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Amy's Neuro Lectue 1
| Question | Answer |
|---|---|
| Highest level of central nervous system | cortical level (cognitive) |
| Brain stem or subcortical level controls | BP, respiration, equilibrum, primitive emotions |
| Lowest functional level of CNS | Spinal cord (autonomic motor responses, reflexes) |
| Sinuses help to.... | Keep head lighter |
| Meninges cover.... | brain and spinal cord |
| white fibrous membrane that lines interior of skull; how many folds? | dura matar; 4 |
| Falz cerebri | divides frontal lobe into right and left side. |
| Tentorium cerebelli | supports occipital lobes; keeps from pressing on cerebellum |
| Falx cerebelli | divides 2 lateral lobes of cerebellum |
| Diaphragma sella | forms circular fold to create roof for sella turcica |
| What sits in sella turcica? | pituitary gland |
| Arachnoid Matar | middle weblike layer; allows passage of cerebral arteries and veins |
| csf flows where? | Subarachnoid space between arachnoid and pia matar |
| CSF formed where? is for? | in ventricles; cushion, nutrients |
| What can happen if too much CSF? | hydrocephalis |
| Pia Mater | highly vascular, transparent layer; covers entire surface of brain, like shrink wrap |
| Pia Mater gets blood supply from? | internal carotid and vertebral arteries |
| Pia Mater of spinal cord is ? | Thicker, firmer, more durable, less vascular than that of the brain |
| Cerebral arteries have ? walls. | thinner |
| Veins and sinuses have ? valves. | no |
| encephalon? | brain |
| Encephalon divided into 3 areas: | cerebrum, brain stem, cerebellum |
| Brain is made up of ?% of water. | 2 |
| Brain receives ? ml/min of blood; ?% of total resting cardiac output | 750; 15% to 20% |
| Brain is dependent on ? for metabolism. | glucose |
| "Think tank of the brain" | cerebrum |
| Cerebrum is separated into 2 hemispheres by? | great longitudinal fissure |
| Wrinkles of the brain? Do what? | gyri; increase surface area |
| Each hemisphere of cerebrum is covered by? How thick? | cerebral cortex of gray matter; 2-5 mm |
| Under cerebral cortex is? | white matter that contains nerve fibers and neuroglia |
| Frontal lobe of cerebrum controls? | eye movement, personality, judgement, emotions, speech |
| Parietal lobe of cerebrum controls? | touch, pin awareness, spatial relationships, processing sensory input |
| Temporal lobe of cerebrum controls? | memory, intellect, processing info. |
| Skull is thickest where? | frontal lobe |
| Occipital lobe of cerebrum controls? | vision and others |
| Basal ganglia- located ? Controls? | deep in cerebral cortex; fine motor movement, integrates and modulates unconscious motor activity |
| Diencephalon? Includes? | Major division of cerebrum; thalamus, epithalamus, hypothalamus, subthalamus |
| Thalamus? | responsible for pain awareness, focusing attention, reticular activating system and limbic system |
| Epithalamus? | dorsal portion of diencephalon; responsible for growth and development, "food getting" reflex |
| Hypothalamus? | basal region of diencephalon; forms walls of 3rd ventricle; responsible for appetite, sexual arousal, thirst (primitive emotions) |
| Subthalamus? | below thalamus; closely related to basal ganglia in function (fine motor movement, unconscious motor activity) |
| Most cranial nerves originate where? | Brain stem |
| 3 major division of brain stem? | midbrain, pons, medulla |
| Midbrain- where? function? | between diencephalon and pons; serves as pathway between hemispheres and lower brain, center of auditory and visual reflexe (CN III, IV) |
| Pons- where? function? | bridge between midbrain and medulla; contains 4th ventricle; some contol of resp function (CN V-VIII) |
| Medulla- where? | continuous w/spinal cord, level w/foramen magnum and root of C-1. (CN IX-XII) |
| Cerebellum located ? | In posterior fossa and attached to sections of midbrain |
| 3 layers of cerebellum? | cortex, white matter, deep cerebellar nuclei |
