Neuro (test 4)

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52 Terms
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"Ballerina" controls balance and movement
Center of intellect and consciousness
How many cranial nerves are there?
CNS is made up of ___ and ____
brain and spinal cord
Space between two neurons
Axons are surrounded by ___ sheath
internal body balance
Normal cerebrospinal spinal fluid pressure
70-125 cm
True or false? Once destroyed, cells in the brain cannot be replaced
Aging related changes to nervous system
- loss of neurons - blood flow to brain is decreased - homeostasis is harder to maintain
Romberg test
Measures function of cerebellum - have patient stand with feet together and close eyes, if normal, balance will be maintained.
glasgow coma scale measures
- eye opening - motor response - verbal response optimal score is 15 - 3 or less indicates total comatose, 8 indicates comatose level
rapid back and forth eye movement
Decorticate posturing
deCOREticate: extremities flexed inwards towards core
decerebrate posturing
extremities flexed away from core/body
Should a neuro check be delegated to UAP?
difficulty swallowing - high fowler's while eating and 30 min after
Inability to express oneself in speech or writing, or inability to comprehend language - r/t head injury - receptive, expressive or global types (see page 496 for more)
Closed head injury - brief disruption in LOC
brain is bruised blood vessels break and edema develops - increased ICP possible
Coup-countercoup injury
Head is moving and hits a stationary object
Coup vs countercoup
Coup = original impact contrecoup = brain bouncing off front of skull (secondhand injury)
Subdural hematoma
Rupturing of blood vessels in the dura
Three layers of skull
D: dura (top) A: arachnoid (middle) P: pia (inner layer) (dope ass pie)
Battle sign
bruising behind the ear
HOB should be how high to promote drainage from the head/ for patients with head injury
20-30 degrees
Normal ICP
Signs of increasing ICP/ cushing's triad
- rising systolic B/P - widening pulse pressure - bradycardia with full bounding pulse - rapid or irregular respirations
HOB at __ for increased ICP
20-30 degrees with head and neck midline - hip flexion less than 90 degrees
Nursing care for patient with increased ICP
- neuro checks each hour - elevate hob 20-30 degrees - give stool softeners
sensory loss of both arms and legs
paralysis of both legs
levels of spinal cord injury
C5 or above= needs resp help (mechanical ventilation)
Can moving patients with spinal injuries be delegated?
When correcting a metabolic problem does not stop seizures - spontaneous recurrent seizures - classified as partial or generalized
partial vs generalized seizures
partial = affecting one side of body generalized = both sides of body
Petit mal seizures
Only last a few seconds without aura or warning
after a seizure
Atonic or akinetic seizures
loss of body tone leading to collapse
Status epilepticus
rapid, unrelenting seizures with no rest periods
If patient is having a seizure
make area safe, move objects from around the person - do not move the person - cushion the head
Transient ischemic attack
- Mini stroke - brief interruption of blood flow - many of these pts have strokes later
Stroke (CVA)
-Interruption of blood flow to brain - caused by either a hemorrhage (blood vessels rupture and blood leaks) or a clot
ballooning of an artery wall
FAST stroke acronym
Face Arms speech time
Stroke/damage on the left side of the brain causes ___ sided paralysis
right sided
Bacterial meningitis
- inflammation of membranes covering brain and spinal cord - caused by infectious agent getting into bloodstream - infection can easily spread to brain
S/S of bacterial meningitis
- sudden onset fever - severe HA that is worsened by moving of the head - positive brudzinski sign (bend patients neck forward, if knees and hips flex, this is positive) - positive kernig sign (inability to extend the leg past a 90 degree angle)
Viral meningitis
-HIV and herpes are causes - more mild than bacterial meningitis
- acute inflammation of the brain - ticks and mosquitoes are carriers S/S= stiff neck, photophobia, lethargy
food that triggers migraines
Alc, caffeine, chocolate, citrus fruits, artificial sweeteners, meats with nitrates, tyramine foods
Bell's palsy
Weakness or paralysis of facial nerves - usually only on one side of face