PERCEPTION

&
COORDINATION
Maximin A. Pomperada, RN, MAN
NEUROSENSORY
SYSTEM

MUSCULOSKELETAL
SYSTEM
 ANATOMY & PHYSIOLOGY
NERVOUS SYSTEM (NS)

CENTRAL NS
BRAIN & SPINAL CORD

PERIPHERAL NS
CRANIAL & SPINAL NERVES

AUTONOMIC
SYMPATHETIC - THORACO- LUMBAR
PARASYMPATHETIC S2,3,4
 ANATOMY & PHYSIOLOGY
BRAIN:

CEREBRUM

DIENCEPHALON

BRAIN STEM

CEREBELLUM
 ANATOMY & PHYSIOLOGY
CEREBRUM FRONTAL

HEMISPHERES PARIETAL

LOBES TEMPORAL

CORPUS CALLOSUM OCCIPITAL

BASAL GANGLIA
 ANATOMY & PHYSIOLOGY
FRONTAL LOBE:
PERSONALITY, BEHAVIOR
HIGHER INTELLECTUAL FUNCTIONING
PRECENTRAL GYRUS: MOTOR FXN
BROCAS AREA MOTOR SPEECH BROO---M
WERNICKES AREA OF TEMPORAL: SENSORY SPEECH

PARIETAL LOBE:
POST CENTRAL GYRUS : GENERAL SENSATION
INTEGRATES SENSORY INFO
 ANATOMY & PHYSIOLOGY
TEMPORAL LOBE
HEARING, TASTE & SMELL
WERNICKES AREA SENSORY SPEECH

OCCIPITAL LOBE
BROCAS AREA OF FRONTAL LOBE MOTOR SPEECH

VISION
BASAL GANGLIA
REGULATE & INTEGRATE MOTOR ACTIVITY
PART OF EPS
 ANATOMY & PHYSIOLOGY
DIENCEPHALON
THALAMUS PRIMITIVE EMOTIONS: RAGE & FEAR
HYPOTHALAMUS
CONTROL CENTER FOR PITUITARY
REGULATION OF VITAL FXN : BP, SLEEP, FOOD INTAKE, BODY TEMP

BRAINS STEM
MIDBRAIN, PONS, MEDULLA
NUCLEI OF CNs - 12
VITAL CENTERS OF: REPIRATORY, VASOMOTOR & CARDIAC
FXNS
CEREBELLUM
MUSCLE TONE & EQUILIBRIUM
 ANATOMY & PHYSIOLOGY
SPINAL CORD

GRAY MATER
31 SEGMENTS :

H SHAPED
INTERIOR 8 CERVICAL
WHITE MATER 12 THORACIC
EXTERIOR 5 LUMBAR
5 SACRAL
CENTER OF REFLEX
ACTIONS 1 COCCYGEAL
ANATOMY & PHYSIOLOGY
MENINGES

SEROUS MEMBRANE OF
CRANIOSPINAL CAVITY

3 LAYERS:
DURA
ARACHNOID -CS FLUID
PIA
ANATOMY & PHYSIOLOGY

NERVES

FIBERS WHICH EXTEND

BEYOND CNS
NEURON -BASIC UNIT
SENSORY/MOTOR
MIXED
PERIPHERAL

REFLEX ARC
BASIC FXNAL UNIT OF N.S.
 ASSESSMENT FACTORS
1. HEADACHE
2. SYNCOPE
3. VERTIGO
4. SEIZURES
5. NEUROLOGIC PAIN
6. INCREASED ICP
7. ABN BODY TEMP ALTERATIONS
8. APHASIA
 HEADACHE/ CEPHALGIA
MUSCLE CONTRACTION
VASCULAR
CAUSE: HEADACHE HEADACHE
MIGRAINE (SICK H/A)
CLUSTER HISTAMINE HEADACHE
MTC
PRECIPITANTS:
TENSION
INFLAMMATORY/
PSYCHOGENIC
ALLERGIES : ANXIETY
DISPLACEMENT/ TRACTION
/ DEPRESSION
INFLAMMATION/ HEADACHE
DIRECT PRESSURE ON
PERFECTIONISTS & HARDWORKING
TYRAMINE
PAIN-SENSITIVE STRUCTURES
SEVERE
STRESS
MANAGEMENT:
EMOTIONAL
CAUSE:
VERY RARE STRESS
DILATATION OF ARTERIES
FATIGUE
CONSTRICTION, THEN DILATION OF CEREBRAL VESSELS
ORGANIC
TREATMENT:
VASODILATING
OCCURS
WARM IN IN NATURE
AM
COMPRESS DRUGS
CLASSIFICATION:
VASOCONSTRICTORS ERGOTAMINE TARTRATE
GENTLE
ICE PACK
MASSAGE
TYPES:
INVOLVES
ANALGESICS,
QUIET,
THE ENTIRE HEAD
TRANQUILIZERS
DARKENED ROOM
MUSCLE CONTRACTION H/A
1.PSYCHOTHERAPY
MIGRAINE 2. CLUSTER 3. INFLAMMATORY
VASCULAR H/A
 SYNCOPE/FAINTING
TRANSIENT LOSS OF CONSCIOUSNESS
INADEQUATE BRAIN PERFUSION

