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NURS 1103 > UNIT 10 NERVOUS SYSTEM DYSFUNCTION > Flashcards

UNIT 10 NERVOUS SYSTEM DYSFUNCTION Flashcards

1
Q

Intracranial pressure (ICP)

A

an increase in volume of brain tissue, CSF or blood

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2
Q

ICP signs ans symptoms

A 
headache
nausea
confusion
seizures
coma
increased BP
loss of pupillary reflex
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3
Q

Causes of ICP

A

brain swelling
tumors
hydrocephalus

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4
Q

Brain swelling

A
  1. vasogenic = extracellular fluid increase

2. cyctotoxic = intracellular fluid increase (infection leading to inflammation)

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5
Q

Hydrocephalus

A

CSF increases in volume of ventricles
swelling of pons and cerebellum
may not always increase ICP -> brain tissue volume decreases and replaced by CSF (Alzheimer’s)

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6
Q

consequences of ICP

A
  • brain compression
  • compartment syndrome (cut off of blood flow)
  • brain herniation = pushed brain out of position (causes blurred/double vision)
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7
Q

How does the body compensate for ICP

A
  • CSF shunt to spinal cord
  • hyperventilation -> vasoconstriction (limits free radicals)
  • induced coma decreases metabolism and decreases injury
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8
Q

Evaluation of brain injury

A
  • neurological exam and ABC
  • CT scan
  • monitor for increased ICP (headache etc)
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9
Q

Primary TBI

A
  • concussion

- contusion

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10
Q

Contusion definition

A

injury that doesn’t disrupt skin integrity usually caused by blows to head or violent movement of skull
-loss of integrity of blood vessels

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11
Q

characteristics of contusion

A
  • swelling
  • discoloration
  • pain
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12
Q

contusion classifications

A
  • focal contusion

- polar contusion = coup and countercoup

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13
Q

Concussion definition

A

functional loss due to damaged axons

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14
Q

characteristics of concussion

A
  • microscopic damage
  • axonal injury
  • loss of memory
  • it is usually temporary
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15
Q

concussion classifications

A

grade 1 = transient confusion, no loss of consciousness, symptoms resolve in less than 15min
grade 2= transient confusion, no loss of consciousness, symptoms resolve in more than 15min
grade 3= any loss of consiousness

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16
Q

Secondary TBI causes

A
  • ischemia
  • hemorrhage
  • infection
  • increased ICP
17
Q

Hematoma/hemorrhage

A
  1. Epidural hematoma
  2. subdural hematoma
  3. subarachnoid hemorrhage
  4. intracerebral hemorrhage
18
Q

Epidural hematoma

A
  • rapid bleeding
  • between dura and the skull
  • results in coma
19
Q

Subdural hematoma

A
  • slow bleeding
  • between dura and arachnoid matter
  • caused by blunt trauma
  • non-specific symptoms caused by increased ICP
20
Q

Subarachnoid hemorrhage

A
  • between arachnoid and pia layer
  • caused by traumatic contusion of brain or rupture of berry aneurysms
  • high mortality
21
Q

Intracerebral hemorrhage

A
  • complication of head trauma
  • leads to rupture of intracerebral vessels
  • non-traumatic forms also occur (leukemia, stroke)
22
Q

Atherosclerosis

A

vessel occlusion

  • wall of artery weakens and stretches, increasing risk of rupture and hemorrhage
  • increased risk of clot formation
23
Q

Strokes

A
  • Ischemic
  • Hemorrhage
  • transient ischemic attack (TIA)
  • acute stroke
24
Q

Ischemic strokes

A
  • 88% of strokes are ischemic
    1. Thrombotic (80%) = atherosclerosis with thrombus formation
    2. embolic (20%) = caused by Afib, valvular disease
    - leads to cerebral infarcts -> global aphasia (broca and wernicke area affected), Receptive aphasia (wernicke affected), Expressive aphasia (broca affected)
25
Q

Hemorrhagic stroke

A
  • 15%
  • caused by structural abnormalities
  • aneurysms form (in circle of willis berry aneurysms)
26
Q

TIA

A
  • mini stroke
  • resolve quickly
  • no permanent loss of function
27
Q

Acute stroke

A
  • focal neurological signs

- depends on where damage is

28
Q

CNS infections

A

Meningitis:

- headache, stiff neck, fever, changes in level of consciousness, CSF high in protein and WBC and low in glucose

29
Q

Brain tumors

A
  • high mortality rate
  • malignant tumors of the brain do not metastasize
  • 50% of brain tumors are metastases from: lung cancer, breast cancer or melanoma
30
Q

clinical manifestations of brain tumors

A
  1. focal disturbances
    - dysfunction of certain areas
    - seizures, hallucinations, weakness, sensory deficits
  2. generalized disturbances
    - increased ICP
31
Q

Seizures

A

erratic firing of cortical neurons

- provoked by electrolyte imbalance, hypoglycemia, CNS infection or damage

32
Q

Epileptic syndromes

A

Partial seizures

Generalized seizures

33
Q

Partial seizures

A
  • can tell ahead of time
  • begin in one hemisphere and can spread to the other side
    1st stage = Aura
    2nd stage = Ictus
    3rd stage = post-ictus
34
Q

Generalized seizures

A
  • both hemispheres

- consciousness is lost at onset

35
Q

functional forms of seizures

A

ABSENCE = disturbance in consciousness
ATONIC = loss of muscle tone
MYOCLONIC = long muscle contractions
TONIC-CLONIC = shorter muscle contractions and loss of consciousness
GENERALIZED CONVULSIVE = continue without recovery between seizures

36
Q

Alzheimers Disease characteristics

A
  • dementia
  • cerebral atrophy
  • neurofibrillary tangles
  • amyloid plaques
  • decreased Ach production
37
Q

Alzheimer stages

A
  1. short term memory loss
  2. confusion
  3. incontinence, cant recognize family/friends

NURS 1103 (9 decks)

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