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Adults Exam 3 > Neurological System Overview > Flashcards

Neurological System Overview Flashcards

1
Q

what are the two major parts of the neurological system?

A

CNS & peripheral NS

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2
Q

what is a function of the nervous system?

A

controls the motor, sensory, autonomic, cognitive, & behavioral activity

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3
Q

what is the brain made up of?

A

neurons & spinal cord

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4
Q

list some functions of the brain (6)

A
  1. contains over 100 billion cells that monitor all of the above along w internal & external environment & helps to maintain homeostasis
  2. works very closely w the endocrine system
  3. cells link motor & sensory pathways
  4. responds to internal / external environments
  5. maintains homeostasis
  6. directs all psychological, biologic, & physical activity through complex chemical & electrical messages
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5
Q

what are neurons? what 3 things do they contain?

A

cells of the NS (primary functioning unit) contain dendrites, axon, & nerve cell bodies

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6
Q

dendrites

A

receive electrochemical messages from the previous neuron

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7
Q

axon

A

carries impulses away from cells; long part of the nerve; if damaged in anyway, the impulse will not be carried properly & the wires will short out

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8
Q

nerve cell bodies

A

ganglia; helps w transmission of messages

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9
Q

acetylcholine
- part of SNS or PNS?
- function

A

part of the parasympathetic nervous system; usually excitatory; may be inhibitory (heart vagal nerve)

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10
Q

serotonin
- SNS or PNS?
- function

A

Inhibitory; controls mood / sleep, inhibits pain (lots to do w depression)

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11
Q

dopamine
- SNS or PNS?
- function
- which type of patients lack dopamine?

A

inhibitory; affects behavior (attention, emotion) fine motor movement; parkinson’s disease patients often lack dopamine

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12
Q

norepinephrine
- SNS or PNS?
- function

A

excitatory; affects mood & overall activity; fight or flight

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13
Q

gamma-aminobutyric acid
- SNS or PNS?
- function

A

inhibitory; calms nerves down; often used in patients w seizures or neuropathy pain (gaba pentin) decreases stimulation of nerve

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14
Q

enkephalin / endorphin
- SNS or PNS?
- function

A

excitatory; pleasurable sensation; inhibits pain transmission; released a lot when exercising

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15
Q

which two neurotransmitters must have a good relationship?

A

acetylcholine & dopamine!

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16
Q

the brain accounts for approximately ____ of total body weight

A

2%

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17
Q

3 major areas of the brain & their main functions

A
  1. Cerebrum: deals w cognition, concentration, abstract thinking, motor function, speech, judgment, & personality
  2. brain stem: Center for auditory & visual reflexes; Reflex centers for respiration, BP, HR, coughing, vomiting, swallowing, & sneezing are also located in the medulla
  3. Cerebellum: integrates sensory info to provide smooth coordinated movement; Controls fine movement, balance, & position (postural) sense of proprioception (awareness of position of extremities w out looking at them)
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18
Q

corpus callosum

A

connects the two hemispheres of the cerebrum; transmits info across the two hemispheres

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19
Q

3 parts of the cerebrum & their functions

A
  1. Thalamus: relay station for senses except smell (memory, sensation, & pain impulses); relays
    messages from one area of the brain to the next
  2. Hypothalamus: relay station for all hormones
    Important in the endocrine system
    Works w the pituitary
    Temp regulation
    Hunger center / appetite control
    Sleep-wake cycle, BP, aggressive & sexual behavior, emotion responses (blushing, rage, depression, panic, & fear); Controls / regulates ANS
  3. Basal ganglia: responsible for control of fine motor movements, including those of the hands & lower extremities
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20
Q

list & describe the 4 lobes of the basal ganglia

A
  1. frontal: largest lobe; front of the brain (concentration, abstract thought, info storage / memory, & motor function) responsible for person’s affect, judgment, personality, & inhibitions

parietal: analyzes sensory info & relays the interpreted info to the cortex. Essential to person’s awareness of body position in space, size, shape, & right-let orientation

Temporal: contains the auditory receptive areas; plays role in memory of sound & understanding of language & music

Occipital: responsible for visual interpretation & memory

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21
Q

which lobe of the basal ganglia is the Broca’s speech area part of? which hemisphere of the brain is it in?

