Neurological System Flashcards
Cerebrum is responsible for…
Responsible for sensory and motor activity, thought and learning.
Cerebral cortex is responsible for…
Responsible for sensory and motor activity, thought and learning.
Diencephalon is comprised of….
Contains the thalamus and hypothalamus
Thalamus is responsible for
Relaying messages to the cortex
Hypothalamus is responsible for
Regulating sleep, stress, appetite, body temperature, fluid balance and emotions
Brain stem is comprised of…
Mid-Brain, Pons and Medulla oblongata
Mid-brain is responsible for…
Motor coordination
Function of the pons
Regulates breathing
Function of the Medulla Oblongata
Cardiac and respiratory center
Cerebellum is responsible for…
Balance and coordination
Normal CSF pressure
50-75 mm H20
Normal volume of CSF
125-150mL
Function of sensory neurons
Carry impulses to the CNS
Function of motor neurons
Carry impulses away from the CNS
Function of the sympathetic nervous system
Fight or flight –> dilates pupils, increases heart rate and rhythm, contracts blood vessels, relaxes smooth muscle of the bronchi.
Function of the parasympathetic nervous system
“Feed and breed” “rest and digest” Contracts pupils, slows heart rate and rhythm, dilates blood vessels and contracts smooth muscle of the bronchi.
Limbic system
Responsible for feelings and emotions.
Frontal lobe is responsible for
Calculations (math) and knowledge of current events.
Hippocampus
Responsible for recall of recent events
Cheyenne-Stokes respirations
Rhythmic respirations with periods of apnea. Indicates dysfunction within the cerebral hemisphere.
Neurogenic hyperventilation
Regular, rapid and deep respirations. Indicates a dysfunction in the low mid-brain or pons.
Aneustic respirations
Irregular respirations with pauses at the end of inspiration and expiration.
Decorticate posturing (flexor)
Flexing of one or both arms on the chest and possible extension of legs
Decerebrate posturing (extensor)
Stiff extension of one or both arms and possibly the legs.
Flaccid posturing
No motor response in the extremities
Babinski reflex
Dorsiflexion of the big toe and fanning of other toes caused by stroking the lateral aspect of the sole of the foot.
Glasgow Coma Scale - Motor Response
- Obeys simple request - 6 points
- Moves to painful stimuli - 5 points
- Withdraws from painful stimuli - 4 points
- Abnormal flexion - 3 points
- Abnormal extension - 2 points
- No response to pain - 1 point
Glasgow Coma Scale - Verbal Response
- Oriented - 5 points
- Confused - 4 points
- Inappropriate words - 3 points
- Incomprehensible sounds - 2 points
- No response - 1 point
Glasgow Coma Scale - Eye Opening
- Spontaneous - 4 points
- To sound - 3 points
- To pain - 2 points
- No response - 1 point
Glasgow coma scale - <8 points
Indicates a coma
Brudinski’s sign
Involuntary flexion of the hip and knee when the neck is passively flexed.
Kernig’s sign
Loss of the ability of a supine client to straighten the leg completely when flexed at the hip and knee.
Signs of increased ICP
- Altered level of consciousness
- Headache
- Abnormal respirations
- Increased BP, decreased pulse
- Increased temperature
- Pupil changes
Intervention for increased ICP
Maintain mechanical ventilation with increase PCO3 at 30-35mmHG to vasoconstrictor and reduce ICP
How to determine if leakage is CSF?
- On a white swab it appears bloody surrounded by yellow stain (circular).
- Tests positive for glucose.
Spinal shock
Complete but temporary loss of motor, sensory, reflex and autonomic function that occurs immediately in response to injury. Usually lasts <48 hours but can continue for several weeks.
Neurogenic shock
Occurs with clients in T6 or above injury right after injury. Causes severe vasodilation resulting in blood pooling in the veins resulting in hypo perfusion and impaired cellular metabolism.
