Podcast
Questions and Answers
Which of the following best describes the role of oligodendrocytes in the central nervous system (CNS)?
Which of the following best describes the role of oligodendrocytes in the central nervous system (CNS)?
- Phagocytosis of pathogens and damaged tissue.
- Production and circulation of cerebrospinal fluid.
- Formation of the blood-brain barrier.
- Production of the myelin sheath to insulate neurons. (correct)
A nurse is teaching a client about the difference between afferent and efferent neurons. Which statement accurately describes the function of afferent neurons?
A nurse is teaching a client about the difference between afferent and efferent neurons. Which statement accurately describes the function of afferent neurons?
- They transmit impulses from the spinal cord to the brain.
- They detect external stimuli and transmit sensory information to the CNS. (correct)
- They transmit impulses from the brain to the muscles.
- They connect sensory and motor pathways within the CNS.
What is the primary function of the myelin sheath that surrounds some neuronal axons?
What is the primary function of the myelin sheath that surrounds some neuronal axons?
- To provide metabolic support to the neuron
- To increase conduction speed of nerve impulses (correct)
- To protect the neuron from physical damage
- To synthesize neurotransmitters
Which event characterizes depolarization during the transmission of a nerve impulse?
Which event characterizes depolarization during the transmission of a nerve impulse?
What is the role of neurotransmitters at a synapse?
What is the role of neurotransmitters at a synapse?
A client is diagnosed with damage to Broca's area. Which manifestation should the nurse expect?
A client is diagnosed with damage to Broca's area. Which manifestation should the nurse expect?
What is the primary function of the cerebellum?
What is the primary function of the cerebellum?
Which structure serves as a relay station for sensory information traveling to the cerebral cortex?
Which structure serves as a relay station for sensory information traveling to the cerebral cortex?
After a stroke affecting the frontal lobe, a client exhibits changes in personality, including increased impulsivity and poor judgment. Which function of the frontal lobe is most likely affected?
After a stroke affecting the frontal lobe, a client exhibits changes in personality, including increased impulsivity and poor judgment. Which function of the frontal lobe is most likely affected?
A nurse is assessing a client's cranial nerves. Which nerve is assessed by testing the client's ability to shrug their shoulders against resistance?
A nurse is assessing a client's cranial nerves. Which nerve is assessed by testing the client's ability to shrug their shoulders against resistance?
Which of the following neurotransmitters is released by sympathetic preganglionic neurons?
Which of the following neurotransmitters is released by sympathetic preganglionic neurons?
Which physiological response is characteristic of parasympathetic nervous system activation?
Which physiological response is characteristic of parasympathetic nervous system activation?
A nurse assesses an older adult and notes some forgetfulness and decreased problem-solving abilities. What is the most appropriate nursing action?
A nurse assesses an older adult and notes some forgetfulness and decreased problem-solving abilities. What is the most appropriate nursing action?
A neurologist orders a lumbar puncture for a client suspected of having meningitis. What is the primary purpose of this diagnostic test?
A neurologist orders a lumbar puncture for a client suspected of having meningitis. What is the primary purpose of this diagnostic test?
When caring for a client after a lumbar puncture, what nursing intervention is most important to prevent complications?
When caring for a client after a lumbar puncture, what nursing intervention is most important to prevent complications?
A client is scheduled for an electroencephalogram (EEG). What pre-procedure teaching should the nurse provide?
A client is scheduled for an electroencephalogram (EEG). What pre-procedure teaching should the nurse provide?
A computerized tomography (CT) scan is ordered for a client with a suspected brain tumor. Which statement is accurate regarding CT scans?
A computerized tomography (CT) scan is ordered for a client with a suspected brain tumor. Which statement is accurate regarding CT scans?
A client is undergoing a magnetic resonance imaging (MRI) scan. What information is essential for the nurse to verify before the procedure?
A client is undergoing a magnetic resonance imaging (MRI) scan. What information is essential for the nurse to verify before the procedure?
During a neurological assessment, the nurse elicits the Babinski reflex in an adult client. What does this finding indicate?
During a neurological assessment, the nurse elicits the Babinski reflex in an adult client. What does this finding indicate?
A nurse is assessing a client's motor strength using a 5-point scale. Which finding indicates normal muscle strength?
A nurse is assessing a client's motor strength using a 5-point scale. Which finding indicates normal muscle strength?
Which assessment finding is indicative of increased intracranial pressure (ICP)?
Which assessment finding is indicative of increased intracranial pressure (ICP)?
