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Neurological Assessment 2


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CNS consists of what 2 structures?
Brain and Spinal cord
PNS consists of...?
Cranial nerves autonomic nervous system
generate and conduct nerve impulses.
When neurons are damaged they are not replaced, although we are born with extras. (Axons can regenerate-better in peripheral-less likely in CNS.)
support neurons. They nurish and protect neurons.
There are more neuroglias than neurons.
Nerve Impulse
Series of action potentials. It is a chemical interaction of K+ and chloride movement in and out of axons. Neurotransmitters can excite or inhibit.
Area of higher level of functioning(complex mental function). Includes Basal ganglia, thalamus, hypothalamus, and the limbic system.
Basal ganglia
Learned and automatic movements Ex: blinking. (Part of Cerebrum)
Relay station between skeletal muscle and sensory input. (Part of Cerebrum)
Regulates temp and some aspects of autonomic and endocrine. (Part of Cerebrum)
Limbic System
Inner surface of cerebral hemisphere, has to do with emotions. (Part of Cerebrum)
Parts of Brainstem
Midbrain, Pons and Medulla
Midbrain and Pons functions
Relay center for vasomotor impulses, control alertness and awareness.
Basic life support. Respiratory and cardiac functions.
Cardiac-slowing center.
Controls equillibrium & Coordination.
How do you test function of the cerebellum?
There are 2:
1. Romberg sign-stand with eyes closed. Normal person can stand 20 seconds without swaying.
2. have patient hold hands out in front flipping hands between pronate and supinate. Watch for drifting.
The peripheral nervous system includes....?
1. Spinal nerves (31 pairs)
2. Cranial nerves (12)
3. Autonomic Nervous System (Sympathetic and parasympathetic)
What is the function of the spinal nerves?
They inervate specific body regions and are motor sensory in nature.
The autonomic nervous system controls...?
Cardiac and other smooth muscles, involentary actions.
It is composed of the sypathetic and parasympathetic systems.
Sypathetic Nervous system
The fight of flight response.
Skeletal muscle vessels dialte, heart rate increases, the liver excretes extra glucose, the thyroid is stimulated, increased sweating and kidney vessels constricts.
Parasympathetic Nervous System
Inhibits. Acts to reserve energy
Circulation to the brain
To the brain is by the corotid and others in the back of the neck (patebral) and venous return is through the jugular.
Nursing assessment, do you have signs and symptoms like...
hearing loss, decreased taste/smell, incontinence, difficulty sleeping, chewing, swallowing, change in sexual performance, or ADL's. Also headaches, numbness/tingling, tremors, memory loss, personality/behavior changes.
Most Neurologic Diseases affect _____?
Mobility and coordination
(dizziness, unsteady gait)
Nursing Assessment, current medications that alter the nervous system
Sedatives, analgesics, stimulants, anti-seizure, mood elevators, antidepressants
Neurological Examination: Cerebral Function
Cortical and Discriminatory interpretation-ability to see an object, recognize it's name and know it's function
Neurological Examination: The Motor System
Symmatry of muscle strength, muscle tone-palpate and look for spasticity, rigidity, flaccidity and involuntary movements
Neurological Examination: Sensory function
1.Pain and temperature (they are transmitted by the same nerve endings), if one is intact no need to test the other.
2.Touch-likely normal if pain and temp are intact. To test use touch discrimination.
Touch discrimination
Have patient close their eyes. Touch each extremity randomly with finger and ask them to point to where the are being touched. Then touch each side of the body at the same time.
Last part the patient is touched in 2 places and moved closer tother.
Glascow coma scale
Eye opening 1-4
Motor response 1-6
Verbal Response 1-5

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