CAN BE EVOKED BY:

EMOTION
PAIN
SUDDEN DECREASE IN CO OR VENOUS RETURN FROM
ANY CAUSE
MANAGEMENT:
DANGLE FEET FOR 30 SEC BEFORE STANDING
SPIRITS OF AMMONIA
 VERTIGO
SENSATION OF:
ROTATING SURROUNDINGS
CLIENT IS ROTATING

SEEN IN:
NEURO DSE
OTOLOGIC DSE
CARDIOVASC DSE

DIZZINESS
NYSTAGMUS
 SEIZURE/EPILEPSY
PATIENT EDUCATION:
NURSING INTERVENTION:
MEDICAL
PETIT
PSYCHOMOTOR
TYPES: MAL TREATMENT:
SEIZURE
FOCAL
1. CARRYMOTOR/
MYOCLONIC
ID CARD JACKSONIAN
SEIZURE
AS AN EPILEPTIC
GRAND
LITTLE MAL
SICKNESS/
PRIMARY ABSENCE
RESPONSIBILITY:
2.
1. REST,
GENETIC REGULAR MEALS, WELL-BALANCED DIET
COUNSELLING
CLINICAL
PROTECT
PERFORMANCE
3. AVOIDANCE
SEQUENCE:
PATIENT
OF:OF FROM INJURYACTIVITIES
AUTOMATIC
ARISE
2.SUDDEN
1. INITIALLY
ANTICONVULSANTS
GRAND
OBSERVE MAL
& IN THE
INVOLUNTARY
RECORD MOTOR
THE AREAS
CONTRACTION
SEIZURE OF A
EPISODE
MOMENTARY
IMPAIRMENT
1. EXTREME
AURA
- LOSS
TAKEN OREPISODE
OF
FOR CONSCIOUSNESS:
OFPHYSICAL
CRYTONIC-CLONIC
SINGLE SMALL
FALL OF BRAIN
EXERTION
OF THE
GROUPS
CONSCIUOSNESS
INCONTINENCE
LIFE L.O.C.
CONVULSIONOF MUSCLE
2. INFECTION
LASTS
2. LOC
DO
PETIT
3. NOT
10-20
MAL SEC
RESTRAIN
EMOTIONAL
PSYCHOMOTOR
THE PATIENT
STRESS
CLIENT
FROM
4.
3. AMNESIA
MAY
FREQUENT
PADDED UNAWARE
LOCAL
OCCUR
ALCOHOL CLONIC
DURING
CAUSES
SIDE
MYOCLONIC OF
RAILS, MOVEMENTS
PETIT MALINTO
FAILURE
NO PILLOWS TREATMENT:
AFTER
1. POOR
CHILDREN
NO
5. THE
APPARENT
MODERATE SEIZURE:
COMPLIANCE
& COFFEE, GENERALIZED
TEA & COLA SEIZURE
ADOLESCENTS
CONVULSION
MAINTAIN AIRWAY
2.
4.
6. FOCAL
INADEQUATE GROGGY
STIMULANT & CONFUSED,
DOSAGE
DRUGS ( DEEP
ACCORDING TOSLEEP
WEIGHT)
PATIENT EDUCATION
 NEUROLOGIC PAIN
ARISE
FROM NEUROLOGIC LESIONS
CONCERNING PAIN SENSATION

SURGERY:
NEURECTOMY 5TH NERVE RESECTON IN
TRIGEMINAL NEURALGIA
RHIZOTOMY- RESECTION OF THE POSTERIOR
NERVE ROOT
CORDOTOMY LATERAL SPINOTHALAMIC TRACT
INCREASED INTRACRANIAL
PRESSURE
INCREASED INTRACRANIAL
PRESSURE

THE SKULL IS A CAVITY

ALL
AN ELEVATIONOF WHICH
IN THETHE
AMOUNT
CONTAINING
MAINTAIN A NORMAL
OF ANY TISSUE,
BRAIN OF THEM WOULD
CSF, & MEAN
BLOOD
PRESSURE INSIDE THE SKULL.
AN ELEVATION IN THE PRESSURE
INSIDE THE CRANIUM CONSIDERING
THAT THE SKULL IS RIGID..
 INCREASED INTRACRANIAL
PRESSURE
CAUSES:

