COORDINATION

PERCEPTION &

NEUROSENSORY SYSTEM

MUSCULOSKELETAL SYSTEM

NERVOUS SYSTEM (NS)

ANATOMY & PHYSIOLOGY

BRAIN & SPINAL CORD

CENTRAL NS

PERIPHERAL NS

CRANIAL & SPINAL NERVES

AUTONOMIC

SYMPATHETIC - THORACO- LUMBAR PARASYMPATHETIC S2,3,4

ANATOMY & PHYSIOLOGY

BRAIN:

CEREBRUM DIENCEPHALON BRAIN STEM CEREBELLUM

ANATOMY & PHYSIOLOGY

CEREBRUM

FRONTAL PARIETAL

HEMISPHERES

LOBES
CORPUS CALLOSUM BASAL GANGLIA

TEMPORAL
OCCIPITAL

ANATOMY & PHYSIOLOGY

FRONTAL LOBE:

PERSONALITY, BEHAVIOR HIGHER INTELLECTUAL FUNCTIONING PRECENTRAL GYRUS: MOTOR FXN BROO---M BROCAS AREA MOTOR SPEECH
WERNICKES AREA OF TEMPORAL: SENSORY SPEECH

PARIETAL LOBE:
POST

CENTRAL GYRUS : GENERAL SENSATION INTEGRATES SENSORY INFO

ANATOMY & PHYSIOLOGY

TEMPORAL LOBE HEARING, TASTE & SMELL WERNICKES AREA SENSORY SPEECH
BROCAS AREA OF FRONTAL LOBE MOTOR SPEECH OCCIPITAL LOBE

VISION BASAL GANGLIA REGULATE & INTEGRATE MOTOR ACTIVITY PART OF EPS

ANATOMY & PHYSIOLOGY

DIENCEPHALON PRIMITIVE EMOTIONS: RAGE & FEAR THALAMUS HYPOTHALAMUS BRAINS STEM
MIDBRAIN,

CONTROL CENTER FOR PITUITARY REGULATION OF VITAL FXN : BP, SLEEP, FOOD INTAKE, BODY TEMP

PONS, MEDULLA NUCLEI OF CNs - 12 VITAL CENTERS OF: REPIRATORY, VASOMOTOR & CARDIAC FXNS

CEREBELLUM
MUSCLE

TONE & EQUILIBRIUM

ANATOMY & PHYSIOLOGY

SPINAL CORD

GRAY MATER

WHITE MATER

H SHAPED INTERIOR EXTERIOR

31 SEGMENTS :
8 CERVICAL 12 THORACIC 5 LUMBAR 5 SACRAL 1 COCCYGEAL

CENTER OF REFLEX ACTIONS

ANATOMY & PHYSIOLOGY

MENINGES

SEROUS MEMBRANE OF CRANIOSPINAL CAVITY

3 LAYERS:

DURA ARACHNOID PIA

-CS FLUID

ANATOMY & PHYSIOLOGY

NERVES

FIBERS WHICH EXTEND BEYOND CNS NEURON -BASIC UNIT

SENSORY/MOTOR MIXED

PERIPHERAL

REFLEX ARC
BASIC FXNAL UNIT OF N.S.

ASSESSMENT FACTORS
1. 2. 3. 4. 5. 6. 7. 8.

HEADACHE SYNCOPE VERTIGO SEIZURES NEUROLOGIC PAIN INCREASED ICP ABN BODY TEMP ALTERATIONS APHASIA

HEADACHE/ CEPHALGIA
CAUSE: MUSCLE CONTRACTION VASCULAR HEADACHE HEADACHE

CLUSTER HISTAMINE HEADACHE TRACTION HEADACHE PSYCHOGENIC : ANXIETY / DEPRESSION DISPLACEMENT/ INFLAMMATION/ DIRECT PRESSURE ON INFLAMMATORY/ ALLERGIES
TENSION MTC PRECIPITANTS: DILATATION OF ARTERIES MANAGEMENT: CAUSE: EMOTIONAL VERY RARE STRESS

MIGRAINE (SICK H/A)

