In-Depth Notes on Nervous System Disorders for Nursing Students

Learning Objectives

  • Review the anatomy & physiology of brain structures.

  • Identify and understand the components of the central nervous system (CNS), particularly the brain and spinal cord.

  • Comprehend the autonomic nervous system which includes the sympathetic and parasympathetic nervous systems.

  • Conduct a thorough assessment of neurological functions.

  • Identify common diagnostic tests in the neurological system.

Understanding the Nervous System: Anatomy & Physiology

  • Central Nervous System (CNS)

    • Brain: The control center of the nervous system, responsible for generating thoughts, emotions, and speech.

    • Spinal Cord: Acts as a center for conducting messages between the brain and the body and serves as a reflex center.

Brain Function (Physiology)

Main Functions of the Brain (Cerebrum, Cerebellum, Diencephalon, Brain stem-MPM)

  • Cerebrum: Contains skills memory, processes intellect and emotions, Interprets sensory input, controls skeletal muscle activity

  • Cerebellum: Processes information provides info for balance, posture and coordinated muscle movement.

  • Diencephalon: Regulates ANS, produces hormones, mediate emotional responses, pass along motor and sensory impulses to the brain.

  • Brain stem: Sends messages between the brain and body, where nerve pathways cross sides (decussation), controls breathing, manage muscle movement

  • Lobes of the cerebrum:

    1)Frontal lobe-behaviour,intelligence, memory, movement (controls voluntary movements)

    2)Parietal lobe-sensation, left side receives input from right side of body vice versa, language, reading

    3)Temporal lobe-interprets olfactory and auditory stimuli, behavior hearing speech

    4)Occipital lobe: interprets visual stimuli



  • Lobes of the Cerebrum:

    • Primary Motor Cortex: Facilitates voluntary movement of skeletal muscles.

    • Sensory Areas: Receive and interpret stimuli from various senses (touch, vision, etc.).

    • Motor Speech Area: Responsible for the vocalization of words.

Other Brain Components

  • Ventricles: The brain houses four ventricles filled with cerebrospinal fluid (CSF), which circulates through ducts.

  • Cerebrospinal Fluid (CSF): A clear, odourless liquid formed by specialized capillaries; it cushions the brain and spinal cord.

  • Meninges: The brain and spinal cord are covered by three connective tissue membranes:

    • Dura Mater (outer layer)

    • Arachnoid Mater (middle layer)

    • Pia Mater (innermost layer)

Understanding the Spinal Cord

  • Composed of bones, muscles, tendons, nerves, forming a structure that extends from the base of the skull to the coccyx (tailbone).

  • Vertebrae: 33 total, categorized into:

    • Cervical (C1-C7)

    • Thoracic (T1-T12)

    • Lumbar (L1-L5)

    • Sacral (S1-S5)

    • Coccyx (fused vertebrae).

  • Protects the spinal cord and serves as a pathway for messages to and from the brain.

  • Cauda Equina: A bundle of spinal nerves extending beyond the conus medullaris (the end of the spinal cord).

Autonomic Nervous System

  • Parasympathetic System

    • Neurotransmitter: Acetylcholine.

    • Function: Operates in non-stressful situations. Results in constriction of pupils, decreased heart rate, increased gastrointestinal activity.

  • Sympathetic System

    • Neurotransmitter: Norepinephrine.

    • Function: Prepares the body for stressful situations: dilates pupils, increases heart rate, decreases urine output, raises mental alertness.

Neurological Assessment

  • AVPU Scale: To assess responsiveness:

    • A: Alert

    • V: Verbal response

    • P: Response to painful stimuli

    • U: Unresponsive (no response to verbal or painful stimuli).

  • Glascow coma scale

Cranial Nerves

  • Essential for understanding neurological function and assessment.

  • 12 cranial nerves (OOOTTAFVGUAH)

Diagnostic Investigations

Cerebral Angiogram
➡ A special X-ray that shows blood vessels in the brain using dye.

CT Scan (Computed Tomography)
➡ A detailed scan that shows cross-section images of the brain or body using X-rays.

Carotid Duplex Study
➡ An ultrasound that checks blood flow in the neck arteries that go to the brain.

Lumbar Puncture (Spinal Tap)
➡ A test where fluid is taken from the spine with a needle to check for brain and spinal cord problems.

X-rays of Skull and Spine
➡ Basic images that show bones of the head and spine to check for injury or problems.