Understanding Medical Surgical Nursing Ch 45
Terms
undefined, object
copy deck
- oligodendrocyte
- produces myelin sheath to electrically insulate CNS neurons
- microglia
- capable of movement & phagocytosis of pathogens & damaged tissue
- astrocyte
- contributes to blood-brain barrier
- ependyma
-
line ventricles of brain
many of cells are ciliated
involved in circulation of cerebrospinal fluid - sensory (afferent) neuron
- transmits impulses from receptors to CNS
- motor (efferent) neuron
-
transmits impulses from CNS to effectors (muscles & glands)
"A before E: You have to feel or sense (afferent) a stimulus before you an take action (efferent)" - nerve impulse
-
AKA action potential
electrical change caused by movement of ions across neuron cell membrane - reflex arc
-
pathway nerve impulses travel when a reflex is elicited
1) RECEPTORS detect stimulus & generate impulse
2) SENSORY NEURONS transmit impulses from receptors -> CNS
3) THE CNS contains one+ synapses & interneurons (may be part of pathway)
4) MOTOR NEURONS transmit impulses from CNS -> effector
5) EFFECTOR performs action - The parts of the brain include . . . (seven listed)
-
1) medulla: vital function regulation - cough/sneeze/swallow/vomit reflex ctrs
2) pons: respiratory ctrs
3) midbrain: reflex ctr - balance
4) cerebellum: coordination - muscle tone - posture/balance
5) hypothalamus: produce several hormones - regulate food intake - stimulate visceral responses when emotional
6) thalamus: sensory pathways (except olfactory)
7) cerebrum: impulses for voluntary movement - sensations interpretation - hearing/smell/taste - learning - memory - There are _____ pair of cranial nerves.
- 12
- The _____ nervous system is dominant in stressful situations.
- sympathetic
- The two neurotransmitters of the sympathetic division are . . .
-
1) acetylcholine
2) norepinephrine - The _____ nervous system dominates during relaxed, nonstressful situations to promote normal functioning of several organ systems.
- parasympathetic
- The neurotransmitter for all parasympathetic synapses is _____?
- acetylcholine
- The twelve cranial nerves are . . .
-
I Olfactory
II Optic
III Oculomotor
IV Trochlear
V Trigeminal
VI Abducens
VII Facial
VIII Vestibulocochlear
IX Glossopharyngeal
X Vagus
XI Accessory
XII Hypoglossal - A basic neurological assessment includes what five steps?
-
1) Assess LOC & orientation
2) Get VS
3) Check pupillary response to light
4) Assess strength/equality of hand grip & movement of extremities
5) Determine ability to sense touch/pain in extremities - expressive aphasia
- pt knows what they want to say but unable to say it coherently
- decerebrate posturing
-
abnormal extension posturing
feet plantar flexed - wrists/fingers flexed - forearms pronated - elbows extended - arms adducted - anisocoria
- unequal pupil dilation
- nystagmus
- involuntary movement of eyes
-
Mnemonic for remebering cranial nerves:
O h
O nce
O ne
T akes
T he
A natomy
F inal
A
G ood
V acation
S eems
H eavenly -
O lfactory
O ptic
O culomotor
T rochlear
T rigeminal
A bducens
F acial
A coustic
G lossopharyngeal
V agal
S pinal accessory
H ypoglossal - Babinski's reflex
-
neurological test
sole of foot stroked - flexion of great toe expected in anyone over age 6 months
if great toe extends & other toes fan out, neurological dysfunction suspected if pt >6 months - lumbar puncture
-
cerebrospinal fluid obtained & evaluated for . . .
~ elevated glucose or protein
~ bacteria or WBC presence
~ immunoglobulin levels
~ culture & sensitivity - electroencephalogram (EEG)
- noninvasive test done to evaluate electrical activity of brain
- contractures
-
permanent muscle contractions w/fibrosis of connective tissue that occur from lack of muscle use
cause permanent deformities & prevent normal function - dysarthria
- difficulty speaking
-
Which of the following are neurons that carry impulses from the CNS to effectors?
a. Mixed
b. Motor
c. Afferent
d. Sensory - b. Motor
-
Which of the following is a symptom of increasing intracranial pressure?
a. Constricted pupils
b. Decreasing LOC
c. Narrowing pulse pressure
d. Bradypnea - b. Decreasing LOC
-
Which of the following actions by the nurse is the best way to determine if a patient with expressive aphasia is oriented?
a. Ask yes-or-no questions.
b. Ask the patient to name the family member in the room.
c. Ask the patient who the cur - a. Ask yes-or-no questions.
-
Asking the patient to stick out his or her tongue evaluates the function of which cranial nerve?
a. IV-trochlear
b. V-trigeminal
c. IX-glossopharyngeal
d. XII-hypoglossal - d. XII-hypoglossal
-
Which of the following nursing interventions can prevent footdrop?
a. Positioning the patient in the left lateral position
b. Providing daily foot massage
c. Using high-top tennis shoes
d. Maintaining an upright position as much as po - c. Using high-top tennis shoes
-
Which of the following activities should be encouraged when a patient returns from a CT scan using a contrast medium?
a. Ambulation
b. Drinking fluids
c. Turning side to side
d. Coughing and deep breathing - b. Drinking fluids
-
When observing a patient's gait, the nurse is checking the integrity of what?
a. Cerebellum
b. Brainstem
c. Diencephalon
d. Cerebrum - a. Cerebellum
-
Which of the following areas of the brain controls speech?
a. Left occipital lobe
b. Broca's area
c. Midbrain
d. Brainstem - b. Broca's area