NU 360 > Ch. 35 > Flashcards

Ch. 35 Flashcards

(52 cards)

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1
Q

the nervous system is made up of

A
  • the central nervous system
  • the peripheral nervous system
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2
Q

central nervous system consists of which body parts?

A
  • spinal cord
  • brain
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3
Q

the peripheral nervous system consists of what body parts?

A
  • 12 pairs of cranial nerves
  • 31 pairs of spinal nerves
  • autonomic nervous system
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4
Q

the autonomic nervous system is part of the ___

A

peripheral nervous system

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5
Q

the autonomic nervous system consists of which body parts?

A
  • sympathetic fibers
  • parasympathetic fibers
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6
Q

neurons

A

transmits info, impulses, messages
- mobility: purposeful movement
- sensory: experience sensation
- myelin sheaths: lipid covering, plays role in impulse conduction, think MS- impaired mobility d/t myelin sheath covering worn away

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7
Q

neuroglial cells

A
  • position, structure, and nutrition for neurons

people with glioblastoma: malignant tumor of glial cell; poor outcome

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8
Q

layers of the brain (out to in)

A
  • scalp
  • cranium: hard bone, protection
  • dura mater: “hard mother;” protection
  • arachnoid
  • subarachnoid space: underneath arachnoid
  • pia mater: right around brain
  • cerebral cortex: brain
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8
Q

cerebral circulation

A

blood flow in the brain that allows the brain to get its nutrients and oxygen even when the blood pressure in the body changes

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9
Q

frontal lobe

A

front of head
- voluntary movement, expressive language, managing higher level executive functions

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10
Q

cerebral cortex

A

all higher functions of the brain
- language, memory, reasoning, thought, learning, decision-making, emotion, intelligence, personality

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11
Q

parietal lobe

A

top back of head
- processes sense of touch, assembles input from other sense into a form you can use

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12
Q

occipital lobe

A

bottom part of the brain; where neck connects
- visuospatial processing, distance and depth perception, color determination, object and face recognition, memory function

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13
Q

cerebellum

A

controls voluntary movement; maintains equilibrium (posture and balance); spacial awareness; muscle tone; motor learning

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14
Q

temporal lobe

A

side of the brain
- helps senses understand and respond to the world around you

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15
Q

medulla

A
  • controls heart rate, breathing, blood pressure, etc; manages automatic responses
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16
Q

reticular formation

A
  • keeps brain awake/regulates consciousness
  • coordinates brain stems
  • controls muscles, reflexes, autonomic functions, feeding actions, bladder emptying, posture
  • modulates pain, biological rhythms
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17
Q

pons

A
  • relays and regulates the signals that give you the sensation of pain from anywhere in the body below the neck
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18
Q

midbrain

A
  • motor control, particularly eye movements and processing of vision and hearing
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19
Q

hypothalamus

A
  • manages body temperature, hunger and thirst, mood, sex drive, blood pressure, sleep
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20
Q

thalamus

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A
  • information relay stations
  • all senses (EXCEPT SMELL) are processed through thalamus before sent to cerebral cortex
21
Q

subthalamic nucleus

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A

regulates movement

22
Q

epithalamic nucleus

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A

connects the limbic system to the brain
- secretion of melatonin, regulation of motor pathways and emotions

23
Q

circulation of the brain originates at

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A

circulation of brain originates at both carotid and vertebral arteries
- forms ring at base of brain: circle of willis

