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39 Cards in this Set
- Front
- Back
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Brain Death
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No function, Hr, respiration, Brain dies due to compression, deoxygenation.
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Cerebral Death
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Cerebral cortex dies, stem still functions keeping basic life support going.
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The three Meninges are...
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Pia mater
Arachnoid mater Dura mater |
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The Brain stem does..
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The brain stem connects the spinal cord to the brain and has three parts:
The midbrain The pons The medulla |
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The Cerebellum is
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coordinate the brain’s commands to the muscles, allowing for smooth and orderly movement
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The Spinal cord..
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is the main connection between the brain and the rest of the body
Pathways of nerve tissue in the spinal cord, called tracts, carry messages to and from the brain Ascending tracts carry information from the peripheral nervous system to the brain Descending tracts carry information from the brain to the peripheral nervous system |
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Effects of aging on the CNS..
conduction time... |
Some elderly patients or residents are not as quick to react to things as they used to be
The amount of myelin surrounding the axons decreases, reducing the speed of nerve conduction by approximately 10 percent Neurotransmitter imbalances can interfere with the ability of a nerve impulse to travel across a synapse, slowing conduction |
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Memory Changes in elderly..
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Many older people experience a mild loss of memory for recent events, while still having excellent long-term memory
Dementia (a significant loss of mental capabilities) is a disorder, not a normal age-related change |
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CVA:
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Stroke, Brain attack
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MS
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Demyalination of the CNS, via autoimmune response, promoting inflammation process. Genetic component.
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ALS, MS, and HIV are all related to what?
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Autoimmune disease process. Along with Rheumatoid arthritis
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MS active and inactive process..
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Disease continues, the pt develops other pathways to compensate, this give what appears to be a remission.
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ALS
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Attack of Afferent and efferent nerve routs, continuous.
--Progresses from one side to the other and continues until death. (18 month prognossis), strikes at 40-60 years old |
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Parkinson's....
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A progressive, degenerative neurological disease
Characterized by Bradykinesia Muscle rigidity Nonintentional tremor Commonly affects older adult Diagnosed between ages 50 to 60 Burden of care increases as disease progresses |
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Parkinson's patho..
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Atrophy of the substantia nigra
Substantia nigra produces dopamine As dopamine decreases, acetylcholine is no longer inhibited |
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Clinical Manifestation of PD
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-Begin subtly with fatigue and slight resting tremor
-Occasionally dementia is first symptom -Bradykinesia Slow movements caused by muscle rigidity Affects eyes, mouth, and voice as well Causes a staring gaze -Excessive sweating of face and neck with absence of sweating on trunk and extremities Heat intolerance Constipation Anxiety Depression Sleep disturbances Dysphagia |
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PD Dx/Labs..
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CBC may show anemia
Chemistry Low albumin, low protein Drug screens to r/o toxic causes EEG shows slow pattern and disorganization An upper GI series shows delayed emptying, distention, megacolon Fluoroscopy shows slowed response of circopharyngeal muscles when swallowing |
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PD nursing Dx...
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Impaired physical mobility
-Impaired verbal communication -Imbalanced nutrition: Less than body requirements |
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PD MEDS....
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-Monoamine oxidase (MAO) inhibitors
-Dopaminergics -Dopamine agonists -Anticholinergics -Antidepressants -Amitriptyline -Non-selective beta-adrenergic receptor blocking agent -Propranolol |
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Risk factors of CVA..
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-HTN
-Diabetes -Sickle cell disease -Substance abuse -Atherosclerosis -Inactivity -Obesity -Smoking -Hypercholesterolemia -hypertriglyceridemia -Oral contraceptives |
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What artery is most often occluded?
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The middle cerebral artery is the artery most often occluded by thrombo-embolism or by atherosclerotic material
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TIA is what... and what is it a precurser to?
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Brief period of neurological deficits that resolve within 24 hours
Often precursors to permanent CVA |
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What causes a TIA...
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-Inflammatory arterial disorders
-Sickle cell anemia -Atherosclerotic changes in cerebral vessels -Thrombosis -Emboli |
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What in the hell is a Thrombotic CVA?
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-Caused by thrombus occluding cerebral vessel.
Thrombi formed on atherosclerotic plaque in large arteries while BP is low (sleep, rest, surgery, anesthesia) -Occurs quickly, deficits come slowly |
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What in the world is a Embolic?
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-From an embolus from out in the body some place.
-Sudden onset w/immediate symptoms -if not desolved, deficit will persist. |
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Hemorrhagic CVA is what?
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-Occurs when a blood vessel ruptures
-Often in patients with long-term, poorly controlled HTN Other risks: intracranial aneurysm, arteriovenous malformation, anticoagulant therapy, liver disease, blood disorders -Most often fatal because of rapidly increasing ICP -Onset of symptoms is rapid -Loss of consciousness occurs in 50% of cases |
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What S/S occur with a internal carotid occlusion?
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-Contralateral motor and sensory deficits of the arm, leg, and face
-In dominant hemispheric CVA -Aphasia -In nondominant hemispheric CVA -Apraxia -Agnosia -Unilateral neglect -Homonymous hemianopsia |
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What S/S occur with a Middle Cerebral Artery?
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-Drowsiness
-Stupor -Coma -Contralateral hemiplegia -Sensory deficit of arm and face, aphasia -Homonymous hemianopsia |
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What S/S occur during an anterior Cerebral Artery occlusion?
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-Contralateral weakness or paralysis
-dermatome deficit @ leg and foot -loss of decision making and voluntary action abilities -Urinary incontinence |
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What S/S occur During a vertebral artery occlusion
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-Pain in face, nose, or eye
-Numbness or weakness of face on ipsilateral side -Problems with gait -Dysphagia (difficulty swallowing) -Dysarthria (difficulty speaking) |
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Hemianopsia is...
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Hemianopsia is a functional defect which can affect the right or left side.
Images from only one half of each eye reach the brain; thus, there is only reception of half-fields for each eye Homonymous hemianopsia is the loss of half of the field of view on the same side in both eyes |
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Neglect is what?
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-"Neglect" is the inattention to, or lack of awareness of visual space to the right or left and is most often associated with a hemianopsia.
-The lesion in the brain causing neglect usually occurs in the right frontal-parietal lobe, resulting in a left side neglect. Some patients just have a hemianopsia with no neglect, but others may experience a lot of "neglect" and may be unaware that they can not see to the affected side. |
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S/S of Neglect?
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Can not or does not readily/spontaneously scan into the area of the hemianopsia.
-No awareness that a hemi field loss exists -Says doesn't see out of the eye (on the side of the neglect) -Bumps into things on side of the hemianopsia but doesn't learn to compensate for the problem -Misses parts of words on the side of the neglect when reading -Misses parts of eye chart line on the side of the neglect -Tendency to orient head or body turned away from the neglect, and the patient may ambulate/drift in direction away from the neglect. |
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Dx of CVA>>>>
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-CT, MRI
-Cerebral angiography -U/S of Carotids |
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How long do you have to us Clot busters?
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3 Hrs
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DVT will causes a CVA..T/F
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False
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A-fibers are at risk for PE and CVA...T/F
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True
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Infections that cause CNS damage..
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-Meningitis, bacterial, viral
----swelling causes secondary hypoxic injury to brain |
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Brain injuries occur how?
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-Fx, tissue damage
-Closed, accel/decel "Contracoo", secondary injury -Neurons break off due to shearing of the force - |
