Neurologic System Lecture Notes PDF

Week 8: The Neurologic System Johns Hopkins School of Nur...

Week 8: The Neurologic System Johns Hopkins School of Nursing Selected Learning Objectives Common Terminology in the Neurologic System ①► Involuntary muscle contractions 1. Understand the common terminology and select medical conditions see in the neurologic system ►Dystonia ►Dyskinesia 0 (repetitive pattern of muscle movements) 2. Perform a neurologic physical examination ⑫ ►-esthesia ② ► Means feeling or sensation ► Involuntary muscle movements (jerky ►PERRLA③ movements) ►Mydriasis④ ⑪ ► Dilated pupils ►Miosis ⑦ is on opoids ► Pupils Equal, Round, Reactive to > may see when someone - ►Anisocoria⑳ Light and Accommodation G. cause by : brain injury ► Difference in pupil sizes tumor ► Small pinpoint pupils 3 infection 4 Common Terminology in the Neurologic System Common Terminology in the Neurologic System o ► Involuntary contraction of opposing · ►Paresthesia groups of muscles (rhythmic) ►Tinnitus ► Continuous, rapid twitching of resting ►Fasciculations muscles Ringing in your ears Anisocoria ►Tremors ⑨ ► # ► Involuntary repetitive twitching ④ ►Tics movements (can be motor and/or vocal) ►Myoclonus G ► Sudden jerks of arms or legs (arrhythmic) ► Tingling, numbness, or ”pins and needles.” 5 6 PERRLA cranial nerves : eyes : 2 ,3 , 4 , 6 cranial nerves : movement of 3, 4 6 eyes : ,  Common Terminology in the Neurologic System Common Terminology in the Neurologic System ⑭② ► Difficulty understanding words or ►Dysarthria putting them together in a sentence ►Dysphagia ► Loss of ability to execute or carry out ►Dysphasia ① skilled movements despite having ability and desire to perform them ►Aphasia ⑪ & ► Difficulty swallowing ►Apraxia (2) ► Difficulty speaking (caused by ►Ataxia (S) muscular problems) test for ataxia · pait ⑤► Impaired coordination · coordination romberg's test 7 8 Common Terminology in the Neurologic System Common Terminology in the Neurologic System Do not need to know movement Disorders Types of Aphasia: i ► Loss of consciousness ►Chorea (6) Wernicke's area : Broca's area ► Memory loss ►Athetosis (4) ► Altered mental status i + difficulty "Bro-ca's" - understand , but can produce speech ►Amnesia (2) ► Twisting, writhing, slow, continuous movements ►Delirium (s) difficulty producing speech , (s)► Altered state of consciousness with but can comprehend ►AMS (3) confusion, that can develop over hours or days (especially in older adults in ►LOC (1) hospital) - does get better overtime (6) ► Sudden rapid, jerky voluntary and involuntary movements of limbs, trunk, or face 9 10 Common Terminology in the Neurologic System Common Terminology in the Neurologic System (1) ► Partial or full loss of smell ►Meningitis (5) ► Inflammation of the active tissues of the (2) ►Encephalitis (2) brain (3) ► This occurs when something blocks blood (3)) ►Stroke CNI : supply to the brain (or when a blood vessel reffect occulamotor ►Anosmia bursts) blocked ischemic stroke > - stroke burst -hemmoraghic i ► Drooping of the eyelid ►Papilledema (a) ► Inflammation of the tissues surrounding ►Ptosis (4) the brain and spinal cord (b) ► Swelling of the optic discs (anterior end of optic nerve) in the eyes due to increased intracranial pressure 11 12 Common Terminology in the Neurologic System Common Terminology in the Neurologic System Encephalitis i ► Eye misalignment ►Myasthenia (2) ► Chronic autoimmune disorder that block, gravis alter, or destroy acetylcholine receptors, preventing muscle contraction ►Peripheral (4) eshaking of withtesting E ► Rhythmic oscillation of the eye the Neuropathy eye the eye ► Damaged nerves located outside of the ►Nystagmus (3) brain and spinal cord (e.g., can cause pain, weakness, muscle twitching, numbness) ►Strabismus (1) (s) ► Also called wryneck. Twisting of neck ►Torticollis (s) causing head to rotate/tilt to one side ►Proprioception (b) (a) ► Also called kinesthesia. This is the awareness of body in space. close their eyes 13 Test by : 14 CAskthemWhichSee are lifting Common Terminology in the Neurologic System Other Common Conditions in the Neurologic System ► Multiple sclerosis ► Guillain-Barré Syndrome ► Bell’s palsy ► Meniere disease ► Epilepsy ► Amyotrophic lateral sclerosis (ALS) ► Parkinson’s disease ► Huntington’s disease ► Brain tumors ► Headaches ► … and many more 15 16 Neurologic Focus: Stroke Neurologic Focus: Stroke 17 18 Neurologic Focus: Stroke Myths Associated with Strokes 19 20 Neurologic Focus: Stroke Risk Factors Neurologic Focus: Stroke Education ► Hypertension (major) ► Genetics ► Smoking cessation ► Eat fewer animal products and foods that ► Diabetes mellitus ► Alcohol and illegal drug use ► Control cholesterol, high blood pressure, contain cheese, cream, and eggs ► Heart disease and blood vessel disease (HF, ► Lack of physical activity and diabetes (e.g., diet, exercise, ► Read labels and stay away from saturated Afib) ► Overweight/obesity medications) fats or anything that contains partially ► Smoking ► Exercise 30 mins/day hydrogenated or hydrogenated fats ► Stress and depression ► Brain aneurysms ► Maintain a healthy weight ► Limit alcohol ingestion ► Unhealthy cholesterol levels ► Conditions that cause inflammation ► Eat a diet rich in fruits, vegetables, and ► Avoid cocaine and other illegal drugs ► Unhealthy diet (infections, lupus, RA) whole grains ► Speak with your healthcare provider about ► Use of NSAIDs (especially prolonged ► Increases with age ► Avoid sodium and fats found in fried the risks of birth control pills use) ► Men more likely to have stroke at younger foods, processed foods, and baked goods ► … and more age; but women more likely to die of stroke 21 22 Question 1 Question 2 ► A client has sustained an injury to the cerebellum. Which area would ► The nurse is performing an admission assessment on an older adult. be the primary area for assessment? What would be an expected finding? a) Vital signs a) Decreased vision b) Lymphatic system b) Numbness and tingling c) Cardiac function c) Delirium d) Coordination d) Dizziness 23 24 Question 3 Question 4 ► The nurse is preparing to perform the Romberg test on an adult male ► The nurse is preparing to assess a client’s cranial nerves using a client. The nurse should instruct the client to screening neurologic examination. Which of the following should the nurse include in this assessment? Select all that apply. a) Squat down as far as he is able to do so b) Keep his eyes open while he bends at the knees a) Visual fields and fundoscopic examination c) Stand erect with arms at the sides and feet together b) Eye movements d) Touch the tip of his nose with his finger c) Hearing d) Finger proprioception e) Facial strength 25 26 ► Weber, J. & Kelley, J. (2022). Health assessment in nursing (7th Question 5 ed.). Philadelphia: Lippincott, Williams, & Wilkins. References ► Image credits are listed in the notes section on applicable slides. ► A young woman comes in with brief, rapid, jerky, irregular Otherwise, image credits are for Weber & Kelley, 2022. movements. They occur at rest or during intentional movements and involved mostly her face, head, lower arms, and hands. How would you describe these movements? a) Tics b) Dystonia c) Athetosis d) Chorea 27 28 Thank you