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39 Cards in this Set

  • Front
  • Back
Major Divisions of the Nervous System
Central Nervous System

Peripheral Nervous System
Central Nervous System
brain and spinal cord
Peripheral Nervous System
=12 cranial nerves
=31 Spinal nerves
=Autonomic nervous system
=Sympathetic & parasympathethic
Types of Neurons
Motor
Sensory
Pathways of Dendrites
Afferent pathway
Efferent pathway
CNS : Brain
Meninges
Subdural space
Subarachnoid space
Lobes of the brain
Frontal
Parietal
Temporal
Occipital
Limbic
Brain stem function
Medulla
Pons
Midbrain
Spinal Cord
Ascending Tracts
Descending Tracts
Sensory changes associated with aging
Decrease pupil size
Decrease touch sensation
Motor changes associated with aging
Slower movement
Slowed sympathetic NS associated with aging
HR less stimulated during stress

lower fever response to infection
Sleep pattern changes associated with aging
~ age 40 (more time awake).

Stage of deep sleep is 50% of that at age 20.
Decreased cranial nerve functions
associated with aging
=Less acute smell, taste, vision, hearing
=Pupils smaller and less reactive to light
=Slight ptosis
=Poor convergence; limited up and down gaze
=Arcus sinilis (opaque white ring around cornea)
Assessment - Health History
=Patient history
=Family history
=Presenting complaint -neuro event or 6 cardinal neuro sx
=Complete Physical Assessment
neuro events or 6 cardinal neuro sx
Headache
Dizziness and Vertigo
Weakness and paresthesia
Pain
Systems Neuro Assessment - Physical Exam
Mental Status
Memory
Attention
Language and Speech
Dysarthria
Cognition
Perception
Cranial Nerves
Motor Status
Glasgow Coma Scale
Mental Status Assessment
Alertness
Orientation
LOC
Language and Speech Assessment
Aphasia - ie expressive, receptive, global
Dysarthria
Cognition Assessment
- general knowledge, abstraction & judgement
Perception Assessment
Sensory status

Pain, temperature, touch

Motion and position
Motor Status Assessment
Gait and stance
Muscle tone
Coordination
Involuntary Movements
Reflexes
Glasgow Coma Scale Assessment
Highest possible score 15
Low possible score 3
Diagnostic Studies
Plain Xrays
Laboratory Assessment
Cerebral angiogram
CT Scan
Analysis of CSF
Magnetic resonance imaging (MRI)
Positive emission tomography (PET scan)
Cerebral flood flow (CBF)
Plain Xrays
X-rays of skull and vertebrae
Laboratory Assessment
Blood cultures
CMP, CBC
Serology
ABG
Drug levels
Drug screen
Cerebral angiogram
(contrast medium)
Visualizes the cerebral circulation
CT Scan
Non-invasive, cross-section view
Dense areas = white; air = black; brain in varying shades of gray
Uses of a CT Scan
Info re: hemorrhage, edema, compression, shift/herniation of brain/spinal cord tissue
Tumors, abscess, emboli
Degenerative disorders
Nursing management for a CT Scan
Sedation if restless or claustrophobic
Consent if contrast used (see Chart 44-5)
Sedation if restless or claustrophobic
Consent if contrast used (see Chart 44-5)
Magnetic resonance imaging (MRI)
Can detect soft tissue lesions
Positive emission tomography (PET scan)
Glucose & oxygen utilization and blood flow
Cerebral flood flow (CBF)
Used to evaluate cerebral vasospasms
Analysis of CSF
AKA Lumbar puncture, LP, spinal tap
Subarachnoid space (L4 – 5)
Purposes of testing CSF
Analyze specimen
Measure CSF pressure / reduce ICP
Inject contrast medium
Administer anesthetic
CSF Procedure
=Side-lying, fetal position / sitting, edge of bed
=Needle inserted with obturator
=CSF drips from hub when needle removed
=3 test tubes to examine fluid – PRO, glucose, blood cells, culture
Nursing Implications for CSF Procedure
=Requires consent
=Empties bladder /bowel before
=Keep maximally flexed; remain still during
=Feels administration of local anesthesia; pressure from spinal needle
=Support client – hand on shoulder & knees
=Provide information during procedure
Nursing Implications – Post procedure for CSF Procedure
=Specimen to lab immediately – cells deteriorate
=Bedrest usually 6 – 24 hours post procedure
=Increase fluid intake if not contraindicated
=Assess V/S, site for bleeding & leakage, leg movement, nuchal rigidity, muscle spasm in lower back/thigh, headache, ability to void
Neurological Disorders
Seizures
Degenerative Diseases
Polyneuritis
Peripheral Nerve Trauma