Term
|
Definition
| OLFACTORY : Sensory : Sense of smell |
|
|
Term
|
Definition
| Optic Sensory : Visual acuity and visual fields; sense of sight |
|
|
Term
|
Definition
| OCULOMOTOR : Motor : Muscles that move the eye and lid, pupillary constriction, accommodation |
|
|
Term
|
Definition
| TROCHLEAR : Motor : Muscles that move the eye |
|
|
Term
|
Definition
| TRIGEMINAL : Mixed : Facial sensation (face, scalp, and teeth), corneal reflex, mastication |
|
|
Term
|
Definition
| ABDUCENS : Motor : Muscles that move the eye |
|
|
Term
|
Definition
| FACIAL : Mixed : Facial expression and muscle movement, salivation and tearing, taste, sensation in ear |
|
|
Term
|
Definition
| ACOUSTIC : Sensory : Hearing and equilibrium |
|
|
Term
|
Definition
GLOSSOPHARYNGEAL : Mixed : Sense of taste; sensory for cardiac; respiratory and blood pressure
Reflexes; contraction of the pharynx; secretion of saliva; gag reflex |
|
|
Term
|
Definition
VAGUS : Mixed : Sensory in cardiac, respiratory, and blood pressure reflexes; sensory and motor to
Larynx (speaking); decreases heart rate; contraction of alimentary tube (peristalsis); increases digestive Secretions |
|
|
Term
|
Definition
| ACCESSORY : Motor : Contraction of neck and shoulder muscles; motor to larynx (speaking) |
|
|
Term
|
Definition
| HYPOGLOSSAL : movement of the tongue |
|
|
Term
|
Definition
fight or flight, prepares body for stressful or emergency situations, stimulates responses that are needed to meet the emergency and inhibits those visceral activities that can be delayed momentarily. Increases heart rate, respirations, sweat secretion, bp, pupils dilated
slowed: digestion, sphincters are contracted, uterus contracted |
|
|
Term
|
Definition
conservation and restoration of energy, most active under ordinary relaxed conditions, rest and digest
decreased: bp, respiration rate, muscle walls of bladder contracted, bronchiales constricted, pupils constricted |
|
|
Term
|
Definition
Motor area that coordinates skeletal muscle activity
Maintains muscle tone, posture, and balance |
|
|
Term
|
Definition
A type of nerve cell. It is they structural unit that conducts impulses.
Made up of Cell body (similar to other types of cells),
dendrites (transmits impulses to the cell body – one or more),
and axon (transmits impulses away from the cell body – one) |
|
|
Term
|
Definition
| Neurotransmitters role is to assist with the transmission of nerve impulses between neurons. Some have an excitatory effect and some have an inhibitory effect. Starts out at terminal end of axon |
|
|
Term
|
Definition
| Connective tissue covering that protects the brain and spinal cord. |
|
|
Term
|
Definition
| thin, delicate, closely adheres to brain and spinal cord, follows every sulsi |
|
|
Term
|
Definition
| middle, thin, numerous threadlike strands that attach to innermost pia mater, follows along top of Gyri |
|
|
Term
|
Definition
| outer, tough, fibrous, forms envelope around brain and spinal cord |
|
|
Term
|
Definition
| motor areas that initiate voluntary movement – regulates sequence of movements for learned skills and movement involved in speech – (area for math problem reasoning); personality, behavior, emotion, intellectual function |
|
|
Term
|
Definition
| general sensory area; feels and interprets the cutaneous senses and conscious muscle |
|
|
Term
|
Definition
| auditory areas for hearing and interpretation – olfactory areas for sense of smell and interpretation |
|
|
Term
|
Definition
| visual areas for vision – interpretation of spatial relationships |
|
|
Term
|
Definition
| in all lobes – abstract thinking, reasoning, learning, memory, and personality |
|
|
Term
|
Definition
| Centrally located, surrounded by cerebral hemispheres- consists of Thalamus, Hypothalamus, Epithalamus |
|
|
Term
|
Definition
| relay station for sensory impulses going to cerebral cortex except for smell |
|
|
Term
|
Definition
| key role in homeostasis, regulates endocrine activity and autonomic nervous system; appetite |
|
|
Term
|
Definition
| involved with rhythmic cycles in the body (circadian rhythm, sleep/wake cycles) |
|
|
Term
|
Definition
Slowing speech
Delay in response to verbal suggestions
Not oriented
Doesn’t follow commands
Needs persistent stimuli
Confusion
Restlessness
Increased drowsiness |
|
|
Term
| Decreased LOC – pt assessment |
|
Definition
Glasgow Coma Scale
Posturing
CT
MRI
EEG
Lab tests |
|
|
Term
|
Definition
Score of 3 = severe impairment of neurologic function, brain death, or pharmacologic inhibition of the neurologic response
Score of 15 = patient is fully responsive
Based on eye opening, verbal response, and motor response |
|
|
Term
| Decreased LOC – pt assessment Lab tests |
|
Definition
Blood glucose
Electrolytes
Serum ammonia
Liver function tests
BUN levels
Serum osmolality
Calcium levels
Partial thromboplastin
Prothrombin times |
|
|
Term
|
Definition
Decorticate: arms in to the chest
Decerebrate: arms to the side think planking, worse of the two
flaccid: |
|
|
Term
|
Definition
Ineffective airway clearance r/t altered LOC
Risk of injury r/t decreased LOC
Deficient fluid volume r/t inability to take fluids by mouth
Impaired oral mucous membrane r/t mouth breathing, absence of pharyngeal reflex, and altered fluid intake
Risk for impaired skin integrity r/t prolonged immobility
Impaired tissue integrity of cornea r/t diminished or absent corneal reflex
Ineffective thermoregulation r/t damage to hypothalamic center
Impaired urinary elimination (incontinence or retention) r/t impairement in neurologic sensing and control
Bowel incontinence r/t impairment in neurologic sensing and control and also r/t changes in nutritional delivery methods
Disturbed sensory perception r/t neurologic impairment
Interrupted family processes r/t health crisis |
|
|
Term
|
Definition
| Reduces the metabolic demand and results in a decrease in cerebral oxygen demand |
|
|
Term
|
Definition
| To identify increased pressure early (before cerebral damage occurs) |
|
|
Term
|
Definition
a fluid-filled catheter is inserted into the anterior horn of the lateral ventricles through a burr hole.
