Chapter 47 Neurological Function, Assessment, And Therapeutic Measures

Front 1

Central Nervous System (CNS) contains

Back 1

Brain and spinal cord

Front 2

Peripheral nervous system (PNS) contains

Back 2

Cranial nerves and spinal nerves which include nerves of autonomic nervous system (ANS)

Front 3

Nerve tissue

Back 3

Consists of neurons and cells called neroglia

Front 4

All neuron cell bodies are found in the _______, _________, or within the ________.

Back 4

brain, spinal cord, trunk of the body

Front 5

What carries the electrical nerve impulse?

Back 5

Cell body and axon

Front 6

In PNS axons and dendrites are wrapped in?

Back 6

Schwann cells

Front 7

Schwann cells form the

Back 7

Myelin sheath

Front 8

Spaces between the Schwann cells along the axon are called?

Back 8

Node of Ranvier

Front 9

The nuclei and sytoplasm of the Schwann cells are outside the myelin shealth and form the?

Back 9

Neurolemma

Front 10

Axons may regrow through the tunnels provided by the

Back 10

Neurolemma

Front 11

What forms the myelin sheaths in the CNS?

Back 11

Oligodendrocytes

Front 12

Oligodendrocytes

Back 12

Produce the myelin shealth to electrically insulate neurons of the CNS

Front 13

Microglia

Back 13

Capable of movement and phagcytosis of pathogens and damaged tissues

Front 14

Astrocytes

Back 14

Contribute to the BBB, prevents potentially toxic waste products in the blood from diffusing out into brain tissue, disadvantage: some useful medications cannot cross it which become important during brain infection, inflammation, or other disease.

Front 15

Ependyma

Back 15

Line the ventricles of the brain; many of the cells are ciliated; involved in the circulation of cerebrospinal fluid.

Front 16

Synapses

Back 16

When axon of neuron must transmit an impulse to dendrite or cell body of another neuron, impulse crosses gap called synapse.

Front 17

The end of the axon is called

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the synaptic end bulb and contains neurotransmitters that release into synapse by electrical impulse

Front 18

Types of neurons

Back 18

Sensory, motor or interneuron

Front 19

Sensory (afferent)

Back 19

Transmit impulses FROM receptors TO the CNS. Specialized to detect external or internal changes and generate electrical impulses

Front 20

Sensory neurons from skin, skeletal muscle, and jts are called

Back 20

SOMATIC

Front 21

Neurons from receptors in internal organs are called

Back 21

visceral sensory neurons

Front 22

Motor neurons (efferent)

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Transmit impulses FROM the CNS TO effectors (muscles and glands)

Front 23

Motor neurons to skeletal muscles are called

Back 23

SOMATIC

Front 24

Motor neurons to smooth muscles and cardiac muscle and glands are called

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Visceral

Front 25

Sensory and motor neurons make up the

Back 25

PNS

Front 26

Interneurons are found entirely within the

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CNS

Front 27

Learning Tip:

Back 27

Afferent: A is for affect or sense
Efferent: E is for effect or action

Front 28

A nerve is a group of

Back 28

Peripheral axons, dendrites, or both with blood vessels and connective tissue.

Front 29

Most peripheral nerves are

Back 29

Mixed, containing sensory and motor neurons

Ex: PURELY sensory nerve is the optic nerve for vision, the autonomic nerves are purely motor nerves

Front 30

A nerve tract is

Back 30

Thick myelinated neurons within the CNS, often called WHITE MATTER

Front 31

Nerve impulse

Back 31

Also called action potential is an electrical charge brought by movement of ions across neuron cell membrane.

Front 32

When a neuron is not carrying and impulse it is in a state of

Back 32

Polarization with a positive charge outside the membrane and relatively negative charge inside membrane

Front 33

Sodium ions are more abundant

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outside the cell

Front 34

Potassium and negative ions are more abundant

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inside the cell

Front 35

A stimulus makes the membrane permeable to sodium ions which rush into the cell making the inside

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positive and the outside relatively negative

Front 36

Reversal of charges is called

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depolarization and spreads from the point of stimulus along the entire neuron membrane

Front 37

Following depolarization the membrane becomes permeable to

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K ions, this is called repolarization and restores the positive charge outside and the negative charge inside

Front 38

Sodium and potassium pumps return the sodium ions back outside and the potassium ions inside and the neuron is polarized again and is ready

Back 38

to respond to another stimulus

Front 39

Spinal cord

Back 39

Transmits impulses to and from brain. Inside vertebral canal formed by vertebrae and extends from the foramen magnum of the occipital bone to the intervertebral disk b/w first and second lumbar vertebrae.