PERFECTIONISTS & HARDWORKING PAIN-SENSITIVE STRUCTURES TYRAMINE STRESS SEVERE

CONSTRICTION, THEN DILATION OF CEREBRAL VESSELS FATIGUE ORGANIC IN NATURE TREATMENT: VASODILATING OCCURS IN AM DRUGS WARM COMPRESS CLASSIFICATION: VASOCONSTRICTORS ERGOTAMINE TARTRATE GENTLE MASSAGE ICE PACK TYPES: INVOLVES THE ENTIRE HEAD ANALGESICS, TRANQUILIZERS QUIET, DARKENED ROOM MUSCLE CONTRACTION H/A 1. MIGRAINE 2. CLUSTER 3. INFLAMMATORY PSYCHOTHERAPY VASCULAR H/A

SYNCOPE/FAINTING

TRANSIENT LOSS OF CONSCIOUSNESS INADEQUATE BRAIN PERFUSION

CAN BE EVOKED BY:

EMOTION PAIN SUDDEN DECREASE IN CO OR VENOUS RETURN FROM ANY CAUSE

DANGLE FEET FOR 30 SEC BEFORE STANDING SPIRITS OF AMMONIA

MANAGEMENT:

VERTIGO
SENSATION OF:
ROTATING SURROUNDINGS CLIENT IS ROTATING

SEEN IN:
NEURO DSE OTOLOGIC DSE CARDIOVASC DSE

DIZZINESS NYSTAGMUS

SEIZURE/EPILEPSY
PATIENT EDUCATION: NURSING INTERVENTION: MEDICAL TREATMENT: TYPES: PETIT PSYCHOMOTOR MAL SEIZURE FOCAL MOTOR/ JACKSONIAN 1. CARRY ID CARD AS AN EPILEPTIC MYOCLONIC SEIZURE GRAND MAL PRIMARY RESPONSIBILITY: LITTLE SICKNESS/ ABSENCE
2. REST, REGULAR MEALS, WELL-BALANCED DIET 1. GENETIC COUNSELLING CLINICAL SEQUENCE: PROTECT PATIENT FROM INJURYACTIVITIES PERFORMANCE OF AUTOMATIC 3. AVOIDANCE OF: ARISE INITIALLY IN THE MOTOR AREAS SUDDEN INVOLUNTARY CONTRACTION OF A 1. GRAND MAL 2. ANTICONVULSANTS OBSERVE & RECORD THE SEIZURE EPISODE 1. EXTREME PHYSICAL EXERTION IMPAIRMENT MOMENTARY EPISODE OF CONSCIOUSNESS: OF BRAIN L.O.C. AURA LOSS TONIC-CLONIC OF CONSCIUOSNESS FALL INCONTINENCE CONVULSION OF THE CRY SINGLE OR SMALL GROUPS OF MUSCLE TAKEN FOR LIFE 2. INFECTION 2. PETIT MAL PSYCHOMOTOR LASTS LOC 10-20 SEC 3. NOT EMOTIONAL STRESS DO RESTRAIN THE PATIENT FROM LOCAL CLONIC MOVEMENTS MAY OCCUR DURING PETIT MAL FREQUENT CAUSES OF FAILURE INTO TREATMENT: CLIENT AMNESIA UNAWARE 4. ALCOHOL 3. MYOCLONIC PADDED SIDE RAILS, NO PILLOWS AFTER THE SEIZURE: GENERALIZED POOR COMPLIANCE 1. CHILDREN NO APPARENT & COFFEE, ADOLESCENTS CONVULSION 5. MODERATE TEA & COLA SEIZURE MAINTAIN AIRWAY 4. FOCAL GROGGY & CONFUSED, DEEP SLEEP 2. INADEQUATE DOSAGE ( ACCORDING TO WEIGHT) 6. STIMULANT DRUGS PATIENT EDUCATION

NEUROLOGIC PAIN
ARISE

FROM NEUROLOGIC LESIONS CONCERNING PAIN SENSATION

SURGERY:
NEURECTOMY

5TH NERVE RESECTON IN

TRIGEMINAL NEURALGIA
RHIZOTOMY- RESECTION OF THE POSTERIOR

NERVE ROOT
CORDOTOMY

LATERAL SPINOTHALAMIC TRACT

INCREASED INTRACRANIAL PRESSURE

INCREASED INTRACRANIAL PRESSURE

THE SKULL IS A CAVITY ALL OF WHICH AN ELEVATION IN THE AMOUNT CONTAINING THE MAINTAIN A NORMAL OF ANY TISSUE, OF THEM WOULD MEAN BRAIN CSF, & BLOOD PRESSURE INSIDE THE SKULL. AN ELEVATION IN THE PRESSURE INSIDE THE CRANIUM CONSIDERING THAT THE SKULL IS RIGID..

