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159 Cards in this Set
- Front
- Back
The CNS is composed of the
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spine and brain
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The PNS is composed of the
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spinal nerves and cranial nerves.
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The autonomic nervous system is composed of the
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sympathetic and parasympathetic nerves.
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The ____ is the larger portion or center of the neuron. The ___ brings messages to the cell body and the ____ carries the messages away from the cell body to the synapse.
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cell body
dendrites axon |
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The ____ are the shorter part of the neuron.
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dendrites
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3 parts of a neuron are the
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cell body
dendrite axon |
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The ____ is the cell body and the dendrites.
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grey matter
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The ____ is the myelinated tissues.
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white matter
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____ is a sheath on some of the nerves that helps the nerve to conduct messages faster.
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Myelin
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____ is the primary intracellular electrolyte.
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Potassium
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____ is the primary extracellular electrolyte.
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Sodium
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____ fuels the Sodium-Potassium pump.
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Oxygen
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High potassium affects _____.
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muscles
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_____ are chemical messengers that transmit information or messages throughout the nervous system.
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Neurotransmitters
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____ is an excitatory neurotransmitter. It's kind of like stepping on the accelerator.
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Acetylcholine
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____ is an excitatory or inhibitory neurotransmitter.
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Norepinephrine
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Nerves that transmit impulses through the release of acetylcholine (ACh) are called _____.
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cholinergic.
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A person with a frontal lobe tumor may have loss of ____ or ____.
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memory or personality changes.
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Two major neurotransmitters are
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acetylcholine and norepinephrine.
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Nerves that transmit impulses through the release of norepinephrine (NE) are called _____.
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adrenergic
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The ____ is an important structure of the brain that integrates motor and sensory information with appropriate responses.
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cerebrum
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The cerebrum is the ____ of the brain at the _____.
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large portion
front and side |
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The cerebrum is divided into 4 lobes:
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-frontal
-temporal -parietal -occipital |
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The ____ lobe of the brain is responsible for memory and me. It is a large part of who we are.
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frontal
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The ____ lobe of the brain is associated with vision.
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occipital
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The ____ lobe of the brain is associated with hearing and smelling.
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temporal
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The _____ lobe of the brain is associated with pain, coldness, and light touch.
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parietal
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The ____ is at the back of the brain and is responsible for coordination of voluntary responses.
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cerebellum
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The ____ contains the pons, medulla, and midbrain. It has cell bodies of cranial nerves, reticular formation, and projection tracts.
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brain stem
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The ____ is part of the brain stem that has to do with the sleep wake cycle.
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reticular formation
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The ____ are paths along which messages flow.
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projection tracts
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If a patient has a high brain stem injury we often see _____.
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sudden death
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The ____ is responsible for sorting and processing. It also is first perception of pain.
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thalamus
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Brain Stem CPR is something you can't live without.
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Cranial nerves
Projection tracts Reticular system |
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The ____ is responsible for automatic movement.
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basal ganglia
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The ____ is the body's neuroendocrine control center. It controls temperature and water metabolism.
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hypothalamus
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The ___ are the supporting cells of the nervous system. They are the glue that holds the brain together.
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glia
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The glia are ____-like.
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web
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____ transmit information via myelin sheath and synapses.
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Neuron
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The 4 major types of arteries that supply the brain with blood are the
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-vertebral arteries
-basilar arteries -carotid arteries -cerebral arteries (external-->internal-->middle) |
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The vertebral arteries merge into one _____.
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basilar artery
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The carotid arteries come up the front and split into the
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external cerebral, internal cerebral and middle cerebral arteries.
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The ____ serves the brain stem and posterior portion of the brain.
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vertebral arteries
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The ____ is the small area at the top of the brain where all the arteries of the brain come together. It is a back-up system of blood supply.
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Circle of Willis
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Blood clots in the arteries of the brain come from either the ___ heart, ____, ____ system, or the ____ brain branches.
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Blood clots in the arteries of the brain come from either the Left heart, aorta, vertebral/basilar system, or the middle cerebral brain branches.
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A _____ stroke is very deadly because they carry so much blood.
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vertebral artery or basilar artery
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Blood clots in the legs cause _____.
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pulmonary embolisms
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___ heart blood flow goes to the subclavian and up.
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Left
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____ heart blood flow goes to the lungs and back down.
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Right
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Sympathetic nerve endings secrete _____.
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norepinephrine
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The ____ mobilizes energy for the fight/flight response.
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sympathetic nervous system
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Parasympathetic nerve endings secrete ____.
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acetylcholine (ACh)
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The ____ conserves energy for normal functioning.
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parasympathetic
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Adrenergic nerves have the same actions as ____ medications.
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anticholinergic
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Cholinergic nerves have the same actions as _____ medications.