What is the primary reason for using tennis shoes or splints for a client with foot drop?
What is the primary reason for using tennis shoes or splints for a client with foot drop?
Following a stroke, a client has difficulty understanding spoken language. Which type of aphasia is the client experiencing?
Following a stroke, a client has difficulty understanding spoken language. Which type of aphasia is the client experiencing?
A patient with dysphagia following a stroke is prescribed thickened liquids. What is the primary rationale for this intervention?
A patient with dysphagia following a stroke is prescribed thickened liquids. What is the primary rationale for this intervention?
A client recovering from a neurological injury has paresis in the right arm. What nursing intervention is most appropriate to prevent contractures?
A client recovering from a neurological injury has paresis in the right arm. What nursing intervention is most appropriate to prevent contractures?
A client is diagnosed with damage to the medulla oblongata. Which potential complication is of greatest concern?
A client is diagnosed with damage to the medulla oblongata. Which potential complication is of greatest concern?
The nurse is caring for a client with a spinal cord injury. Which intervention should the nurse prioritize to prevent pressure ulcers?
The nurse is caring for a client with a spinal cord injury. Which intervention should the nurse prioritize to prevent pressure ulcers?
What instructions regarding safety should the nurse provide to the family of a client with receptive aphasia?
What instructions regarding safety should the nurse provide to the family of a client with receptive aphasia?
During a neurological assessment, the nurse notes that the patient is oriented to person and place but not to time. How should this be documented?
During a neurological assessment, the nurse notes that the patient is oriented to person and place but not to time. How should this be documented?
A nurse is caring for a client with autonomic dysreflexia. Which intervention is the highest priority?
A nurse is caring for a client with autonomic dysreflexia. Which intervention is the highest priority?
When teaching an older adult about the effects of aging on the nervous system, which information is most accurate?
When teaching an older adult about the effects of aging on the nervous system, which information is most accurate?
A patient is admitted with a spinal cord injury at the level of T10. Which function is the most likely preserved?
A patient is admitted with a spinal cord injury at the level of T10. Which function is the most likely preserved?
A nurse is conducting a Romberg's test. Which observation indicates a positive test?
A nurse is conducting a Romberg's test. Which observation indicates a positive test?
The nurse is reviewing the Glasgow Coma Scale (GCS) scores of a patient who sustained a head injury. A GCS score of 6 indicates what?
The nurse is reviewing the Glasgow Coma Scale (GCS) scores of a patient who sustained a head injury. A GCS score of 6 indicates what?
The nurse is teaching a patient's family about decorticate posturing. Which statement best describes this type of posture?
The nurse is teaching a patient's family about decorticate posturing. Which statement best describes this type of posture?
An elderly patient is admitted with a possible stroke. The physician orders tissue plasminogen activator (tPA). Which is the most critical piece of information the nurse needs to gather before administering the medication?
An elderly patient is admitted with a possible stroke. The physician orders tissue plasminogen activator (tPA). Which is the most critical piece of information the nurse needs to gather before administering the medication?
The nurse is reviewing a patient's medication list and notes that the patient is taking phenytoin (Dilantin). The nurse would monitor the patient for which of the following side effects related to this medication?
The nurse is reviewing a patient's medication list and notes that the patient is taking phenytoin (Dilantin). The nurse would monitor the patient for which of the following side effects related to this medication?
The nurse is caring for a patient with myasthenia gravis being considered for thymectomy. What diagnostic test would the nurse expect to assess thymus enlargement prior to surgery?
The nurse is caring for a patient with myasthenia gravis being considered for thymectomy. What diagnostic test would the nurse expect to assess thymus enlargement prior to surgery?
The nurse is providing discharge teaching to a patient with myasthenia gravis. Which statement by the patient indica`tes a need for further teaching?
The nurse is providing discharge teaching to a patient with myasthenia gravis. Which statement by the patient indica`tes a need for further teaching?
Which of the following statements accurately reflects why interneurons make humans unique?
Which of the following statements accurately reflects why interneurons make humans unique?
Which combination of vital sign abnormalities, often referred to as Cushing's triad, indicates increasing intracranial pressure and potential brain herniation?
Which combination of vital sign abnormalities, often referred to as Cushing's triad, indicates increasing intracranial pressure and potential brain herniation?
Which clinical situation would warrant immediate intervention, even before a full neurological examination can be completed?
Which clinical situation would warrant immediate intervention, even before a full neurological examination can be completed?
A patient is prescribed both albuterol and ipratropium, a combination commonly used for chronic obstructive pulmonary disease (COPD). The administration of albuterol, a beta-2 adrenergic agonist, directly leads to which physiological outcome?
