Neuro (test 4)

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Part of final review

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52 Terms

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Cerebellum
"Ballerina" controls balance and movement
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Cerebrum
Center of intellect and consciousness
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How many cranial nerves are there?
12
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CNS is made up of ___ and ____
brain and spinal cord
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Synapse
Space between two neurons
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Axons are surrounded by ___ sheath
myelin
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homeostasis
internal body balance
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Normal cerebrospinal spinal fluid pressure
70-125 cm
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True or false? Once destroyed, cells in the brain cannot be replaced
True
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Aging related changes to nervous system
- loss of neurons
- blood flow to brain is decreased
- homeostasis is harder to maintain
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Romberg test
Measures function of cerebellum
- have patient stand with feet together and close eyes, if normal, balance will be maintained.
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glasgow coma scale measures
- eye opening
- motor response
- verbal response
optimal score is 15
- 3 or less indicates total comatose, 8 indicates comatose level
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Nystagmus
rapid back and forth eye movement
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Decorticate posturing
deCOREticate: extremities flexed inwards towards core
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decerebrate posturing
extremities flexed away from core/body
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Should a neuro check be delegated to UAP?
no
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dysphagia
difficulty swallowing
- high fowler's while eating and 30 min after
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Aphasia
Inability to express oneself in speech or writing, or inability to comprehend language
- r/t head injury
- receptive, expressive or global types (see page 496 for more)
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Concussion
Closed head injury
- brief disruption in LOC
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Contusion
brain is bruised blood vessels break and edema develops
- increased ICP possible
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Coup-countercoup injury
Head is moving and hits a stationary object
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Coup vs countercoup
Coup = original impact
contrecoup = brain bouncing off front of skull (secondhand injury)
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Subdural hematoma
Rupturing of blood vessels in the dura
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Three layers of skull
D: dura (top)
A: arachnoid (middle)
P: pia (inner layer)
(dope ass pie)
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Battle sign
bruising behind the ear
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HOB should be how high to promote drainage from the head/ for patients with head injury
20-30 degrees
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Normal ICP
0-15
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Signs of increasing ICP/ cushing's triad
- rising systolic B/P
- widening pulse pressure
- bradycardia with full bounding pulse
- rapid or irregular respirations
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HOB at __ for increased ICP
20-30 degrees with head and neck midline
- hip flexion less than 90 degrees
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Nursing care for patient with increased ICP
- neuro checks each hour
- elevate hob 20-30 degrees
- give stool softeners
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Tetra/quadriplegia
sensory loss of both arms and legs
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paraplegia
paralysis of both legs
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levels of spinal cord injury
C5 or above= needs resp help (mechanical ventilation)
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Can moving patients with spinal injuries be delegated?
No
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Epilepsy
When correcting a metabolic problem does not stop seizures
- spontaneous recurrent seizures
- classified as partial or generalized
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partial vs generalized seizures
partial = affecting one side of body
generalized = both sides of body
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Petit mal seizures
Only last a few seconds without aura or warning
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Postictal
after a seizure
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Atonic or akinetic seizures
loss of body tone leading to collapse
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Status epilepticus
rapid, unrelenting seizures with no rest periods
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If patient is having a seizure
make area safe, move objects from around the person
- do not move the person
- cushion the head
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Transient ischemic attack
- Mini stroke
- brief interruption of blood flow
- many of these pts have strokes later
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Stroke (CVA)
-Interruption of blood flow to brain
- caused by either a hemorrhage (blood vessels rupture and blood leaks) or a clot
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Aneurysm
ballooning of an artery wall
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FAST stroke acronym
Face
Arms
speech
time
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Stroke/damage on the left side of the brain causes ___ sided paralysis
right sided
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Bacterial meningitis
- inflammation of membranes covering brain and spinal cord
- caused by infectious agent getting into bloodstream
- infection can easily spread to brain
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S/S of bacterial meningitis
- sudden onset fever
- severe HA that is worsened by moving of the head
- positive brudzinski sign (bend patients neck forward, if knees and hips flex, this is positive)
- positive kernig sign (inability to extend the leg past a 90 degree angle)
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Viral meningitis
-HIV and herpes are causes
- more mild than bacterial meningitis
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Encephalitis
- acute inflammation of the brain
- ticks and mosquitoes are carriers
S/S= stiff neck, photophobia, lethargy
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food that triggers migraines
Alc, caffeine, chocolate, citrus fruits, artificial sweeteners, meats with nitrates, tyramine foods
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Bell's palsy
Weakness or paralysis of facial nerves
- usually only on one side of face