Neurological System (Exam One) Flashcards
What are the two divisions of the nervous system?
- Central Nervous System
- Peripheral Nervous System
What is included in the central nervous system?
- Brain
- Spinal cord
What is included in the peripheral nervous system?
Includes the autonomic nervous system (ANS)
What is nerve tissue comprised of?
- Neurons
- Support cells
List the six different parts of a neuron.
- Soma
- Dendrites
- Axon
- Myelin Sheath
- Nodes of Ranvier
- Synaptic Knob
What part of the neuron is considered the control center?
Soma (cell body)
What part of the neuron contains the nucleus?
Soma (cell body)
What part of the neuron receives transmissions and sends out impulses to other cells in the body?
Dendrites
What part of the neuron carries nerve signals away from the soma?
Axon
What part of the neuron encases the axon and increases and conducts speed?
Myelin sheath
What are the gaps in between the myelin sheath called?
Nodes of Ranvier
What is present at the end of axon branches?
Synaptic knob
What do synaptic knobs contain?
A neurotransmitter
What are the different types of neurons?
- Sensory
- Motor
- Interneurons
Sensory neurons are responsible for what?
- Detecting stimuli
- Sending information about the stimuli to the CNS
Motor neurons are responsible for what?
Relay messages from the brain to the body so the muscle or gland can respond to the stimulus
What do the interneurons do?
Connect the incoming sensory messages with the outgoing motor messages
What is a nerve?
Group of axons and blood vessels wrapped in connective tissue
Most nerves are _____.
Mixed
Where is the spinal cord located?
In the vertebral column
List the components of the spinal cord.
- White matter
- Gray matter
- Epidural space
- Subarachnoid space
- Central canal
- Anterior horn
- Posterior horn
List the vertebral column or spinal nerves.
- Cervical
- Thoracic
- Lumbar
- Sacral
- Coccygeal
How many cervical nerves are there?
8
How many thoracic nerves are there?
12
How many lumbar nerves are there?
5
How many sacral nerves are there?
5
How many coccygeal nerves are there?
1
Are reflexes voluntary or involuntary movements?
Involuntary movements
What is the largest portion of the brain?
Cerebrum
What is the second largest portion of the brain?
Cerebellum
What does the brainstem consist of?
- Midbrain
- Pons
- Medulla oblongata
What are meninges?
Three layers of connective tissue that cover the central nervous system
What is the function of the cerebral spinal fluid?
- Permits exchange of waste and nutrients between blood and neurons
- Shock absorber
What is the primary reflex center?
Midbrain
What is the primary respiratory center?
Pons
The medulla is responsible for what? Give examples.
-Responsible for vital life functions
- Heart rate
- Blood pressure
The cerebellum is responsible for what?
- Coordination
- Posture
- Balance
What does the hypothalamus control?
Thermoregulation or body temperature
The anterior hypothalamus controls heat _____. Give examples of how this mechanism is carried out within the body.
Heat loss
- Sweating
- Vasodilation
The posterior hypothalamus controls heat _____. Give examples of how this mechanism is carried out within the body.
Heat production
- Vasoconstriction
- Muscle contraction and shivering
List the four different lobes of the brain.
- Frontal lobe
- Temporal lobe
- Occipital lobe
- Parietal lobe
What is the name of cranial nerve I?
Olfactory
What is the name of cranial nerve II?
Optic
What is the name of cranial nerve III?
Oculomotor
What is the name of cranial nerve IV?
Trochlear
What is the name of cranial nerve V?
Trigeminal
What is the name of cranial nerve VI?
Abducens
What is the name of cranial nerve VII?
Facial
What is the name of cranial nerve VIII?
Vestibulocochlear
What is the name of cranial nerve IX?
Glossopharyngeal
What is the name of cranial nerve X?
Vagus
What is the name of cranial nerve XI?
Accessory
What is the name of cranial nerve XII?
Hypoglossal
What are the two divisions of the autonomic nervous system (ANS)?
- Sympathetic Nervous System
- Parasympathetic Nervous System
The sympathetic nervous system is also known as what?
Fight-or-flight
The parasympathetic nervous system is also known as what?
Rest-or-digest
What neurotransmitters are in the sympathetic nervous system?
- Acetylcholine
- Norepinephrine
Are extreme forgetfulness and confusion a normal part of aging?
No
Decreased blood flow to brain because of aging causes what?
- Increased syncope
- Decreased mental function
In relation to aging, the deposition of aging pigment lipofuscin in nerve cells and amyloid in blood vessels causes what?
Impairment in cognition, reasoning, judgement, and orientation
Decreased norepinephrine due to aging results in what?
Altered sleep patterns
Decreased acetylcholine and progressive loss of dendrites due to aging causes what?
