Neurologic Dysfunction Flashcards
Neural Systems Vital to Cognitive Function
-Memory and Language system
- Info is communicated
Neural Systems Vital to Cognitive Function
-Attentional System
- Provide arousal and maintenance of attention over time
Neural Systems Vital to Cognitive Function
-Affective or emotive system
- Mediate mood, emotion, and intention
Vegetative State
- When a person loses cerebral function, the reticular system and brain stem can maintain a crude waking state
Disorders above the Tentorial Plate (Supratentorial)
- Produces changes in arousal by either diffuse or localized dysfunction
5 Categories of Neurologic function
- LOC
- Pattern of breathing
- Pupillary reaction
- Oculomotor responses
- Motor responses
LOC
- LOC is the MOST CRITICAL clinical index of nervous systen function
Post-hyperventilation Apnea
- Lower brain stem centers regulate the breathing pattern by responding only to changes in PaCo2
Cheyne-Stokes Respirations
- Abnormal pattern of ventilation with alternating periods of tachypnea and apnea
Levels Of Altered Consciousness
-Confusion
- Loss of ability to think rapidly and clearly
2. Impaired judgement and decision making
Levels Of Altered Consciousness
-Disorientation
- Beginning loss of consciousness
- Disorientation to time followed by disorientation to place and impaired memory
- Recognition of self is lost last
Levels Of Altered Consciousness
-Lethargy
- Limited spontaneous movement or speech
- easy arousal w/ normal speech or touch
- May or may not be oriented X4
Levels Of Altered Consciousness
-Obtundation
- Mild to moderate reduction in arousal.
- Limited response to environment
- Falls asleep unless stimulated verbally or tactilely
Levels Of Altered Consciousness
-Stupor
- Condition of deep sleep or unresponsiveness from which person may be aroused or caused to open eyes only by vigorous and repeated stimulation
- Response is usually withdrawing or grabbing at stimulus
Levels Of Altered Consciousness
-Coma
- No verbal response to external environment or to any stimuli such as deep pain or suctioning do not yield motor movement
Levels Of Altered Consciousness
-Light Coma
- Associated with purposeful movement on stimulation
Levels Of Altered Consciousness
Coma
- Associated with non-purposeful movement only on stimulation
Levels of Altered Consciousness
-Deep Coma
- Associated with unresponsiveness or no response to any stimulus
Oculocephalic Reflex Response
-Normal Response
- Eyes turn together to side opposite from turn of head
Oculocephalic Reflex Response
-Abnormal Response
- Eyes do not turn in conjugate manner
Oculocephalic Reflex Response
-Absent response
- Eyes move in direction of head movement
- BRAIN STEM INJURY
Oculovestibular Reflex
- Ice water is injected into the ear canal
Oculovestibular Reflex
-Normal Response
- Nistagmus and conjugate eye movement
Oculovestibular Reflex
-Abnormal Response
- Non-conjugate eye movement
Oculovestibular Reflex
-Absent response
- No eye movements
Brain Death
- An isoelectric, or flat, EEG for 6-12 hrs in a person who is not hypothermic and has not ingested depressant drugs indicates brain death
- Brain is damaged so completely that it can never recover and cannot maintain the body’s internal homeostasis
Cerebral Death (Irreversible Coma)
- Death of the cerebral hemispheres exclusive of the brain stem and cerebellum
- Brain stem may continue to maintain internal homeostasis
Locked-In Syndrome
- Complete paralysis of voluntary muscles w/ the exception of eye movement
- Content of thought and level of arousal are intact
- efferent pathways are disrupted.
Normal ICP Intra-cranial Pressure
- 1 to 15 mm Hg
