Adult Health II: Neurological Nursing Concepts

Vocabulary flashcards based on the Adult Health II workshop notes on neurological conditions, assessment, nursing interventions, surgical procedures, and diagnostic studies.

Altered State of Consciousness

A condition occurring when a patient is disoriented, does not obey commands, or requires persistent stimuli to achieve alertness, spanning a continuum from normal alertness to coma.

Coma

A state of unresolvable unresponsiveness in which the patient does not open their eyes, respond to verbal stimuli, or move extremities upon request.

Persistent Vegetative State

A condition in which an unresponsive patient resumes sleep-wake cycles after a coma but completely lacks cognitive or affective mental function.

Minimally Conscious State

A condition differing from persistent vegetative state in which the patient exhibits inconsistent but reproducible signs of consciousness.

Locked-in Syndrome

A neurological disorder caused by a lesion affecting the pons (protuberancia anular) resulting in paralysis and inability to speak, while vertical eye movements and eyelid elevation remain intact.

Pupillary Examination in Altered Consciousness

Assessment of pupil size, equality, and reaction to light; equal reactive pupils suggest toxic or metabolic coma, while fixed dilated pupils indicate brainstem injury or elevated intracranial pressure.

Respiratory Patterns in Neurological Lesions

Abnormal breathing patterns caused by alterations in the brain's respiratory center, including Cheyne-Stokes respiration, hyperventilation, and ataxic breathing.

Cheyne-Stokes Respiration

An abnormal breathing pattern indicating deep lesions in both cerebral hemispheres, the basal ganglia region, and the upper section of the brainstem.

Ataxic Respiration

A respiratory pattern with irregularity in depth and frequency, serving as an ominous sign of damage to a medullary center.

Decorticate Posture

An abnormal motor response characterized by flexion of the upper extremities, adduction, internal rotation of the lower extremities, and plantar flexion of the feet.

Decerebrate Posture

An abnormal motor response characterized by extension, pronation, and adduction of the upper extremities alongside plantar flexion of the feet.

Craniotomy

The surgical opening of the skull to gain direct access to intracranial structures.

Seizure

An episode of abnormal motor, sensory, autonomic, or psychic activity resulting from sudden, excessive neuronal discharge in the brain.

Epilepsy

A group of neurological syndromes characterized by unprovoked, recurrent seizures.

Aura

A premonitory visual, auditory, or olfactory sensation that serves as a warning sign preceding an impending seizure.

Status Epilepticus

An acute medical emergency defined as continuous electrical or clinical seizure activity lasting at least $30\,\text{minutes}$ or generalized seizures recurring without full recovery of consciousness between episodes.

Spinal Cord Injury (SCI)

Traumatic damage to the spinal cord, vertebral column, supporting soft tissues, or intervertebral discs, most frequently caused by motor vehicle accidents, falls, violence, or sports injuries.

Complete Spinal Cord Injury

A spinal cord lesion characterized by the total loss of voluntary motor and sensory communication from the brain to the periphery below the level of injury, producing paraplegia or tetraplegia.

Incomplete Spinal Cord Injury

A spinal cord lesion in which the ability to transmit sensory or motor messages to and from the brain is partially preserved below the level of injury.

Septic Meningitis

Inflammation of the meninges caused by bacterial infection, with Streptococcus pneumoniae and Neisseria meningitidis being responsible for most adult cases.

Aseptic Meningitis

Inflammation of the meninges caused by viruses (most commonly enteroviruses), secondary to malignancy, or associated with a weakened immune system such as HIV.

Kernig's Sign

A clinical sign of meningeal irritation where extension of the knee produces pain and resistance when the hip is flexed at $90^\circ$.

Brudzinski's Sign

A clinical sign of meningeal irritation where passive flexion of the neck induces involuntary flexion of the hips and knees.

Parkinson's Disease

A slow-progressing neurodegenerative movement disorder of gradual onset and chronic evolution characterized by resting tremor, rigidity, bradykinesia, and postural instability.

Antiparkinsonian Pharmacotherapy Overview

A summary of main medications used in Parkinson's disease—including Amantadine, Bromocriptine, Levodopa, and Carbidopa— detailing their indications, therapeutic effects, and common side effects.

Amantadine

An antiparkinsonian medication that reduces rigidity, tremor, bradykinesia, and postural changes in early Parkinson's disease.

Bromocriptine

A dopamine agonist used in early Parkinson's disease or as a secondary therapy when carbidopa or levodopa loses efficacy.

Levodopa

A metabolic precursor that converts into dopamine in the basal ganglia to relieve motor symptoms of Parkinson's disease.

Carbidopa

A medication administered with levodopa to inhibit its peripheral metabolism before it can reach the brain.

Deep Brain Stimulation (DBS)

A surgical treatment for Parkinson's disease involving the implantation of an electrode in the globus pallidus or subthalamic nucleus to deliver electrical signals that regulate movement.

Microdiscectomy

A surgical technique using an operating microscope to resect herniated or protruding intervertebral disc material through a small incision of approximately $2.5\,\text{cm}$.

Laminectomy

Surgical resection of the bone between the spinous process and the junction of the facet joint and pedicle to expose neural elements and relieve spinal canal compression.

Lumbar Puncture

A diagnostic and therapeutic procedure in which a needle is inserted into the lumbar subarachnoid space (between L3-L4 or L4-L5) to collect CSF, measure or reduce ICP, or instill medications.

Post-Lumbar Puncture Headache

A severe bifrontal or occipital headache occurring hours to days after a lumbar puncture due to persistent CSF leakage through the dural puncture site, which worsens upon standing and improves when recumbent.

Cerebral Angiography

An X-ray examination of cerebral circulation performed by injecting a contrast medium into a selected artery to evaluate vascular patency and structural anomalies.

Myelography

A radiographic evaluation of the spinal subarachnoid space conducted following the injection of a contrast medium via lumbar puncture.

Transcranial Doppler

A non-invasive ultrasound test that uses a handheld probe to measure blood flow velocity in intracranial vessels, aiding in the assessment of vasospasm and vascular occlusive disease.

Electroencephalogram (EEG)

A diagnostic recording of the brain's electrical activity obtained through scalp electrodes or microelectrodes, used in assessing seizure disorders, coma, and brain death.