow into cell
- increase effect of GABA or increase amount of GABA
What are Tonic-Clonic Seizures ?
whole body drops to the ground and starts shaking
- has lots of brain involvement
What are Focal Seizures ?
stares into space and stops talking
- has little bit of brain involvement
Which hemispheres of the brain does partial seizures use?
involves one hemisphere
Which hemispheres of the brain does generalized seizures use ?
involves both hemispheres
- loss of consciousness
