Med Surg II Unit 2 Exam Review(1)

7/31/2019 Med Surg II Unit 2 Exam Review(1)

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PARTSOFNERVOUSSYSTEMCNS: Brain & Spinal CordPeripheral: Crainial & Spinal nerves

Autonomic: part of peripheral, Sympathetic & parasympathetic

NEUROTRANSMITTERSChemical substances that excite, inhibit, or modify response of another neuron. Neuron

releases it.

COVERINGSOFTHEBRAINGrey matter(outer part of the brain) billions of neurons. Neurons basic cells of the nervoussystem

.3 components:Cell body: controls the function of the neuronAxon: impulses away cell bodyDendrites: impulses towards cell body

FORAMENMAGNUMSpinal cord continuation of the brainstemExits skull through the foramen magnum: opening at the base of the skull

CRANIALNERVESHOWMANYPAIR

12 pairs of cranial nerves. Originated from the brain or brainstem. Most from brainstem.Functions:SensoryMotormixed

FUNCTIONOF ANSMain function is to maintain homestasis

FIGHTORFLIGHTRESPONSE

Subdivision on the ANS: sympathetic & parasympatheticSympathetic: activated by stress fight or flight

Increased HR

Increased BP

Vasoconstriction

Decreased Peristalsis

Dilated pupils

Increased secretions of epinephrine & sweat


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Decreased secretions of digestive juices & saliva

GLASGOWCOMASCALEOBJECTIVE tool for assessing consciousness in clients (mainly head injuries)

Eye openingVerbal responseMotor response

Total scores indicate coma severity15: oriented7: state coma3:deep coma

PERRLAEqual round and reactive to light & demonstrate accommodation

ONLY when pupil is normal.Abnormal in one or both, finding written out for clarity.

ATAXIAInability to preform any of the following movements.Incoordination of voluntary muscle action.

ROMBERG

Test for BALANCE. Feet together arms in front eyes closed. slight sway normal.Always stand in front of client, anticipating a fall.

TERMSONPG. 1267

PLANTARREFLEXSuperficial reflexFanning: positive BABInskis reflex.Plantar flexion , curling under of the toes should occur.

SKULLFRACTURESFRACTURES are usually caused by extreme force.CLOSED-dura mater is intactOPEN-Dura mater is torn

Manifestation is pain.


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LINEAR-nondisplaced cracks.COMMINUTED-fragmentsDEPRESSED-fragments pressing into intracrainial cavity.BASILAR- base of skull.

Basilar particular concern because of the proximity of fragile sinus bones & adhesionsof dura mater in this area.CSF could leak into EARS & NOSEInternal Carotid Artery & Cranial Nerves can easily be damaged.

TESTSFORNERVOUSSYSTEMDISORDERSLumbar puncture (LP)Electroencephalogram(EEG)Electromyogram(EMG)

Cerebral angiographyBrain scanMyelogramImaging: CT PET SPECT MRI

TYPESOFBRAININJURYCAUSES:

ACCELERATION-baseball bat (object moving).DECELERATION-car dashboard (head moving).ROTATIONAL-whiplash (twisting brainstem).PENETRATING MISSLE-bullet.

Open:Closed:Hemorrhage:Increased Intracranial Pressure:

CEREBRALLACERATIONTearing of the cortical tissueDAI(diffuse axonal injury) in conjunction with brainstem injuries.

This widespread damage to nerve cells in white matter causes immediate coma, extensionposturing, increased intracranial pressure

CONTUSIONSurface bruises

Unconscious for a longer period of time than with concussion.Pulse bp resp all below norm.Cerebral edema with widespread injury.


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INTRACRANIALHEMORRHAGECOMMON COMPLICATION OF ANY HEAD INJURY.

Epidural hematoma: momentary unconscious followed by conscious state of few hrs or wk.Neurological status deteriorates.Headaches seizures, hemiparesis, decrebration(severing of spinal cord) dilated fixed pupils.Surgery: evacuate the hematoma, stop the bleeding, relieve pressure on the brain.

Subdural hematoma:immediate. Acute(48 hrs) subacute(2-14 days) chronic(2wks-mths)Headaches drowsiness, slow mentation, confusionSmall:reabsorbedLarge: hematomas surgical removal

Subarachnoid: intraventricular common inSEVERENuchial rigidity: stiffness or inability to bend neck + increases intracranial pressure.

MORE

CONCUSSIONTransients neurological deficits caused by shaking of the brainCLOSEDBlunt forceCOUP injuries- impact head against object.CONTRECOUP injuries-impact brain opposite side of skull.

PARALYSISLOWEREXTREMITIES

INTRACRANIALHEMATOMAS

CVA

TIA

RISKFACTORSSTROKE

SEIZURESTAGES

ELECTRICALDISTURBANCE


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HERNIATEDDISKCAUSES

SPINALSHOCK

PARKINSONS MEDICATION

MS MEDICATION

ALZHEIMERSMEDICATION

NEURALGIA

ENCEPHALITIS

MIGRAINES

EARWAX

TERMSONPG. 1312

SENSORINEURALHEARINGLOSS

PROFTIPPG. 1318

TYPESOFEARINFECTION

PRIMARYFORMSOFGLAUCOMA

NEARSIGHTEDNESS

DETACHEDRETINA

INCREASEDINTRACRANIALPRESSURE


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Med Surg II Unit 2 Exam Review(1)