INCREASED INTRACRANIAL PRESSURE

CAUSES:
1. 2. 3. 4. 5.

TUMOR HEAD INJURY INFLAMMATORY DSES OF THE NERVOUS SYSTEM CONDITIONS WITH ARTERIOLAR SPASM (e.g.MALIGNANT HPN) ANYTHING THAT BLOCKS PARTLY OR COMPLETELY THE NORMAL COURSE OF CSF

INCREASED INTRACRANIAL PRESSURE

TREATMENT: CONSERVATIVE:
1.

HYPERBARRIC O2 / HYPERVENTILATION

2.
3.

AGGRESSIVE: MECHANICAL DECOMPRESSION

ELEVATE HOB MEDICATIONS 1. MANNITOL CRANIOTOMY BRAIN TISSUE EXPANSION 1. VENTRICULAR DRAINAGE 2. 2. STEROIDSDECADRON ONLY STEROID THAT CAN
CROSS THE BBB

VASOCONSTRICTION DUE TO HYPOCAPNIA

4.

FLUID RESTRICTION

INCREASED INTRACRANIAL PRESSURE

MANIFESTATIONS:
1. 2. 3. 4. 5. 6.

HERNIATION UNCAL UNRELATED TO MEALS TENSION REFLEX EFFECT ON OF CHOKED DISC INTRACRANIAL OR NAUSEA HEADACHE 7. LOSS OF MOTOR VESSELS PRESSURE & CEREBRAL ANOXIA ANOXIA VISUAL IMPAIMENT PROJECTILE REFLEX EFFECT OF RISING BP FUNCTION VOMITING IRREGULAR SIZE & PUPILLARY OF MEDULLA PRESSURE STIMULATION OF 8. SEIZURE RESPONSE WIDENING PULSE NURSING UNCAL HERNIATION CARE: NURSING MEDULLA CARE: OBLONGATA PUPILS FIXED PRESSURE 9. UNILATERALLY LOSS OF SPHINCTER DILATEDCONTROL & LATER, BILATERALLY SLOWING OF NURSING KEEP HOB MONITOR CARE: ELEVATED VS HOURLY VENOUS ENGORGEMENT OF NURSING MONITOR CARE: VS HOURLY RESPIRATION 10. CENTRAL TEMPERATURE REPORT POST: NO WIDENING TRENDELENBERG RETINA OF I & O VARIATIONS FALLING PULSE RATE MONITOR ASPIRIN AS VS PULSE ORDERED HOURLY PRESSURE WITHHOLD PULSE IN 1 FULL ORAL MIN FLUIDS 11. CHANGES IN NURSING CARE: PAPILLEDEMA RR NOIN NARCOTICS 1 FULL MIN LOC IF NEEDED BULGING OF SUCTION PUPILLARY CHECKS : EQUALITY 12. ( PUPILLARY CHANGES) FONTANELS & REACTION TO LIGHT

INCREASED INTRACRANIAL PRESSURE

DAMAGE TO LETHARGY EARLIEST SIGN MANIFESTATIONS: 1. HYPOTHALAMUS HEADACHE OF INCREASED ICP DECORTICATE PRESSURE CEREBRAL METABOLIC CHANGES 7. LOSS OF MOTOR 2. VOMITING PRESSURE MECHANICAL ON PRESSURE CEREBRAL DECEREBRATE INTERFERE WITH DEVELOPMENT OF FUNCTION INTRACRANIAL & RAS 3. CORTEX WIDENING PULSE PRESSURE SPHINCTER ON INHIBITORY MOTOR MENINGITIS 8. SEIZURE STIMULATION TO BRAIN NURSING CARE: PRESSURE CONTROL CENTERS 9. LOSS OF SPHINCTER NURSING CARE: 4. SLOWING OF NURSING CARE: CONTROL NURSING CARE: NOTE REPORT RESTLESSNESS CSF LEAKAGE NURSING CARE: RESPIRATION ANTIPYRETICS 10. TEMPERATURE EVALUATE REINFORCE WITH RECORD I&O ICE BAG 5. FALLING PULSE RATE VARIATIONS CARRYOUT SEIZURE CONSCIOUSNESS DRESSINGS RECORD DISTENTION/ HEMIPARESIS CHECK REMOVE EXCESSIVE 6. PAPILLEDEMA 11. CHANGES IN LOC PRECAUTION RECORD DISORIENTATION CN INCONTINENCE CXS CLOTHING 12. BULGING OF & HALLUCINATIONS CHECK REFLEXES CATHETERIZE PREVENT CHILLS FONTANELS