1. TUMOR
2. HEAD INJURY
3. INFLAMMATORY DSES OF THE NERVOUS
SYSTEM
4. CONDITIONS WITH ARTERIOLAR SPASM
(e.g.MALIGNANT HPN)
5. ANYTHING THAT BLOCKS PARTLY OR
COMPLETELY THE NORMAL COURSE OF CSF
 INCREASED INTRACRANIAL
PRESSURE
TREATMENT:
CONSERVATIVE:
1. HYPERBARRIC O2 / HYPERVENTILATION
VASOCONSTRICTION DUE TO HYPOCAPNIA
AGGRESSIVE: MECHANICAL DECOMPRESSION
2. ELEVATE HOB
3. MEDICATIONS
1.
CRANIOTOMY BRAIN TISSUE EXPANSION
1. MANNITOL
2. 2. STEROIDS-
VENTRICULAR DRAINAGE
DECADRON ONLY STEROID THAT CAN
CROSS THE BBB

4. FLUID RESTRICTION
 INCREASED INTRACRANIAL PRESSURE
MANIFESTATIONS:
UNCAL
UNRELATED HERNIATION
TO MEALS
TENSION
REFLEX
CHOKED DISC INTRACRANIAL
EFFECT
ON OF
HEADACHE LOSS OF OR NAUSEA
MOTOR
1.
VESSELS
PRESSURE
7.
VISUAL &CEREBRAL
ANOXIA ANOXIA
IMPAIMENT
PROJECTILE
REFLEX EFFECT
FUNCTION OF RISING BP
2. VOMITING OF MEDULLA
IRREGULAR SIZE & PUPILLARY
PRESSURE STIMULATION
RESPONSE
SEIZURE OF
3. WIDENING PULSE NURSING
UNCAL
8.
HERNIATION
CARE:
PRESSURE NURSING
PUPILS MEDULLA
CARE:
9. UNILATERALLY
LOSS OBLONGATA
FIXED
OF SPHINCTER
DILATEDCONTROL
& LATER, BILATERALLY
4. SLOWING OF KEEP
MONITOR
NURSING
VENOUS HOB CARE:
ELEVATED
VS HOURLY
ENGORGEMENT OF
NURSING
MONITOR CARE:
VS HOURLY
RESPIRATION POST:
REPORT NO WIDENING
TRENDELENBERG
RETINA OF
TEMPERATURE
10. CENTRAL
I & O
FALLING PULSE RATE MONITOR VARIATIONS
5. ASPIRIN ASVS
PULSE
ORDERED
HOURLY
PRESSURE
WITHHOLD
PULSE
NURSING IN 1 FULL
ORAL
CARE: MIN
FLUIDS
6. PAPILLEDEMA NOIN
RR NARCOTICS
11. 1 FULL MIN LOC
CHANGES IN
SUCTION
PUPILLARY IF NEEDED
CHECKS : EQUALITY
12.
( PUPILLARY
BULGING CHANGES)
OF
& REACTION TO LIGHT
FONTANELS
 INCREASED INTRACRANIAL PRESSURE
DAMAGE TO
LETHARGY EARLIEST SIGN
1. HYPOTHALAMUS
OF INCREASED
HEADACHE ICP
MANIFESTATIONS:
DECORTICATE
CEREBRAL
METABOLIC PRESSURE
CHANGES LOSS OF MOTOR
PRESSURE
MECHANICAL
VOMITING
DECEREBRATE
2. ON
INTERFERE WITH PRESSURE
CEREBRAL 7.
DEVELOPMENT
INTRACRANIAL OF FUNCTION
3. CORTEX
PRESSURE
SPHINCTER &ON
WIDENING RAS
INHIBITORY
MOTOR
PULSE
MENINGITIS
STIMULATION TO BRAIN SEIZURE
NURSING
CONTROL CARE:
PRESSURE CENTERS
8.

NURSING CARE: 9. LOSS OF SPHINCTER

NURSING
NURSING
4. CARE:
SLOWING
CARE:
OF CONTROL
NOTE
REPORT
NURSING RESTLESSNESS
CSF
CARE:LEAKAGE
ANTIPYRETICS
RESPIRATION
EVALUATE
REINFORCE
RECORD WITH
I & OPULSE RATE
10. TEMPERATURE
ICE BAG
CARRYOUT
FALLING SEIZURE VARIATIONS
CONSCIOUSNESS
DRESSINGS
5.
RECORD
CHECK
REMOVE DISTENTION/
HEMIPARESIS
EXCESSIVE
RECORD
6. PRECAUTION
DISORIENTATION
PAPILLEDEMA 11. CHANGES IN LOC
CN INCONTINENCE
CXS
CLOTHING
&
CHECKHALLUCINATIONS
CATHETERIZE
REFLEXES
12. BULGING OF
PREVENT CHILLS FONTANELS
INCREASED INTRACRANIAL PRESSURE

