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54 Cards in this Set
- Front
- Back
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The central nervous system (CNS) is composed of what?
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Central nervous system (CNS)
Brain and spinal cord |
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The PNS or peripheral nervous system is composed of what?
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Peripheral nervous system (PNS)
Cranial nerves; Spinal nerves Pathways:Afferent (ascending) Efferent (descending) |
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What do sensory neurons do?
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Sensory
Transmit impulses from sensory receptors to the CNS |
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What do associational neurons do?
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Associational
Transmit impulses from neuron to neuron |
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What do motor neurons do?
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Transmit impulses from the CNS to an effector organ
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Name the 4 types of neuroglia and their functions.
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Glial cells provide support, norurishment, and protections to neurons. They make up 1/2 the brain and spinal cord mass and are 10x more numerous than neurons. They are: oligodendrocytes, astrocytes, ependymal cells, and microglia. Oliodenrocyes: produce myelin sheath of nerve fibers in the CNS (not to be confused with schwann cells which myelinate the nerve fibers in the periphery), and are found in white matter of CNS; Astrocytes: proved sturctural support to neuons and theri delicated processes form the blood-brain barrier w/endothelium of blood vessels, and play a role in synaptic transmission. They are found in ray matter. If the brain is injured astrocytes act as phagocytes for neuronal debris, but proliferation of them forms scartissue (gliosis). Ependymal cells lin brain ventricles and aid in secretion of cerebrospinal fluid. Microlia, a macrophage, are rare and found in CNS tissue. CNS tumors usually involve neuroglia, but not malignant ones because these cells are not USUALLY mitotic.
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What is the primary somatic sensory area of the brain and what are the functions involved?
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This is the postcentral gyrus. It registers body sensations like touch, pain, temperature, from the OPPOSITE SIDE of the body.
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What is the primary somatic motor area of the brain and what are the functions involved?
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It is called the precentral gyrus an dit controls intitiation of movement on THE OPPOSITE SIDE of the body.
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Cranial nerves are part of the pns or cns?
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Peripheral nervous system.
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What is the name for ascending and descending pathways?
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Afferent and Efferent respectively
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What nerves are part of the peripheral nervous system?
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Spinal nerves (but spinal cord is part of cns), cranial nerves, (but brain is part of cns)
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Explain where the following neurons send their messages: Sensory, Associational, and motor.
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Sensory: to the cns
Transmit impulses from sensory receptors to the CNS Associational Transmit impulses from neuron to neuron Motor: from cns to motor (reflex arc) Transmit impulses from the CNS to an effector organ |
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Name the parts of the cerebrum and their location and main functions.
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Frontal lobe (front) w/cortical motor areas (precentral gyrus) and Broca's area (expression of speech, parietal top to back 1/2 n 1/2 w/sensory somatic-post central gyrus and association;temporal- sides: association and auditory and Warnicke's area responsible for comprehension of speech and integrating auditory language; occipital(back lobe) is sensory visual. Thalamus: traffic cop-relays sensory and motor inputs to cortex and other parts of the cerebrum. Hypothalamus (below thalamus) Regulates endocrine and autnomic funceions like (feeding, sleeping and emotionaly and sexual responses. Limbic system (lateral to hypothalamus) influences affective (emotional) behavior and basic drives like feeding and sex.
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What is the basic function of Cerebellum?
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Coordinates voluntary movement and maintains trunk stability and equilibrium. In order to do this it receives information from the cerebral cortex, muscles, joints, and inner ear.
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What does the olfactory nerve (cranial nerve 1) innervate and how would you test this nerve?
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It is a sensory nerve in the nasal cavity. Client would smell two smells like lemon and onion and distinguish between them.
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What does the optic nerve (cranial nerve 2) innervate and how would you test this nerve?
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Innervates the retina of the eyes. A simple vision test: read a sentence on a wall or out of a book.
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What does the Oculomotor nerve (cranial nerve 3) innervate and how would you test this nerve?
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Innervates 4 muscles for eye movement and the smooth muscle of eyeball. See if they can keep head straight and move eyes from side to side and up and down.
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What does the trochlear nerve (cranial nerve iv) innervate and how would you test this nerve?
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Innvervates the superior oblique muscle of the eye. Use PERLA: Pupils Equal and Reactive to Light and Accommodation test.
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What is the name of cranial nerve V and what does it innervate?
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The trigeminal nerve innervates several areas is a split formation to the eye, the nasal cavity, face, upper teeth, and lower teeth and jaw and anterior tongue. Test: cotton ball on side of cheek...
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What is the name of cranial nerve VI and what does it innervate?
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The abducens nerve innervates the one eye movement- lateral rectus muscle. Test: Rolling the eyes.
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What is the name of cranial nerve VII and what does it innervate?
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The Facial Nerve innervates the facial muscles of expression and cheek muscle the buccinator and 2 thirds of the tongue. Test: Smile, frown, puff out cheeks, eyebrows...
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What is the name of cranial nerve VIII and what does it innervate?
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Vistibulocochlear or Auditory=innervates the auditory and cochlea, and vestibular apparatus. Test: they can hear the spoken word
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Explain the spinal cord and its main functions.