INCREASED INTRACRANIAL PRESSURE

GENERAL MEASURES:
AVOID STRAINING WITH DEFECATION PREVENT COUGHING REDUCE ENVIRONMENTAL STIMULI RESTRAIN CLIENT PRN ALWAYS ASSUME THAT CLIENT CAN HEAR

ABNORMAL BODY TEMPERATURE

NURSING MANAGEMENT: HYPERTHERMIA/ HYPERPYREXIA > or = 41o C or 106 o F BRAIN TISSUE IS OC MAINTAIN ROOM TEMP EACH OF RISE IN HIGHLY TEMP = INCREASE FLUIDS 3000 ML/DAY The temperature-regulatory center in the hypothalamus ANTIPYRETICS SUSCEPTIBLE TOO HYPOXIA.. 13 %INCREASE IN can be disturbed by: 2 REQIREMENT COMFORT MEASURES OF BODY TISSUES CEREBRAL EDEMA MONITOR VS CEREBROVASCULAR DISEASE ICE BAGS TO GROIN, AXILLA INTRACRANIAL SURGERY

HEAD INJURY BRAIN TUMORS

APHASIA OR DYSPHASIA

ORGANIC DISTURBANCE IN LANGUAGE FROM CORTICAL TISSUE DAMAGE NURSING CARE: FRONTAL LOBE:
REHAB 6-12 WKS AFTER STROKE PERSONALITY, BEHAVIOR FORMAL SPEECH TEMPORAL LOBE THERAPY HIGHER INTELLECTUAL FUNCTIONING VERBAL STIMULATION HEARING, TASTE & SMELL PRECENTRAL GYRUS: MOTOR FXN TALK SLOWLY & IN A NATURAL TONE WERNICKES AREA SENSORY SPEECH BROCAS AREA & MOTOR SPEECH SIMPLE WORDS PHRASES
USE

CARDS, PICTURES, SLATE BOARDS

DIAGNOSTIC ASSESSMENT
LUMBAR PUNCTURE QUICKENSTEDT TEST CISTERNAL & VENTRICULAR PUNCTURES ISOTOPE SCANNING OF THE BRAIN COMPUTERIZD AXIAL TOMOGRAPHY EEG ECHOENCEPHALOGRAPHY EVOKED RESPONSES RADIOLOGOC STUDIES

LUMBAR PUNCTURE
NEEDLE IS INSERTED BETWEEN L3-L4 OR Complications: NORMAL THE LEVEL CSFOF CHARACTERISTICS: THE SPINAL CORD L4-L5 BELOW HEADACHE CONTRAINDICATION: PRESSURE : 6-13 mmHg HYPOTENSION INCREASED ICP APPEARANCE : clear & colorless MENINGITIS SEPTICEMIA OR INFECTION RBC : none SUBARACHNOID HEMATOMA USE OF ANICOAGULANT WBC : 0-5 cells/mm SPACE OCCUPYING LESION Protein: very little Glucose: 40-80 mg /dl Chlorides: 720-750 mg/dl

DIAGNOSTIC ASSESSMENT
LUMBAR PUNCTURE QUICKENSTEDT TEST CISTERNAL & VENTRICULAR PUNCTURES ISOTOPE SCANNING OF THE BRAIN Assess CSF circulation & any COMPUTERIZD AXIAL TOMOGRAPHY Detect subarachnoid obstruction in block the EEG & increased ICP subarachnoid space ECHOENCEPHALOGRAPHY EVOKED RESPONSES Decrease danger of herniation RADIOLOGOC STUDIES