GENERAL MEASURES:

AVOID STRAINING WITH DEFECATION

PREVENT COUGHING
REDUCE ENVIRONMENTAL STIMULI
RESTRAIN CLIENT PRN
ALWAYS ASSUME THAT CLIENT CAN HEAR
 ABNORMAL BODY TEMPERATURE
HYPERTHERMIA/NURSING MANAGEMENT:
HYPERPYREXIA
> or = 41o C or 106 o F
BRAIN
EACH OC TISSUE
MAINTAIN IS
OF RISEROOMIN HIGHLY
TEMP
TEMP =
INCREASE FLUIDS 3000 ML/DAY
The temperature-regulatory center in the hypothalamus
13 %ANTIPYRETICS
SUSCEPTIBLE
INCREASE
can be disturbed by: TOOHYPOXIA..
IN 2 REQIREMENT
CEREBRAL
COMFORT
OF BODY EDEMATISSUESMEASURES
MONITOR
CEREBROVASCULAR VS
DISEASE
ICE BAGS
INTRACRANIAL SURGERYTO GROIN, AXILLA
HEAD INJURY
BRAIN TUMORS
 APHASIA OR DYSPHASIA
ORGANIC DISTURBANCE IN LANGUAGE FROM
CORTICAL TISSUE DAMAGE
NURSING CARE:
FRONTAL LOBE:
REHAB 6-12 WKS AFTER STROKE
PERSONALITY, BEHAVIOR
TEMPORAL LOBE THERAPY
FORMAL SPEECH
HIGHER INTELLECTUAL FUNCTIONING
HEARING,
TASTE & SMELL
VERBAL STIMULATION
PRECENTRAL
GYRUS: MOTOR FXN
WERNICKES AREA SENSORY SPEECH
TALK SLOWLY & IN A NATURAL TONE
BROCAS
AREA &
SIMPLE WORDS MOTOR SPEECH
PHRASES
USE CARDS, PICTURES, SLATE BOARDS
 DIAGNOSTIC ASSESSMENT
LUMBAR PUNCTURE
QUICKENSTEDT TEST
CISTERNAL & VENTRICULAR PUNCTURES
ISOTOPE SCANNING OF THE BRAIN
COMPUTERIZD AXIAL TOMOGRAPHY
EEG
ECHOENCEPHALOGRAPHY
EVOKED RESPONSES
RADIOLOGOC STUDIES
 LUMBAR PUNCTURE
NEEDLE IS INSERTED BETWEEN L3-L4 OR
Complications:
L4-L5 BELOWNORMAL
THE LEVEL
CSFOF
CHARACTERISTICS:
THE SPINAL CORD
CONTRAINDICATION:
HEADACHE
PRESSURE : 6-13 mmHg
HYPOTENSION
INCREASED ICP
APPEARANCE : clear & colorless
MENINGITISOR INFECTION
SEPTICEMIA RBC : none
SUBARACHNOID
USE HEMATOMA
OF ANICOAGULANT
WBC : 0-5 cells/mm
SPACE OCCUPYING LESION
Protein: very little
Glucose: 40-80 mg /dl
Chlorides: 720-750 mg/dl
 DIAGNOSTIC ASSESSMENT
LUMBAR PUNCTURE
QUICKENSTEDT TEST
CISTERNAL & VENTRICULAR PUNCTURES
ISOTOPE SCANNING OF THE BRAIN
Assess CSF circulation & any
Detect subarachnoid
COMPUTERIZD
obstruction in block
AXIAL TOMOGRAPHY
the
EEG & increased ICP
subarachnoid space
ECHOENCEPHALOGRAPHY

