Neurology Lecture Notes Review

Neurons and Nervous System Structure

• Neuron: The functional unit of the nervous system responsible for conducting electrical impulses.
• Central Nervous System (CNS): Comprises the brain and spinal cord.
• Peripheral Nervous System (PNS): Composed of nerves in the peripheral parts of the body.
• Cerebrospinal Fluid (CSF): Circulates through the CNS, providing cushioning and nutrient transport.

Neurologic Assessment

• Key Evaluations:
  • Level of consciousness
  • Pupillary size and response
  • Coordination and balance
  • Sensory function
  • Reflexes
  • Vital signs
• Increased Intracranial Pressure (ICP):
  • Can impair cerebral tissue perfusion leading to ischemia and respiratory arrest.
  • Signs and Symptoms:
  • Decreased level of consciousness
  • Pupil dilation without light response
  • Motor deficits and abnormal posture
  • Fever, increased blood pressure
  • Bradycardia and respiratory depression
• Measures to Decrease ICP:
  • Positioning the patient
  • Hyperventilation
  • Fluid restriction
  • Mechanical drainage
  • Drug therapy

Seizures and Management

• Definition: Abnormal activity in the brain due to erratic electrical impulses.
• Treatment: Anticonvulsant therapy, and addressing underlying causes.
• Nursing Care Considerations:
  • Risk for injury and coping deficits.

Head Injury and Care

• Focuses on:
  • Cerebral tissue perfusion
  • Oxygenation and risk of infection
  • Impaired mobility and altered self-concept.

Neurologic Disorders

• Meningitis and Encephalitis: Nervous system infections.
• Guillain-Barré Syndrome (GBS):
  • Autoimmune response to viral infections.
  • Characterized by progressive neurologic deficits with potential for recovery.
• Parkinson Syndrome:
  • Progressive disorder affecting coordination and movement.
  • Treatable with physical therapy and dopamine-boosting drugs.
• Multiple Sclerosis (MS): Progressive degenerative disease impacting motor pathways.
• Amyotrophic Lateral Sclerosis (ALS): Rapidly progressive, usually fatal within 3 years.
• Myasthenia Gravis: Impulse conduction defect leading to muscle weakness; treated with anticholinesterase drugs.
• Trigeminal Neuralgia: Causes intense pain in the trigeminal nerve; treated with medications or surgery.
• Cerebral Palsy: Impairment in motor coordination due to cerebral damage.

Cerebrovascular Accident (CVA) (Stroke)

• Definition: Interruption of blood flow to the brain causing neurologic dysfunction.
• Risk Factors:
  • Atherosclerosis, atrial fibrillation, hypertension,
    diabetes, cardiac disease, alcohol use, smoking with OCPs.
• Classification:
  • TIA (Transient Ischemic Attack)
  • Stroke in evolution
  • Completed stroke
• Health Impact:
  • TIA: temporary dysfunction without acute infarction; considered a warning sign.
  • Stroke: symptoms lasting over 24 hours.

Types of Stroke

• Hemorrhagic Stroke: Resulting from blood vessel rupture.
• Ischemic Stroke: Caused by blockage from embolus or thrombus.
• Symptoms: One-sided weakness, numbness, visual problems, confusion, dysphagia, speech issues.
• Aphasia: Inability to comprehend or form appropriate responses.
• Dysarthria: Impairs clear speech.
• Dysphagia: Difficulty with swallowing.
• Dyspraxia: Impaired initiation of coordinated movements.
• Hemiplegia: Paralysis on one side of the body, opposite the brain injury.

Medical Treatment of CVA

• Potential treatments include:
  • Oxygen therapy
  • Diuretics and corticosteroids
  • Anticoagulants and thrombolytics
  • Intravenous fluids and dietary changes
  • Addressing underlying risk factors.

Post-Stroke Rehabilitation

• Patient recovery dynamics:
  • Complete independence
  • Partial recovery of abilities
  • Total dependence
• Rehabilitation goals: Enhance recovery through stimulation and practice of functional abilities.