A patient is prescribed both albuterol and ipratropium, a combination commonly used for chronic obstructive pulmonary disease (COPD). The administration of albuterol, a beta-2 adrenergic agonist, directly leads to which physiological outcome?
A patient exhibiting decorticate posturing demonstrates which characteristic positioning?
A patient exhibiting decorticate posturing demonstrates which characteristic positioning?
What is the Glasgow Coma Scale (GCS) primarily used for?
What is the Glasgow Coma Scale (GCS) primarily used for?
Which of the following Glasgow Coma Scale (GCS) component scores would indicate a moderate head injury?
Which of the following Glasgow Coma Scale (GCS) component scores would indicate a moderate head injury?
A nurse assesses a patient with repetitive, rhythmic jerking movements of the body. This behavior is characteristic of which type of seizure?
A nurse assesses a patient with repetitive, rhythmic jerking movements of the body. This behavior is characteristic of which type of seizure?
Following a tonic-clonic seizure, a patient remains unresponsive and begins to exhibit shallow breathing. What should be the nurse's immediate action?
Following a tonic-clonic seizure, a patient remains unresponsive and begins to exhibit shallow breathing. What should be the nurse's immediate action?
Which nursing intervention is most important for a patient immediately following a seizure?
Which nursing intervention is most important for a patient immediately following a seizure?
A patient with a history of seizures is prescribed phenytoin. The nurse should emphasize the importance of which intervention to the patient?
A patient with a history of seizures is prescribed phenytoin. The nurse should emphasize the importance of which intervention to the patient?
Which intervention is most appropriate for a patient with increased intracranial pressure (ICP)?
Which intervention is most appropriate for a patient with increased intracranial pressure (ICP)?
What is the rationale for maintaining a patient with increased intracranial pressure (ICP) in a neutral head position?
What is the rationale for maintaining a patient with increased intracranial pressure (ICP) in a neutral head position?
A patient with increased ICP is ordered mannitol. What outcome indicates the medication is having the desired effect?
A patient with increased ICP is ordered mannitol. What outcome indicates the medication is having the desired effect?
Which of the following assessment findings in a patient with increased ICP would warrant immediate notification of the physician?
Which of the following assessment findings in a patient with increased ICP would warrant immediate notification of the physician?
Which of the following statements accurately describes the primary difference between delirium and dementia?
Which of the following statements accurately describes the primary difference between delirium and dementia?
What is the priority nursing intervention when caring for a patient with Alzheimer's disease who becomes agitated and confused?
What is the priority nursing intervention when caring for a patient with Alzheimer's disease who becomes agitated and confused?
The family of a patient with Alzheimer's disease asks the nurse about medications to improve cognitive function. What is an accurate response?
The family of a patient with Alzheimer's disease asks the nurse about medications to improve cognitive function. What is an accurate response?
A patient with Alzheimer's disease is frequently disoriented and wanders. What is the priority nursing action to ensure the patient's safety?
A patient with Alzheimer's disease is frequently disoriented and wanders. What is the priority nursing action to ensure the patient's safety?
What is the initial diagnostic test typically performed to evaluate for acute stroke?
What is the initial diagnostic test typically performed to evaluate for acute stroke?
A patient with a suspected stroke is prescribed tissue plasminogen activator (tPA). What is the primary goal of administering this medication?
A patient with a suspected stroke is prescribed tissue plasminogen activator (tPA). What is the primary goal of administering this medication?
Following a stroke, a patient develops unilateral neglect. Which intervention would be most appropriate for the nurse to implement?
Following a stroke, a patient develops unilateral neglect. Which intervention would be most appropriate for the nurse to implement?
A patient who suffered a stroke now experiences difficulty swallowing. What healthcare provider is best suited to assess and treat this?
A patient who suffered a stroke now experiences difficulty swallowing. What healthcare provider is best suited to assess and treat this?
Which long-term complication is a patient most at risk for following a stroke?
Which long-term complication is a patient most at risk for following a stroke?
What is the underlying cause of the manifestations seen in multiple sclerosis (MS)?
What is the underlying cause of the manifestations seen in multiple sclerosis (MS)?
Which factor is most closely associated with the etiology of multiple sclerosis?
Which factor is most closely associated with the etiology of multiple sclerosis?
What is the primary pathological change in Parkinson's disease that leads to its clinical manifestations?
What is the primary pathological change in Parkinson's disease that leads to its clinical manifestations?