Decrease danger of herniation

EVOKED RESPONSES
RADIOLOGOC STUDIES
 DIAGNOSTIC ASSESSMENT
Record of electrical activity patterns of the
Clients head
Initial
ANGIOGRAPHY
LUMBAR isassessment
PUNCTURE scanned @of various angles
intracranial
brain using Scalp electrode
Complete
QUICKENSTEDT brain
lesion &study
vascular
TEST abnormalities
Electrical
Prep:
Use responses
PNEUMOENCEPHALOGRAM
of ultrasonic of the brain
waves to pickPUNCTURES
up to
Dye
CISTERNAL & VENTRICULAR external
1-2 days before: no tranquilizers, anticonvulsants, stimulus
echoes
MYELOGRAM from various intracranial tissues
Diagnosis of:
ISOTOPE SCANNING stimulants including
OF THE BRAINalcohol
Omit
Multiple tea. CoffeeAXIAL
sclerosis
DISCOGRAPHY
COMPUTERIZD & cola; TOMOGRAPHY
regular meals & sleep
Localized
EEG brain lesion
VENTRICULOGRAM
Death
ECHOENCEPHALOGRAPHY
Injection
Films
Dye
Lumbarinto
showingofthe
lateral
puncture radiopaque
ventricles
outline of dye
through
subarachnoid
burr holes
space
Contrast
EVOKED media to the intervertebral disk
RESPONSES
Dye or airof
Injection contrast
air into the subarachnoid space
Locate abn configurations, characteristics & damages
Locate
Detect
Study pathological
Contrast blockade
ofpicture
RADIOLOGOC of dse of SC activity
subarachnoid
STUDIES
cerebrovascular cisterns & ventricles
 VENTRICULOGRAM
NURSING CARE:

POST COMPLETION OF TEST:

PRESURGICAL:
FLAT
OR SEMIFOWLERS
SEDATIVE
FORCE
FLUIDS
SHAVING ABSORPTION OF CONTRAST MEDIA
INCREASED
SALIVATION
CAROTID/VERTEBRAL & PERSPIRATION
PUNCTURE: MX NECKIS NORMAL
REDUCE ENVIRONMENTAL STIMULI
CIRCUMFERENCE
PAIN
RELIEF
RECORD FOR HEADACHE
BASELINE NEUROLOGIC DATA
NO
ANTIPYRECTICS
EXPLAIN : MAY MASK INFECTION
THE PROCEDURE
 THE UNCONSCIOUS CLIENT
NURSING
NURSING CARE
CARE:
NURSING
CAUSE:
NURSING CARE CARE
UNCONSCIOUSNESS:
NURSING
Maintain CARE:
sensory
MAINTAIN PATENT function
AIRWAY
MONITOR
Maintain fluid
MAINTAIN
MAINTAINING VS && NEURO
JOINT intestinal
STATUS
MOBILITY
PSYCHOSOCIAL status FUNCTION
INTERFERENCE WITH OXYGEN SUPPLY
STATE OF DEPRESSED CEREBRAL FUNCTION
SpecialSKIN
HIGHEST
MAINTAIN ophthalmic
PRIORITY solutions : loss of blinking reflex
INTEGRITY
ASSESS THE
Unconscious
PROPER
ASSESS RATE,
period:
POSITIONING
CLIENTS QUALITY
3L/day of&fluid
STATE RHYTHYM OF
LOWER JAWAND
PULSE & TONGUE FALLS BACKWARD
RESPIRATION
ProlongedIN
FREQUENT
EXPLAIN coma:
TURNING NGT TERMS
SIMPLE feeding
&isISCHEMIA
EXERCISE
Talk
INTERFERENCE to
SUCTIONING
BLANCHING
NONO
client-
WITH hearing
INDICATES GLUCOSE the SUPPLY
last faculty to be lost
USE ORAL
Observe
REACTION TEMP
client
THE
TO
MECHANICAL for AIDS:
incontinence,
STIMIULI
PROCEDURES & constipation
THERAPIES
POSITIONING
NEURO CHECKS: LOC, PUPILS,MOTOR STRENGTH
& impaction
MORE FREQUENT
& SENSORY FUNCTION POSITION CHANGE
DIARRHEA
FOOTBOARD early sign of fecal impaction
INTERFERENCE
RESPONSES
No rectal
WITH
ON THETRANSMISSION
ISstimulation- REFLEX
increase LEVEL
ICP
OFONLY.
NEURONS
TROCHANTER ROLLS
HAND ROLLS
 CARE OF NEUROSURGICAL
CLIENTS
POSITIONING VITAL SIGNS FOODS &
FLUIDS

SUPRA LIMIT TO 1.5L/DAY

SEMIFOWLERS NO SPECIFIC DAT AFTER RETURN
TENTORIAL
OF SWALLOWING
& GAG
INFRA FLAT ON EITHER OBSRVE FOR
NPO X 24 HRS
PO FLDS - DAT AFTER
TENTORIAL SIDE RESPIRATORY RETURN OF SWALLO
DIFFICULTY WING & GAG