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cholinergic
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Action of anticholinergic meds
____ pupils ____ intraocular pressure ____ bronchi ____ pulse ____ BP ____ sphincters (GI/Urinary) ____ GI motility ____ cardiac arterioles ____ blood glucose ____ nasal secretions |
Action of anticholinergic meds
dilate pupils elevate intraocular pressure dilate bronchi increase pulse increase BP contract sphincters (GI/Urinary) decrease GI motility dilate cardiac arterioles elevate blood glucose decrease nasal secretions |
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If a patient cannot pee they may be given ____ medications.
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cholinergic
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If a patient has COPD they should not take _____ medications.
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cholinergic
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If a patient has glaucoma they should take ______ medications.
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cholinergic
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____ medications are good for motion sickness.
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Anticholinergic
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Sometimes there will be diseases that cause ____ spinal fluid pressure.
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elevated
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CSF is made from filtered blood in the ____ of the brain and circulates through the _____.
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ventricles
meninges |
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The 3 layers of the meninges of the brain are
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-pia
-arachnoid -dura |
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The ____ is the layer of meninges that is a delicate film that adheres to the brain.
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pia
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The ___ is the layer of the meninges that is a weblike combination of cells.
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arachnoid
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The ____ is the layer of the meninges that is a tough, durable, fabric-like substance that adheres to the skull.
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dura
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The ventricles are where ____ is made.
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CSF
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The composition of CSF includes:
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-WBCs
-glucose -protein -immunoglobulins (sometimes) |
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CSF should not have ____. This only occurs with injuries or a traumatic spinal fluid tap.
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RBCs
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The thick rubbery cord that runs down our back is called the ____.
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spinal cord
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The spinal cord is surrounded and protected by ____ vertebrae.
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33
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Between each vertebrae there is an _____.
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interverterbal disc
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The spinal cord extends from the ____ to the ____.
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medulla to the first lumbar vertebrae.
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The purpose of the spinal cord is to...
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conduct messages to and from the brain as a reflex center.
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In the PNS there are ___ pair of spinal nerves. Each of the spinal nerves contains sensory and motor fibers.
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31
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In the PNS there are ____ pair of cranial nerves. They are sensory and motor.
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12
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____ are automatic, rapid and involuntary motor response.
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Reflexes
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Reflexes are dependent on 5 things:
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-receptor
-sensory neuron -integration center -motor neuron -effector |
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The ____ picks up the message.
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receptor
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The ____ recognizes what is going on and starts carrying the message forward.
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sensory neuron
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The ____ tells the body that something needs to be fixed.
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integration center
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The ____ carries efferent impulses.
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motor neuron
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The ____ is the area that responds.
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effector
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The ____ regulates the internal environment of the body.
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autonomic nervous system
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Acidosis and increased CO2 affect the nervous system by causing ___ and ___.
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vasodilation and lethargy
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Alkalosis and decreased CO2 effect the nervous system by causing ___ and ____.
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vasoconstriction and agitation
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____ and ____ cause brain cell damage.
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Hypoglycemia and hypoxia
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The Cram And Die List reminds us how CO2 can be fatal.
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Carbon dioxide increases
Acidosis Dilation (vasodilation) Lethargy Vasodilation increases ICP and the person can die. |
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Any cell deprived of oxygen will ____.
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swell
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Cells deprived of oxygen swell because...
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the NaK pump shuts down and Na accumulates in the cell therefore attracting water into the cell.
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Low ____ and Low ____ stumps the brain.
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oxygen
glucose |
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A basic neuro check begins with the _____, checking ____, assessing _____, and _____.
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Glasgow Coma Scale
pupil response strength/movement touch/pain |
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A Glasgow Coma score of ___ is a great score.
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15
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A Glasgow Coma score of ____ signals severe brain injury. We start talking about organ donation.
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9
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When assessing mental status look at the patients ___ and ____.
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appearance and behaviors.
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When assessing cognitive function assess the patients ____, _____, and _____.
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orientation, recent memory, remote memory
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How did you get to the hospital? assesses a patient's ______.
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recent memory
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What president was shot? assesses a patient's ____.
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remote memory
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Assessing orientation looks at
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time, place, person, situation
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Cranial Nerve I-
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Olfactory- smell
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Cranial Nerve II-
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Optic- visual fields and acuity
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Cranial Nerve III-
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oculomotor- EOM's, pupils, upper eye lid raising
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Cranial Nerve IV-
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Trochlear- EOM's down and in
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Cranial Nerve V-
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Trigeminal- Facial/Corneal sensation, temporal masseter muscles (jaw strength and chewing muscles)
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Cranial Nerve VI-
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Abducens- EOM's lateral
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Cranial Nerve VII-
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Facial- movement of facial muscles, close eye lids, taste on anterior 2/3 of tongue
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Cranial Nerve VIII-
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Acoustic- hearing and balance
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Cranial Nerve IX-
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Glossopharyngeal- movement or pharynx and gag reflex, taste on posterior 1/3 of tongue
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Cranial Nerve X-
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Vagus- swallowing, gag, vocal cord movement, voice
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Cranial Nerve XI-
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Spinal Accessory- shoulder shrug and turn head against resistance
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Cranial Nerve XII-
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Hypoglossal- tongue movement for speech and swallowing
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Cranial nerves ___ and ___ control swallowing.
