Med term - ch 11

PNS - cranial nerves

- 12 pairs that emerge from the brainstem - carry impulses between the brain and the head and neck - named for each pair that reflects its location or function

PNS - spinal nerves

- 31 pairs that emerge from the spinal cord - carry messages between the spinal cord and the chest, abdomen, and extremities - named for each pair according to the vertebra next to it

Neurons

- basic structural and functional units of nervous system - interconnecting to form complicated networks called nerves that transmit electrical impulses throughout the body

Ischemic stroke

- blood supply to brain is blocked or significantly slowed - caused by a thrombus when an occlusion builds up in an artery - most often the result of atherosclerosis - most often occurs in internal or common carotid arteries

CNS - brain

- highly complex in structure and function - trillions of synapses work together to control every physical and mental activity of the body - center for memory, emotion, thought, judgment, reasoning, and consciousness

Treatment for stroke

- initial emergency care is supportive while test results are pending - laboratory test, ECG, and computed tomography (CT) scans with results back within 4 minutes after assessment - thrombolytic therapy within 1 hour of arrival - careful serial neurological assessments to detect changes promptly

Spinal cord injurt

- location of spinal cord injury and severity of trauma determine whether paraplegia or quadriplegia results - in paraplegia, there is loss of motor and sensory functions in the legs and trunk - in paraplegia, bowel, bladder, and sexual function may be lost

Alzheimer's treatment

- no known cure - supportive and geared to helping alleviate symptoms - drugs to prevent breakdown of the neurotransmitter acetylcholine in the brain allow better functioning of the remaining neurons

Intracerebral hemorrhage

- occurs in the deeper tissues of the brain - usually is caused by uncontrolled hypertenstion

Subarachnoid hemorrhage

- occurs on the surface of the brain - commonly caused by a ruptured cerebral aneurysm - very serious and requires surgery to correct - often fatal

Neuroglia

- perform functions of support and protection - do not transmit electrical impulses - certain small glial cells are phagocytic cells - protect CNS from disease by engulfing and digesting invading microbes

Treating spinal cord injury

- restoration and stabilization of injured spinal are - halo brace keeps head and neck immobile while fusion and healing take place - decompression of compressed neurological structure - prevent progressive spinal cord tissue damage - surgery, drugs, or cooling the affected portion of the spine

Stroke

- symptoms vary and depend on the are of the brain affected - visual disturbances and language disturbances - weakness or paralysis on one side of the body - drowsiness, severe headache, and dysphagia

CNS - meninges

- three connective tissue membranes that cover the spinal cord and brain - protect and nourish the spinal cord

Focuses on minimizing effects of the disease - maintaining independence as long as possible antidepressants, antipsychotics, and antianxiety drugs - may be used as last resort to control symptoms of depression and behavioral disturbances

Alzheimer treatment

What are the two main divisions of the nervous system?

Central nervous system (CNS) and peripheral nervous system (PNS)

Joan X is diagnosed with a spinal cord injury. She asks the doctor nurse to explain its cause.

He explains that acute traumatic injury of the spinal cord results from automobile accidents, sports injuries, falls, or violence.

caused by a blood clot that is created somewhere in the body - often initiates within the heart and travels through the arteries - eventually is trapped in a smaller vessel, preventing passage of blood

Ischemic stroke

What does the PNS consist of?

Peripheral nerves that connect the CNS to remote body parts to relay and receive messages.

Mr. F is a resident in the Alzheimer unit. He no longer recognizes his wife and daughter when they come for a visit. In addition, he is completely dependent on his caregivers for his daily needs. Mr. F is in what stage of Alzheimer disease?

Stage 3

Mrs. C asks about the importance of taking a folic acid vitamin supplement during pregnancy.

The medical assistant explains that folic acid intake decreases the risk of the child being born with the congenital defect called spina bifida.

Baby Smith is diagnosed with spina bifida cystica, and the mother asks the physician to explain this congenital defect

The physician explains that spina bifida cystica involves protrusion of the meninges (meningocele), spinal cord (myelocele), or both (meningomyelocele).

What is the function of neuroglia cells?