Autonomic dyreflexia
Sudden onset of extremely high BP common in spinal injuries above T6.
Symptoms of autonomic dysreflexia
- Severe headache
- Severe hypertension
- Bradycardia
- Flusing
- Pale extremities
- Dilated pupils and blurred vision
Dexamethasone
Anti-inflammatory and edema reducer. May interfere with health.
Dextran
Plasma expander used to increase capillary blood flow to the spinal cord and to prevent and treat hypertension.
Dantrolene and baclofen
Used for clients with upper motor neuron injuries to control muscle spasticity.
Tonic-Clonic Seizure
Tonic phase - stiffening of muscles and loss of consciousness (10-20 seconds).
Clonic phase - Hyperventilation and jerking of the extremities (30 seconds)
Right brain damage caused by stroke results in:
- Left sided paralysis
- Spatial perception problems
- Denial or minimizing the problem
- Rapid performance, short attention span
- Impulsive, safety problems
- Impaired judgement
- Impaired time concept
Left brain damage caused by stroke results in:
- Right sided paralysis
- Aphasia (impaired speech and language)
- Slow performance, cautious
- Aware of deficits, anxiety and depression
- Impaired comprehension - language and math
Agnosia
Inability to recognize familiar objects or people
Apraxia
Loss of ability to execute skilled movements or gestures even though they have the physical ability to do these.
Hemianopsia
Blindness in half the visual field
Neglect syndrome
Client unaware of the paralyzed side
Multiple sclerosis
A chronic, progressive, degenerative disease characterized by demylenation of the neurons. This results in deterioration in communication and usually results in decrease of ability to walk.
Myasthenia Gravis
Neuromuscular disease characterized by considerable weakness and abnormal fatigue of the voluntary muscles. Usually results in respiratory failure
Signs and symptoms of myasthenia gravis
- Weakness and fatigue
- difficulty chewing and swallowing
- Dysphagia
- Ptosis
- Diplopia
- Diminished breath sounds
- Respiratory paralysis and failure
Edrophonium test
Injection performed by neurologist to diagnose myasthenia graves. Risk of VF and cardiac arrest. If injection improves symptoms it is a positive diagnosis.
Parkinson’s disease
Degenerative disease caused by a depletion of dopamine in the brain. Results in bradykinesia, akinesia and monotonous speech.
Trigeminal neuralgia
Sensory disorder which results in severe, recurrent, shape facial pain.
Bell’s Palsy
Paralysis of one side of the face caused by lower motor neuron lesion of the 7th cranial nerve. Caused by tumor, trauma, infection.
Guillain-Barre Syndrome
Acute infective neuritis of the cranial and peripheral nerves. The immune system overreacts to the infection causing rapid onset muscle weakness. Usually proceeded by a respiratory infection or gastroenteritis. Main nursing concern is difficulty breathing.
Amyotrophic Lateral Sclerosis ALS - Lou Gehrig’s Disease
Progressive degenerative disease characterized by increasing muscle weakness leading to respiratory failure. Care is treatment of symptoms, no cure.
Meningitis
Inflammation of the brain and spinal cord which can be bacterial or viral. Transmitted via droplets or direct contact. CSF is analyzed to confirm diagnosis (will be cloudy with increased levels of protein). Patient should be in respiratory isolation.
occipital lobe
Vision
frontal lobe
controls voluntary muscle activity, including speech, and an impairment can result in expressive aphasia
parietal lobe
ontains association areas for concept formation, abstraction, spatial orientation, body and object size and shape, and tactile sensation.
anosognosia
The stroke client will exhibit neglect of the affected side.
Global aphasia
a condition in which the affected person has few language skills as a result of extensive damage to the left hemisphere
stereognosis
The ability to distinguish an object by touch is called stereognosis, which is a function of the right parietal area.
Hydrocephalus
buildup of too much cerebrospinal fluid in the brain. Normally, this fluid cushions your brain. When you have too much, though, it puts harmful pressure on your brain.
