Increased metabolic needs require MORE or LESS oxygen & glucose, which are supplied in blood volume in the cranium.
For head injuries, head of bed should be kept at what height? (to promote venous drainage from the head)
L4, L5 & S1
90-95% of lumbar herniations occur at what 3 disks?
Cervical herniation commonly occurs to what disks?
Diaphragm is innervated at what levels of the cervical column? (disks)
inability to communicate; due a brain lesion
A progressive disease characterized by neurofibrillary tangles and plaque in the brain, lack of acetylcholine. Nueurons of frontal and medial temporal lobes are affected, with biochemical & structural changes.
Characteristic physiologic changes are neurofibrillary tangles and amyloid plaques (deposits of protein), found throughout the cortex, which interfere with cells' ability to transmit impulses are found in what disease?
The Hippocampus, the part of the limbic system responsible for learning, memory & emotions, have neurons that use acetelcholine as the neurotransmitters, are affected in what disease?
This drug is an antialzheimers agent, increases level of acetocholine in CNS by inhibiting breakdown & slowing of neuron destruction to increase cognitive functions. Side affect can be liver toxicity and bradycardia.
This is an anit-Alzheimers agent. It is used to help memory functions.
There are how many stages in Alzheimers disease?
Razadyne, Exelon & Aricept, used in enhancing cognition & slow progression, and Namenda, which delays progression of symptoms, are used in treating what disease?
The focus of nursing care of the Alzheimer's client is often care of who?
PREFIX MEANING WITHOUT, NOT
HEPARIN, COUMADIN, FRAGMIN, LOVENOX are what category of drugs?
TICLID, PLAVIX, PLETAL ARE WHAT CATEGORY OF DRUGS?
localized dilatation in the wall of an artery that expands with pulsation of the artery. Maintain bedrest in a semi-Fowlers or side-lying position. No stimulation.
Peculiar sensation preceding a seizure or migraine; may be a taste, smell, sight, sound, dizziness, or just a "funny feeling"
Mechanical, repetitive motor behavior performed unconsciously (lip smacking, etc) Can be a symptom of Complex partial seizures (in epilepsy) coming on.
this is an emergency situation resulting in a hypertensive crises (elevated systolic pressures of 260-300mm Hg), bradycardia, severe headache and possibly stroke or seizure activity. Happens to client with injury above 6th thoracic vertebra (paralyzed) and is caused by noxious stimuli - full bladder, fecal impaction, wrinkle in clothing, cramps, ingrown toenail, etc. Drug of choice is nitroprusside sodium (Nipride) or Nifedipine (procardia)
Hypertensive crisis - BP 300/116
Spinal injury of T4 & above can cause this (not looking for plegia's)
AUTONOMIC NERVOUS SYSTEM
the part of the peripheral nervous system consisting of the sympathetic and parasympathetic nervous systems and controlling unconscious activities. Connects CNS to visceral organs such as heart, stomach, intestines & glands. It is involved in unconscious activities, such as breathing.
Capacity to perceive sensory impressions through thoughts and actions
Ecchymosis over mastoid area are referred to as what?
CALCIUM CHANNEL BLOCKERS
This classification of drugs causes dilation of blood vessels
This is a surgery to incise the carotid artery and remove plaque resulting in the increase of blood flow to the brain. Checking: airway, LOC, intact suture,
This is the tearing of cortical tissue (injury). Symptoms of this brainstem injury include deep coma from time of impact, extension posturing, autonomic dysfunction, nonreactive pupils & respiratory difficulty. Ability to relay nerve impulses from high levels in brain is lost. Diffuse axonal injury (DAI) usually occurs in conjunction with brainstem injuries.
Headache; also known as:
antihypertensive agents, anticoagulants, thrombolytics, antiplatelets are all drugs in what category?
ThIs type of breathing is rhythmic with periods of apnea. Can indicate a metabolic dysfunction or dysfunction in cerebral hemisphere or basal ganglia
This type of respiration is regular rapid & deep sustained respirations. Indicates a dysfunction in the low midbrain & middle pons.