DIAGNOSTIC ASSESSMENT
Record of electrical activity patterns of the LUMBAR PUNCTURE ANGIOGRAPHY Clients head is scanned @of various angles Initial assessment intracranial brain using Scalp electrode QUICKENSTEDT TEST Complete brain study lesion & vascular abnormalities Electrical responses of the brain to PNEUMOENCEPHALOGRAM Prep: Use of ultrasonic waves to pickPUNCTURES up CISTERNAL & VENTRICULAR Dye 1-2 days before: no tranquilizers, anticonvulsants, external stimulus echoes from various intracranial tissues MYELOGRAM ISOTOPE SCANNING OF THE BRAIN stimulants including alcohol Diagnosis of: Omit tea. Coffee & cola; TOMOGRAPHY regular meals & sleep DISCOGRAPHY COMPUTERIZD AXIAL Multiple sclerosis Localized brain lesion EEG VENTRICULOGRAM Death ECHOENCEPHALOGRAPHY Dye Injection ofthe radiopaque dye Films into showing lateral ventricles outline of through subarachnoid burr holes space Lumbar puncture Contrast media to the intervertebral disk EVOKED RESPONSES Dye or airof contrast Injection air into the subarachnoid space Locate abn configurations, characteristics & damages RADIOLOGOC STUDIES Locate blockade of SC activity Contrast picture of dse subarachnoid cisterns & ventricles Detect Study pathological of cerebrovascular

VENTRICULOGRAM
NURSING CARE:
PRESURGICAL: POST COMPLETION OF TEST:
SEDATIVE FLAT OR SEMIFOWLERS SHAVING FORCE FLUIDS

ABSORPTION OF CONTRAST MEDIA CAROTID/VERTEBRAL PUNCTURE: MX NECKIS NORMAL INCREASED SALIVATION & PERSPIRATION CIRCUMFERENCE REDUCE ENVIRONMENTAL STIMULI RECORD BASELINE NEUROLOGIC DATA PAIN RELIEF FOR HEADACHE EXPLAIN THE PROCEDURE NO ANTIPYRECTICS : MAY MASK INFECTION

THE UNCONSCIOUS CLIENT

NURSING CARE NURSING CARE: NURSING CARE UNCONSCIOUSNESS: CAUSE: NURSING CARE NURSING CARE: Maintain sensory function MAINTAIN PATENT AIRWAY
MONITOR Maintain fluid VS & & NEURO intestinal STATUS status FUNCTION MAINTAIN JOINT MOBILITY MAINTAINING PSYCHOSOCIAL INTERFERENCE WITH OXYGEN SUPPLY STATE OF DEPRESSED CEREBRAL FUNCTION Special ophthalmic solutions : loss of blinking reflex ASSESS HIGHEST PRIORITY MAINTAIN SKIN INTEGRITY THE RATE, QUALITY RHYTHYM OF Unconscious period: 3L/day of& fluid PROPER POSITIONING ASSESS CLIENTS STATE LOWER JAW & TONGUE FALLS BACKWARD PULSE AND RESPIRATION ProlongedIN coma: NGT TERMS feeding FREQUENT TURNING & EXERCISE EXPLAIN SIMPLE Talk to clienthearing is the SUPPLY last faculty to be lost INTERFERENCE WITH GLUCOSE SUCTIONING BLANCHING INDICATES ISCHEMIA NO REACTION TO STIMIULI NO ORAL TEMP Observe client for AIDS: incontinence, constipation USE MECHANICAL THE PROCEDURES & THERAPIES NEURO POSITIONING CHECKS: LOC, PUPILS,MOTOR STRENGTH & impaction MORE FREQUENT POSITION CHANGE & SENSORY FUNCTION DIARRHEA early sign of fecal impaction FOOTBOARD INTERFERENCE WITH TRANSMISSION OF NEURONS RESPONSES IS ON THE REFLEX LEVEL ONLY. No rectal stimulationincrease ICP TROCHANTER ROLLS HAND ROLLS

CARE OF NEUROSURGICAL CLIENTS

POSITIONING VITAL SIGNS FOODS & FLUIDS

SUPRA TENTORIAL INFRA TENTORIAL COMMONALITIES

SEMIFOWLERS

NO SPECIFIC

LIMIT TO 1.5L/DAY DAT AFTER RETURN OF SWALLOWING & GAG

FLAT ON EITHER SIDE

OBSRVE FOR RESPIRATORY DIFFICULTY

MONITOR VS OBSERVE FOR SHOCK & INCREASE ICP

NPO X 24 HRS PO FLDS - DAT AFTER RETURN OF SWALLO WING & GAG

KEEP OFF OPERATIVE SITE TURN Q 2H

I & O

CARE OF NEUROSURGICAL CLIENTS

OTHER MEASURES: DRESSING AVOID ENEMA- MAY INCREASE SUCTION AS NECESSARY ICP DEEP BREATHING, NO COUGHING ICE BAG TO HEAD BOWEL & BLADDER ELIMINATION ANALGESIC, ANTICONVULSANT, STIMULANTS, STEROIDS EYE CARE

CLEAR DRAINAGE CATHETERIZE RESTRAINT CLIENT

NEUROLOGIC DISORDERS
1.
MULTIPLE SCLEROSIS PARKINSONS DSE MYASTHENIA GRAVIS

DEGENERATIVE DISEASES PREMATURE SENESCENCE OF CELLS

2.