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Lies within the vertebral canal & is protected by the vertebral column
Connects the brain & the body Conducts somatic & autonomic reflexes; Provides motor pattern control centers; Modulates sensory & motor function. |
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What is the name of cranial nerve IX and what does it innervate?
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The glossopharangeal nerve has to do with taste. Test: The client would identify sour or sweet taste on the back of the tongue.
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What is the name of cranial nerve X and what does it innervate?
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Vagus Nerve innervates sensation of pharynx.: Test: say ‘ah’ and observe movement of palate and pharynx.
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What is the name of cranial nerve XI and what does it innervate?
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Accessory Spinal Nerve: Innervates head and shoulders. Test: Ask client to shrug shoulders and turn head against passive resistance.
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What is the name of this cranial nerve XII and what does it innervate?
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Hypoglossal nerve is a motor nerve that innervates position of the tongue. Test: Ask client to stick out tongue to midline and move it from side to side
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What are dermatomes?
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Body surface Areas of body that are innervated by particular the spinal cord nerves.
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Explain the function and pathway of a reflex arc. Also what are the common reflexes to test?
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Each muscles contains a small sensory unit called a muscle spindle. The muscle spindle controls muscle tone and detects changes in the length of muscle fibers. Tapping a tendon w/a reflex hammer stretches the muscle and the tendon which will legthen the small muscle spindle. This lengthening causes the spindle to send nerve impulses along afferent nerve pathways to the dorsal horn of the spinal cord segment. Within milliseconds the impulses reach the spinal cord and synapse to a motor neuron, which sends its efferent message impulse back to the muscle causing a reflex response specific to the body part. There are deep tendon reflexes (patellar, biceps, triceps, and achilles) which are tested by tapping tendons and cutaneous reflexes (plantar, gluteal, abdominal) which are tested by stimulation of the skin superficially.
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Explain the neurotransmitters, their types, function and classifications.
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Neurotransmitters are the chemical agents that actually transmit an impulse across the synaptic cleft. Some are excitatory and some are inhibitory whatever has the net effect wins. The neurotransmitters known to have excitatory effects are: aectylcholine, norepinephrine, serotinin, dopamine, glutamate, and histamine. Inhibitory are:The inhibitory ones are: (amino acids) GABA, glycine, glutamate & aspartate. There are also neurotranmitters that have opiate like qualities and will also inhibit pain perception in/and are found throughout the CNS and PNS: These include: endorphins, enkephalins, and substance P. Remember that epinephrine is not only an excitatory nt, but also is a hormone from the adrenal medulla.
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What are the parts of the peripheral nervous system and main function?
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Peripheral nervous system (PNS)
Somatic nervous system Motor & sensory pathways regulating voluntary motor control of skeletal muscle Autonomic nervous system Motor & sensory pathways regulating the body’s internal environment through involuntary control of organ systems Sympathetic Parasympathetic31 pairs of spinal nerves Names correlate with the vertebral level from which they exit Mixed nerves Arise from the anterior and posterior horn cells of the spinal cord 12 pairs of cranial nerves Sensory, motor, and mixed |
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Explain in general, the sympathetic nervous system.
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Mobilizes energy stores in times of need
“Fight or flight” response Receives innervation from cell bodies located from the first thoracic (T1) through the second lumbar (L2) regions of the spinal cord Thoracolumbar division Sympathetic (paravertebral) ganglia |
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Explain in general, parasympathetic nervous system
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Functions to conserve and restore energy
“Rest or repose” response Receives innervation from cell bodies located in the cranial nerve nuclei and sacral region of the spinal cord Craniosacral division |
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What are some tricky functional health questions where the classification might not be intuitive?
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Health perception-health mgmt: What are your usual daily activities, do you use any recreational drugs; Activity-Exercise pattern: Do you have weakness or lack of coordination caused by a neurologic problem.
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What is the romberg test and what is the pronator drift?
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The romberg test is a motor test where a person puts their feet together and stands still, once with eyes open and once with eyes closed. If they don't drift it's negative/if they do-it is positive. The pronator drift the person stands straight with feet together and puts arms straight out in front with palms up; if they start to drift down on one side or both this is a possible sign of hemispheric brain damage.
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What is the brudzinki sign and kernig sign?
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Brudzinski is an indicator of meningitis when someone's knees draw up along with neck when lying supine. Kernig a person lying supine can't straighten hamstrings at 90 degrees-sign of meningitis.
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what is astereognosis
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The inability to recognize an object when feeling it without visual input.
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What is the opisthotonus?
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Opisthotonos is a condition in which the body is held in an abnormal posture. It usually involves rigidity and severe arching of the back, with the head thrown backward. If a person with opisthotonos lays on his or her back, only the back of the head and the heels would touch the supporting surface.
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What are the following:
Diplopia Dysphagia Ataxia, dyskinesia |
Diplopia=double vision
Dysphagia=sometimes words and thoughts don’t get put together the right way. Ataxia=drunken sailor gait; cerebellum issue, dyskinesia: jerky movements or one side is acting different than the other. disphagia: trouble swallowing. |
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What is the number measurement rating for reflexes? How does it compare to muscle strength measurement.