This type of breathing is irregular respirations with pauses at the end of inspiration & expirations. Indicates a dysfunction in the middle or caudal pons
This type of respiration is totally irregular in rhythm & depth. Indicates a dysfunction in the medulla
This type of respiration is: Clusters of breaths with irregularly spaced pauses, indicates a dysfunction in the medulla & pons.
Condition characterized by abnormal, involuntary, purposeless movements of all musculature of the body.
CONCUSSION, CONTUSION, LACERATION
3 Types of closed head injuries are:
Coup injuries are caused by impact of head against an object. ___________ injuries are caused by the impact of the brain against the opposite side of the skull.
Involuntary and inappropriate swearing
This is done along with evacuation and control of bleeding for intracranial hematomas. Surgical procedure that involves an incision thru the cranium to remove accumulated blood or a tumor.
This refers to 1) Bradycardia, 2) Widening pulse pressure along with increasing systolic pressure and 3) Respiratory irregularities
In ______, the volume in the skull is so excessive that intracranial pressure cannot be maintained below 15mm Hg. Neurological changes are exhibited because of cellular hypoxia & displacement of brain, which compresses neurons, especially in the brainstem.
Difficult and defective speech due to a dysfunction of the muscles used for speech
Loss of emotional control
Inflammation of the brain
This is a disorder of cerebral function in which the client experiences sudden attacks of altered consciousness, motor activity or sensory phenomenon. Seizures initiated by electrical disturbance in neurons. Seizures classified as generalized or partial.
TONIC CLONIC SEIZURES
These seizures involve rigid _____ contractions of muscle & loss of postural control followed by a ____ stage of intermittent contraction and relaxation. May begin with an aura.
These seizures involve loss of conscious activity without the muscular involvement of tonic-clonic seizures.
These seizures are very mild, sudden, involuntary contractions of a muscle group or rapid, forceful movements. Usually occur in trunk or extremities & involve no loss of consciousness.
abdomen, fluid/fiber intake, regular exercise, bowel regime, bowel sounds, LBM,
GILLES DE LA TOURETTES SYNDROME
This syndrome is a neurological movement disorder that also has prominent behavioral manifestations. Obsessive-compulsive and Attention deficit hyperactivity disorders may coexist with this syndrome.
Acute inflammatory process of the motor sensory neurons of the PNS
You would keep the head of bed elevated to decrease perfusion if a person had this kind of stroke.
The Biggest risk factor for stroke is:
Risk factors of stroke are: DM, atherosclerosis, aneurysm, drug abuse, sedentary lifestyle
Reaction on same side as injury of lesion
this disease is a chronic, progressive hereditary disease of the nervous system. It is characterized by a progressive involuntary choreiform (abnormal & involuntary movement) movement and progressive dementia. S & S = Facial tic, grimacing, difficulty chewing, swallowing & speech.
This hemorrhage is usually due to an arterial bleed, is a common complication of any head injury. Bleeding in the epidural, subdural, subarachnoid spaces, ventricles or intracerebrally. Neurological changes caused by pressure on brain from space-occupying hemorrhage.
Pain experienced upon gentle raising of the fully extended leg of the supine positioned patient to 20-60 degrees, stems from stretching of the inflamed sciatic nerve.
Inflammation of the meninges
This is a chronic, progressive, degenerative disease of the CNS, characterized by a loss of myelin in the brain, spinal cord (or both) and the occurrence of sclerotic (hardened) patches. Thought to be the result of an autoimmune response or viral infection. Interferes with the conduction of impulses. Sclerotic tissue replaces the myelin.
Paroxysmal pain that extends along the course of one or more nerves
Hypotensive situation resulting from the loss of sympathetic control of vital functions from the brain. Happens with clients with injury above the 6th thoracic vertebra.
stiffness or inability to bend neck
Meningitis and or subarachnoid hemorrhage will cause this condition (rigidity):
Constant, involuntary movement of the eye in various directions
this operation is a probe inserted into brain. A small lesion is made deep in brain to interrupt electrical pathways that cause rigidity and tremors (in Parkinsons)
Edema at the optic disc due to intercranial pressure.