A

frontal lobe; left hemisphere

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22
Q

if a patient has a left hemispheric stroke, which side of the body will it affect?

A

right!

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23
Q

the spinal cord has ascending & descending pathways - what is the difference?

A

ascending: carries signals from the periphery to the brain
descending: carries signals from the brain to the periphery

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24
Q

list the 4 segments of the spinal cord

A
  1. cervical
  2. thoracic
  3. lumbar
  4. sacral (posterior leg, cervical vertebrae)
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25
Q

if there is a fracture in C1 or C2 area of the brain, why is this extra serious?

A

they are typically deadly!

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26
Q

how does the cranium protect the brain? how many bones does it have?

A

protects the brain from swelling when injured; has 8 bones

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27
Q

what does the vertebral column protect? how many vertebrae does it contain?

A

protects the spinal cord; has 33 vertebrae

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28
Q

what is the role of the meninges? how many layers does it have? (list & briefly describe them)

A

anchor the spinal cord & brain together
3 layers:
1. dura mater: outermost layer; tough & thick layer (epiDURAL)

  1. Arachnoid (spider webs): middle layer; cerebral spinal fluid being made & stored in the subarachnoid space & coats the surface of the brain
  2. Pia mater: innermost layer that hugs the brain
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29
Q

cerebral spinal fluid (CSF)
- what is it?
- how much is produced per day?
- important function?
- what does it contain?

A
  • clear, colorless fluid produced in the ventricles
  • produce about 500 ml per day
  • important in immune & metabolic functions in the brain
  • contains protein, glucose, & electrolytes
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30
Q

which ventricle drains CSF & where does it drain it to?

A

4th ventricle drains this fluid into the subarachnoid space on the surface of the brain & spinal cord

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31
Q

what should the CSF NOT contain?

A

RBC & minimal WBC

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32
Q

if sugar is found in nasal drainage, what does this indicate?

A

a CSF leak!

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33
Q

how do arteries & veins protect the brain?

A

provide nutrients & O2 to brain tissue (remains constant) - if not enough, there will be confusion in patients

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34
Q

what percentage of CO goes to the brain?

A

15%-20%

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35
Q

circle of willis

A

collateral circulation in the brain; if blocked, then brain tissue will die (strokes, aneurysms, & clots often occur in the bifurcation along the circle of willis)

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36
Q

how many layers do blood vessels in the brain have?

A

2

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37
Q

how many layers do arteries in the brain have? this makes arteries more susceptible to ___

A

3; rupture

38
Q

veins in the brain have no ___

A

valves

39
Q

blood brain barrier
- what is it?
- what is it formed by?
- what does it prevent?

A

protective function formed by epithelial cells of the brain’s capillaries & prevents certain drugs from crossing into the brain tissue

40
Q

what types of drugs can cross the blood brain barrier?

A

lipophilic (fat-soluble) drugs

41
Q

what types of drugs can not cross the blood brain barrier?

A

hydrophilic (water-soluble) drugs

42
Q

resting potential in spinal cord

A

nerve impulses get prepared to fire

43
Q

nerve impulses in spinal cord

A

message is carried down nerve cell

44
Q

myelin in spinal cord

A

coding that helps carry nerve impulse

45
Q

receptors in spinal cord
- where are they located?
- what is their function?

A

located on the dendrites; pick up the neurotransmitters that are in the synapse

46
Q

in the peripheral & autonomic NS, impulses are carried along ___

A

axon

47
Q

how many cranial nerves are there?

A

12

48
Q

how many pairs of spinal nerves are there?
- list them

A

31 pairs
- 8 cervical
- 12 thoracic
- 5 lumbar
- 5 sacral
- 1 coccygeal

49
Q

sympathetic NS
- function
- what is the main neurotransmitter?

A
  • “fight or flight”
  • norepinephrine is the main neurotransmitter
50
Q

parasympathetic NS
- function
- what is the main neurotransmitter?

