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Chp. 44 Med-Surg I
Assessment of the Nervous System pg. 922 II
| Question | Answer |
|---|---|
| Neuroglial cells four types | astroglial = provide support for neuron, regulate chemical enviornment, nourish neuronependymal=form lining of ventricles and central canal of spinal cordoliogdendocytes=form myelin sheaths around axonsmicroglial=scavenger for infection |
| Cerebral Circulation=ring at base of brain Circle of Willis anterior communicationg artery, anterior cerberal arteryposteiror commun. artery, posteiror cerebral artery | the anterior, middle, and posterior cerebral arteries are joined together by small communicating arteries |
| Cerebrospinal fluid | surrounds and cushions the brain and spinal cord, circulates thru subarachnoid space, fluid is produced by the choroid plexus |
| Spinal Cord | controls body movement; regulates visceral function; pocesses sensory information form the extremities, trunk, and many internal organs; transmits iformation to and from brain |
| Autonomic Nervous System | Sympathetic Nervous System= cells of origin located in gray matter of spinal cord from T1 - L2 or L3Parasympatheitc Nervous System= cells of orgin located in gray matter of sacral areal of spinal cord (S2-S4) plus portions of CN III, VII, IX, X |
| Look at Chart on pg. 932 Effects of Autonomic Nervous system on various organs of the bodySome EXAMPLES | Sympathetic Stimulation (SS)Parasympathetic Stimulation (PS)Eye - SS= DilatedPS= ConstrictedSweat glands- SS= copious sweating (cholinergic)PS- sweating of palms and of the handsHeart SS- increased ratePS-slowed rate |
| Assessment TechniquesFamily History and Genetic Risk | history of family heart attack, stroke, miagranes, Huntington's disease, alzheimer's disease, MS, and Parkinson's disease have genetic basis |
| Personal HistoryQuestions about ADLs | Know which side is the client's dominant side (it is usually stronger when tested) |
| Assessment of Mental StatusLevel of Consiousness adn Orientation LOC | A change in LOC is the FIRST indication that neurologic function has declinedAlert- awake and responsiveOrientation- person, place, timeClient's ablility to relate onset of symptomsname of physician or nurseyear and monthher address |
| Memory REMOTE, RECALL, IMMEDIATE | Remote: long-term (test by asking birthdate, schools attended, maiden name of client's mother)Recall: accuracy of medical history, time of admission, mode of transportation to hospitalImmediate: giving them two or three words to remember |
| Attention How to assess? | Serial sevens or ask Ct to repeat a series of three numbers (4, 7, 3) then increase series by one number |
| Language and Copying | Ct demonstrates language comprhension by following directions (getting undressed and providing urine specimen) |
| Cognition | Hobbies Current EventsAbstract reasoning: asking the meaning of proverbs |
| Assessment of Craninal Nerves | not tested unless ct has a suspected problem affecting one or more of the cranial nerves |
| Assessment of Sensory Functionpain, superficial and deep sensation, light touch, and proprioception | Usually for CT with problems affecting the spinal cord or spinal nerves, such as trauma, intervertebral disk disease, GBS, neoplasm, infection, stenosis, or transverse myelitis. |
| Pain and Temperaturesharp or dull and temp. warm hand on spine or cold reflex hammer | pain and temp sensations are transmitted by the same nerve endingsif one sensation is intact then the other should be too |
Created by:
prettydee1908
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