A chronic, progressive disease that affects the brain area that controls movement. Depletion of dopamine interferes with inhibition of excitatory impulses which results in dysfunction of extra-pyramidal tracts.
A client with this disease will shuffle feet, have no arm movement when walking & will lean forward when walking
S & S of this disease are muscular rigidity, bradykinesia (slowness of voluntary movement & speech), resting tremors, muscular weakness & loss of postural reflexes.
haldol, cocaine, thorazine contributes to this condition: Drugs such as cocaine, haloperidol (Haldol) and chlorpromazine (Thorazine)
Clients with Parkinson's Disease should avoid taking multivitamins, food high in ____ (what vitamin?) and high protein foods when taking levodopa.
COCAINE, HALDOL, THORAZINE
these drugs can cause parkinsonian syndrome
This is an antiviral agent, effective in Parkinson's disease, it either releases dopamine storage areas or delays the reuptake of dopamine.
This drug blocks breakdown and blocks metabolism of central dopamine, so more dopa gets in the CNS. Is an antiparkinson agent. Causes vivid dreams.
Primary method of controlling seizure activity
After a seizure
With visual problems, the client must turn the head to scan the complete range of vision.
ASSESSING PUPILLARY RESPONSE
Shining a light in center eye by passing it from the outer eye toward the center of eye. You are doing what?
Dysfunction or paralysis of both arms, both legs, and bowel and bladder
What should be checked during a seizure
is a theory that an individual DNA can be altered due to radiation exposure or miscoding of enzymes
LINEAR, COMMINUTED, DEPRESSED, BASILAR
4 Types of skull fractures are
This type of skull fracture are nondisplaced cracks in the bone
This type of skull fracture is when the bone is broken into fragments
This type of skull fracture has bone fragments pressing into the intracranial cavity
this type of skull fracture are of the bones in the base of the skull. Particular concern because of proximity to sinus bones & adhesion of dura mater to this area. Dura mater can easily tear & CSF can leak from ears or nose. Internal carotid artery & cranial nerves can also be damaged easily with this type of skull fracture.
These types of injuries are hyperextension, hyperflexion, or lateral flexion of head, which cause twisting of cerebrum on brainstem (whiplash).
DEXTROSTICK & HALO TEST
Two tests used to test fluids leaking from nose or ears for CSF are:_____ & _____. First will check for glucose level and second will check for yellow halo around pink or bloody drainage on white cloth.
Cessation of motor, sensory, autonomic, and reflex impulses below the level of injury; characterized by flaccid paralysis of all skeletal muscles, loss of spinal reflexes, loss of sensation, and absence of autonomic functions below the level of injury. Aka Neurogenic shock
Acute, prolonged episode of seizure activity that lasts at least 30 minutes and may or may not involve loss of consciousness. Is a medical emergency & results in respiratory arrest & irreversible brain damage. Abrupt withdrawal of anticonvulsant drugs can cause this.
surgical procedures including thalamotomy, palidotomy & subthalamic necleotomy which destroy areas of the brain to control intractable tremors or akinesia, used Parkinsins clients who are unresponsive to drug therapy.
This drug therapy is used to control symptoms of PD. This is converted into dopamine in the basal ganglia to replace the deficit of dopamine.
L-dopa, Sinement, Artane, and Cogentin are used to treat what disease?
This is used in Parkinsons disease treatment to prevent conversion of levodopa to dopamine in peripheral tissue.
ARTANE & COGENTIN
These drugs are used in Parkinsons disease treatment to control tremors & rigidity.
annual blood pressure check, decrease sodium and fat intake, check cholesterol levels, daily exercise, no smoking , no alcohol
These are caused by ischemia (oxygen deprivation) resulting from a thrombus, embolus, severe vasospasm or cerebral hemorrhage.
A client during acute phase of a stroke should be positioned on the side with the head of the bed elevated at what height?
A postacute stroke client should be positioned 2 hours on unaffected side ____ minutes on affected side and prone for 30 minutes, three times daily.
A stroke caused by bleeding would not be treated with what?
this classification of drugs dissolve clots. A complication of it could be bleeding. Streptokinase, Eurokinase, Activase.
