The Nervous System Review and Neurologic Dysfunction N 331.
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Transcript of The Nervous System Review and Neurologic Dysfunction N 331.
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The Nervous System Review and Neurologic DysfunctionN 331
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Functional Organization of the Brain and Spinal Cord•4 major brain regions
▫Cerebrum▫Diencephalon▫Cerebellum▫Brain stem
Pons Medulla Midbrain
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Functions of the Diencephalon, Cerebellum, and Brainstem
•These 3 form the more primitive areas of the brain.
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Meninges
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Blood supply to the brain• Brain receives 20% of
cardiac output or 800 -1000ml of blood per minute
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Circle of Willis – serves as collateral flow
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12 Cranial Nerves
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Alterations in Nervous System Functioning
Manifestations of Global Brain Injury
Consciousness Alterations in Neuro
Function
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Consciousness
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Alterations in neurologic function
•Level of Consciousness•Breathing Patterns•Vomiting •Pupillary Changes •Oculomotor Responses •Motor Responses
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Glasgow Coma Scale Eye Opening
Spontaneous 4
To loud voice 3
To pain 2
None 1
Verbal Response
Oriented 5
Confused, Disoriented 4
Inappropriate words 3
Incomprehensible words 2
None 1
Motor Response
Obeys commands 6
Localizes pain 5
Withdraws from pain 4
Abnormal flexion posturing 3
Extensor posturing 2
None 1
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Breathing patterns
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Cheyne-Stokes Respirations
https://www.youtube.com/watch?v=zrcXQhFK6ro
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Brain stem damage
•Irregular and unpredictable breathing patterns
https://www.youtube.com/watch?v=FpKdq-_ZvsI
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Vomiting
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Pupillary Changes & Oculomotor Responses
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Motor Responses
•Posturing ▫Decorticate
Brain stem intact, loss of cerebral cortex functioning
▫Decerebrate May indicate more
serious damage and results from disruption of higher brain centers and the brainstem.
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Alteration in Intracranial Pressure
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Measuring ICP
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Neurologic DeathCerebral death Brain deathPersistent vegetative state
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Scalp lacerations
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Head Injuries
• Closed vs Open
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Traumatic Brain Injury Major Head Trauma
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Concussion
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Contusion
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Coup/Contrecoup
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Protective Coverings of Brain
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Epidural hematoma
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Subdural hematoma
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Diffuse Axonal Injury
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Shaken Baby Syndrome
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Spinal Cord Trauma
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Complete cord involvement
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Paralysis
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Partial cord involvement
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Spinal shock
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Low Back Pain
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Aneurysm & AV Malformation
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Subarachnoid hemorhhage
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CVA
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A Stroke is an Emergency act: - Face
▫ Ask the person to smile. Does one side droop?
– Arms▫ Ask person to raise both arms. Does one drift
downward? Is one arm weak or numb?
– Speech▫ Ask person to repeat a simple sentence. Is speech
slurred.
– Tongue▫ Stick out tongue, Does it deviate from midline?
F
A
ST
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Ischemic StrokeThrombolytic vs Embolytic
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Visual Deficits
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Intracranial Infections/Neoplasms
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One of the physically demonstrable symptoms of meningitis is Brudzinski's sign. Severe neck stiffness causes a patient's hips and knees to flex when the neck is flexed.
One of the physically demonstrable symptoms of meningitis is Kernig's sign. Severe stiffness of the hamstrings causes an inability to straighten the leg when the hip is flexed to 90 degrees.
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Encephalitis
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Abscess & Neoplasms
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Seizures
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Tonic Clonic Seizures
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Nerve Conduction Disorders
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Muscle toneHypotonia and Hypertonia
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Muscle movement Hypokinesia and Hyperkinesia
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Muscular Dystrophy• Normal skeletal muscle • Muscular Dystrophy
Deposition of collagenous scar tissue (RED)
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Myasthenia Gravis
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Multiple Sclerosis
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Amotrophic Lateral Sclerosis
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ALS
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Cerebral Palsy