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Neurology Focus
Neurological and Spinal Cord Disorders
| Neurology Focus | Answer |
|---|---|
| Aura | A peculiar sensation that precedes a set of symptoms |
| Automatism | Aimless behavior performed without conscious control or knowledge |
| Contralateral | opposite side |
| Decerebrate posturing | An abnormal extension of the upper extremities with extension of the lower extremities; accompanies increased pressure on the entire cerebrum and the motor tract structures of the brain stem |
| Decorticate posturing | abnormal flexion of the upper extremities of the lower extrmities; accompanies increased pressure on the frontal lobes |
| Encephalitis | inflammation of brain tissue |
| Hemiparesis | weakness on one side of the body |
| Hemiplegia | paralysis on one side of the body |
| Intracranial | within the skull |
| Ipsilateral | same side |
| Neuralgia | pain in a nerve or along the course of a nerve |
| Neurotransmitter | biochemical messenger at nerve endings that stimulates an excitatory or inhibitory response |
| Paresthesia | an abnormal sensation |
| Postictal | after a seizure |
| Seizure | convulsion; series of involuntary contractions of voluntary muscles |
| Autonomic dysreflexia | abnormally exaggerated response of the autonomic nervous system to a stimulus |
| Dermatome | area of skin supplied by sensory nerve fibers from a single posterior spinal root |
| Flaccid | soft; in relation to muscles, lacking tone |
| Myelinated | surrounded with a sheath |
| Paraplegia | loss of motor and sensory function due to damage to the spinal cord that spares the upper extremities but, depending of the level of the damage, affects the trunk, pelvis, and lower extremities |
| Quadriplegia | loss of motor and sensory function in all four extremities due to damage to the spinal cord |
| Spasticity | abnormally increased muscle tone |
| Functional unit of the nervous system | neuron (nerve cell) which conducts electical impulses from one area of the brain to another |
| afferent neuron | neurons that transmit information from distal parts of the body or environment toward the CNS; also known as sensory neurons |
| efferent neuron | neurons that carry information from the CNS to the periphery; also known as motor neurons |
| neurotransmitters | used to pass impulses from one neuron to another across the neural synapse. Common ones acetylcholine, norepinephrine, epinephrine, and dopamine. |
| Age-related changes to brain tissues | # of nerve cells decrease, brain weight is reduced, and the ventricles decrease in size, plaques and tangled fibers are increased as well in nervous tissue. Associated c AD, but postmortam pt s dementia have also found to have these as well |
| potential causes of neurological disorders | developmental and genetic disorders, trauma, infections and inflammation, neoplasms (tumors), degenerative processes, vascular disorders, and metabolic and endocrine disorders |
| componants of a neurological examination | LOC, pupillary evaluation, neuromuscular response, vital signs |
| componants of the advanced neurological examination | cranial nerve function, coordination and balance, neuromuscular function and reflexes |
| Babinski's reflex | accompanies abnormalities in the motor pathways in the cerebral cortex. In the presence of cortical dysfunction, the big toe dorsiflexes and other toes fan out. (you should be knowledgeable in how to perform this functional tests) |
| common diagnostic tests and procedures | Lumbar puncture, cerebral angiography, magnetic resonance imaging, brain scan, electromyography |
| common drugs for tx of neurological disorders | Anticonvulsants (phenytoin [Dilantin], fosphenytoin [Cerebrex], gabapentin [Neurontin]) and barbituates (phenobarital [Luminal], carbamazepine [Tegretol], diazepam[Valium],clonazepam[klonopin] |
| normal amount of ICP | 0 to 15 mm Hg |
| amount of perfusion pressure needed to ensure adequate cerebral functioning | 70 mm Hg (30 mm Hg or < is incompatible with life) |
| most reliable indicator of mental status and why | LOC, because of its extreme sensitivity to oxygen levels in the cerebral bloos. As ICP increases and perfusion is reduced, O2 delivery to tissue is also reduced: 1st sign of IICP. |
| the effect of increased pressure affecting midbrain or pons | decerebrate (extension)posturing |
| the effect of increasing pressure on cerebral tissue above the midbrain | decorticate (flexion) posturing |
| s/s IICP | hemiparesis, hemiplegia, inc SBP c no chance in DBP, hypo or hyperthermia, bradycardia, hypotension, widening of pulse pressure (Cushing's triad) |
| med tx IICP | positioning at or < 30 degrees, hyperventilation, fluid management, mechanical drainage, and drug therapy (IV mannitol is most common, a hyperosmolar diuretic) |
| four common types of HA's | migraines, cluster, tension, and HA r/t disorders of the eyes, teeth, or sinuses |
| Migraine HA etiology and s/s | thought to be due to intracranial vasoconstriction followed by vasodilation. s/s depression, irritability, vision disturbances, nausea, paresthesias. pain is usually unilateral and pain very intense |
| Cluster HA etiology and s/s | occur in a series of episodes followed by periods c no sx. may be r/t stress or anxiety and usually have no warning system and shorter in duration |
| Tension HA etiology and s/s | resultws from prolonged muscle contraction associated c anxiety, stess, or stimuli. pt c/o N/V, dizziness, tinnitus, or tearing. may persist for days to even years. |
| seizures | an electrical impulse that is conducted in a highly chaotic pattern that yields abnormal activity and behavior. Involves a large number of hyperactive neurons that use excessive O2 and glucose.This can result in brain damage |
| partial (focal) seizures | only affects one part of the brain. The observed activity corresponds to the area of the brain affected |
| generalized seizures | involves the entire brain from the onset and are associated with loss of consciousness |
| status epilepticus | a medical emergency in which the pt has continuous seizures or repeated seizures in rapid succession for 30 minutes or more. This depletes the brain of O2 and glucose, which can lead to permanent brain damage |
| common nursing dx for seizures | risk for injury, ineffective coping, deficient knowledge |
| pt teaching: seizures | warning signs (dizziness, numbness, perception of offensive odor). triggers (stress, fever, large caffeine intake, failure to take med). know your drugs and wear a medic-alert braclet. when a seizure is percieved, seek a safe place and lie down. |
| types of head injuries | scalp, concussion, contusion, hematomas, subdural hematoma, epidural hematoma, intracerebral hemorrhage, penetrating injuries |
| nursing care that can decrease ICP | positioning to prevent neck and hip flexion, limiting suctioning, space nursing care, preventing isometric muscle contraction, elevate HOB as ordered, and carefully regulate adm of IV fluids to prevent fluid volume excess |
| meningitis etiology and s/s | inflammation of the meningeal coverings of the brain and spinal cord caused by either viruses or bacteria. |
Created by:
blumchen
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