COMMONALI- KEEP OFF OPERA- MONITOR VS I & O

TIVE SITE OBSERVE FOR
TIES
TURN Q 2H SHOCK &
INCREASE ICP
 CARE OF NEUROSURGICAL
CLIENTS
OTHER MEASURES:
CLEAR DRAINAGE
CATHETERIZE
DRESSING RESTRAINT CLIENT
AVOID ENEMA- MAY INCREASE
SUCTION AS NECESSARY
ICP
DEEP BREATHING, NO COUGHING
ICE BAG TO HEAD
BOWEL & BLADDER ELIMINATION
ANALGESIC, ANTICONVULSANT, STIMULANTS,
STEROIDS
EYE CARE
 NEUROLOGIC DISORDERS
1. DEGENERATIVE DISEASES PREMATURE SENESCENCE OF CELLS
MULTIPLE SCLEROSIS
PARKINSONS DSE
MYASTHENIA GRAVIS

2. CEREBROVASCULAR DISEASES
ARTERIOSCLEROSIS
ANEURYSM, HEMORRHAGE
INFARCTION

3. TRAUMATIC INJURIES
HEAD INJURY
SPINAL INJURY TRIGEMINAL NEURALGIA
4. NEUROPATHIES BELLS PALSY

5. NEOPLASMS
 MULTIPLE SCLEROSIS
DEGENERATIVE, PROGRESSIVE
MANAGEMENT:
MANAGEMENT:
MANAGEMENT:
DEMYELINATION OF MOTOR NERVE FIBERS WITHIN THE
BRAIN & SPINAL CORD
ASSIST
PREVENT TO& OVERCOME
HELP PATIENT TREAT
WITH EFFECTS
MUSCLE
OPTIC OF
SPASTICITY
AND SPEECH
ETIOLOGY:
INCOORDINATION
UNKNOWN;
DEFECTS
MUSCLE RELAXANT
WALK
SLEEP WITH
CRANIAL
AUTOIMMUNE;PRONEFEET
NERVES WIDER APART
FOR SIGHT
VIRUSES &
SUPPORTIVE
AVOID
SPEECH SKIN
AREMEASURES
PRESSURE
AFFECTEDFOR
&BY BLADDER
IMMOBILITY
MS
S/SX : CHARCOTS TRIAD:
DISTURBANCE
DECUBITUS
EYE PATCH ULCERS
ATROPINE & PROBATHINE NYSTAGMUS
TRAIN IN ACTIVITIES OF DAILY LIVING
INTENTION
BLADDER PROGRAM TREMOR
SCANNING
SPEECH
 PARKINSONS DISEASE
PROGRESSIVE
INVOLVES DYSFXN OF BASAL GANGLIA
BASAL GANGLIA
DEFICIENCY OF DOPAMINE FROM
REGULATE & INTEGRATE MOTOR ACTIVITY
SUBSTANTIA NIGRA
PART OF EPS

ACETYLCHOLINE
DOPAMINE
 PARKINSONS DISEASE
S/SX:
MANAGEMENT
PILL ROLLING & MUSCLE RIGIDITY
DRUG THERAPY
LEVODOPA
ANTICHOLINERGICS
MASKLIKE APPEARANCE COGENTIN, ARTANE
PHYSICAL THERAPY
COMBAT MUSCLE RIGIDITY
SHUFFLING PROPULSIVE GAIT (FESTINATING
GAIT TRAINING
GAIT)
SURGICAL THALAMOTOMY
ALLEVIATE TREMOR & RIGIDITY
COGWHEEL MOTION OF JOINTS
 MYASTHENIA GRAVIS
SSX:
DIAGNOSIS:
ACETYLCHOLINE DEFICIENCY
SKELETAL
EDROPHONIUM
FAILURE
MUSCLE OF IMPULSE TRANSMISION
OR TENSILON
TEST
WEAKNESS
WEAKNESS

WEAKNESS
MANAGEMENT:
CAUSE: OF THE MUSCLES OF :
DRUGS
EXTERNAL OCULAR
UNKNOWN
RADIATION
PHARYNGEAL
OF THYMUS/ THYMECTOMY
AUTOIMMUNE
JAW
QUININE, MORPHNE, NEOMYCIN, LARGE
DOSES
SHOULDER
OF BARBITURATES
INCREASED CHOLINESTERASE
ARM
 MYASTHENIA GRAVIS
MYASTHENIA
BRITTLE CRISIS
CRISIS
COMPLICATIONS:CRISIS
CHOLINERGIC
INSENSITIVITY OF ACETYLCHOLINE RECEPTORS
SUDDEN INABILITY TO SPEAK OR MAINTAIN PATENT
OVERMEDICATION WITH ANTICHOLINESTERASE
AIRWAY
TOO MUCH ACETYLCHOLINE
MYASTHENIC CRISIS
CAUSES:
WEAKNESS OF THE MUSCLES OF:
RESPIRATORY
SIGNS
TEMPORARY& SYMTOMS:
RESPIRATION
CHOLINERGIC RESISTANCE
SIGNS TO ANTICHOLINESTERASE
& SYMPTOMS:
CRISIS DEPRESSION
SE
NEED CNS
ANTICHOLINESTERASE
FOR INCREASE IN DOSAGE INJURY
LARYNX INITIAL: DYSPHAGIADRUGS:
OF &
BRITTLE
ACTH ABDOMINAL
THERAPY CRAMPS
PHARYNX
CRISIS CEREBRAL
DIFFICULTY &IN
HYPOXIA
AIRWAY SPEAKING
DIARRHEA
BULBAR EYELID DEATH
PTOSIS
OBSTRUCTION
INCREASE SALIVATION
RESPIRATORY ARREST
INCREASE SWEATING
INCREASE BRONCHIAL SECRETION
CEREBRO-VASCULAR DISEASE
CEREBRAL ARTERIOSCLEROSIS
& ANEURYSM

