NEURO

  • Neurologic System Overview

    • Composed of the central nervous system (CNS) and peripheral nervous system (PNS).

  • Central Nervous System (CNS)

    • Consists of the brain and spinal cord:
    • Cerebral Cortex: Outer layer responsible for high functions (thought, memory, reasoning).
    • Hemispheres: Two halves of cerebrum, each with four lobes.
      • Frontal Lobe: Personality, behavior, emotions, Broca’s area (motor speech).
      • Parietal Lobe: Postcentral gyrus (primary sensation center).
      • Occipital Lobe: Primary visual receptor center.
      • Temporal Lobe: Primary auditory center, Wernicke’s area (language comprehension).

  • Key CNS Structures:

    • Basal Ganglia: Initiates and coordinates movement, controls automatic movements.
    • Thalamus: Relay station for sensory pathways to cerebral cortex.
    • Hypothalamus: Regulates temperature, heart rate, appetite, stress response, and autonomic activity.
    • Cerebellum: Coordinates voluntary movements and maintains equilibrium.
    • Brainstem: Central core of the brain (midbrain, pons, medulla oblongata).
    • Spinal Cord: Connects brain to spinal nerves; mediates posture, urination, pain responses.

  • Neural Pathways:

    • Sensory Pathways: Monitor sensation and include anterolateral tract (pain, temperature) and posterior columns (position, vibration).
    • Motor Pathways: Include corticospinal tract (skilled movements), extrapyramidal tract (muscle tone), and cerebellar system (coordination).
    • Upper vs Lower Motor Neurons: Upper in CNS; lower in PNS connected to muscles.

  • Peripheral Nervous System (PNS):

    • Connects CNS to sensory receptors, muscles, and glands.
    • Reflexes: Quick reactions to stimuli; types include deep tendon, superficial, and visceral reflexes.
    • Cranial Nerves: 12 pairs: I & II from cerebrum; III-XII from brainstem; primarily for head and neck functions.
    • Spinal Nerves: Mixed nerves supplying body; categorized by region.
    • Autonomic Nervous System: Governs involuntary muscles and maintains homeostasis.

  • Development and Aging:

    • Neurologic system underdeveloped at birth; motor control improves with myelin acquisition.
    • Aging leads to neuron atrophy, decreased nerve conduction, memory loss distinct from Alzheimer’s, and stroke prevalence varies by demographics.

  • Neurologic Assessment:

    • Subjective Data: Evaluate headaches, dizziness, tremors, swallowing difficulties.
    • Objective Data:
    • Sequence: Mental status, cranial nerves, motor and sensory exams, reflexes.
    • Screen patients with no concerns, complete exams for neurologic issues, rechecks for known deficits.
    • Health Promotion: Educate on stroke signs (F.A.S.T.) and encourage timely medical response for ministrokes.