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Definition
(nerve cell)-transmits nerve impulses
billions exist - 3/4 in cerebral cortex-
receive info from other neurons by dendrites & axons |
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| carry impulses away from cell body of the neuron, each neuron has one axon/ may have numerous dendrites. |
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| Carry impulses toward the cell body. |
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| white, protein-lipid complex formed by Schwann cells in PNS & by oligodendrites in the CNS which surrounds some axons. |
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Definition
supportive tissue in CNS
5-10x> then neurons,
divide-most CNS tumors originate in them.
4 types w/ specific functions. |
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Neuroglial- (glia)
name the types & functions
1-4 |
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Definition
1. Microglia-phagocytotic scavengers of damaged nerve tissue.
2. astrocytes-(star) structure of BBB, provide nutrients to neurons & Build scar tissue w/trauma, nutrients, gases,waste
3. Oligodendrocytes-form myelin
4. Ependymal cells-line brain and spinal cord and help produce CSF. |
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| Forms the myelin sheath in PNS |
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neurotransmitters-
Acetylcholine- What is its action? |
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Definition
| excitation, inhibitory on some of PSN |
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Neurotransmitter-
Dopamine- What is its action? |
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Definition
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Neurotransmitter-
Norepinephrine |
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Definition
| generally excitation, inhibtory effect on postsynaptic neurons |
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Neurotransmitter-
Serotonin- |
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Neurotransmitter-
Glutamate |
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Definition
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Definition
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Neurotransmitter-
Substance P |
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Definition
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Neurotransmitter-
Endorphin |
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Definition
| Excitation to systems that inhibit pain |
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Definition
| Cranial nerves, Spinal nerves, Autonomic Nervous System |
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| Corpus Collosum Function? |
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Definition
| Allows impulses from one side of the brain to the other |
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Definition
| Blood, Brain tissue and CSF in balance. |
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Term
| 2 main arteries that supply blood to the brain are? |
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Definition
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Definition
| Vertebral and Cerebral arteries connect to form this. |
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Definition
| Selectively permeable, Does not allow lrg molecules cross. allows- Glucose, O2, Co2- but gets irritable. |
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Definition
| CO2 in excess, CO, pathogens, toxins, Extra tissue |
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Definition
| RBCs damage to walls, made weak, thin via genetics or abnormalities |
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Term
| What happends when toddler holds breath? |
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Definition
| Chemoreceptors in aortic arch of brain- Co2 builds up and causes resp. acidosis, Shuts off, ANS kicks in, Blows off CO2. |
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| CSF- How much in body? How much produced daily? |
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Definition
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Brain utilizes glucose for energy.
What does it like the range to be? |
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Definition
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Definition
| CEREBRAL PERFUSION PRESSURE, INTRACRANIAL PRESSURE, MEAN ARTERIAL PRESSURE. |
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Definition
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Definition
| Pressure exerted on brain tissue. |
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| Factors that change CSF via BLOOD |
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Definition
| aneurysm, venous stenosis, embolism, HTN, Hypotension, hemorrhage, lytes (na+) Glucose 80-120 <70 dangerous |
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| Changes in CSF- Brain Tumor |
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Definition
| Tumor, viral inf-irritates tissue, trauma, ischemic stroke, Pituitary-GF |
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Definition
| Blockage, inf response, meningitis, viral encephalitis |
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| how many pairs of spinal nerves? |
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Definition
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Term
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Definition
6 afferent- ascending- Sensory
8 efferent- descending- motor |
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| Plexuses- bundles of nerves |
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Definition
| cervical, brachial, lumbosacral |
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Term
| Spinal decussation- What is it? |
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Definition
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Term
ANS-
autonomic nervous system |
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Definition
unconscious
connects motor nerves to organs and glands. |
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Definition
| Thoracocolumnar- flight or fight, norepinephrine. |
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Definition
| Carniosacral system, acetylcholine, Non stressfull situations |
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Definition
| myelin decreases, conduction delay, cell degeration, neuron death, pain sensation varies, Proprioception (parietal), pupil response, motor function, muscle tone |
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Definition
| Conscious, language, memory, cranial nerve functioning. |
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Term
| GCS- major head injury = score of? |
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Definition
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| GCS- moderate head injury score of? |