CEREBRAL INFARCTION
& HEMORRHAGE

CEREBROVASCULAR ACCIDENT
CEREBRAL ARTERIOSCLEROSIS
ATHEROMA IN TH BLOOD VESSELS
LOSS OF MEMORY FOR RECENT EVENTS
CONFUSION
PERSONALITY CXS
VERTIGO TIAs

CEREBRAL ANEURYSM
LOCALIZED OUTPOUCHING OF THE WALL OF AN ARTERY

CEREBRAL EMBOLISM
OCCLUSION OF THE CEREBRAL VESSEL
CEREBROVASCULAR ACCIDENT
EFFECTS & MANIFESTATIONS:
NURSING CARE: HEADACHE
GENERAL CARE:
EMERGENCY CARE:NUCHAL RIGIDITY
PREMONITORY SYMPTOMS:
ADEQUATE OXYGENATION
LOC VS DIZZINESS
TURNING TO SIDE THICKENED TONGUE
FLUID
CONVULSION & ELEC BALANCE
PROPER POSITIONING
ELEVATE HEAD
HEADACHE & VOMITING
ADEQUATE ELIMINATION
VITALPROTECT EYESENVIRONMENT
SIGNSQUIET
CXS
MOTORMOBILIZATION & REHAB
& SENSORY DEFICITS
SPEECHWHEN CONSCIOUSNESS REGAINED
DEFECTS
BIG
 HEAD INJURY
CLASSIFICATION:

LACERATION OF THE SCALP

SKULL INJURY
INTRACRANIAL
BRAIN INJURY HEMORRHAGE
CONCUSSION
CONTUSION EPIDURAL
LACERATION SUBDURAL
COMPRESSION INTRACEREBRAL OR
SUBARACHNOID
INTRACRANIAL
RESULT
VENOUS
MOST FROM
IN ORIGIN
COMOON TEAR IN THE
CAUSE:
HEMORRHAGE
WALL OF MIDDLE
EPIDURAL S/SX:
MENINGEAL ARTERY
LEAKING CONGENITAL
SUBDURAL ANEURYSM
S/SX:
ACUTE
INTRACEREBRAL OR UNCONSCIOUSNESS
LOC
IMMEDIATELY AFTER
SUBARACHNOID
SURGERY
REGAIN CONSCIOUSNESS
CHRONIC
(LUCID INTERVAL)
CONSCIOUS FOR SEVERAL
WEEKS
LOCOR MONTHS, THEN
PATIENT SHOWS
NEUROLOGIC SIGNS
 HEAD INJURY
NURSING CARE:
GENERAL CARE: PROPHYLACTIC TETANUS
AIRWAY OBSERVE CSF LEAKAGE:
EMERGENCY CARE: OTORRHEA, RHINORRHEA
PREVENT ASPIRATION BATTLES SIGN
AIRWAY
PN OBSERVE FOR S/SX OF
CHECK
SUPINECARDIOVASC
STRAIGHT, THEN TURNED TO LATERAL
INCREASED ICP
COMPLICATIONS CONTROL RESTLESS-
OR SEMIPRONE
SEARCH
POSSIBLE EVIDENCE
CERVICALOFFX: NO NECK
NESS FLEXION
& PAIN: NO
&
SPINAL INJURY
HYPEREXTENSION NARCOTICS
CHECK SKULL & SCALP MAINTAIN F&E, ACID-
KEEP PX COVERED, QUIET & UNDISTURBED
INJURIES CAUGHT BASE BALANCE
 SPINAL CORD INJURIES
CAUSES: TYPES:

CONCUSSION
TRAUMA
COMPRESSION
FALLS CONTUSION &
GSW TRANSECTION
LACERATION
TUMORS
HEMORRHAGE
(HEMATOMYALIA)
COMPRESSION OF BLOOD
SUPPLY TO THE CORD
 CLINICAL EFFECTS OF SCI
SPINAL SHOCK