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X and XII
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Cranial nerves ____, ____ and ____ control eye movements.
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III, IV, and VI
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Cranial nerves ___ and ____ control the gag reflex.
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IX and X
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During visual field testing assess for 2 things
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loss of peripheral vision
homonomyous hemianopia |
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____ is when a person loses vision is half of their eye.
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Hemianopia
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If a person loses vision in the same side of both eyes it is called _____.
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homonymous hemianopia
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3 assessments of motor function are:
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-rapid alternating movement
-precise motor movement -gait |
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Motor function balance is assessed with the
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Romberg test.
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Abnormal reflexes that indicate motor function problems are
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babinski and abnormal posturing
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2 types of abnormal posturing are
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decorticate and decerebrate.
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____ is when the patient is unable to put their thoughts into language. They can't respond written or verbal.
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Expressive aphasia
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____ is when the patient is unable to understand language either verbal or written.
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Receptive aphasia
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______ is when a patient is unable to form clear words d/t weakness of the tongue, lips, palate, or respiratory muscles. They can understand instructions.
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Dysarthria
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Dysarthria puts a patient at risk for ____ and _____.
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dysphagia and aspiration
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A _____ looks at the patients blood supply to the brain via x-ray view.
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cerebral angiography
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A ____ is a LP with dye in the needle to look at vertebral disks.
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myelogram
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A cerebral angiography is done thru the _____.
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groin
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____ is the awareness of self and environment and the ability to respond.
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Consciousness
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Consciousness follows a predictable _____ to ____ progression.
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rostral to caudal
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Consciousness is dependent upon ___ and ____.
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arousal and cognition
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Manifestations of consciousness are
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-arousal (easy/hard)
-cognition (who, what, when, where) -patterns of breathing changes -pupillary and oculomotor response changes -motor function changes |
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_____ is the LOC associated with slowed thinking, poor memory, law attention level, and bewilderment.
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Confusion/agitation
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____ is the LOC in which the person is not aware of time or place.
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Disorientation
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____ is the LOC in which the person is lethargic and somnolent/sleepy. They are responsive to verbal and tactile stimuli but quickly go back to sleep.
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Obtundation
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____ is the LOC in which the person is unresponsive. They may be aroused briefly by vigorous or painful stimuli. They shrink away from the pain or grab at the source but don't actually wake up.
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Stupor
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____ is the LOC in which the person does not move spontaneously. They don't respond to stimuli, don't wake up but may moan or groan.
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Semicomatose
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____ is the LOC in which the person is unarousable. There is no stirring or moaning. They may have nonpurposeful movements of area stimulated but makes no attempt to withdraw.
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Coma
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____ is the LOC in which there is an absence of brain stem reflexes. The person is completely unarousable, unresponsive to pain, impairment of swallowing and no corneal reflexes.
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deep coma
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If a person has an altered mental status think
AEIOU and TIPS |
A- alcohol
E- epilepsy I- insulin O- overdose U- uremia T- trauma I- infection P- psychiatric S- stroke |
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Uremia is _____.
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kidney failure
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If a patient has an altered mental status think
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decreased glucose
decreased oxygen medication |
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A ____ is a state of wakefulness with complete lack of cognition and awareness of self or environment.
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persistent vegetative state
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____ is the inability to communicate but without loss of awareness or cognition.
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Locked In Syndrome
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____ is permanent loss of brain function.
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Brain death
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Criteria for death by neurological criteria (Brain death) are:
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-Apnea
-absent reflexes -no spontaneous movement -Flat EEG -no change over time |
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____ is an increase in blood, brain tissue or CSF. It is a life threatening injury.
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Increased Intracranial Pressure
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IICP can come from an increase in blood caused by
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ruptured aneurysm or hematoma after injury.
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IICP can come from an increase in tissue caused by
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brain tumor, premature closure of the fontanels or tissue swelling.
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IICP can be caused by an increase in CSF related to ____.
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hydrocephalus
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Increased blood, tissue, or CSF creates ____ which creates ____ and leads to increased ____.
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hypoxia
edema swelling |
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S/Sx of IICP include:
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decline in LOC
pupil dilation and fixation widened pulse pressure Full, bounding pulse Cheyne- Stokes respirations Hyperthermia |
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Therapeutic interventions for IICP are
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-oxygenation
-treatment of cerebral edema -positioning -valsalvas prevention -hypothermia blanket |
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Medications that are used to treat cerebral edema include:
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mannitol, decadron, and lasiks
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When using a hypothermia blanket the nurse should
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assess and protect skin
use a temp probe prevent shivering |
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____ is a medication that can prevent shivering.
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Thorazine
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When positioning a patient with IICP the following should be adhered to
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HOB elevated
neck straight no hyperflexion of hips Tq2h |
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If IICP is not controlled ____ will occur. When this happens the brain shifts out of the foramen magnum or shifts to one side.
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herniation
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The earliest sign that there is a problem with the ICP is
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a change in the level of consciousness
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