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94 Cards in this Set
- Front
- Back
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Aura
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Peculiar sensation that proceeds a set of symptoms.
ex: seizure or Migraine headache |
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Contralateral
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Opposite side
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Decorticate
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Abnormal posturing - flexing of upper extremities with extension of lower limbs, accompanied by elevated pressure on frontal lobe
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Encephalitis
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Inflammation of brain tissue
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Hemiparesis
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Weakness on one side of the body
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Hemiplegia
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Paralysis on one side of the body
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Intracranial Pressure
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Pressure within the cranium or skull
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Ipsalateral
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both sides of the body
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Neuralgia
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Nerve pain
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Aura
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Peculiar sensation that proceeds a set of symptoms.
ex: seizure or Migraine headache |
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Contralateral
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Opposite side
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Decerebrate
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Abnormal extension of the upper extremities with extension of the lower extremities accompanies increased pressure on the entire cerebrum, the motor tract and the brain stem
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Decorticate
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Abnormal posturing - flexing of upper extremities with extension of lower limbs, accompanied by elevated pressure on frontal lobe
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Encephalitis
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Inflammation of brain tissue
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Hemiparesis
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Weakness on one side of the body
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Hemiplegia
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Paralysis on one side of the body
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Intracranial Pressure
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Pressure within the cranium or skull
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Ipsalateral
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same side of the body
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Neuralgia
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Nerve pain
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Neurotransmitters
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Biochemical messengers at nerve endings that activate receptors to stimulate or inhibit a response
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Parathesia
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abnormal sensation
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Postical
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after a seizure
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Seizure
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Convulsions, series of involuntary contractions of voluntary muscles
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Neuron
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Main cell body
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Axons
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Conduct impulses away from the cell body
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Dendrites
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Conduct impulses toward the cell body
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Common neurotransmitters
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Acetycholine, Norepinephrine, epinephrine, dopamine
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CNS
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Consist of brain and spinal cord
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Peripheral nervous system
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All nerves including spinal and cranial nerves
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Sympathetic nervous system
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Fight or flight response
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Parasympathetic nervous system
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Returns body to resting state
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Brain stem and Diencephalon
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Controls awareness and alertness through reticular activating system. composed of fibers scattered through the mid-brain,pons and medulla
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Medulla
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Links upper brain centers to other body parts through the spinal cord. Controls respiration, heart beat( partially) constricts blood vessels to raise the blood pressure
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Pons
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Relays messages from medulla to upper brain center, reflex center for some cranial nerves
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Cerebellum
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coordinates movement, balance, posture and spatial orientation
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hypothalamus
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controls pituitary, appetite, sleep and some emotions
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Cerebrum ( forebrain)
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Controls higher function and activity ( conscious mental processes, sensations, emotions and voluntary movement
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Frontal Lobe
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Voluntary muscle movement, verbal and written speech
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Parietal Lobe
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sensory reception areas, interprets pain, touch, temp, distances, size and shape
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Temporal Lobe
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auditory center for hearing and understanding spoken language, controls olfactory center
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Occipital Lobe
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visual center for seeing and reading
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Neurological age related changes
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decrease in # of nerve cells, Brain weight is reduced, Ventricles increase in size, Lipofuscin (age related pigment) deposited in nerve cells, amyloid ( a protein) is deposited in nerve cells, plaques and tangled fibers increased, Pupil size is smaller, eye tracking movements may be jerky, Achilles tendon jerk reflex is often absent, reaction time increases, tremors of hands, face and head are common
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Migraine headaches
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Thought to be caused by intracranial vasoconstriction followed by vasodilation . Patients may experience depression, irritablility, vision disturbances, nausea, and parathesias before onset of pain. Pain is usually unilateral, often begins in temple or eye area, is often intense, Tearing, nausea and vomiting may occur and patient may be hypersensitive to light and sound.
