Nuerological Disease Flashcards
What are the functions of the neurological system
Senses changes within the body
Interprets stimuli
Responds to changes identified in order to maintain homeostasis
What is the central nervous system made up of
What is the peripheries nervous system made up of
The brain and the spinal cord
31 pairs of spinal nerves
12 pairs of cranial nerves
Parts of the autonomic nervous system
What are the functions of nerve cells
Control and recurve transmission of impulses
Receive and transmit signals from organs to the brain
Irritability and contractibility
In the central nervous system what cells can regenerate and which can’t
The myelinated cells (white matter) can
Unmyelinated (grey matter) can’t
Describe the cerebrum
Two hemispheres
Grey matter (cortex) develops faster than white matter causing folds and rolls on itself
Folds= gyri
Deepest groves= fissures
Shallowest groves = sulci
Loves frontal
Parietal
Temporal
Occipital
What does the cerebrum deal with
Read Write Speak Calculate Reasoning Conscious coordination
What does the cerebellum do
It's a motor area Movement of skeletal muscle Equilibrium Balance Posture
What does the medulla oblongata do
Contains the respiratory centre
Cardiovascular centre controlling heart rate, force concentration, blood vessel diameter
Other centres for vomiting, coughing, sneezing
It’s located above the foramen magnum
Name the maniges
Dura matter
Arachnoid matter
Pis matter
Describe cerebral spinal fluid
Clear, colourless
Mechanical protection
Chemical protection
Circulation for exchange of nutrients and waste
80-150ml circulating
Produced and stored in 4 ventricles to circulate around the brain and spinal cord
Discribe the blood and glucose supply to the brain
Comes in through the circle of Willis at the base of the brain
Must have a constant supply of glucose as it has no reserves
Label the arteries of the head and neck in diagram
Vertebral artery Internal carotid artery External carotid artery Common carotid artery Superficial temporal artery Brachiocephalic trunk Subclavian artey
Label the arteries of the brain
Frontal lobe Optic chiasma Internal carotid artery Mammillary body Temporal lobe Pons Occipital lobe Cerebral arterial circle Basilar Vertebral artery Cerebellum
Where does the spinal cord taper
L1-L2
Into the cauda equina
Nerves leave column lower than the cord
What is the decision of spinal nerves and which do what
31 pairs 8 cervical 12 thoracic 5 lumbar 5 sacral 1 coccygeal
C3 4 5 keep diagram alive
T2-11 keep the intercostal alive
Name the medical conditions associated with neurological system
Paraplegia Tetraperliagia/quadrapliagia Hemiplegia Monoplegia Meningitis Epilepsy Stroke Parkinson Multiplesclorosis Beware of hypoxia
What is the cell structure of a nerve cell
Dendrites
Cell body
Axon
Neuclous
What are the sensory receptors
Somatic: pain touch hear and cold
Proprioceptors: originate in the joints and muscles and contribute to the maintenance of balance and posture
Special senses: sight, hearing, balance, smell and taste
What does the frontal lobe deal with
Higher centre function/ judgement/problem solving/ Broca’s area- motor speech/empathy/personality
Parietal lobe sensory perception and body position
Temporal sensory speech area, understand spoken language
Occipital-receives visual information, interprets colour shape and distance
Brain stem
Mid brain- communication of motor signals
Pons- sleep/dreaming- also relay sensory information between the cerebellum and cerebrum/ respiratory function-depth and intensity of breathing
Medulla maintains life
What is a stroke
Stroke idle a clinical syndrome consisting of readily developing clinical signs of focal and sometimes global disturbance of the cerebral function, lasting more than 24 hours or resulting in death with no other apparent cause other than vascular origin
What is a transient ischeamic attack
A stroke with signs and symptoms that resolve with 24 hours.
What happens in a ischeamic stroke
A blockage of the blood vessel due to an embolus or thrombosis causing damage to a critical area of brain tissue.
What happens in an hemoragic stroke
A blood vessel rupture within the brain which applies pressure to or bless into the surrounding brain tissue
What are the signs and symptoms of a stroke
Slow full pulse with raised BP
Flushed, warm skin
Pupils possibly unequal on the affected side, pupils may be slow to react.
Noisy breathing and snoring (stertorous), often with puffing of the cheeks.
Flaccid or paralysed muscles on one side with drooping of the mouth.
Difficult or slurred speech with dribbling from the mouth.
