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NURSING OF ADULTS 111 Introduction to Neurological Nursing
NERVOUS SYSTEM ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
  CENTRAL NERVOUS  SYSTEM ,[object Object],[object Object],[object Object]
.  1 .  Central Nervous System =  Brain & Spinal Cord ,[object Object],[object Object],[object Object],[object Object]
The Brain ,[object Object],[object Object],[object Object]
FUNCIONAL AREAS OF THE CEREBRAL CORTEX Frontal Lobe Parietal Lobe Temporal Lobe Brain Stem Occipital Lobe Cerebellum Written speech Motor speech Auditory receiving area Auditory interpretation area Motor cortex Sensory area (pain, touch, etc.) Visual interpretation area Visual receiving  area
Functions of the cerebral cortex: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Cerebral Cortex (cont.) ,[object Object],[object Object]
Cerebral Cortex (cont) ,[object Object],[object Object],[object Object]
Cognitive Function ,[object Object]
WHAT PROTECTS THE BRAIN? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
NEURONS ,[object Object],[object Object]
CEREBRAL CIRCULATION ,[object Object],[object Object],[object Object],[object Object]
Brainstem   - The lower extension of the brain where it connects to the spinal cord. Neurological functions located in the brainstem include those necessary for survival (breathing, digestion, heart rate, blood pressure) and for arousal (being awake and alert). Most of the cranial nerves  come from the brainstem .   The brainstem is the pathway for all fiber tracts passing up and down  from peripheral nerves and spinal  cord to the highest parts of the brain.
Anatomy of the Autonomic Nervous System  (Brunner 2000, p. 1618) What impact on body re SC injury?
EFFECTS ON AGING ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Cognitive and Perceptual    Disorders ,[object Object]
Neurologic System:  History ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Neurologic System:  Physical Exam ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Neurologic System:  Physical Exam ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Neurologic System: Physical Exam ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Neurologic System:  Physical Exam ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Neurologic System:  Physical Exam ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Neurologic System:  Physical Exam ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Posturing  ,[object Object],[object Object]
Neurologic System:  Physical Exam ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Neurologic System:  Physical Exam ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Neurologic System:  Physical Exam ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Neurologic System:  Diagnostic Tests ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Neurologic System: Diagnostic Tests ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CONSCIOUSNESS ,[object Object],[object Object],[object Object],[object Object]
AROUSAL The mediator of arousal and sensory stimulation is the  RETICULAR ACTIVATING SYSTEM (RAS).   The RAS is located in the Brain Stem and contains projections between the Thalamus and the Cortex.  A network of neurons in the RAS monitors ascending and descending stimuli. Nerve cells run through the medulla, pons, midbrain, thalamus, and hypothalamus.  RAS maintains muscle tone, keeps the higher brain in a state of alert wakefulness, and filters incoming messages .
HOW UNCONSIOUSNESS     OCCURS ,[object Object],[object Object],[object Object]
DISORDERS PRODUCING    UNCONSCIOUSNESS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object]
Stages of decreasing LOC ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SUSTAINED  UNCONSIOUSNESS ,[object Object],[object Object]
  BREATHING IN THE  UNCONSCIOUS CLIENT ,[object Object],[object Object],[object Object],[object Object]
EYE MOVEMENTS IN THE  UNCONSCIOUS CLIENT ,[object Object],[object Object],[object Object]
PUPILLARY CHANGES IN THE  UNCONSCIOUS CLIENT ,[object Object],[object Object],[object Object],[object Object],[object Object]
MOTOR RESPONSES SEEN IN  UNCONSCIOUSNESS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CHANGES IN VITAL SIGNS ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object]
The Glasgow Coma Scale    (GCS) Universally used  Measures eye, verbal, and motor response Excellent scale to measure  Arousal .   Know the difference b/t  content & arousal
GLASGOW COMA SCALE SCORE (GCS) Eyes   1 Closed at all times 2 Opens to pain 3 Opens to voice command 4 Open spontaneously Motor   1 No response  2 Extension (decerebrate rigidity)  3 Flexion posturing  4 Flexion withdrawal  5 Localizes painful stimulus  6 Obeys commands Verbal   1 No response  2 Incomprehensible sounds  3 Inappropriate words  4 Disoriented and converses  5 Oriented and converses  15 (top score) A score of 10 or less indicates a need for  emergency attention A score less than 7 is interpreted as  coma
 
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Any process  that results in  ↑ ICP will produce impairment of content and arousal .  *** Remember  restless  and other changes in behavior frequently precede changes in vital signs, However, changes in LOC will occur first.

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NurseReview.Org - Cranial Nerves Nursing Lecture

  • 1. NURSING OF ADULTS 111 Introduction to Neurological Nursing
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  • 6. FUNCIONAL AREAS OF THE CEREBRAL CORTEX Frontal Lobe Parietal Lobe Temporal Lobe Brain Stem Occipital Lobe Cerebellum Written speech Motor speech Auditory receiving area Auditory interpretation area Motor cortex Sensory area (pain, touch, etc.) Visual interpretation area Visual receiving area
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  • 14. Brainstem - The lower extension of the brain where it connects to the spinal cord. Neurological functions located in the brainstem include those necessary for survival (breathing, digestion, heart rate, blood pressure) and for arousal (being awake and alert). Most of the cranial nerves come from the brainstem . The brainstem is the pathway for all fiber tracts passing up and down from peripheral nerves and spinal cord to the highest parts of the brain.
  • 15. Anatomy of the Autonomic Nervous System (Brunner 2000, p. 1618) What impact on body re SC injury?
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  • 32. AROUSAL The mediator of arousal and sensory stimulation is the RETICULAR ACTIVATING SYSTEM (RAS). The RAS is located in the Brain Stem and contains projections between the Thalamus and the Cortex. A network of neurons in the RAS monitors ascending and descending stimuli. Nerve cells run through the medulla, pons, midbrain, thalamus, and hypothalamus. RAS maintains muscle tone, keeps the higher brain in a state of alert wakefulness, and filters incoming messages .
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  • 44. The Glasgow Coma Scale (GCS) Universally used Measures eye, verbal, and motor response Excellent scale to measure Arousal . Know the difference b/t content & arousal
  • 45. GLASGOW COMA SCALE SCORE (GCS) Eyes 1 Closed at all times 2 Opens to pain 3 Opens to voice command 4 Open spontaneously Motor 1 No response 2 Extension (decerebrate rigidity) 3 Flexion posturing 4 Flexion withdrawal 5 Localizes painful stimulus 6 Obeys commands Verbal 1 No response 2 Incomprehensible sounds 3 Inappropriate words 4 Disoriented and converses 5 Oriented and converses 15 (top score) A score of 10 or less indicates a need for emergency attention A score less than 7 is interpreted as coma
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  • 48. Any process that results in ↑ ICP will produce impairment of content and arousal . *** Remember restless and other changes in behavior frequently precede changes in vital signs, However, changes in LOC will occur first.