Front 40

The spinal nerves emerge from the

Back 40

intervertebral formaina

Front 41

Grey matter

Back 41

Surrounded by white matter, and is where cell bodies of motor neurons and interneurons are located

Front 42

White matter

Back 42

myelinated axons

Front 43

Ascending tracts transmit

Back 43

sernsory impulses to the brain

Front 44

Descending tracts transmit

Back 44

motor impulses from the brain to motor neurons

Front 45

Central canal of the spinal cord

Back 45

small tunnel that is continuous with ventricles of the brain and contain CSF

Front 46

Spinal nerves

Back 46

31 pairs

Front 47

How many cervical spinal nerve pairs?

Back 47

8 pairs

Front 48

How many thoracic spinal nerve pairs?

Back 48

12 pairs

Front 49

How many lumbar spinal nerve pairs?

Back 49

5 pairs

Front 50

How many sacral spinal nerve pairs?

Back 50

5 pairs

Front 51

How many coccygeal spinal nerve pairs?

Back 51

1 very small pair

Front 52

Nerves are often referred to by letter and number for example:

Back 52

Second cervical nerve is C2 and tenth thoracic is T10 and so on

Front 53

Cervical nerves supply

Back 53

The back of the head the neck, shoulders, arms, diaphragm (the phrenic nerves)

Front 54

The first and second thoracic nerves also contribute to

Back 54

peripheral nerves in the arms

Front 55

The remaining thoracic nerves supply

Back 55

the trunk of the body

Front 56

The lumbar and sacral nerves supply

Back 56

the hips, pelvic cavity, and legs

Front 57

The small coccygeal pair supply area

Back 57

around the coccyx

Front 58

Each spinal nerve has

Back 58

two roots which are neurons entering or leaving the spinal cord

Front 59

Dorsal root ganglion is

Back 59

an enlargeent of this root that contains the cell bodies of these sensory neurons

Front 60

The ventral root is the motor root; it is made of

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motor neurons that carry impulses from the spinal cord to muscles or glands

Front 61

When the two roots merge the nerve thus formed is a

Back 61

mixed nerve

Front 62

Reflex arc

Back 62

1) Receptor detects change and generates impulse
2) Sensory neurons transmit impulses from receptors to the CNS
3) The CNS contains one or more synapses and the interneurons that may be part of pathway
4) Motor neurons transmit impulses from the CNS to the effector
5) The effector performs its characteristic action

Front 63

Spinal cord reflexes include

Back 63

stretch reflexes and flexor reflexes

Front 64

Stretch reflex

Back 64

muscle that is stretched automatically contracts

Front 65

Flexor reflexes

Back 65

withdrawal reflex, stimulus is something painful and the response is to pull away

Front 66

Parts of the brain

Back 66

medulla, pons, midbrain, cerebellum, hypothalamus, thalamus, cerebrum

Front 67

Ventricles

Back 67

Four cavities within brain, two lateral vents, third is midline with thalamus and fourth midline b/w brainstem an cerebellum.

Front 68

Each ventricle contains

Back 68

Choroid plexus which forms cerebrospinal fluid from blood plasma

Front 69

Medulla

Back 69

Regulates heart rates, resps for breathing, blood pressure. Has reflexes for sneezing, coughing, swallowing, and vomitting.

Front 70

Pons

Back 70

Two resp centers work with medulla to produce normal breathing rhythm

Front 71

Midbrain

Back 71

Regulates visual reflexes and auditory reflexes and righting reflexes that keep the head upright and contribute to balance

Front 72

Cerebellum

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Coordination, maintain balance and equilibrium

Front 73

Hypothalmus

Back 73

Produces ADH and oxytocin stored in ppg. Production of releasing hormones like GHRH, regulate body temp by shivering or sweating, feelings of full or hungry, increased heart rate

Front 74

Thalamus

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Sensory pathways to brain except olfactory, can supress sensations to promote cerebrum to concentrate on more important sensations

Front 75

Cerebrum

Back 75

Largest part of brain. R and L hemispheres connected by corpus callosum

Front 76

Cerebral cortext

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Surface of the cerebrum, gray matter consisting mainly cell bodies of neurons

Front 77

Gyri

Back 77

Give neurons more surface area

Front 78

Fissures (deeper)

Back 78

Folds in brain

Front 79

Fissures (shallower) Sulci

Back 79

Folds in brain

Front 80

Frontal lobes

Back 80

Motor areas, left lobe has Broca's motor speech area involved w/ speaking

Front 81

Patietal lobes

Back 81

Sensory areas for skin and muscle sense and taste

Front 82

Temporal lobes

Back 82

Oldfactory and hearing L side has speech

Front 83

Occipital lobes

Back 83

visual areas and impulses from retinas of the eyes. Perception and interpretation of sight occurs here

