Week 9 Neurocognition I

Question 1

Somatic Nervous System SNS

Answer 1

Controls skeletal muscle contraction

Question 2

Autonomic Nervous System ANS

Answer 2

• Provides automatic regulation
• Smooth & cardiac muscles
• Glands
• Adipose tissue

Question 3

Intracranial Pressure ICP

Answer 3

• Pressure within the cranial cavity
• Measured in mmHg
• Impacted by volume

Question 4

Cerebral Perfusion Pressure CPP

Answer 4

Pressure gradient drives oxygen to cerebral tissue

Question 5

Increased ICP

Answer 5

• Decrease in CPP
• Brain ischemia
• Drain damage
• Death

Question 6

Causes of Increased ICP

Answer 6

• Stroke
• Infection
• Trauma/aneurysms
• Hypertension
• Hypoxemia
• Tumours
• Hydrocephalus
• Seizures/epilepsy

Question 7

Increased ICP S/S

Answer 7

• Mental status changes
• Irregular breathing
• Nerve changes
• Posturing
• Weakness/decline in motor function
• Vomiting
• Headache

Question 8

Cushing’s Triad

Answer 8

• Late stage increased ICP
• Heart, lungs , BP

Question 9

Oculocephalic Reflex

Answer 9

Head rotates right, eyes move to left

Question 10

Babinski’s Reflex

Answer 10

Fanning of toes

Question 11

Decerebrate Posturing

Answer 11

• Elbow extension
• Forearm pronation
• Hand flexion

Question 12

Decorticate Posturing

Answer 12

Elbow & hand flexion

Question 13

Increased ICP Medical Interventions

Answer 13

• VP or LP shunts
• Change vent settings
• Craniectomy surgery
• Acetazolamide med
• Lumbar puncture no longer common

Question 14

Spinal Cord Injury

Answer 14

• Damage to spinal cord
• Impacts on strength, motor function, bowel/bladder, sensation, reflexes
• Temp or perm

Question 15

Spinal Cord Injury Progression

Answer 15

• Primary - initial traumatic event or insult
• Secondary - edema & hemorrhage that follow injury
• Prognosis most accurately assess 72+h post-trauma

Question 16

Complete Transection

Answer 16

Complete loss of mobility, sensation, reflexes below injury

Question 17

Incomplete/Partial Transection

Answer 17

• Some signals
• Some movement/sensation retained

Question 18

Paraplegia

Answer 18

Lower extremity

Question 19

Tetraplegia

Answer 19

All extremities

Question 20

Cervical C1-C8

Answer 20

• Tetraplegia
• C4 & above loss of diaphragm
• Bowel/bladder support

Question 21

Thoracic T1-T12

Answer 21

• Paraplegia
• Control of upper extremities & trunk

Question 22

Lumbar L1-L5

Answer 22

• Ambulation with assistance
• Hips & legs impacted

Question 23

Respiratory Impact - Spinal Cord Injruy

Answer 23

• Impaired function of accessory muscles
• Hypoventilation
• Atelectasis
• Pneumonia

Question 24

Cardiovascular Impact - Spinal Cord Injury

Answer 24

• SNS activation can be compromised
• Bradycardia
• Vasodilation
• Hypotension
• Decrease CO
• DTV

Question 25

Autonomic Dysreflexia

Answer 25

- Stimulation of sensory receptors below injury - Causes vasoconstriction & hypertension - Nerves can't respond to stimulus

Question 26

Autonomic Dysreflexia S&S

Answer 26

- Sudden BP increase - Headache - Hypertension - Bradycardia - Sweating & flushing above injury site - Piloerection - Nasal congestion

Question 27

Autonomic Dysreflexia Nurse Management

Answer 27

- 45 degrees - Administer antihypertensives (IV) - Remove stimuli

Question 28

Spinal Shock

Answer 28

- Post spinal cord injury - Areflexia motor, bowel, bladder - Loss of sensation - Paralysis - Flaccidity - Bradycardia & hypotension

Question 29

Neurogenic Shock

Answer 29

Injuries above T6

Question 30

Neurogenic Shock Causes

Answer 30

- Autonomic dysfunction - Decreased systemic vascular resistance & bradycardia - Vasodilation & venous pooling

Question 31

Neurogenic Shock S/S

Answer 31

- Fever - Perspiration above injury - Warm dry skin below injury - Hypotension - Decreased HR

Question 32

Neurogenic Shock Nursing Management

Answer 32

- Code blue - ABCs - Administer oxygen - IV access - Vasopressors - Atropine