Possible incontinence
Possible vomiting
Cerebral irritation
Confusion due to cerebral hypoxia, agitation and aggression.
Fits induced by hypoxia
Possible loss of consciousness
Headaches
What are the risk factors for a stroke
Modifiable- diet, smoking, excess alcohol, sedentary life style (lazy), stress, CVD, diabetes, obesity,
Atrial Fibrillation
Non modifiable- age, gender, ethnicity, hereditary, previous stroke,
What is the management of a conscious stroke patient
Ensure airway open
Suction if necessary be careful not to endure bracycarida.
Position the patient carefully so as to facilitate drainage from the mouth.
Administer oxygen in accordance to latest evidence based recommendations
Encourage patient to take deeper and more regular respirations
T.l.c patients may be frightened or confused
FAST
Acquire baseline observations and basic ECG
Consider placing the patient in the semi recumbent position or best position for postural drainage.
Send pre alert to appropriate department i.e. Stroke centre.
What is the management of a unconscious stroke patient
Open airway
Aspirated if necessary
Consider o.p airway
Administer oxygen to relieve hypoxia
Consider assisting respirations if they are less than 10 per min with 100% oxygen to relieve hypoxia if required
Continually monitor vital signs for change
Position in supine or recovery position as appropriate
Smooth and rapid transport with ASHICE to appropriate department
What other conditions can mimic a stroke
Hypoglycaemia Infection Hemiplegic migraine Dementia Bell's palsy Hypoxia Acute confusional state
What needs to happen with a stroke patient
Rapid transport
Pre alert to hyper acute stroke unit, or ED
Patient requires immediate CT scan
If ischeamic and within 4.5 hours of onset thrombolysis may be provided with alteplase
What is epilepsy
A tendency to have recurrent seizures
A single seizure is not epilepsy.
Of those people who have a single seizure 20% will have no further attack.
It is not an illness in its own right but is a symptom of many different diseases with different causes, many of which are not diagnosed.
What causes seizures
Paroxysms of uncontrolled discharges of the nerve tissue of the brain.
Other than epilepsy what are other causes of confusions
Acute insult to the brain Low blood sugar Lack of oxygen Drug or alcohol withdrawal Fever in child (febrile convulsions) Stroke Eclampsia (in pregnant women) Drugs or poisons.
What are the two types of seizure
Focal involves part of the brain
Can be simple where consciousness is not impaired or complex where consciousness is impaired
These can lead to generalised seizures
Generalised involves the whole brain
What are the types of generalised seizures
Tonic-clonic- both sides of the brain are involved from onset, patient becomes rigid, falls to the ground and jerks all over with subsequent injuries common
Tonic- sudden muscle stiffening, patient becomes ridged and falls
Atonic (drop attack) loss of muscle tone and drop to the floor
Absences (petit mal) may be blank staring, fluttering eyelids
Describe the 4 stages of generalised seizures.
Aura
Sudden unconsciousness preceded by an ‘aura’ the patient experiences a subconscious warning. They may cry out as they fall.
Tonic
Brief tonic rigidity, only for a short period
Clonic
Convulsing of whole or groups of muscles
Loss of bowel or bladder control
Cyanosis due to spasmodic contraction of chest muscles affecting respiration
Severe contraction of jaw muscles, the patient may bite their tongue
Post Ictal
Consciousness returns slowly, patient remains disorientated
Heart and respiratory rates remain increased
Patient is likely to sleep.
What is status epilepticus
Uncommon but potentially life threatening condition.
Occurs when you have a seizure that lasts 30 minutes or more or you have a cluster of short seizures for 30 minutes or more with little or no recovery inbetween
What is the management for epilepsy
ABC remove dangers Protect head and limbs-do not hold down Oxygen to address hypoxia a coursing to guidelines Reduce stimulus Seek clinical guidance e.g. Paramedic Do not restrain conclusion movements or Attempt to force an OPA into the airway Consider and NPA
Management of status eplilepticus
Establish an open airway Assist ventilations if required Administer high concentration of oxygen Paramedic assistance is required Assume seizures likely to resume Smooth and rapid evacuation to hospital Alert receiving hospital ASHICE call Diazepam IV or PR by paramedic
What is febrile convulsions
Tonic-colonic conclusions not caused by epilepsy but by high temperature resulting from illness or infection
Predominantly affect children between 6 months to 6 years
Usually self-contained,stoping within 5-10 minutes