Front 84

In all lobes

Back 84

Learn, remember, think, personalities,

Front 85

Grey matter called basal ganglia

Back 85

Regulation of muscle tone, inhibiting tremor, use of accessory movements such as swinging arms when walking

Front 86

Meninges

Back 86

3 layes covering CNS
Outer most- dura mater
Middle- arachnoid mater (weblike)
Inner- pia mater (thin tissue on surface of brain)

Front 87

B/w arachnoid mater and the pia mater is the

Back 87

subarachnoid space which contains CSF

Front 88

CSF

Back 88

Permits exchange of nutrients and wastes b/w blood and CNS

Front 89

Cranial Nerve 1- Olfactory

Back 89

Smell

Front 90

Cranial Nerve 2- Optic

Back 90

Sight

Front 91

Cranial Nerve 3- Oculomotor

Back 91

Dilate pupils

Front 92

Cranial Nerve 4- Trochlear

Back 92

Move eyeball

Front 93

Cranial Nerve 5- Trigeminal

Back 93

Sense in face

Front 94

Cranial Nerve 6- Abducens

Back 94

Movement of eyeball

Front 95

Cranial Nerve 7- Facial

Back 95

Smile

Front 96

Cranial Nerve 8- Vestibulocochlear

Back 96

Hearing

Front 97

Cranial Nerve 9- Glossopharyngeal

Back 97

Taste

Front 98

Cranial Nerve 10- Vagus

Back 98

Voice

Front 99

Cranial Nerve 11- Accessory

Back 99

Speaking

Front 100

Cranial Nerve 12- Hypoglossal

Back 100

Movement of tongue

Front 101

ANS

Back 101

Part of PNS affecting smooth muscle, cardiac muscle, glands. Two divisions sympathetic and parasympathetic

Front 102

Sympathetic Division

Back 102

In thoracic and some lumbar segments of spinal cord. Fear, anxiety, exercise. ^ HR, vasodilation. Acetylcholine and norepi

Front 103

Parasympathetic

Back 103

Rest/digest
In cranial nerves 3,7,9,10

Front 104

Basic Neurological Assessment

Back 104

1) LOC
2) VS
3)Pupil response
4) Strength of grips
5) Ability to sense touch

Front 105

Glasgow Coma Scale

Back 105

Ranging from 3-15
Eye opening, verbal response, motor response

Front 106

Pupils unequal in size

Back 106

Anisocoria

Front 107

Nystagmus is

Back 107

involuntary movement of the eyes

Front 108

Where is lumbar puncture usually inserted at

Back 108

L3-4 or L4-5 in adults

Front 109

Dysarthria

Back 109

Diffuculty speaking

Front 110

If pt has aphasia (loss of conciousness) assume they cant understand

Back 110

do not stand till i get back. Will fall

Front 111

Which neurons carry impulses from CNS to effectors?
A) Mixed
B) Motor
C) Afferent
D) Sensory

Back 111

B) Motor

Front 112

Which structure in the CNS regulates body temp?
A)Hypothalmus
B) Temporal lobe
C) Pons
D) Pituitary

Back 112

A) Hypothalmus

Front 113

Which of the following is a symptom of increasing intracranial pressure that should be reported immediately to the primary care provider?
A) Contricted pupils
B)Decreasing LOC
C) Narrowing pulse pressure
D) Bradypnea

Back 113

B)Decreasing LOC

Front 114

What are the normal effects of aging in the CNS? Select all that apply.
A) Increase postual stability
B) Reduced blood flow to the brain
C) Impaired short term memory
D) Sleep disturbances
E) Loss of deep tendon reflexes

Back 114

B) Reduced blood flow to the brain
C) Impaired short term memory
D) Sleep disturbances

Front 115

Pt asks what to expect when she has an angiogram. Which response by the nurse is best?
A) "A small needle will be inserted into your spinal column to withdraw fluid for examination."
B) "You will be in a large machine that uses magnetic energy to create images; it has a noisy knocking sound."
C) "Electrodes will be placed on your head to monitor electrical activity in your brain."
D) "A catheter will be placed into your femoral artery, and dye will be injected that will make your vessels show up on xray."

Back 115

D) "A catheter will be placed into your femoral artery, and dye will be injected that will make your vessels show up on xray."

Front 116

Which of the following activities should be encouraged when a patient returns from a CT scan using a contrast medium?
A)Ambulation
B)Drink fluids
C)Turning side to side
D)Coughing and deep breathing

Back 116

B)Drink fluids

Front 117

Which of the following nursing interventions can help prevent footdrop?
A) Position the patient in the left lateral position
B) Provide daily foot massage
C) Apply high top tennis shoes
D) Maintain the patient in an upright position as much as possible

Back 117

C) Apply high top tennis shoes