A
  • “rest & digest”
  • acetylcholine is the main neurotransmitter
51
Q

olfactory cranial nerve
- number
- S or M?
- function

A

I ; sensory only ; olfaction (smell)

52
Q

optic cranial nerve
- number
- S or M?
- function

A

II; sensory only; vision

53
Q

oculomotor cranial nerve
- number
- S or M?
- function

A

III; sensory & motor; extraocular eye movement (PERRLA)

54
Q

trochlear cranial nerve
- number
- S or M?
- function

A

IV; sensory & motor; serves the superior oblique eye muscle (up & down eyeball movement)

55
Q

trigeminal cranial nerve
- number
- S or M?
- function

A

V; sensory & motor; sensory from face & mouth (brush cotton ball across cheek), motor to muscles of mastication (jaw movement)

56
Q

abducens cranial nerve
- number
- S or M?
- function

A

VI; sensory & motor; lateral eye movement

57
Q

facial cranial nerve
- number
- S or M?
- function

A

VII; sensory & motor; serves the muscles of facial expression (raise of eyebrows & puff out cheeks) & taste on tip of tongue

58
Q

vestibulocochlear or auditory cranial nerve
- number
- S or M?
- function

A

VIII; sensory; equilibrium & hearing (whisper test)

59
Q

Glossopharyngeal cranial nerve
- number
- S or M?
- function

A

IX; sensory & motor; gag reflex / swallowing & ability to taste on the back of tongue

60
Q

Vagus cranial nerve
- number
- S or M?
- function

A

X; sensory & motor; vibrations from pharynx (voice box) & swallowing & speaking

61
Q

Accessory cranial nerve
- number
- S or M?
- function

A

XI; sensory & motor; serves muscles that move head, neck, & shoulders

62
Q

Hypoglossal cranial nerve
- number
- S or M?
- function

A

XII; sensory & motor; positioning & moving of the tongue

63
Q

which group of meds can cause muscle weakness?

A

statins!

64
Q

which vitamins are vital to the neuro system? lack of ___ & ___ can cause seizures or muscles weakness

A

B vitamins; lack of Mg & Ca

65
Q

when examining reflexes, which type are abnormal?

A

pathologic

66
Q

list the 6 types of deep tendon reflexes

A
  1. Biceps
  2. triceps
  3. Brachioraldialis
  4. patellar
  5. achilles
  6. clonus
67
Q

clonus reflex

A

hyperactive dorsiflexion (jerking) - when tapping knee w hammer in particular spot, foot jumps up

68
Q

what are the 3 superficial reflexes (cutaneous) - can touch the skin & may withdrawal from you

A
  1. corneal
  2. gag
  3. upper / lower abdominal
69
Q

list the 4 pathologic reflexes

A
  1. Babinski’s
  2. snout
  3. suck or rooting
  4. Grasp
70
Q

Babinski’s reflex
- describe
- indicate of?

A

Abnormal is dorsiflexion of the toes (fanning) when something is rubbed against bottom of foot
indicative of upper motor neuron lesion
normal in a baby but not in an adult

71
Q

snout reflex
- describe
- indicative of?

A

pursing lips when touched; normal in a baby but not in an adult
indicative of progressive nerve degeneration

72
Q

suck or rooting reflex
- describe
- indicative of?

A

lips will be touched & patient will immediately try to suck
normal in a baby but not in an adult
indicates progressive nerve degeneration

73
Q

grasp reflex
- describe
- indicative of?

A

touching palm of hand & trying to close hand around you
indicative of progressive nerve degeneration

74
Q

CT scan
- used w or w out contrast?
- pre procedure responsibilities
- post procedure responsibilties

A
  • if patient has mental status changes or possible CVA, will use w out contrast first!
  • pre procedure responsibilities: always find out which type of stroke it is before giving a CT w contrast; assess allergies
    & kidney function
  • post procedure responsibilities: increase fluids to flush contrast out
75
Q

which procedure is usually done after a CT scan if answer was not found?