ARTERIOSCLEROSIS ANEURYSM, HEMORRHAGE INFARCTION HEAD INJURY SPINAL INJURY

CEREBROVASCULAR DISEASES

3.

TRAUMATIC INJURIES NEUROPATHIES NEOPLASMS

TRIGEMINAL NEURALGIA BELLS PALSY

4. 5.

MULTIPLE SCLEROSIS
DEGENERATIVE, PROGRESSIVE DEMYELINATION OF MOTOR NERVE FIBERS WITHIN THE MANAGEMENT: MANAGEMENT: MANAGEMENT: BRAIN & SPINAL CORD ASSIST TO EFFECTS OF PREVENT HELP PATIENT & OVERCOME TREAT WITH MUSCLE OPTIC SPASTICITY AND SPEECH ETIOLOGY: UNKNOWN; INCOORDINATION DEFECTS MUSCLE RELAXANT AUTOIMMUNE; VIRUSES WALK WITH FEET WIDER APART SLEEP CRANIAL PRONE NERVES FOR SIGHT & SUPPORTIVE MEASURES FOR BLADDER AVOID SPEECH SKIN ARE PRESSURE AFFECTED & BY IMMOBILITY MS S/SX : CHARCOTS TRIAD: DISTURBANCE DECUBITUS EYE PATCH ULCERS NYSTAGMUS ATROPINE & PROBATHINE TRAIN IN ACTIVITIES OF DAILY LIVING INTENTION BLADDER PROGRAM TREMOR

SCANNING SPEECH

PARKINSONS DISEASE
PROGRESSIVE

DYSFXN OF BASAL GANGLIA BASAL GANGLIA DEFICIENCY OF DOPAMINE FROM REGULATE & INTEGRATE MOTOR ACTIVITY SUBSTANTIA NIGRA
PART OF EPS

INVOLVES

DOPAMINE

ACETYLCHOLINE

PARKINSONS DISEASE
S/SX: MANAGEMENT

DRUG THERAPY LEVODOPA ANTICHOLINERGICS COGENTIN, ARTANE MASKLIKE APPEARANCE PHYSICAL THERAPY COMBAT MUSCLE RIGIDITY SHUFFLING PROPULSIVE GAIT (FESTINATING GAIT TRAINING GAIT) SURGICAL THALAMOTOMY ALLEVIATE TREMOR & RIGIDITY

PILL ROLLING & MUSCLE RIGIDITY

COGWHEEL MOTION OF JOINTS

MYASTHENIA GRAVIS
SSX: DIAGNOSIS: ACETYLCHOLINE DEFICIENCY SKELETAL EDROPHONIUM FAILURE OF IMPULSE TRANSMISION MUSCLE OR TENSILON TEST WEAKNESS WEAKNESS

CAUSE: MANAGEMENT: WEAKNESS OF THE MUSCLES OF : DRUGS EXTERNAL OCULAR UNKNOWN RADIATION PHARYNGEAL OF THYMUS/ THYMECTOMY AUTOIMMUNE JAW QUININE, MORPHNE, NEOMYCIN, LARGE DOSES SHOULDER OF BARBITURATES INCREASED CHOLINESTERASE ARM

MYASTHENIA GRAVIS
MYASTHENIA CRISIS BRITTLE CRISIS CHOLINERGIC COMPLICATIONS:CRISIS
INSENSITIVITY OF ACETYLCHOLINE RECEPTORS SUDDEN INABILITY TO SPEAK OR MAINTAIN PATENT OVERMEDICATION WITH ANTICHOLINESTERASE AIRWAY TOO MUCH ACETYLCHOLINE MYASTHENIC CRISIS CAUSES: WEAKNESS OF THE MUSCLES OF: RESPIRATORY SIGNS & SYMTOMS: TEMPORARY RESISTANCE TO ANTICHOLINESTERASE CHOLINERGIC CRISIS RESPIRATION SIGNS & SYMPTOMS: DEPRESSION CNS INJURY SE OF ANTICHOLINESTERASE DRUGS: NEED FOR INCREASE IN DOSAGE LARYNX INITIAL: DYSPHAGIA & BRITTLE CRISIS ABDOMINAL CEREBRAL & HYPOXIA ACTH THERAPY CRAMPS PHARYNX DIFFICULTY IN SPEAKING AIRWAY DIARRHEA BULBAR EYELID PTOSIS OBSTRUCTION DEATH INCREASE SALIVATION RESPIRATORY ARREST INCREASE SWEATING INCREASE BRONCHIAL SECRETION