A patient with Parkinson's disease exhibits shuffling gait, bradykinesia and tremors. Which medication manages these symptoms?
A patient with Parkinson's disease exhibits shuffling gait, bradykinesia and tremors. Which medication manages these symptoms?
What is a characteristic motor manifestation commonly observed in Parkinson's disease?
What is a characteristic motor manifestation commonly observed in Parkinson's disease?
A patient with suspected meningitis is undergoing diagnostic testing. Which test would confirm the diagnosis of meningitis?
A patient with suspected meningitis is undergoing diagnostic testing. Which test would confirm the diagnosis of meningitis?
A patient who has meningitis exhibits nuchal rigidity, severe headache, and photophobia. What is the underlying cause of these signs and symptoms?
A patient who has meningitis exhibits nuchal rigidity, severe headache, and photophobia. What is the underlying cause of these signs and symptoms?
What nursing intervention is a priority when caring for a patient with meningitis?
What nursing intervention is a priority when caring for a patient with meningitis?
A patient diagnosed with Guillain-Barre syndrome (GBS) reports increasing muscle weakness. What is the most critical assessment for the nurse to perform?
A patient diagnosed with Guillain-Barre syndrome (GBS) reports increasing muscle weakness. What is the most critical assessment for the nurse to perform?
A patient with Guillain-Barre syndrome is at risk for which of the following life-threatening complications?
A patient with Guillain-Barre syndrome is at risk for which of the following life-threatening complications?
A patient with Myasthenia Gravis should be given which discharge instruction?
A patient with Myasthenia Gravis should be given which discharge instruction?
What is a key complication that the nurse should monitor for in a patient with myasthenia gravis?
What is a key complication that the nurse should monitor for in a patient with myasthenia gravis?
Following instruction on potential therapeutic treatments, which statement by the patient with Myasthenia Gravis indicates a good understanding of the disease process?
Following instruction on potential therapeutic treatments, which statement by the patient with Myasthenia Gravis indicates a good understanding of the disease process?
A patient with myasthenia gravis is prescribed a regimen of pyridostigmine. What is a key strategy when discussing this medication?
A patient with myasthenia gravis is prescribed a regimen of pyridostigmine. What is a key strategy when discussing this medication?
A patient is suspected of nystagmus. What assessment technique should the nurse prioritize?
A patient is suspected of nystagmus. What assessment technique should the nurse prioritize?
A patient who is exhibiting alterations in thought content, and thought process should undergo what assessment?
A patient who is exhibiting alterations in thought content, and thought process should undergo what assessment?
During triage, the nurse has four patients who require care. Which patient presents with needs more in excess of their resources and therefore needs the quickest care?
During triage, the nurse has four patients who require care. Which patient presents with needs more in excess of their resources and therefore needs the quickest care?
A patient with a recent stroke is prescribed swallowing exercises by the speech therapist. What is the most critical reason for this intervention?
A patient with a recent stroke is prescribed swallowing exercises by the speech therapist. What is the most critical reason for this intervention?
Which assessment finding is most indicative of increased intracranial pressure (ICP) following a traumatic brain injury?
Which assessment finding is most indicative of increased intracranial pressure (ICP) following a traumatic brain injury?
A client is diagnosed with damage to the medulla oblongata. The most concerning potential complication is:
A client is diagnosed with damage to the medulla oblongata. The most concerning potential complication is:
In which stage of a tonic-clonic seizure does the patient experience repetitive, rhythmic jerking movements?
In which stage of a tonic-clonic seizure does the patient experience repetitive, rhythmic jerking movements?
A patient who has been diagnosed with myasthenia gravis reports increased difficulty swallowing and facial muscle weakness later in the day, post-medication administration. Which of the following interventions or medications has a greater risk of exacerbating or triggering a myasthenic crisis?
A patient who has been diagnosed with myasthenia gravis reports increased difficulty swallowing and facial muscle weakness later in the day, post-medication administration. Which of the following interventions or medications has a greater risk of exacerbating or triggering a myasthenic crisis?
Flashcards
Glasgow Coma Scale (GCS)
Glasgow Coma Scale (GCS)
A scale used to assess level of consciousness; scores range from 3 to 15, based on eye opening, verbal response, and motor response.
Decorticate Posturing
Decorticate Posturing
Arms flexed at the elbow, hands raised towards the chest, legs extended; indicates significant cerebral impairment.
Decerebrate Posturing
Decerebrate Posturing
Arms and legs extended, arms internally rotated; indicates brainstem damage.