They perform the function of support and protection. Certain small glial cells are phagocytic cells and protect the CNS from disease by engulfing and digesting invading microbes

Neuritic plaques

accumulations of sticky substance made of amyloid protein found in the gray matter of the brain that are frequently characteristic of Alzheimer disease

Antipsychotics

alter neurotransmitters int eh brain to alleviate symptoms of psychosis, paranoia, and schizophrenia

encephalo

brain

Central Nervous System (CNS)

brain and spinal cord

What does the CNS consist of?

brain and spinal cord

Hemorrhagic stroke

caused by a ruptured cerebral vessel that allows blood to escape into brain tissue and results into two major types: intracerebral and subarachnoid hemorrhage

What are the two main divisions of the nervous system

central nervous system and peripheral nervous system

Pertaining to the cerebrum

cerebral

Pertaining to the cerebrum and spine

cerebrospinal

cerebro

cerebrum

CNS - spinal cord

column of nervous tissue within the spinal cavity of the vertebral column - extends from brainstem to second lumbar vertebra in the spinal column carries all the nerves to and from the limbs and lower part of the body - pathway for impulses going to and from the brain protected by bony structures of the vertebral column

Antiparkinsonian agents

control tremors and muscle rigidity associated with Parkinson disease by increasing dopamine levels in the brain

Hydrocephalus

cranial enlargement caused by accumulation of fluid within the ventricles of the brain

Peripheral Nervous System (PNS)

cranial nerves and spinal nerves

Incision of the cranium (skill)

craniotomy

Zia is having surgery to remove a brain tumor. The surgeon needs to create an opening in the skull to gain access to the tumor. This surgery is known as a (craniotomy, thalamotomy, tractotomy).

craniotomy

Mrs. A is becoming forgetful and withdrawing from social interactions with her family. She loses track of time and commonly forgets to eat her meals. After a complete PE, the physician diagnoses her disorder as (deterioration, dyslexia, dementia).

dementia

Spina bifida

developmental defects of the first trimester of pregnancy characterized by incomplete closure of the bones encasing the spinal cord

Epilepsy

disorder affecting the CNS that is characterized by recurrent seizures

.Ms. A experienced a stroke and now has difficulty eating and swallowing. How should the nurse chart these difficulties?

dysphagia

Mrs. L experienced a stroke that affected the left side of her brain and resulted in a speech impairment. The physician charts this disorder as (aphasia, dysphagia, dysphasia).

dysphasia

Trephination

excision of a circular disk of bone using a specialized saw called a trephine - reveals brain tissue for neurosurgery - used to relieve ICP

glio

glue, neurological tissue

Mr. R experienced a stroke 6 months ago. Today he must use a cane when he walks because of weakness in his left leg. The medical term for this weakness is (paraplegia, hemiplegia, hemiparesis).

hemiparesis

Condition of water in the head

hydrocephalus

Positron emission tomography (PET)

imaging procedure that records metabolic activity - use of a tracer that emits positively charged molecules - commonly used in conjunction with CT - used to scan brain and nervous tissue - identifies area of abnormal activity that occur in schizophrenia, tumors, epilepsy, stroke, and Alzheimer disease

Craniotomy

incision of the skull to gain access to the brain during neurological procedures

Craniotomy

incision of the skull to gain access to the brain during neurological procedures - performed to control brain bleeds, relieve intracranial pressure (ICP), and remove brain tumors

Spina bifida occulta is the most common and least severe spinal cord defect

incomplete closure of one or more vertebrae without protrusion of spinal cord or meninges, spinal cord is covered with a layer of skin

To alter destruction of neurons in Alzheimer disease, the physician prescribes drugs to (increase, decrease, inhibit) levels of acetylcholine in the brain.

increase

Stage 1 of Alzheimer disease

increasing forgetfulness

Two types of stroke

ischemic stroke and hemorrhagic stroke

meningo, meningio

meninges (membranes covering brain and spinal cord)

Baby Mary is diagnosed with spina bifida that involves protrusion of the meninges. The medical term for this is (meningocele, meningomyelocele, myelocele).

meningocele

Spina bifida cystica has two classifications

meningocele and meningocyelocele

Baby Mark is diagnosed with spina bifida cystica that involves the protrusion of the meninges and spinal cord. This diagnosis is charted as (meningocele, meningomyelocele, myelocele).

meningomyelocele

Hernia(tion) of meninges and spinal cord

meningomyelocele

Lumbar puncture

needle puncture of spinal cavity to withdraw a sample of cerebrospinal fluid - used for biochemical, microbiological, and cytological laboratory analysis - introduces agents into spinal canal (anesthetics, radiopaque substances)