| cerebellum controls? | fine motor movement, coordinates muscle groups, maintains balance |
| Autonomic Nervous System made up of? | only motor neurons |
| ANS regulates? | activities of the viscera, including all smooth (involuntary) muscles, cardiac muscles, and glands |
| ANS purpose? | maintain stable internal environment |
| ANS composed of? | sympathetic and parasympathetic |
| sympathetic responds to? Releases? | stress situations (fight or flight); norepinephrine and epinephrne (adrenergic) |
| Parasympathetic stimulates? | visceral activities assoc. w/conservation, restoration, maintenance of normal functioning level |
| Parasympathetic secretes? | acetylcoline at postganglion neuron (cholinergic) |
| Potential difference? | difference in electrical charge on either side of cell membrane |
| Stimuli conduct? and creates? | an impulse; action potential |
| Reversal of sodium and potassium across cell membrane causes? | depolarization |
| Impulse is conducted from 1 neuron to the next across? | synapse |
| The cell then? | repolarizes and returns to resting state |
| CN I | Olfactory- specific to sense of smell |
| CN II | Optic- part of visual system |
| CN III | Oculomotor- 4 of 6 muscles that move eye; lifts eyelid; pupil constriction nd lens accomodation; pupilary dilation |
| CN IV | Trochlear- moves eye downward and inward |
| CN V | Trigeminal- sensory (pain, temp, and light touch of entire face and scalp) Motor (supplies muscles of mastication) |
| CN VI | Abducens- innervates lateral rectus muscle that rotates eye laterally on horizontal plane |
| CN VII | Facial Nerve- sensory (tasee to anterior 2/3 of tongue, sensation of external auditory canal) Motor (closin eye, smiling, whistling, showing teeth, wrinkling nose, grimacing, wrinkling brow) |
| CN VIII | Acoustic- 2 branches- cochlear (hearing), vestibular (balance, body position, spatial orientation) |
| CN IX | Gossopharyngeal- sensory (taste receptors posterior 1/3 of tongue, sensation from pharynx, tongue, eustachian tube, carotid sinus), motor (moves pharynx, carry parasympathetic fibers to parotid gland) |
| CN X | Vagus- sensory (external auditory meatus, pharynx, larynx, thoracic and abdominal viscera, taste receptors of posterior pharynx) Motor (moves soft palate, pharynx, larynx, parasympathetic innervation of thoracic and abdominal organs) |
| CN XI | Cranial Nerve- spinal accessory; innervates sternocleidomastoid and upper trapezius muscles; shrugs shoulders and rotates head |
| CN XII | Hypoglossal- speech, swallowing |
| CSM for neuro assessment? | cognition, sensory, motor |
| Full consciousness | A&O to time, place, person |
| Confusion | usually confused to time 1st, then place, then person |
| Lethargy | A&O to time, place, person, but kind of slow and sleepy |
| Obtunded | rousable w/stimulation, can follow simple command; deeper lethargy |
| Stuporous | lies quietly, unresponsive except to vigorous awakening techniques |
| Comatose | unresponsive |
| Glascow Coma Scale assesses? highest score? | eye opening, motor response, verbal response; 15 |
| decortiction? | abnormal posturing; arms, wrists, fingers are flexed w/internal rotation and plantar flexion of legs |
| decerebration? | abnormal posturing; extension of arms and legs, pronation of arms, platar flexion and body spasm where body is bowed forward |
| With refexes, the more magnesium you have, the more? | it suppresses reflexes. |
| An EEG would be done to check for? | brain electrical activity, seizures |
| PET scan- no ? before test. | caffeine, alcohol, tobacco for 24 hrs before |
| lumbar puncture needle inserted where? For what? | between L-3 and L-4 or L-4 and L-5; exam CSF, pressure reading, inject contrast medium, anestetics or medications |
| Sudden release of CSF pressure can cause? | brain herniation |
| After lumbar puncture, patient may have severe? | headache |
| After lumbar puncture, pt is restricted to bedrest for? | 4-6 hrs to prevent leakage from puncture site |