Impaired short-term memory
A decrease in dopamine due to aging causes what?
- Decreased motor function
- More accidents and falls
Decreased postural stability due to aging leads to what?
More accidents and falls
Describe Babinski’s sign. List a normal and abnormal sign.
- Firmly stroking sole of foot
- Normal response is flexion of the great toe
- Abnormal if the great toe extends and the other toes fan out (patient >6 months old)
Describe Romberg’s test.
- Patient stands feet together and eyes closed
- Patient will have minimal swaying in a negative Romberg test
- A patient who sways or leans to one side has a positive Romberg test
When is Romberg’s test often utilized?
In concussion patients
Why is the Glasgow Coma Scale used?
Used to assess the patients level of consciousness
Using the Glasgow Coma scale, at what score is the patient considered comatose?
7
Using the Glasgow Coma scale, at what score is the patient considered severe?
8 and below
A Glasgow Coma scale score of 15 indicates what?
Patient is fully alert and oriented
What is decorticate posturing? What does this indicate?
- Flexion of body
- Indicates significant cerebral impairment
What is decerebrate posturing? What does this indicate?
- Extension of body
- Indicates brainstem damage
FOUR Score Coma Scale assesses patients who are in what type of state?
Comatose state
What four components are assessed during the FOUR Score Coma scale?
- Eye responses
- Motor responses
- Brainstem reflexes
- Respirations
What is anisocoria?
Pupils are unequal in size
What is nystagmus? What type of nystagmus is most common?
- Involuntary eye movement
- Horizontal nystagmus
Why is B12 assessed as a neurological diagnostic test?
To rule out fatigue or tiredness
Why are hormone levels assessed as a neurological diagnostic test?
To identify problems in the pituitary gland or hypothalamus
Why are liver and kidney function assessed as a neurological diagnostic test?
Problems with the brainstem
A lumbar puncture is most commonly used to assess what disease?
Meningitis
What nursing management should be provided to a post-operative lumbar puncture patient?
- Maintain flat bedrest for 6 to 8 hours
- Encourage fluids
- Monitor puncture site
- Monitor movement, sensation, headache
Why should a post-operative patient be kept on flat bedrest for 6 to 8 hours following a lumbar puncture?
Prevent spinal headache
What must the nurse assess before obtaining a CT scan with contrast dye?
Assess for shellfish allergy
What must the nurse assess before obtaining an MRI?
- Presence of pacemaker
- Metal within the body
- *Absolutely NO metal can enter the machine**
What must the nurse assess before obtaining a myelogram with contrast dye?
- Assess for shellfish allergy
- Assess for history of seizures
What does an electroencephalogram (EEG) assess?
Seizure activity
What is meningitis? Is it bacterial or viral?
- Infection or inflammation of the brain and spinal cord
- Can be either bacterial or viral
Is viral or bacterial meningitis more common? Is it considered a serious disease?
- Viral meningitis (enterovirus)
- Rarely considered serious
When can brain damage occur with bacterial meningitis?
With the onset of a fever
Bacterial meningitis can kill an individual within _____ hours.
24
What are the signs and symptoms of meningitis?
- Severe headache
- Nuchal Rigidity
- Positive Kernig’s sign
- Positive Brudzinski’s sign
What is the LPN/RN’s responsibility when a lumbar puncture is performed?
Hold the patient in position
Why might codeine products be contraindicated in a patient with meningitis?
Codeine may impair neurological assessment
What precaution is in place for 24 hours after antibiotics have been administered to a patient with bacterial meningitis?
Droplet isolation
What is encephalitis? What might it cause?
- Inflammation of brain tissue
- Cause increased intracranial pressure
- Cause possible herniation of the brain
What is the most common cause of encephalitis?
Viruses
What particular virus is related to encephalitis? Who will this virus most negatively affect?
- West nile virus
- Affects infants and children
How would the fontanel look in a child who has encephalitis?
Bulging fontanel
Increased intracranial pressure results from an increase in what three components?
- Brain
- Blood
- Cerebrospinal fluid
What is a classic late sign of increased intracranial pressure?
Cushing’s Triad
What results if Cushing’s Triad is present?
- Increased systolic blood pressure
- Decreased heart rate
- Decreased respirations
What are the early signs of increased intracranial pressure?
- Decreased LOC
- Confusion
- Slurred speech
What measures prevent increased intracranial pressure?
- HOB at 30 degrees
- Avoid neck and hip flexion
- Prevent strenuous activities
- Promote rest
List examples of a primary headache.
- Migraine
- Tension
- Cluster
What is a secondary headache?
Caused by trauma, infection, or other disease
What education should be provided to a patient who has headaches or seizures?
Keep a diary with trigger, timing, symptoms
What are the two classifications of seizures?
- Partial
- Generalized