CEREBRO-VASCULAR DISEASE
CEREBRAL ARTERIOSCLEROSIS & ANEURYSM CEREBRAL INFARCTION & HEMORRHAGE

CEREBROVASCULAR ACCIDENT

CEREBRAL ARTERIOSCLEROSIS
ATHEROMA IN TH BLOOD VESSELS LOSS OF MEMORY FOR RECENT EVENTS CONFUSION PERSONALITY CXS VERTIGO TIAs

CEREBRAL ANEURYSM
LOCALIZED OUTPOUCHING OF THE WALL OF AN ARTERY

CEREBRAL EMBOLISM
OCCLUSION OF THE CEREBRAL VESSEL

CEREBROVASCULAR ACCIDENT
EFFECTS & MANIFESTATIONS:

HEADACHE GENERAL CARE: EMERGENCY CARE:NUCHAL RIGIDITY PREMONITORY SYMPTOMS: ADEQUATE OXYGENATION DIZZINESS LOC VS TURNING TO SIDE THICKENED TONGUE FLUID & ELEC BALANCE CONVULSION PROPER POSITIONING ELEVATE HEAD HEADACHE & VOMITING ADEQUATE ELIMINATION VITAL SIGNS CXS PROTECT EYESENVIRONMENT QUIET MOBILIZATION & REHAB MOTOR & SENSORY DEFICITS WHEN CONSCIOUSNESS REGAINED SPEECH DEFECTS

NURSING CARE:

BIG

HEAD INJURY
CLASSIFICATION:
LACERATION OF THE SCALP SKULL INJURY INTRACRANIAL BRAIN INJURY HEMORRHAGE

CONCUSSION CONTUSION LACERATION COMPRESSION

EPIDURAL SUBDURAL INTRACEREBRAL OR SUBARACHNOID

INTRACRANIAL
RESULT VENOUS FROM IN ORIGIN TEAR IN THE MOST COMOON CAUSE: WALL OF MIDDLE EPIDURAL S/SX: MENINGEAL ARTERY LEAKING CONGENITAL ANEURYSM SUBDURAL S/SX: ACUTE INTRACEREBRAL OR UNCONSCIOUSNESS LOC IMMEDIATELY AFTER SUBARACHNOID SURGERY REGAIN CONSCIOUSNESS CHRONIC (LUCID INTERVAL) CONSCIOUS FOR SEVERAL WEEKS LOC OR MONTHS, THEN PATIENT SHOWS NEUROLOGIC SIGNS

HEMORRHAGE

HEAD INJURY
NURSING CARE:
PROPHYLACTIC TETANUS GENERAL CARE: OBSERVE CSF LEAKAGE: AIRWAY EMERGENCY CARE: OTORRHEA, RHINORRHEA PREVENT ASPIRATION BATTLES SIGN AIRWAY PN OBSERVE FOR S/SX OF SUPINE STRAIGHT, THEN TURNED TO LATERAL CHECK CARDIOVASC INCREASED ICP OR SEMIPRONE COMPLICATIONS CONTROL RESTLESSSEARCH EVIDENCE OFFX: NO NECK POSSIBLE CERVICAL & NESS FLEXION & PAIN: NO SPINAL INJURY NARCOTICS HYPEREXTENSION CHECK SKULL & SCALP MAINTAIN F&E, ACID KEEP PX COVERED, QUIET & UNDISTURBED INJURIES CAUGHT BASE BALANCE

SPINAL CORD INJURIES

CAUSES: TRAUMA FALLS GSW TUMORS

TYPES:
CONCUSSION COMPRESSION CONTUSION & TRANSECTION LACERATION HEMORRHAGE (HEMATOMYALIA) COMPRESSION OF BLOOD SUPPLY TO THE CORD