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Cluster Headaches
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Occur in series of episodes followed by a long period with no symptoms. Intensely painful seem to be related to stress and anxiety
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Tension Headaches
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Result from prolonged muscle contraction associated with anxiety, stress or external stimuli (brain tumor, abcessed tooth. Location of pain may vary, patient may have nausea and vomiting, dizziness, tinnitus, or tearing
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Partial Seizures
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abnormal electrical activity may be generated in localized areas of brain
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Simple Seizures
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Occurs in part of 1 central hemisphere - consciousness not impaired. May include motor, somatosensory, autonomic or psychic symptoms
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Focal motor seizures
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abnormal brain activity remains localized to a specific motor area, May or may not occur with "Jacksonian March"
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Jacksonian March
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Term for when an abnormal activity in one area "marches" (spreads) to adjacent areas
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Complex Seizure
Pyschomotor or temporal lobe seizures. |
Consciousness impaired - patient may exhibit bizarre, repetitive behaviors
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Partial Seizure
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can progress to involve entire brain = partial seizures with secondary generalization
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Generalized Seizures
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Involves entire brain from onset.
Consciousness is lost |
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Tonic -Clonic Seizure
(Grand Mal seizure) |
tonic phase - Stiffening of muscles of extremities with loss of consciousness
Clonic phase - rhythmic movement of extremities occurs |
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Absence Seizure
( petit mal) |
Brief period of loss of consciousness. Patient may appear to be daydreaming, May have automatisms
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Automatisms
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Lip-smacking, and eye blinking
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Myoclonic Seizure
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brief jerking or stiffening
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Atonic Seizure
( drop attack) |
sudden loss of muscle tone causes patient to collapse
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Status ellipticus
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medical emergency, continous seizure or repeated seizures in rapid succession for 30 minutes or more depriving the brain of oxygen and glucose (can lead to permanent brain damage)
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Nursing interventions for seizures
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protect patient from injury during and after seizures.
Teach patient and family about seizure disorders and treatments |
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Concussion
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Head trauma with no visible sign of trauma, loss of consciousness for more than 5minutes
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Contusion
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More serious than concussion, causes actual bruising and bleeding of brain tissue. Can be very serious if brainstem is affected
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hematoma
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Collection of blood ( usually clotted)
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Subdural Hematoma
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Usually a result of tearing of veins that drain the blood , allows blood to accumulate in space beneath dura.
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Acute subdural hematoma
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develops within 24hrs of injury
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Subacute subdural hematoma
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develops 24hrs - 1 wk after initial injury
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Chronic Subdural hematoma
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develops weeks or months after initial injury. associated with low impact injuries causing slow, diffuse bleeding
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Epidural Hematoma
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forms in the space between inner surface of skull and outer most meningeal covering of brain. Results from arterial bleeding, secondary to laceration and tearing of meningeal arteries. Marked by -Momentary lapse of consciousness, Period of alertness, then rapid deterioration, and elevated Intracranial pressure. requires surgery to relieve pressure, remove clot, and stop bleeding
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Intracerebral hemorrhage
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results from lesions within tissue of brain, may be small or large and is accompanied by massive neurological deficits
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penetrating injuries
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result from sharp objects that penetrate the skull and brain tissue. Requires prompt surgical intervention
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Meningitis
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Inflammation of meningeal coverings of brain and spinal cord, caused by viruses and bacteria, signs and symptoms: headache, nuchal rigidity, irritablility, decrease in level of consciousness, Photophobia, hypersensitivity, seizures, Postive Kernigs sign. Positive Brudenski's sign
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Kernig's sign
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flex hip 90 degrees, then extend.
Positive result will produce pain in the hamstring |
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Brudzenski's sign
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flexion of both hips when examiner flexes patients neck
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Encephalitis
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Inflammation of brain tissue caused by viruses. symptoms are directly related to area of brain affected and include fever, nuchal rigidity, headache, confusion, delirium, agitation, and restlessness
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Gulliane Barre syndrome
( acute inflammatory polyneuropathy) |
believed to be an autoimmune response to a viral infection. Myelin sheath is destroyed. signs and symptoms in 3 phases. 1. initial symmetric muscle weakness typically begining in lower extremities,and ascending to trunk and upper extremities, may affect cranial nerves resulting in vision & hearing problems and problems chewing and lack of facial expression, respiratory muscles may also be infected 2. Patient remains unchanged but there is no further deterioration in neurological function. 3. Muscle strength returns in a proximal-distal pattern and remylinization occurs.