Alzheimer Disease

neritic plaques and neurofibrillary tangles instead of normal orderly arrangements develop in the brain - deficiency of function of neurotransmitters

neuro

nerve

Tumor of nerve, embryonic cell

neuroblastoma

Separation, destruction, or loosening of a nerve

neurolysis

What are the cells that transmit impulses called?

neurons

Crushing a nerve

neurotripsy

Complete spinal cord injury

no feeling or function beneath the injury

-plegia

paralysis

A veteran presents to the clinic with paralysis of the lower portion of the body and both legs. The medical term in the chart for this spinal cord impairment is (paraplegia, quadriplegia, total paralysis).

paraplegia

Jena has a loss of motor and sensory functions in the legs and trunk following an auto accident. This type of spinal injury is known as (paraplegia, quadriplegia, complete spinal injury).

paraplegia

Thalamotomy

partial destruction of the thalamus portion of the brain - used as a treatment for psychosis and intractable pain

-paresis

partial paralysis

Inflammation of gray matter of spinal cord

poliomyelitis

Anticonvulsants

prevent or reduce severity of epileptic or other convulsive seizures, also called antiepileptics

Anesthetics

produce partial or complete loss of sensation, with or without loss of consciousness - general anesthetics act on brain to produce complete loss of consciousness - local anesthetics act on nerves or nerve tracts to affect a local area only

Stage 3 of Alzheimer disease

progression to complete dependency - ability to recognize others is lost - death occurs from complications of immobility

Stage 2 of Alzheimer disease

progressive cognitive deterioration causes difficulty doing simple calculations or answering questions

Paralysis of four (limbs)

quadraplegia

The nurse explains that a C6 injury results in paralysis of all four extremities and usually the trunk. This type of impairment is called (paraplegia, quadriplegia, total paralysis).

quadriplegia

Electromyography (EMG)

recording and analysis of electrical activity of selected muscle groups while at rest and during voluntary contraction - test determines whether muscle weakness is caused by a muscular disease or nerve damage - aids in diagnosis of neuromuscular disorders

Electroencephalography (EEG)

recording and analysis of electrical activity of the brain - record obtained is called an electroencephalogram (paper strip tracings) - electrodes are placed on scalp - helpful in studying epilepsy and convulsive disorders and locating lesions in the cerebrum

Meningocele and meningomyelocele - treatment

require surgical repair of sac and supportive measures to promote independence and decrease possibility of complications - folic acid in diet of women of childbearing age decreases risk of spina bifida

Meningomyelocele

sac contains meninges, CSF, and a portion of the spinal cord

Mengingocele

sac contains only meninges and cerebrospinal fluid (CSF)

-lepsy

seizure

Sciatica

severe pain int eh leg along the course of the sciatic nerve, which travels from the hip to the foot

Incomplete spinal cord injury

some feeling and function remains beneath the injury

-phasia

speech

myelo

spinal cord

Insufficient supply of oxygenated blood to the brain - due to a clot or ruptured blood vessel (hemorrhage) - causes brain tissue to die (ischemia)

stroke symptoms

John has chronic pain caused by an injury to his back from an auto accident 10 years ago. The physician performs a partial destruction of the thalamus to treat his chronic pain. This is charted in the medical record as a

thalamotomy

Cognition

the ability to think, includes attention, memory, learning, reasoning, problem solving, and ddecision making

Mrs. J asks the doctor to explain the treatment recommended for spina bifida occulta.

the nurse explains that spina bifida occulta does not require surgery and there is little or no treatment

Mr. C is aware that strokes are commonly preceded by mild, strokelike symptoms that usually resolve within 24 hours. His physician advises him to seek medical attention if he experiences such symptoms, called a TIA, which is the abbreviation for

transient ischemic attack

To relieve pressure on the brain, the neurosurgeon excises a circular disk of bone of the skull. This surgical procedure is charted as a (craniotomy, thalamotomy, trephination).

trephination

What is the name of the specialized saw that can excise a circular disk of bone? (trephine, thalmine, LP)

trephine

Computed tomography (CT)

use of a computer to generate three-dimensional images - especially effective in diagnosing disorders of the brain and spinal cord - used to visualize tumors, abscesses, hemorrhage, and trauma

Spinal cord injury resulting in paralysis

usually consequence of fracture or dislocation, or both, of the vertebral column

Spina bifida occulta - treatment

usually does not require treatment