| Amount of CSF produced daily? | 500 mL |
| Electroencephalogram (EEG) records? Takes how long? | electrical activity of cerebral hemispheres; 40-60 minutes |
| Two things pt should do before EEG? | Be sleep deprived and avoid caffeine |
| CVA is __ most common death in US? | 3rd |
| A TIA is a warning of? AKA? | diminished blood supply to part of the brain; silent stroke |
| 1/2 of all strokes are? | thrombotic |
| Thrombotic strokes occur when? Onset? | daytime; gradual |
| With a thrombotic stroke, pt is? contributing factors to this type of stroke? | alert, awake; HTN, atherosclerosis |
| What is a RIND? Difference between this and TIA? | reversible ischemic neurologic deficit; TIA pt is symptomatic for a few minutes to less than 24 hrs. RIND pt is symptomatic for more than 24 hours, but less than a week. |
| Embolic stroke has __ symptoms. onset? Improves? | abrupt; daytime; rapidly |
| With a hemorrhagic stroke, you bleed into one of 3 places: | ventricles, subdural, subarachnoid |
| Hemorrhagic strokes happen often after? Onset? | ruptured aneurysm; abrupt |
| Risk factors for hemorrhagic stroke? | HTN, cardiac valve replacement, DM, obesity, hypercholesteremia, heredity, migraines, oral contraceptives, lifestyle |
| symptoms of stroke: | change in LOC, hemiparesis, hemiplegia, aphasia, agnosia, apraxia, neglect, visual field disturbances, emotional lability, signs of increased intracranial pressure |
| Right hemisphere stroke effects? | disoriented, visual spatial defect, neglect of left visual field, loss of depth, perception, lack of awareness |
| Left hemisphere stroke effects? | aphasia, agraphia, reading problems, right visual field deficits, slow cautious, depressin, quick anger, intellectual impairment |
| 2 nursing interventions for Intracranial pressure monitoring: | head of bed 30 degrees, space nursing activities |
| Drug therapy for strokes | thrombolytics, anticoagulants, antiplatelets, anticonvulsants |
| Surgery for strokes: | endarterectomy, extracranial-intracranial bypass, AVM occlusive therapy or clippin, craniotomy |
| Spinal cord injuries are classified as: | complete (no function below area damaged) or incomplete (some function below area damaged) |
| 50% of spinal cord injuries are from: | motor vehicle accidents |
| 2nd leading cause of spinal cord injuries: | falls, acts of violence and sports injuries |
| Spinal cord damage can be caused by diseases like: | polio, meningitis, spina bifida, cancer tumors |
| 4 mechanisms that have potential to cause injury: | hyperflexion, hyperextension, axial loading, excessive rotation |
| Hyperflexion is from: | sudden deceleration, like hitting head on front windshield |
| Lateral hyperflexion is from: | extreme lateral flexion or rotation of head or neck, like a car hitting your car from the side |
| Hyperextension is from: | a whiplash type motion |
| Axial loading injury is from: | vertical force exerted on spinal column, like diving into a shallow pool. |
| With lumbosacral injuries, peripheral nerves have potential for: | recovery and regrowth- can get some function back |
| lumbosacral injuries usually have __ bladder. | neurgenic |
| Always clear c-spine by x-ray before: | removing c-collar or moving c-spine |
| Why ABG lab test when treating c-spine injury? | Resp function may be altered from injury |
| Drug therapy for c-spine injury: | methylprednisolone to decrease swelling and inflammation |
| Damage to spinal cord results in damage to: | ANS |
| 2 ANS syndromes: | spinal shock, autonomic dysreflexia |
| Spinal shock? | flaccid paralysis, loss of reflex below level of injury, bradycardia, paralytic ileus, hypotension |
| spinal shock lasts how long? | few days to several months |
| autonomic dysreflexia? | occurs AFTER spinal shock period, severe rapidly occuring hypertesion, bradycardia, flushing above level of injury, severe throbbing headache, nasal congestion, sweating, nausea, blurred vision |
Created by:
wvc
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