Reflex
Reflex
Signup and view all the flashcards
Seizure
Seizure
Signup and view all the flashcards
Agnosia
Agnosia
Signup and view all the flashcards
Aphasia
Aphasia
Signup and view all the flashcards
Dysarthria
Dysarthria
Signup and view all the flashcards
Increased Intracranial Pressure (ICP)
Increased Intracranial Pressure (ICP)
Signup and view all the flashcards
Cushing's Triad
Cushing's Triad
Signup and view all the flashcards
Dementia
Dementia
Signup and view all the flashcards
Alzheimer's Disease
Alzheimer's Disease
Signup and view all the flashcards
MMSE
MMSE
Signup and view all the flashcards
Stroke
Stroke
Signup and view all the flashcards
Paresis
Paresis
Signup and view all the flashcards
Paralysis
Paralysis
Signup and view all the flashcards
Contralateral Deficits
Contralateral Deficits
Signup and view all the flashcards
Multiple Sclerosis (MS)
Multiple Sclerosis (MS)
Signup and view all the flashcards
Parkinson's Disease
Parkinson's Disease
Signup and view all the flashcards
Meningitis
Meningitis
Signup and view all the flashcards
Guillain-Barre Syndrome (GBS)
Guillain-Barre Syndrome (GBS)
Signup and view all the flashcards
Myasthenia Gravis (MG)
Myasthenia Gravis (MG)
Signup and view all the flashcards
ptosis
ptosis
Signup and view all the flashcards
Anticholinesterase Inhibitors
Anticholinesterase Inhibitors
Signup and view all the flashcards
Study Notes
Neurologic System
- The nervous system has two divisions: the central nervous system (CNS) with the brain and spinal cord and the peripheral nervous system (PNS) with the nerves of the autonomic nervous system (ANS).
- Electrical impulses transmit through the nervous system allowing sensory, motor, and integrative activity.
- Actions are automatic by reflex or from organizing, gathering, and processing data.
Nerve Tissue
- Nerve tissue is composed of neurons and support cells called neuroglia.
- Neurons display diversity through unipolar, bipolar, and multipolar anatomy.
- Multipolar neurons with multiple dendrites and a single axon are the most common type.
- Myelination of axons raises conduction speed, correlating to the speed's necessity.
- Neurons in protective reflexes are heavily myelinated, whereas processing neurons of the CNS lack myelin.
Types of Neurons
- Functional classification considers a neuron's position and signal direction.
- Sensory (afferent) neurons transmit signals towards the CNS.
- Motor (efferent) neurons conduct signals away from the CNS
- Interneurons are positioned between afferent and efferent neurons.
- Receptors specialize to detect external or internal changes and produce electrical impulses.
- Sensory neurons from skin, skeletal muscles, and joints are somatic, and those from internal organs are visceral.
- Motor neurons that innervate skeletal muscle are somatic, while those affecting smooth, cardiac muscle, and glands are visceral.
Nerve Impulses
- A nerve impulse, also called an action potential, involves an electrical change caused by ion movement across the neuron cell membrane.
- At rest, a neuron is polarized with a positive charge outside and a negative charge inside.
- A threshold stimulus causes a charge reversal (action potential), creating a depolarization wave along the neuron.
- Repolarization restores the original charges after depolarization.
- After a refractory period, the neuron is ready for another stimulus.
- Myelinated neurons can transmit hundreds of impulses per second at speeds exceeding 100 meters per second.
Synapses
- When a neuron axon transmits an impulse to another neuron's dendrite or cell body, it crosses a synapse.
- Electrical impulses cannot cross synapses; impulse transmission becomes chemical.
- Neurotransmitters release at chemical synapses, ensuring one-way transmission, crucial for neuronal function.
- Synapses are targets for medications as antidepressants block serotonin reuptake, elevating mood-boosting levels.
Neuron Structure
- The cell body (soma) is the neuron's control center containing the nucleus.
- Dendrites look like tree branches and receive signals from other neurons, conducting the knowledge to the cell body; the numbers vary.
- The axon carries nerve signals away and is typically longer than dendrites, containing a few branches; there is only one per cell.
- Many axons are encased in a myelin sheath, consisting mostly of lipid, which acts to insulate the axon.
- In the peripheral nervous system, Schwann cells form the myelin sheath, while in the CNS, oligodendrocytes have the role.
- Gaps in the myelin sheath, called nodes of Ranvier, occur at regular intervals.
- The axon end branches extensively, with each axon terminal ending in a synaptic knob, which contains neurotransmitters for transmission.