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4 types of Gulliane Barre syndrome
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1. ascending
2. descending 3. Miller-Fisher syndrome 4. Pure motor GBS |
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Parkinson Disease
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Progressive degenerative disorder of basal ganglia that results in eventual loss of coordination and control of involuntary motor movement. unknown cause but related to a deficiency of dopamine in the basal ganglia. Other types of Parkinson's is caused by atherosclerosis, use of phenothiazines and some toxins.
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Parkinson's disease Major Triad
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Tremors
Rigidity Bradykinesia |
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Multiple Sclerosis
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Chronic progressive degenerative disease. Thought to be autoimmune disorder. Attacks Myelin sheath around axons and disrupts conduction of nerve impulses through the CNS. can affect motor, sensory, cerebellar, and other pathways
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Multiple Sclerosis Signs and Symptoms
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vary from patient to patient.
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Types of Multiple Sclerosis
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Chronic Progressive - disease progresses steadily
Exacerbating-Remitting- marked by exacerbations and remissions Relapsing-Progressive - less stable periods with fewer remissions Stable - No active disease for at least 1 year |
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Amyotrophic Lateral Sclerosis (ALS, Lou Gerhig's disease)
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Unknown cause viruses have been suspected. Degeneration of anterior horn cells and corticospinal tracts occur.
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Signs and symptoms of Amyotrophic lateral Sclerosis
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patients have both upper and lower motor neuron symptoms.
Upper motor neuron symptoms: spascity and hyperflexia Lower motor neuron symptoms:weakness, atrophy, cramps, and muscle twitching. Some patients have dysphagia and slurred speech. Intellect and sensory perception, vision and hearing are not affected |
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Huningtons's Disease
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Inherited degenerative neurological disorder. Begins in Middle adulthood
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Huningtons's Disease signs and symptoms
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abnormal movements, emotional disturbances, and intellectual decline. symptoms progress steadily with increasing disability and death within 10 to 20 years
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Myasthenia Gravis
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Chronic progressive disease, Defect at neuromuscular junction where electrical impulses are transmitted to muscle tissue
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Myasthenia Gravis signs and symptoms
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weakness of voluntary muscle esp. muscles of chewing, swallowing and speaking. Partial improvements of strength with rest.
Dramatic improvement with anticholinergic drugs |
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Amyotrophic lateral sclerosis
Key signs and symptoms |
awkwardness of fine finger movements
dysphagia fatigue Muscle weakness of hands and feet fasciculations ( twitching) |
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Amyotrophic lateral sclerosis
Key Test Results |
Creatinine kinase level elevated
Electromyography shows impaired impulse conduction in the muscles |
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Amyotrophic lateral sclerosis
Key Treatments |
Symptomatic relief
Neuroprotective agents ( Rilutek) |
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Amyotrophic lateral sclerosis
Key Interventions |
Monitor neurological and respiratory status
Evaluate swallow and gag reflexes Monitor and record VS and I&O Devise an alternate method of communication when necessary Suction orapharynx PRN |
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Gulliane-Barre Syndrome
Key signs and treatments |
Symmetrical Muscle weakness
(ascending from legs to arms) |
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Gulliane-Barre Syndrome
Key Test results |
History of preceeding febrile illness( usually a respiratory tract infection)
CSF protein level begins to rise peaking at 4 to 6 weeks CSF- WBC count remains normal CSF Pressure - may rise above normal in severe cases |
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Gulliane-Barre Syndrome
Key Treatments |
Anticoagulents
Corticosteroids ET intubation, Tracheotomy or mechanical ventillation IV fluid therapy NG tube feedings or TPN Plasmapheresis |
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Gulliane-Barre Syndrome
Key interventions |
Watch for ascending sensory loss which precedes motor loss.
Monitor VS and LOC Monitor and treat respiratory dysfunction Maintain respiratory support Reposition Patient every 2 hrs Provide NG tube feedings as needed Inspect clients legs for signs of thrombophlebitis, apply antiembolism stockings and sequential compression devices. Encourage adequate fluid intake |