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The response measurement for reflexes is as follows: 0/5=absent, 1/5= weak, 2/5 =normal, 3/5=exaggerated, 4/5 =hyperflexia w/clonus (an abnormal response is a continued rhythmic contraction of the muscle with continuous application of the stimulus. The muscle strength a 4/5 or 5/5 is a good thing....
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What are all the neurological decreases in the elderly?
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Decreases in the following: Brain weight & size, # of neurons, neurotransmitters, CBF, 02 supply, myelin, Sleep, REM, electrical activity, Muscle, sensory, DTRs
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What are the 3 volume components found within the skull?
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Brain tissue: 78%
Blood: 12% CSF: 10% |
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What are the factors that effect ICP
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Arterial & venous pressure
Abdominal & thoracic pressure Temperature & posture ABGs (↑PaCO₂, ↓O₂) The degree in which these are affected depends on the ability of the brain to accomodate. |
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What is ICP?
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Intracranial pressure is the pressure of the cerebral spinal fluid (CSF) in the subarachnoid space between the skull & the brain.
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What are the early signs and symptoms of ICP in infants?; What are the late signs and symptoms of ICP in infants?
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Early: headache, emesis, change in LOC, decrease in GCS score, irritability, sunsetting eyes, decreased eye contact (infant), pupil dysfunction, Cranial nerve dysfunction and seizures. Note: notice that the early signs are observable outward signs and the late signs are more inward signs, which are: Further decrease in LOC, bulging fontanels (infant), Decreasing spontaneous movements, Posturing, Pailledema, Pupil dilation with decreased or no response to light, Increased bp, Irregular respierations, and Cushing's triad: HYPERTENSION, BRADYCARDIA, AND IRREGULAR RESP. (an onminous sign).
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What are some of the causes of ICP in children; what are some of the causes of ICP in adults?
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Children: Birth trauma, hydrocephalus, head trauma, infection, brain tumor, Guillain-Barre’ syndrom, asphyxia, tumor, hematoma Adults: Lesions, cerebral edema, metabolic insults,
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What are the chain of events in ICP that lead to death.
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Cranial insult/tissue edema leads to ICP, which compresses blood vessels, decreased cerebral blood flow, decrease in O2 leads to brain cell death (w/edema at necrotic tissue), increased ICP compresses brain stem and resp center-increase in CO2, vasodilation, which increases blood volume ending in death of client. If compression of the brainstem is unrelieved, resp. arrest will occur due to compression of the respiratory control center in the medulla
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What is the nursing care for persons with ICP?
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“Neuro checks” Report changes quickly. LOC (level of consciousness)
VS: Q15’ – Q2° T↑, HR, RR, BP ∆’s Reflexes ↓ Pupils or size & reaction (PERL), I&O, Skin care; massage, positioning, ROM, Oral care ALSO: Close monitoring (neurologic status) Maintain a patent airway Monitor vital signs closely (hyperthermia) Administer IV fluids Monitor fluid balance (I&O) Monitor lab values, ABGs Protect from injury Administer anti-seizure medications (Dilantin) Provide emotional support Administer medications to decrease cerebral edema Analgesia & sedation A craniotomy is recommended when all other measures have been unsuccessful |
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According to the Glasgow Coma Scale A score of 8-4 indicates? What things are tested in the Glasow coma scale?
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8-4 is state of coma.
Score of 9-15 is unaltered state of consciousness; Score of 3 or below is deep coma. Pupil size and reaction, Eyes open: What provokes them to open? Best motor response: what provokes client to make motor movements; Best response to auditory and or visual stimulus: If they are greater than 2yrs of age: what provokes a verbal response, if less than 2 years: what provokes a facial or verbal response. Hand grip, muscle tone, LOC, eye movement, mood/affect, and fontanel/window. |
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What is the abnormal response in each of the following states of consciousness?
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Alert: client answers appropriately to normal tone of voice. Lethargy: is drowsy, might answer-fall back asleep in response to loud voice; Obtundation: patient opens eyes and looks confused w/out interest to surrounding and being shaken gently; Stupor: stuporous person ONLY responds to pain and responses are slow; Coma patient does not responde to anything and eyes are closed.
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What are some diagnostic tests that can be done for ICP?
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Cerebrospinal fluid (CSF): have to do lumbar puncture. Should be clear unless you hit a little capillary. But mostly clear. Should have very little protein. Lumbar puncture (LP)
Radiology, Xray, Angio, CT, MRI, PET, Myelo, SPECT, Electrographic (EEG), Ultrasound |
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According to Ms. Meredith-What are the neuro rules of assessment.
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Become systematic & observant of all systems with interactions
Baseline assessments for comparison, Consider “chief complaint”, Recognize “normal” for age, Prepare client properly, create trust, Assess mental/emotional status during interaction, Support patients & families. |
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What is decorticate and what is decerebrate?
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decorticate: arms flexed to midline, hands flexed; Decrebrate: arms extended, pronated, hands flexed.
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What does PERRLA stand for?
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Pupils Equal Round Reactive to Light & Accomodation
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