Sensory, Interneurons, and Motor Neurons
- Sensory (afferent) neurons detect stimuli like touch, pressure, heat, cold, or chemicals and transmit information to the CNS.
- Interneurons in the CNS connect incoming sensory pathways with outgoing motor pathways, receiving, processing, and storing information.
- They contributes significantly to each person’s uniqueness of thought, feeling, and action.
- Motor (efferent) neurons relay messages from the brain in response to stimuli to the muscle or gland cells.
Nerves and Nerve Tracts
- A nerve, whether cranial, spinal, or peripheral, consists of axons with blood vessels, wrapped in connective tissue.
- Most nerves are mixed; some are exclusively sensory or autonomic.
- A nerve tract is thickly myelinated neurons within the CNS, appearing white and carrying sensory or motor impulses; those in the brain may have integrative functions.
Spinal Cord
- The spinal cord carries impulses between the brain and acts as the spinal cord reflexes' integrating center.
- It is housed within the vertebral canal that is consisted via vertebrae, stretching from the foramen magnum to the intervertebral disk that lies between the first/second lumbar vertebrae.
- Spinal nerves stem from intervertebral foramina.
- The spinal cord has an oval shape, an H-shaped mass of gray matter surrounded by white matter.
- Each spinal nerve links to the cord via dorsal/ventral roots.
- The cord is protected via the meninges (3 layers of tissue) and circulating CSF.
Spinal Nerves
- There are 31 nerve pairs, named by vertebrae: 8 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 1 coccygeal.
- They are referred by letter and number, for example, the second cervical nerve is C2 and the tenth thoracic is T10.
Spinal Cord Reflexes
- A reflex is a fast, involuntary, automatic, and predictable response to a stimulus by using a independent neural circuit.
- Somatic spinal cord reflexes includes stretch and flexor reflexes.
- Stretch reflex describes an automatically contracted muscle that had been stretched. The purpose is to maintain upright posture without conscious processing and prevent overstretching.
- Flexor reflexes, or withdrawal reflexes, respond to painful trauma by pulling away without conscious thought.
- Clinical tests assess spinal cord reflexes to evaluate the functioning of their reflex arcs.
- An absent patellar reflex may indicate issues with the quadriceps femoris muscle, femoral nerve, or spinal cord.
Spinal Cord Structure
- The spinal cord stretches from the brain's base to the first lumbar vertebra and is a bundle of nerve fibers.
- Spinal nerves from the cervical region innervate chest, head, neck, shoulders, arms, hands, and diaphragm.
- Thoracic region nerves connect to intercostal/abdominal and back muscles.
- Lumbar nerves innervate the lower abdominal wall, thighs, and legs.
- Sacral region nerves connect thighs, buttocks, legs/feet skin, and anal/genital areas.
- The cauda equina, a bundle of nerve roots named for resemblance to a horse's tail, stems from the spinal cord end.
Brain
- The brain is consisted of the cerebrum, the diencephalon, the brainstem, and the cerebellum.
Meninges
- The meninges are connective tissue layers over the CNS referred as cranial meninges in the brain.
Regions of the Brain
- The cerebrum, the largest brain portion, has ridges (gyri) that are separated via grooves(sulci and deeper fissures).
- Diencephalon sits between cerebrum and midbrain.
- The cerebellum is the second largest among the regions.
- The brainstem is consisted of the midbrain, pons, and medulla oblongata.
Ventricles and Cerebrospinal Fluid
- Ventricles are four brain cavities: two lateral ventricles that are located in cerebral hemispheres, a midline third ventricle inside the thalamus, and a midline fourth ventricle between the brainstem and cerebellum.
- Cerebrospinal fluid originates from capillaries that includes the plexus, circulating through all the ventricles.
- CSF circulation flows inferiorly inside of the CNS, into the subarachnoid region, draining into the dural venous sinuses.
- CSF exchanges nutrients and wastes between blood/CNS neurons, also acting as a shock absorber for the CNS.
- Its pressure and contents are determined via lumbar puncture (spinal tap), to diagnoses meningitis as well as related illnesses.
Brainstem
- Primarily it is a reflex center and the midbrain controls visual coordination, auditory reflexes, and balance.
- The pons has respiratory centers that work with the medulla to creating a normal breathing rhythm.
- The medulla just superior of spinal cord and has regulatory control of life functions.
Cerebellum
- The cerebellum is posterior to the brainstem and involuntary controls of voluntary movements.
- Its functions are the coordination, direction/endpoint, posture, and balance. Balance maintains via vision, proprioceptors, and equilibrium receptors.
