scc nursing
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| cell body | contains cell nucleus. center of cell metabolism
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| dendrites | short unsheathed processes that transmit impulses to cell body.
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| axons | longer process that transmit impulses away from cell body
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| myelin sheath | covering for most axons. insulates nerve fiber. made up of fat cells
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| saltatory conduction | nodes of ranvier, intermittent gaps in myelin shealth. provide for smooth nerve conduction.
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| cervical nerve plexus | c1-c4, sends motor impulses to neck muscles, sends out phrenic nerve activating diaphragm, recieves sensory impulses from neck and back of head.
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| brachial plexus | c5-t1, innervates shoulder, arm, forearm, wrist, and hand.
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| lumbosacral plexus | t2-s4, innervates lower extremites. sends out large sciatic nerve
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| Lower motor neurons | outside CNS, goes to skeletal muscles of the body. lesions cause weakness paralysis, muscle atrophy, and decrease muscle tone (flacidity) hyporeflexia
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| Upper motor neurons | inside CNS lesions cause weakness/paralysis, hyperreflexia, increased muscle tone spastic
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| anosognosia | inability to recognize bodily defect or disease. Lesions in r pariental cortex.
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| aphasia, dysphagia | loss or impaired language comprehension,expression, both. l cerebral cortex lesion
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| dysarthria | lack of coordination in articulating speech. cerebellar or cranial nerve lesion.
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| anisocoria | inequality of pupil size. optic nerve inj
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| diplopia | double vision. lesions affecting nerves of extaocular muscles, cerbellar damage.
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| homonymous hemianopsia | loss of vision in one side of visual field. lesions in the contraleteral occipital lobe
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| dysphagia | difficulty swallowing Lesions involving motor pathways of Cn IX X including lower brainstem
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| ophthalmoplegia | paralysis of eye muscle lesions in brainstem
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| papilledema | choked disc swelling of opic nerve head increase in intracranial pressure
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| Apraxia | inability to perform learned movements despite having desire and physical ability to perform them cerebral cortex lesion
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| ataxia | lack of coordination of movement lesions of sensory or motor pathway, cerebellum, antiseizure drugs, sedatives, hypnotic drug toxicity
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| dyskinesia | impairment of voluntary movement resulting in fragmentary of incomplete movements disorder of basal ganglia, idosyncratic reaction to psychotropic drugs
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| hemiplegia | paralysis on one side stroke and other lesions involving motor cortex
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| nystagmus | jerking or bobbing of eyes as they track moving object lesions in cerebellum, brainstem, vestibular system
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| analgesia | loss of pain sensation lesion in spinothalmic tract or thalamus
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| anesthesia | abesence of sensation. lesions in spinal cord thalamus, sensory cortex, peripheral sensory nerve
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| paresthesia | alteration in sensation lesions in the posterior column or sensory cortex
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| astereognosis | inability to recognize form of object by touch lesions in parietal cortex
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| extensor plantar response (babinski) | upgoing toes with plantar stimulation upper motor neuron lesion
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| deep tendon reflexes | deminished or absent motor response lower motor neuron lesions
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| paraplegia | paralysis of lower extremities spinal cord transection or mass lesion thoracolumbar region
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| tetraplegia | paralysis of all extremities spinal cord transection or mass lesion cervical lesion
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| monro kellie principal | any increase of volume of one component (brain tissue, blood, csf)changes the volume of other two.
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| fx that influence ICP | b/p (a+v) intraabdominal/intrathroacic pressure posture temperature blood gases (acidosis dialation)
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| Normal ICP | 0-15mmhg
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| Initial adaption of ICP | csf absorption displacement of csf through brainstem, collapse of cerebral veins and sinuses
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| secondary adaption of ICP | decreased production of csf change in intracranial blood volume venous outflow slight compression of brain tissue
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| cerebral perfusion pressure | pressure needed to ensure blood flow to brain. norm 70-100mmhg.
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| CCP equation | CCP=MAP-ICP
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| ccp below 60 | ischemia
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| ccp below 30 | not compatible with life
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| CCP changes Stage One | autoregulation is occuring.
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| CCP changes Stage Two | compliance is beginning to lessen. increase in volume places patient at risk
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| CCP changes Stage Three | IICP with Cushing Triad
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| Cushings Triad | widening pulse pressure, bradycardia, changes in respirations.
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| CCP Stage Four | hernation is occuring IICP causes cerebral edemia and anoxia.
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| Factors affecting cerebral blood flow | Pao2 levels <50=cerebral vasodialation paco2 acidotic state potent vasodialtor
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| Blood pressure should be maintained to: | 100-140 systolic
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| O2 should be maintained to: | 95%
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| IICP | any increase in the brains three components
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| Vasogenic cerebral edema | change in white matter and blood brain barrier. Leakage of proteins from capillaries causing change in osmotic force.
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| Causes of vasogenic cerebral edema | brain tumor ingested toxins hemorrhages
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| cytotoxic cerebral edema | local distruption of cell membrane (gray matter) Fluid moves from intravascular space into cells.
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| Causes of cytotoxic cerebral edema | any hypoxic inj sodium depletion SIADH
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| interstitial cerebral edema | Increased CSF pushed into interstitial space
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| Causes of interstitial edema | hydrocephalus water overload
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| Conciousness | awareness of self and surroundings
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| altered conciousness | change in normal loc
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| unconsciousness | unaware of self and surroundings
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| arousal | state of wakefullness dependent on FAS
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| content | ability to think, reason, feel and react purposefully
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| unconcious state | does not respond to pain or corneal/gag/swallow pupillary reflexes
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| Cheyne Stokes respirations | cycles of hyperventilation and apnea Abg decrease co2 slight decrease o2
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| central neurogenic hyperventilation | sustained regaular rapid and deep breathing abg respiratory alkalosis brain stem dysfx lower midbrain/upper pons
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| apneustic | apneustic center deep and prolong inspiration dysfx in pons
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| cluster breathing | clusters of breaths follow each other with irregular pauses between dysfx of pons or medulla
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| ataxic (biots) | completely irregular breathing pattern with some dep and some irregular pauses. slow rate medulla dx
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