Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
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 |