24
spinal cord: descending tracts
- begin in brain, end in spinal cord - autonomic or non-voluntary movements
25
spinal cord: ascending tracts
- begin in spinal cord, end in brain - sensation pain, temperature, light touch/pressure - awareness of movement
26
ANS: sympathetic
- fight or flight
27
neuro nursing assessment
- Family history and genetic risk: stroke risk, hx of stroke in fam/pt, - Personal history: stroke, TIA, a-fb/clotting hx - Level of consciousness and orientation: A&O, GCS - Language and copying: difficulty - Cerebellar function: coordinated muscle movement - Memory: remember certain number of words (dementia, early s/sx) - Attention: participate in convo, engage; lose 1:1/eye contact; need redirection? - Cognition: what the patient is able to process/understand/think, carry on conversation/answer questions - Cranial nerves - Sensory function: touch: sharp, dull, pain, temperature, lack of sensation - Reflex activity: brisk or hypo-reflexive
27
ANS: parasympathetic
- rest and digest - can slow body function when needed
28
assessment of mental status includes
- consciousness: LOC - cognition: test of memory and attention
29
GLASCOW coma scale: eye
4- open spontaneously 3- open to verbal command 2- open to pain 1- no eye opening
30
GLASCOW coma scale: verbal
5- oriented 4- confused 3- inappropriate words 2- incomprehensible sounds 1- no verbal response
31
GLASCOW coma scale: motor
6- obeys commands 5- localising pain (crosses the midline to site of pain) 4- withdrawal from pain (away from pain) 3- flexion to pain (decorticate; posturing reflex) 2- extension to pain (decerebrate; posturing reflex) 1- no motor response
32
"posturing" includes
decorticate and decerebrate
33
decorticate
- curl in; internal rotation; turning into core - stimulate patient and get abnormal pulling in of body - arms to chest, toes point in - injury to the lower brain; trauma or lack of oxygen - a little better than decerebrate
34
decerebrate
- curl out; external rotation - stimulate patient and get abnormal pulling out of body - toes point out - extension of body - rigid - WORSE than decorticate - dysfunction in the brainstem
35
physical assessment: pupils
PERRLA: pupils, equal, round, reactive to light, accommodating - brisk - sluggish - fixed: pupils don't constrict with light; happens with cardiac arrest; artificial eye* - dilated: big; from uppers: meth, cocaine, adderall, focalin - pinpoint: small; from opioids
36
physical assessment: muscle strength
- hands & feet - should be equal - move with resistance vs gravity - dominant can be slightly stronger- normal - know patients history (hx of stroke)
37
diagnostic assessment techniques
Laboratory assessment Skull and spine x-rays Cerebral angiography (arteriography) Computed tomography (CT) scan Magnetic resonance imaging (MRI) Positron emission tomography (PET) Single-photon emission CT (SPECT) Magnetoencephalography (MEG)
38
electromyography (EMG)
Used to identify nerve and muscle disorders, as well as spinal cord disease
39
lumbar puncture
- Insertion of spinal needle into the subarachnoid space (between the third and fourth lumbar vertebrae) - taking out CSF to test - Empty bladder - Position: side-lying - Spinal headache possible from spinal tap
40
lumbar puncture is contraindicated in patients with
Contraindicated in patients with increased intracranial pressure
41
what do we want/not want cerebrospinal fluid (CSF) to look like?
- want to see clear - bloody, sediment: do not want to see
42
electroencephalography (EEG)
- for undiagnosed seizure activity; to check brain activity - Graphically records the electrical activity of the cerebral hemispheres - want to cause a seizure: Sleep deprivation requirement; Anticonvulsants possibly withheld; hyperventilate; flashing lights - can do it as a sleep study- depends on what provider orders
43
nursing management of electroencephalography (EEG)
- clean hair, may have to cut hair - no lotion - sleep deprivation - no anticonvulsants - not painful to pt!
44
carotid blockages
- carotid blockage causes: lack of perfusion to brain - don't massage both carotids at the same time bc will cut off blood flow
45
cranial nerves: name in order (HINT: on occasion our trusty truck acts funny very good vehicle any how)
olfactory optic oculomotor trochlear trigeminal abducens facial vestibulocochlear glossopharyngeal vagus accessary hypoglossal
46
cranial nerves: sensory vs motor (HINT: some say marry money but my brother says big brains matter more)
sensory sensory motor motor both motor both sensory both both motor motor
47
blown pupil
- profoundly impacts mental status and cognition - one pupil normal, one pupil hugely dilated - could be caused by pressure in brain from injury, brain bleed
48
anasychoria
- born with unequal sized pupils - normal, not concerning
49
highest possible GCS score
15
50
lowest possible GCS score (patient is dead)
3
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