With stroke patients, do not give _______ therapy until a diagnosis is made.
This classification of drugs dilate blood vessels, increase cerebral profusion. Do not take calcium channel blockers when taking these.
This classification of drugs prevents thrombus from forming & prevent agglutination. They decrease platelets and keep them from sticking together. Ticlopidine (ticlid)
This is restricted (from the diet) for a few days after a CVA.
The head of a client's bed is kept in what position to increase cerebral perfusion in cases of embolic or thrombolic strokes.
The head of the bed is _______ to decrease cerebral perfusion in the event of a hemorrhagic stroke.
Oxygen deprivation to tissues
TRANSIENT ISCHEMIC ATTACKS
These are mini-strokes and frequently precede a stroke. It is a temporary or transient episode of neurological dysfunction caused by temporary impairment of blood flow to the brain.
an abnormal condition in which a clot develops in a blood vessel
This classification of drugs dissolve clots: activase, streptokinase, urokinase, tPA
the classification of this med is to dissolves blood clots that have already formed with walls of blood vessels
You would keep the head of bed kept flat to increase cerebral perfusion for a person who had this kind of stroke
ACTIVASE, STREPTOKINASE, TPA, UROKINASE
types of thrombolytics
TRANSIENT ISCHEMIC ATTACKS
this condition is caused by a momentary disruption of blood flow to the brain lasting from a few minutes to 24 hrs. Causing brief episodes of neurological dysfunction
Failure to recognize or care for one side of the body. Means that the individual has no insight into their problems or give care to the affected side of the body. Client unaware of the existence of his or her paralyzed side.
URINARY TRACT INFECTION
this infection is strongly correlated to the cause of acute confusion in the elderly adult
Spinal Cord Injuries are classified as either complete or incomplete (partial)
Decadron is given to patients with brain tumors to ______ cerebral edema
This med is given to patients with brain tumors to decrease cerebral edema
Motor weakness when flexing the hip and the knee and then extending the knee
This results from pathological conditions of hypoxia
This is type of bleeding in the brain is classified as acute, subacute or chronic
EARLY SIGNS OF ICP
A decrease in LOC is a symptom of what?
The type of injury suffered as a result of being hit with a baseball is what?
A closed head injury with transient neurological deficit caused by shaking of the brain
BASILAR SKULL FX
Clear fluid draining from the nose after a head trauma will show in what kind of skull fracture?
when oxygen to the brain decreases this increases
This blood/sugar condition can cause seizure activity
When assessing this, include in the charting: duration, pupil size & what the person was doing before and after
This is done to drain blood from the brain
SPINAL CORD PROTECTION
CSF, Skull, meninges, and blood brain barrier are for what?
COMPLEX PARTIAL SEIZURE
This type of seizure generally involves loss of consciousness & produce cognitive, affective, psychosensory or psychomotor symptoms. Client performs inappropriate purposive behaviors (automatisms) & has aura's. Does not remember the episode.
The extreme forward movement of the head, causes compression of the vertebral bodies & damage to the posterior ligaments & intervetebral disks
The extreme backward movement of the head, causing injury to the posterior vertebral structures and anterior ligaments.
This occurs when extreme pressure is placed on spinal column (diving accidents or falling on butt). Compression shatters the vertebral body
Compression fractures and posterior ligament injury can be caused by this (turning the head beyond the normal range).
Part of brainstem that controls respiratory & cardiovascular functions, vomiting & vasomotor centers. Controls heart rate, respiration. Blood vessel diameter, sneezing, swallowing, vomiting & coughing.
CARDIO & BREATHING
The Medulla Oblongata is controls what 2 things?
Part of the brainstem that contains respiratory centers & regulates breathing
The Pons controls what?
Part of the brainstem responsible motor coordination, visual reflex & auditory relay centers
COORDINATION, VISUAL & AUDITORY
The Midbrain is responsible for what 3 things?
