PARTS

OF NERVOUS SYSTEM

CNS: Brain & Spinal Cord Peripheral: Crainial & Spinal nerves Autonomic: part of peripheral, Sympathetic & parasympathetic

NEUROTRANSMITTERS
Chemical substances that excite, inhibit, or modify response of another neuron. Neuron releases it.

COVERINGS

OF THE BRAIN

Grey matter(outer part of the brain) billions of neurons. Neurons basic cells of the nervous system .3 components: Cell body: controls the function of the neuron Axon: impulses away cell body Dendrites: impulses towards cell body

FORAMEN

MAGNUM

Spinal cord continuation of the brainstem Exits skull through the foramen magnum: opening at the base of the skull

CRANIAL

NERVES HOW MANY PAIR

12 pairs of cranial nerves. Originated from the brain or brainstem. Most from brainstem. Functions: Sensory Motor mixed

FUNCTION FIGHT

OF

ANS

Main function is to maintain homestasis

OR FLIGHT RESPONSE

Subdivision on the ANS: sympathetic & parasympathetic Sympathetic: activated by stress fight or flight Increased HR Increased BP Vasoconstriction Decreased Peristalsis Dilated pupils Increased secretions of epinephrine & sweat

Decreased secretions of digestive juices & saliva

GLASGOW

COMA SCALE

OBJECTIVE tool for assessing consciousness in clients (mainly head injuries) Eye opening Verbal response Motor response Total scores indicate coma severity 15: oriented 7: state coma 3:deep coma

PERRLA
Equal round and reactive to light & demonstrate accommodation ONLY when pupil is normal. Abnormal in one or both, finding written out for clarity.

ATAXIA
Inability to preform any of the following movements. Incoordination of voluntary muscle action.

ROMBERG
Test for BALANCE. Feet together arms in front eyes closed. slight sway normal. Always stand in front of client, anticipating a fall.

TERMS

ON PG.

1267

PLANTAR

REFLEX

Superficial reflex Fanning: positive BABInskis reflex. Plantar flexion , curling under of the toes should occur.

SKULL

FRACTURES

FRACTURES are usually caused by extreme force. CLOSED-dura mater is intact OPEN-Dura mater is torn Manifestation is pain.

LINEAR-nondisplaced cracks. COMMINUTED-fragments DEPRESSED-fragments pressing into intracrainial cavity. BASILAR- base of skull. Basilar particular concern because of the proximity of fragile sinus bones & adhesions of dura mater in this area. CSF could leak into EARS & NOSE Internal Carotid Artery & Cranial Nerves can easily be damaged.

TESTS

FOR NERVOUS SYSTEM DISORDERS

Lumbar puncture (LP) Electroencephalogram(EEG) Electromyogram(EMG) Cerebral angiography Brain scan Myelogram Imaging: CT PET SPECT MRI

TYPES

OF BRAIN INJURY

CAUSES: ACCELERATION-baseball bat (object moving). DECELERATION-car dashboard (head moving). ROTATIONAL-whiplash (twisting brainstem). PENETRATING MISSLE-bullet. Open: Closed: Hemorrhage: Increased Intracranial Pressure:

CEREBRAL

LACERATION

Tearing of the cortical tissue DAI(diffuse axonal injury) in conjunction with brainstem injuries. This widespread damage to nerve cells in white matter causes immediate coma, extension posturing, increased intracranial pressure

CONTUSION
Surface bruises Unconscious for a longer period of time than with concussion. Pulse bp resp all below norm. Cerebral edema with widespread injury.

INTRACRANIAL

HEMORRHAGE

COMMON COMPLICATION OF ANY HEAD INJURY.

Epidural hematoma: momentary unconscious followed by conscious state of few hrs or wk. Neurological status deteriorates. Headaches seizures, hemiparesis, decrebration(severing of spinal cord) dilated fixed pupils. Surgery: evacuate the hematoma, stop the bleeding, relieve pressure on the brain. Subdural hematoma:immediate. Acute(48 hrs) subacute(2-14 days) chronic(2wks-mths) Headaches drowsiness, slow mentation, confusion Small:reabsorbed Large: hematomas surgical removal Subarachnoid: intraventricular common inSEVERE Nuchial rigidity: stiffness or inability to bend neck + increases intracranial pressure. MORE

CONCUSSION
Transients neurological deficits caused by shaking of the brain CLOSED Blunt force COUP injuries- impact head against object. CONTRECOUP injuries-impact brain opposite side of skull.

PARALYSIS

LOWER EXTREMITIES HEMATOMAS

INTRACRANIAL CVA TIA RISK

FACTORS STROKE STAGES DISTURBANCE

SEIZURE

ELECTRICAL

HERNIATED SPINAL

DISK CAUSES

SHOCK MEDICATION

PARKINSONS MS

MEDICATION MEDICATION

ALZHEIMERS NEURALGIA

ENCEPHALITIS MIGRAINES EAR

WAX ON PG.

TERMS

1312
HEARING LOSS

SENSORINEURAL PROF TYPES

TIP PG.

1318

OF EAR INFECTION FORMS OF GLAUCOMA

PRIMARY

NEARSIGHTEDNESS DETACHED INCREASED

RETINA INTRACRANIAL PRESSURE