Diencephalon
- Diencephalon has thalamus/hypothalamus underneath the cerebral hemispheres.
- The thalamus, which is above the brainstem, functions as a gateway, filtering sensory input and letting the cerebrum concentrate.
- The hypothalamus suspends the connected pituitary via the infundibulum.
Cerebrum
- The right and left hemispheres of the cerebrum are connected primarily through the corpus callosum, containing 300 million+ nerve fibers.
- The cerebral cortex displays extensive folding into convolutions/gyri, this creating more surface area for the neurons.
- Grooves are called fissures, and it's shallow areas are called sulci. The cortex has been divided, with extensively mapped functions.
- The cerebral cortex enables learning, memory, and thought forming individual personalities with complex behaviors integrating various cerebral and lower brain regions.
- Basal nuclei (ganglia) are found within the cerebral hemispheres' white matter and has subconscious regulation of muscle tone, inhibiting tremor, and accessory movements.
Cerebral Lobes
- Frontal Lobe: The central sulcus creates the posterior border; its motor areas send signals for voluntary movements.
- Each motor area oversees movement of the opposite body side.
- Broca's motor speech area, typically prominent in the left hemisphere, controls movements for speaking and involves personality.
- It controls initiative, emotion, judgment, reasoning, and conscience.
- Temporal lobe is separated via the lateral sulcus containing areas for hearing, smell, and visual recognition.
- Wernicke’s area, typically located on its left side, contains comprehension of speech.
- Parietal lobe: Central sulcus creates the anterior border, with the roles for receiving, perceiving, and interpreting taste/somatic senses.
- Occipital lobe contains visual areas that receives/interprets sight.
Cranial Nerves
- 12 pairs of nerves emerge from the brainstem except pair one from lobe and pair two from the occipital lobe. A few are sensory but others are mixed.
- Cranial nerves carry impulses for sight, smell, hearing, taste, equilibrium, and somatic senses to respective brain areas.
- Other cranial nerves provides motor signals to neck, face, shoulders, tongue, and glands/ also containing combined somatic/autonomic systems.
Autonomic Nervous System
- The autonomic nervous system (ANS) motor output offers dual innervation to effectors including cardiac, smooth muscle, and glands producing response.
- Division’s function in opposition/activity integrated via hypothalamus.
Sympathetic Division
- The cell bodies of preganglionic neurons is thoracolumbar (T1-L2).
- Sympathetic is high during stressful conditions including trauma, fear, etc.
- The body prepares the physical activity, increases heart rate, and the liver release glucose to promote an increase in blood flow for energy.
Parasympathetic Division
- Preganglionic are craniosacral, high on non stressful phases to maintain an increase functionality, the digestion proceeds while heartbeats are normal.
- This division includes AcH/ has a low heart rate and increased secretions.
- Heart rate increases while vasodilation and the bronchioles dilate to promote an increase in breathing and energy.
Aging in the Nervous System
- As aging progresses, the brain loses neurons, but it's insignificant.
- It has a lack of balance, altered sleep, and syncope contributing to mental changes.
Neurologic Assessment
- The assessment focus is determining function and detecting new changes using a neurologic system.
- Use inspection, palpation, and assess mental and levels of consciousness, vital signs, check for motor levels, and assess if the patient can detect pain and touch.
- Rapid assessment with intervention and detection can differentiate different causes.
Glasgow Coma Scale (GCS)
- The GCS asses/documents LOC.
- It's use has been known to evaluate patients for deterioration while evaluating their trauma or abilities.
- Evaluate from an eye opening score of 1-4. With the four stating their eyes are opened.
- There are abnormal postures in the motor section including decorticate having the arms at the chest, or decerebrate having the arms and legs extensors.
- Assess for verbal responses from 1-5 being with 5 as their normal.
- High motor reflects high function and low will reflect low and comatose.
FOUR Score
- (FOUR) identifies the intubated.
- Assess from eye (0 being shut) and the high is 4.
- Assess for pupils for cranial nerve function. Has 1-4, with four being their normal.
- And uses motor along with breathing patterns.
Collection of Data/ Mental Status
- To collect data, ask the reason and use cognition using: person, where, and time, and memory. With reasoning, test with how to respond in their daily lives.
- Altered memory is from multiple of issues. Memory is impacted by delirium & dementia because of different types.
- Pain impacts the ability, it includes stress, meds, injuries, etc.
Data Related to Cranial Nerve Testing
- Related CN function includes scents; vision using pupils; observe for moving fingers.