REFLEX ACTIVITY

WHIPLASH INJURY

HERNIATED NUCLEUS PULPOSUS

 SPINAL SHOCK
IMMEDIATE FLACCID PARALYSIS & SENSORY LOSS
BELOW THE LEVEL OF LESION
AUTONOMIC DISTURBANCES:
PRIAPISM
SWEATING IS ABOLISHED
BELOW
BULBOCAVERNOUS REFLEX THE LEVEL
IS LOST OF INJURY
BUT REUTRNS
URINE
AFTER&AFECES RETAINED
FEW HRS
GASTRIC ATONY
ORTHOSTATIC HYPOTENSION
OTHER REFLEXES REMAIN ABSENT
SLOW, & STEADY PULSE
3-6 WKS
 REFLEX ACTIVITY
REPLACE SPINAL SHOCK AFTER 2-3 WEEKS IF LUMBO-
SACRAL SEGMENTS ARE UNDAMAGED

OCCURS IN ACUTE SPINAL INJURY, NOT IN PROGRESSIVE

ONES

AUTOMATIC BLADDER; REFLEX SWEATING &

DEFECATION

FIRST SIGN OF WEARING OFF:

CONTRACTION OF HAMSTRING
FLEXION/ EXTENSION OF TOES WITH PLANTAR STIMULATION
 WHIPLASH INJURY
SIGNSHYPEREXTENSION
VIOLENT & SYMPTOMS&: FLEXION OF THE NECK
MANAGEMENT:
USUALLY WITH AUTOMOBILE ACCIDENT
PALE SEVERE OCCIPITAL
LOC HEADACHE
BED REST
CERVICAL
WEAK SPINE DAMAGE:
ANALGESIC
GAIT DISTURBANCE PAIN RADIATES TO THE
HOT PACKS
MUSCLES
DIZZINESS ARMS
PLASTIC COLLAR FOR SEVERAL WEEKS
VOMITING
DISKS NUCHAL RIGIDITY
LIGAMENTS
NERVOUS TISSUE
 HERNIATED NUCLEUS PULPOSUS

S/SX:
CAUSE:
BACK PAIN WITH RADIATION TO THE BACK OF THE
LEG
LIFTING OF
DIFFICULTY IN HEAVY
WALKINGOBJECTS
MUSCLE
SPASM
FALL ON THE BACK
DISORDERS OF SENSATION
NEAR
THORACIC
IMPROPER OR CERVICAL
BODY REGION:NUCHAL
MECHANICS LUMBAR
RIGIDITY RADIATING DOWN THE ARM TO THE
FINGER
MANAGEMENT:

CONSERVATIVE: AGGRESSIVE:
BRACE SINGLE DISK:
VERTEBRA
CAST REMOVAL WITHOUT
TRACTION FUSIONSPINAL CORD
PROLONGED BEDREST SEVERAL DISKS:
PT SPINAL FUSION
INTER-
WITH BRACE
VERTEBRAL
DISK

HERNIATED DISK
 TRIGEMINAL NEURALGIA
MANAGEMENT
TIC DOULOREAUX
5TH CN : OPHTHALMIC, MAXILLARY, MANDIBULAR
AGONIZING PAIN
CONSERVATIVE: AGGRESSIVE
ETIOLOGY
AVOID: UNKNOWN
SERVING TOO -SURGICAL
HOT FOODS INTRACRANIAL
DRUG TX: RESECTIONING
PRECIPITANT: OF PAIN
PRESSURE ON TRIGGER
ANTIEPILEPTIC FIBERS
POINTS :
SHAVING PERIPHERAL
DILANTIN
TALKING
CARBAMAZEPINE INJECTION
WASHING WITH ALCOHOL
TEGETROL
COLD WIND OF PAIN
GANGLIONS
 BELLS PALSY
CN MANAGEMENT:
7
UNILATERAL
RECOVERY
WEAKNESS & : 3-5 WKS
PARALYSIS
FACIAL MASSAGE
PAIN RELIEF
CAUSE: UNKNOWN
PROTECT INVOLVED EYE
S/SX:
ACTH MINIMIZE DENERVATION AND PERMANENT
SEQUELAE
FACIAL NUMBNESS
TEACH PATIENT FACIAL EXERCISES:
DISTORTION
WHISTLE
SPEECH DIFFICULTY
WRINKLE
DIFFICULTY FOREHEAD
WITH EATING
BLOWOUT
PAIN & PUFF
BEHIND THE CHEEKS
EAR OR FACE
 Which of the following reduces cerebral edema
by constricting the cerebral vessels?

a. Dexamethasone (Decadron)
b. Mechanical Hyperventilation
c. Mannitol
d. Ventriculostomy
RELAX.