CLINICAL EFFECTS OF SCI

SPINAL

SHOCK
ACTIVITY INJURY NUCLEUS PULPOSUS

REFLEX

WHIPLASH

HERNIATED

SPINAL SHOCK

AUTONOMIC DISTURBANCES:

IMMEDIATE FLACCID PARALYSIS & SENSORY LOSS BELOW THE LEVEL OF LESION PRIAPISM

SWEATING IS ABOLISHED BULBOCAVERNOUS REFLEX IS LOST BUT REUTRNS BELOW THE LEVEL OF INJURY AFTER& AFECES FEW HRS URINE RETAINED GASTRIC ATONY ORTHOSTATIC HYPOTENSION OTHER REFLEXES REMAIN ABSENT SLOW, & STEADY PULSE 3-6 WKS

REFLEX ACTIVITY

REPLACE SPINAL SHOCK AFTER 2-3 WEEKS IF LUMBOSACRAL SEGMENTS ARE UNDAMAGED OCCURS IN ACUTE SPINAL INJURY, NOT IN PROGRESSIVE ONES AUTOMATIC BLADDER; REFLEX SWEATING & DEFECATION FIRST SIGN OF WEARING OFF:

CONTRACTION OF HAMSTRING FLEXION/ EXTENSION OF TOES WITH PLANTAR STIMULATION

WHIPLASH INJURY
SIGNS & SYMPTOMS VIOLENT HYPEREXTENSION &: FLEXION OF THE NECK MANAGEMENT: USUALLY WITH AUTOMOBILE ACCIDENT PALE SEVERE OCCIPITAL LOC HEADACHE BED REST SPINE DAMAGE: CERVICAL WEAK ANALGESIC GAIT DISTURBANCE PAIN RADIATES TO THE MUSCLES HOT PACKS DIZZINESS ARMS PLASTIC COLLAR FOR SEVERAL WEEKS DISKS VOMITING NUCHAL RIGIDITY

LIGAMENTS NERVOUS

TISSUE

HERNIATED NUCLEUS PULPOSUS

CAUSE: S/SX:
BACK PAIN WITH RADIATION TO THE BACK OF THE LEG LIFTING OF DIFFICULTY IN HEAVY WALKINGOBJECTS MUSCLE SPASM FALL ON THE BACK DISORDERS OF SENSATION IMPROPER BODY MECHANICS NUCHAL LUMBAR NEAR THORACIC OR CERVICAL REGION: RIGIDITY RADIATING DOWN THE ARM TO THE FINGER

MANAGEMENT:
CONSERVATIVE: BRACE CAST TRACTION PROLONGED BEDREST PT
AGGRESSIVE: SINGLE DISK: VERTEBRA REMOVAL WITHOUT SPINAL CORD FUSION SEVERAL DISKS: SPINAL FUSION INTERWITH BRACE VERTEBRAL

DISK

HERNIATED DISK

TRIGEMINAL NEURALGIA
TIC DOULOREAUX MANAGEMENT 5TH CN : OPHTHALMIC, MAXILLARY, MANDIBULAR AGONIZING PAIN AGGRESSIVE CONSERVATIVE: -SURGICAL ETIOLOGY : UNKNOWN AVOID SERVING TOO INTRACRANIAL HOT FOODS RESECTIONING DRUG TX: OF PAIN FIBERS PRECIPITANT: PRESSURE ON TRIGGER POINTS : ANTIEPILEPTIC SHAVING PERIPHERAL DILANTIN INJECTION TALKING CARBAMAZEPINE WASHING WITH ALCOHOL TEGETROL COLD WIND OF PAIN GANGLIONS

BELLS PALSY
CN MANAGEMENT: 7 UNILATERAL WEAKNESS PARALYSIS RECOVERY & : 3-5 WKS FACIAL MASSAGE PAIN RELIEF CAUSE: UNKNOWN PROTECT INVOLVED EYE S/SX: ACTH MINIMIZE DENERVATION AND PERMANENT FACIAL NUMBNESS SEQUELAE DISTORTION TEACH PATIENT FACIAL EXERCISES: SPEECH DIFFICULTY WHISTLE DIFFICULTY WITH EATING WRINKLE FOREHEAD BLOWOUT & PUFF CHEEKS PAIN BEHIND THE EAR OR FACE

Which of the following reduces cerebral edema by constricting the cerebral vessels? Dexamethasone (Decadron) Mechanical Hyperventilation Mannitol Ventriculostomy

a. b. c. d.

RELAX.