- To move head and ask what you might fell as to what you see, and wrinkle/smile to observe symmetry.
- Test throat/gait for movements.
Diagnostic Tests
- To perform/find neurologic disorder find: CK levels, hormonal, and to perform a CBC, or VDRL. Also, infection testing is done.
Lumbar Puncture
- CSF is retrieved to test glucose/protein, immunoglobin, and bacteria.
X-Ray Examination
- Spinal X-rays use visualize trauma & if their spinal injury is affecting their movement.
Computed Tomography
- Diagnostic CT scan is for spinal/neurologic and test for cerebral atrophy/skull fractures .
- Non-contrast takes 10 minutes if unstable, and contrast takes 20-30 minutes and can feel warm.
Magnetic Resonance Imaging
- MRI is for degenerative disease, small tumors, and hemorrhage and may uses resonance angiogram.
- To monitor vessels uses blood in the body or vessel.
Meningitis (inflammation of the meninges)
- Signs/symptoms: fever, headache, stiff neck.
- Diagnostic tests: lumbar puncture to analyze CSF (increased WBCs, protein, decreased glucose).
- Nursing care: antibiotics, antipyretics, pain management, monitor neurological status.
Angiogram
- This diagnostic test gives info about the vessel structure, an appendix A offers an approach and an alternative.
Therapeutic Measures
- The therapeutic measures, moves those with mobility/ positioning issues while preventing injuries.
Activities of Living
- The activities range from issues bending and the needs of different equipment.
Communication
- Issues for communication, might involve slurred speech and make it difficult to understand. Use different techniques for understanding.
Nutrition
- Maintaining balanced nutrition levels can have reasons such as low awareness. It can be difficult because an increase metabolism.
- Use swallow test with liquids and solids to assist with nutrition.
- Enteral routes and ways to prevent for aspirating, and for long-term an abdominal route with help.
Family
- Family can have multiple needs for someone with neurologic deficits ranging from emotional to understanding.
Glasgow Coma Scale
- Used to assess level of consciousness across 3 areas: eye opening, verbal response, & motor response. Scores range from 3–15.
Seizures
- Types: Generalized (tonic-clonic, absence, atonic), Partial (simple, complex). Nursing care: Ensure patient safety(protect from injury, turn on side for airway), observe/document seizure activity.
Nursing Care of Patients with Seizures
- Ensure patient safety, protect from injury during seizure.
- Maintain airway, turn patient to side, loosen clothing.
- Observe/document seizure activity (duration, type of movements).
Increased Intracranial Pressure (ICP)
- Signs/Symptoms: Decreased level of consciousness, headache, vomiting, pupillary changes, Cushing's triad (increased systolic BP, decreased pulse, irregular respirations). Nursing Care: Elevate head of bed, administer medications(osmotic diuretics, corticosteroids), monitor vital signs, neurological status.
Dementia
- Alzheimer’s Care: Provide safe environment, maintain consistent routine, assist with ADLs, promote communication, manage behavioral symptoms, provide support to family.
Diagnostic Work-Up for Stroke
- CT scan, MRI to identify type/location of stroke.
- ECG to rule out cardiac causes.
- Blood tests (coagulation studies, lipid panel) to identify risk factors.
Treatment/Complications of Stroke
- Treatment: Thrombolytics (alteplase) if ischemic stroke within specific time frame, surgery to remove clots or repair aneurysms, rehabilitation (speech, physical, occupational therapy). Complications include paralysis, sensory deficits, speech difficulties, cognitive impairment, emotional lability.
Multiple Sclerosis (MS)
- Pathophysiology: Autoimmune destruction of myelin sheath in brain/ spinal cord.
- Etiology: Genetic predisposition, environmental factors (viral infections, lack of vitamin D).
Parkinson's Disease:
- Manifestations are a tremor, rigidity, bradykinesia(slow movement), postural instability, mask-like face, shuffling gait.
Meningitis
- Signs/Symptoms: Fever, headache, stiff neck.
- Diagnostic tests: Lumbar puncture to analyze CSF (increased WBCs, protein, decreased glucose).
Guillain-Barre Syndrome (GBS)
- Signs/Symptoms: Ascending muscle weakness, paralysis, respiratory failure.
- Patient Education: Disease process, potential for complications, importance of rehabilitation.
Myasthenia Gravis (MG)
- Complications comprise of respiratory failure (myasthenic crisis), difficulty swallowing, aspiration.
- Management involves medications (anticholinesterases, corticosteroids, immunosuppressants), plasmapheresis, thymectomy.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