This part/lobe of the brain is responsible for Body temperature regulation, pituitary hormone control, autonomic nervous system responses. Includes: thalamus, epithalamus, Hypothalamus
TEMP, ANS & HORMONES
The Diencephalon is responsible for what?
what part of the brain provides neuron & synapse networks to produce involuntary responses to sensory stimulation, Carries sensory info, regulates visceral function. Contains the horns (efferent and afferent) & nerve tracts.
The spinal cord carries what?
Hearing, Memory & Speech perception are functions of what lobe?
HEARING, MEMORY & SPEECH PERCEPTION
The temporal lobe has what function?
This part of the brain is responsible for motor speech (not a lobe)
The Broca's Area has what function?
This part (lobe) of the brain is responsible for higher intellectual function, speech production & ipsilateral motor control.
The Frontal lobe of the brain has what function?
This lobe of the brain is the primary somatic sensory area
The Parietal lobe has what function?
This area of the brain (not lobe) is responsible for Auditory comprehension
The Wernicke's Area has what function?
This lobe of the brain is responsible for Vision & visual perception
VISION & VISUAL PERCEPTION
The Occipital Lobe has what function?
Changes if vital signs, decreased LOC, confusion, restlessness, pupil changes, muscle weakness, paraplegia, headache, and vomiting are all S/S of what?
This helps to regulate fluid & electrolyte balance
The CSF reveals an elevated protein level, no elevations of RBC's or WBC;s. These are all indicators of this type of disease.
this seizure medication decreases the effectiveness of birth control pills
"I'm having difficulty using forks and knives correctly" would be something a client with this would say
This is a generalized type of seizure in which an individual may or may not lose consciousness
How many pairs of cervical spinal nerves are there?
What classification of drugs is Lopressor?
_______ hematomas are classified as acute, subacute & chronic
This lobe of the brain is the primary area of hearing, along with memory & speech perception
Hypotension is a key sign of this type of shock following a spinal cord injury
Requip is a medication used to treat what disease?
An osmotic diuretic used to rapidly reduce fluid in the brain. "I think so much better"
"Low Dose" anticoagulants to prevent thrombophlebitis are used in the treatment of this disease
With a T-4 spinal injury, this client is as risk of developing autonomic dysreflexia which leads to:
This type of medication would be prescribed if a client has difficulty with elimination (not urination)
type of partial seizure that initiates in a focal part of the brain. No loss of consciousness
A client that has a _____ _____ feels best lying on their back with knees flexed
A client with this disease can be expected to be prescribed an anticoagulant (low dose).
Area where excess CSF is reabsorbed
THIS LOBE SPECIALIZES IN CRITICAL THINKING (HIGHER INTELLECTUAL FUNCTIONS)
Classification of the drug "Decadron"
This digestive system is not stimulated by the sympathetic nervous system
The inability to carry out a purposeful activity
_____mcg/ml is the Terapeutic Range for Phenobarbital
hOW MANY PAIRS OF THORACIC SPINAL NERVES?
In this type of seizure, the distrubance starts in particular part of the brain. Client DOES NOT loose consciousness
In these types of seizures the client DOES loose consciousness
This is a seizure that lasts more than 30 minutes. Is a medical emergency. Client may be conscious or unconscious
This type of herniation will cause low back pain (buttocks area), Sciatic nerve is affected. Sneezing,& blowing nose can cause pain. Sleep sidweways w/knees flexed.
This type of herniation will be located in C5-6 or 7. Will cause pain in neck & shoulders.
This drug is used in response to decreased BP in autonomic Dysreflexia
This disease will present with increased WBC's, Protein & immunoglobulin in the Cerebral Spinal Fluid
These types of headaches present around or behind 1 eye
These 7 nerves control: diaphragm, chest wall muscles, Arms & Shoulders
these 12 nerves control the uper body & gastrointestianl functions
LUMBAR & SACRAL
These 5 + 5 nerves control the lower body, bowel & bladder.
In this disease, there is a destruction of Motor Neurons in the Medulla, cortex & spinal cord., causing atrophy of muscles innervated by those neurons. Onset 40-70 years , men affected most. Hands, forearms & legs noted first. Spacity in upper extremities, flacid lower motor and decreaased respiratory status.