Nervous System: Brain, Spinal Cord, PNS

• Neurologic system: coordinates and regulates body functions
• Central nervous system (CNS): brain and spinal cord
• Peripheral nervous system (PNS): cranial and spinal nerves
• The basic functional unit of the nervous system is the neuron
• Neurons transmit electrical and chemical signals

Brain

• Cerebrum: largest part of the brain
• Frontal lobe: controls motor function, judgment, and emotions
• Parietal lobe: interprets sensory input such as touch, pain, and temperature
• Temporal lobe: responsible for hearing, taste, and smell
• Occipital lobe: processes visual information
• Cerebellum: coordinates movement and balance
• Brain stem: controls vital functions such as heart rate and breathing
• The brainstem contains the midbrain, pons, and medulla oblongata

Spinal Cord

• Spinal cord: extends from the brainstem to the lumbar region of the vertebral column
• Transmits nerve impulses between the brain and the body
• Controls spinal reflexes

Peripheral Nervous System (PNS)

• Somatic nervous system: controls voluntary muscle movements
• Autonomic nervous system (ANS): regulates involuntary functions such as heart rate, digestion, and breathing
• Sympathetic nervous system: "fight or flight" response
• Parasympathetic nervous system: "rest and digest" response

Neurologic Assessment

• Health history: includes medical conditions, medications, and family history of neurological disorders
• Physical examination: assessing mental status, cranial nerve function, motor function, sensory function, and reflexes
• Mental status: level of consciousness, orientation, memory, and speech
• Cranial nerve assessment: testing each of the 12 cranial nerves for proper function
• Motor function: muscle strength, coordination, and gait
• Sensory function: light touch, pain, temperature, and vibration sensation
• Reflexes: deep tendon reflexes and plantar reflex

Diagnostic Tests

• Computed tomography (CT) scan: uses X-rays to create detailed images of the brain and spinal cord
• Magnetic resonance imaging (MRI): uses magnetic fields and radio waves to create detailed images of the brain and spinal cord
• Electroencephalography (EEG): measures electrical activity in the brain
• Lumbar puncture: involves inserting a needle into the spinal canal to collect cerebrospinal fluid (CSF) for analysis
• Angiography: uses dye to visualize blood vessels in the brain

Common Neurological Disorders

• Stroke: occurs when blood flow to the brain is interrupted
• Traumatic brain injury (TBI): caused by a blow or jolt to the head
• Spinal cord injury: damage to the spinal cord
• Epilepsy: characterized by recurrent seizures
• Parkinson's disease: progressive disorder that affects movement
• Multiple sclerosis (MS): autoimmune disease that affects the brain and spinal cord
• Alzheimer's disease: progressive cognitive decline

Nursing Interventions

• Monitor vital signs: including blood pressure, heart rate, respiratory rate, and temperature
• Assess level of consciousness: using the Glasgow Coma Scale (GCS)
• Administer medications: as prescribed by the physician
• Provide supportive care: including positioning, skin care, and nutrition
• Prevent complications: such as pressure ulcers, pneumonia, and deep vein thrombosis (DVT)
• Educate patient and family: about the neurological disorder and treatment plan
• Rehabilitation: physical therapy, occupational therapy, and speech therapy

Medications Used in Neurological Disorders

• Anticonvulsants: used to prevent seizures
• Anti-Parkinson's medications: used to manage symptoms of Parkinson's disease
• Immunomodulators: used to treat multiple sclerosis
• Analgesics: used to relieve pain
• Antidepressants: used to treat depression associated with neurological disorders
• Corticosteroids: used to reduce inflammation
• Thrombolytics: used to dissolve blood clots in acute stroke

Surgical Interventions

• Craniotomy: surgical opening of the skull to access the brain
• Laminectomy: surgical removal of the lamina to relieve pressure on the spinal cord or nerves
• Spinal fusion: joining two or more vertebrae together to stabilize the spine
• Carotid endarterectomy: surgical removal of plaque from the carotid artery to improve blood flow to the brain
• Deep brain stimulation (DBS): involves implanting electrodes in the brain to control movement disorders

Glasgow Coma Scale (GCS)

• Used to assess level of consciousness
• Assesses eye opening, verbal response, and motor response
• Score ranges from 3 to 15
• Higher score indicates a higher level of consciousness
• Eye opening: spontaneous, to speech, to pain, or none
• Verbal response: oriented, confused, inappropriate words, incomprehensible sounds, or none
• Motor response: obeys commands, localizes pain, withdraws from pain, abnormal flexion, abnormal extension, or none

Increased Intracranial Pressure (ICP)

• Normal ICP: 5-15 mmHg
• Increased ICP: >20 mmHg
• Causes: brain tumor, hemorrhage, edema, or hydrocephalus
• Symptoms: headache, nausea, vomiting, altered level of consciousness, and pupillary changes
• Treatment: elevate head of bed, administer osmotic diuretics, and control blood pressure

Seizures

• Abnormal electrical activity in the brain
• Types: generalized, partial, and status epilepticus
• Causes: epilepsy, fever, head trauma, or stroke
• Treatment: anticonvulsant medications, supportive care, and prevention of injury

Stroke

• Interruption of blood flow to the brain
• Ischemic stroke: caused by a blood clot
• Hemorrhagic stroke: caused by bleeding in the brain
• Symptoms: weakness, numbness, speech difficulties, and vision changes
• Treatment: thrombolytic medications, supportive care, and rehabilitation

Traumatic Brain Injury (TBI)

• Injury to the brain caused by a blow or jolt to the head
• Types: concussion, contusion, and hematoma
• Symptoms: headache, dizziness, confusion, and memory loss
• Treatment: supportive care and monitoring for complications

Parkinson's Disease

• Progressive disorder that affects movement
• Symptoms: tremor, rigidity, bradykinesia, and postural instability
• Treatment: medications to manage symptoms

Multiple Sclerosis (MS)

• Autoimmune disease that affects the brain and spinal cord
• Symptoms: fatigue, numbness, weakness, vision problems, and balance difficulties
• Treatment: immunomodulator medications

Alzheimer's Disease

• Progressive cognitive decline
• Symptoms: memory loss, confusion, and difficulty with language and problem-solving
• Treatment: medications to manage symptoms and supportive care