A

MRI

76
Q

MRI
- pre procedure responsibilities

A
  • Ask if pregnant, have any metal in body or a pacemaker, or work as a mechanic (checklist on sheet of paper to fill out before patient can be sent to MRI)
  • Remove any medication packages that have a foil backing on them!
77
Q

purpose of an MRA

A

visualizes the cerebral vasculature (looks at blood vessels feeding the brain)

78
Q

PET scan
- purpose

A
  • computer-based nuclear imaging; will detect if there is a decrease in blood flow due to lack of sugar in the brain or due to metabolic changes
  • can see tumors, aneurysm, or blood clots
79
Q

brain requires ___ of our body’s blood glucose to function properly

A

80%

80
Q

SPECT
- purpose

A

three-dimensional imaging technique; assesses perfusion of the brain; detects how far a stroke has extended in the brain

81
Q

Myelography
- purpose
- often done on which patients?

A

x-ray of the spinal subarachnoid space after contrast is injected into that
- Looks for any changes in the spinal cord, disk, or vertebrae
- Often done for patients who are having lots & lots of back pain

82
Q

transcranial doppler
- purpose

A

ultrasound of the brain; goes across the cranium; records blood flow velocities of intracranial arteries
- Looks for any signs of stroke, bleeding, tumors

83
Q

cerebral angiography
- purpose

A

contrast media is injected into the arteries of the brain to look for any type of clots & assess blood flow to the brain

84
Q

electroencephalogram (EEG)
- purpose
- used in which patients?
- nursing implications

A
  • purpose: assesses the electrical activity in the brain; detects seizures or if someone is brain dead
  • Used in patients that have seizures or are suspected of having seizures
  • patient will have numerous electrodes placed on their head
  • nursing implications: sleep deprivation, withhold anticonvulsants, tranquilizers, stimulants, & depressants 24-48 hours before; omit coffee, tea, cola, chocolate but MAY have a meal
85
Q

electromyography (EMG)
- purpose

A

assesses the nerve innervation to the muscle (see if the muscle is responding to the impulses sent to it by the nerves)

86
Q

nerve conduction
- purpose

A

can see if impulses are getting through the nerves

87
Q

lumbar puncture
- purpose
- nursing implications

A
  • assesses for any infection in the brain (meningitis or herpes encephalitis) that may be causing swelling; admin of medications (epidural in pregnant women)
  • nursing implications:
  • Be sure patient is lying on side curled up in fetal position
  • Make sure they lay still as this procedure goes into the epidural space to withdrawal cerebral spinal fluid
  • CSF is sent off to lab to test for glucose, red cells, white cells, & other electrolytes
    *see lumbar puncture procedure document on canvas
88
Q

list some complications of a lumbar puncture (8)

A
  1. post-lumbar H/A (place patient flat in bed; remain for 24 hours in order to hold spinal fluid)
  2. herniation of the brain
  3. abscess
  4. hematoma
  5. *meningitis
  6. difficulty voiding
  7. elevated temp
  8. backache / spasms, stiff neck
89
Q

muscle biopsy
- purpose

A

piece of muscle is taken to assess a patient’s weakness and see if it’s either the muscle or nerve causing the problem

90
Q

list some structural & physiologic changes in the geriatric population (4)

A
  1. Decrease in brain size (1,400 grams to 1,200 grams)
  2. Decreased cerebral blood flow & metabolism
  3. Visual & auditory changes (especially at night)
  4. Sleep disturbances (less stage 4 sleep)
91
Q

list some motor alterations in the geriatric population (8)

A
  1. Decreased muscle mass
  2. Decreased motor alertness = response time is slower
  3. Atrophy
  4. Loss of myelin sheath
  5. Deep tendon reflexes decline
  6. Pupils begin to change
  7. Decrease in neurons = fewer synapses resulting in decreased response time
  8. Issues w spinal column
    - Kyphosis: hump back
    - Scoliosis
92
Q

list some sensory alterations in the geriatric population (5)

A
  1. Decrease in temperature regulation & pain perception
  2. Increased risk for delirium - mental status changes are not a normal part of aging though!
  3. Depression is often misdiagnosed!
  4. Decrease in hearing, taste, & smell
  5. Decreased tactile sensation (patients can get burns on them from heating pads due to this decreased sensation)

Adults Exam 3 (2 decks)

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