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Definition
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| GCS- Minor head injury- score of ? |
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Definition
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Term
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Definition
| C spine ok and eval before turning head! ABCs,nutrition, skin integ, mobility-ADLs,fluid lytes,Incontinence, DVTs, infection pneumonia risk?, UTIs, GI- BM? & GU, Mucous membranes dry?, psychosocial, |
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Definition
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Definition
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Definition
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Definition
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Definition
| CN 2,3, 4, 6 eyes move back to midline + not intact |
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Definition
| focus on arms ! flexed in to body= cerebellum (body space) -decorticate |
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Definition
| focus on arms ! flexed away from body- midbrain - lower down, worse re: spinal nerves -decebriate |
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Definition
| brain stem ! rule out spinal cord injurt before pt is ruled as brain dead. |
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Definition
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Term
| Diagnostic Assessment used with Neuro? |
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Definition
| CT, PET, SPECT, MRI, MRA, CEREBRAL ANGIOGRAPHY, MYELOGRAPHY, CAROTID FLOW STUDIES, EEG, EMG, LP |
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Term
| ICP- Intracranial pressure |
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Definition
monitored from lateral ventricles
normal ICP IS 0-15 mm.hg
Monroe Kellie hypothesis- balance depends on which can give. blood and csf are easier, csf is last resort. |
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Term
| What causes increased ICP ? |
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Definition
| cranial insult, tissue edema, comp bld vessels, hypoxia, accumlated CO2, vasodilation, increased blood viscosity with sickle cell and polycythemia. |
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Term
| What would someone look like with Increase ICP ? |
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Definition
| Swollen face, HA, change in Mentation and breathing. pupil change, cushing triad- htn, change resp, bradypnea. Compression of the oculomotor nerve is an early sign of brain hernation. Bradycardia (late sign) loss of sympathetic tone. |
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Term
| Cranial surgery- purposes |
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Definition
| tumor, lower ICP, evacuate clot, stop hemorrhage |
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Term
| Surgical positioning for cranial surg- |
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Definition
Supratentorial -over eye across temple
Non operative side if lrg lesion is removed
1 pillow
HOB 20-30 degrees
Repos Q 2/ skin
Infratentorial- Back of head
small firm pillow or none
ok turn side to side
LOG ROLL- no flexion of neck
Transphenoid- thru nose (pituitary)
access to sella, less risk for hemorrhage
Increased risk for infection thru oropharynx- take antibiotics
No straw/sneeze, cough
delay toothbrush use
Burr holes - |
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Term
| Pre-Op care for Cranial Surgery |
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Definition
Rx- anticonvulsants-prevent sz, steroids-reduce swelling,
Mannitol and Lasix- osmotic- keep ICP low
Antibiotics
Foley- I&O
NO coughing/straws,nose blowing, try not to sneeze
Deep breathing |
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Term
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Definition
Respirator/vent support
Keep free of infection
Fever raises Met rate-
Neuro signs
Fluid and Electrolyte status
Cope w/ sensory deprivation
Hyperoxygenating with head trauma makes the resp drive shut down- BE CAUTIOUS W/ THIS
assess & monioring are critical
Resp- even slight hypoxemia causes cerebral edema
ET tube when awake, breathing spontaneously and ABGs wnl
Analgesics can alter LOC |
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Term
| Temp regulation w/Cranial surgery |
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Definition
monitor, tylenol >99.6, use cooling blanket
Increase in temp increases metabolic demands |
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Term
| Fluid and Lytes w/cranial surgery |
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Definition
has A line, CVP
Monitor- chemistries, wt, I&O,
Na balance can cause inc. cerebral
watch for SIADH- water retention, Hyponatremia
monitor lytes, I&O, SG
Fluid/Na restrict
edema- restrict fluids/Na for some
seroids may cause hyperglycemia
H2recept RX- PPI block histamine responce, prevent ulcers
watch for Diab. Insipidous
check Urine SG 1.010-1.020 norm |
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Term
| Labs with cranial surgery- |
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Definition
BS, lytes, BUN, NH3, serum and urine OSMO, Ca, PT, PTT, Ketones, ABGs, HH,
Ct scan |
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Term
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Definition
Periorbital edema
elev HOB 30 degrees or MD order
Cold compress
Warn pt when we enter room
watch for increasing edema, clot, or increased ICP.
Report neuro changes and observations |
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Term
| Complications from cranial surgery- |
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Definition
Intracranial bleeding or hematoma
Cerebral edema w manipulation
DVT- bedrest
UTI-foley
Pressure Ulcers-immobility
PE- immobility- DVT moving
Post op seizures-possible may be Rx induced. Dilatin etc.
IV access, side rails up, bed in lowest position, yanker (suction) call bell, stay with them when OOB |
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Term
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Definition
iF pregnant
> 5min
repeat intractable
injury as result of
LOC changes after sz
occuring in water or submersion |
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| Antecerebral artery affects- |
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Definition
| judgement, insight and reasoning |
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Term
| Paralysis of lateral gaze effect of which CN? |
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Definition
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Term
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Definition
PNS- relaxes urinary sphincters
SNS- sweat, dilated skin blood vessels |
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