Advantages:
Allows accurate measurement of ICP
Allows drainage or sampling of CSF
Allows instillation of contrast media
Disadvantages
Additional site for potential infection
Most invasive method
Balanced and recalibrated frequently
Catheter can become occluded
Insertion difficult with small ventricle
CSF leakage around insertion site |
|
|
Term
|
Definition
a special hallow, threaded screw or bolt is placed into the subarachnoid space through a burr hole in the front of the skull, behind the hairline.
Advantages
Lower infection rates than IVC
Quickly and easily placed
Can be used with small ventricle
Does not penetrate brain tissue
Disadvantages
Less accurate readings
May be occluded by blood or tissue
Must be balanced and recalibrated frequently
Does not provide for CSF sampling |
|
|
Term
|
Definition
a fiber optic sensor is inserted into the epidural space through a burr hole. Measures changes in the amount of the light reflected from a pressure-sensitive diaphragm in the catheter tip. NON INVASIVE because the device does not penetrate the dura.
Advantages
Least invasive
Decreased risk for infection
Easily and quickly placed
Disadvantages
Accuracy and reliability are questionable
Does not provide for CSF sampling |
|
|
Term
| ICP monitor complications |
|
Definition
Infection
Meningitis
Ventricular collapse
Occlusion
System problems |
|
|
Term
|
Definition
Change in LOC
Slowing speech
Delay in response to verbal suggestions
Restlessness
Confusion
Increasing drowsiness
Cushing’s triad: BP increases; resps decreased and altered (labor, Cheyene stokes); pulse decreases fluctuating. |
|
|
Term
| Pharmacologic tx – increasing ICP |
|
Definition
Osmotic diuretics – MANNITOL
Corticosteroids – DEXAMETHASONE – if d/t tumor helps reduce swelling and inflammation
Inotropic agents – DOBUTAMINE & NOREPINEPHRINE – maintain cerebral perfusion
Paralyzing agents / barbiturate – PROPOFOL, PHENTOBARBITAL, THIOPENTAL – reducing metabolic needs |
|
|
Term
| Complications following CT |
|
Definition
Allergic reactions / change in kidney function – if dye used
Fasting for 4 hours if using contrast |
|
|
Term
| Complications following MRI |
|
Definition
Problems with magnetic / ferromagnetic objects on/in person
Risk of severe injury and death d/t above
Damage to equipment if magnetic |
|
|
Term
| Complications following PET |
|
Definition
| Radioactive substance used may produce side effects |
|
|
Term
| Complications following SPECT |
|
Definition
| Possible allergic reactions to radiopharmaceutical agent used |
|
|
Term
| Complications following Cerebral angiography |
|
Definition
Embolism
Arterial dissection
Nursing Interventions: Pt should be well hydrated and clear liquids are usually permitted up to the time of regular arteriogram or DSA (digital subtraction angiography). Have them void before the procedure.
a) Occlusion of the superior segment of the basilar artery (arrow) and stenosis in the distal segment of the right vertebral artery (arrow head) corresponds to a dissection.
B) Partial recanalization of the basilar artery (arrow).
c) Complete recanalization of the basilar artery (arrow).
d) Therapeutic occlusion of the right vertebral artery with coils (arrow). |
|
|
Term
| Complications following Myelography |
|
Definition
not often
Photophobia
Seizures
Chemical or bacterial meningitis
Nursing interventions: Teach the pt that during the test they may be moved into different positions but after the test they have to elevate the head 30-45 degrees and remain in bed for 3 hrs and drink lots of fluid to replace the fluid removed. The fluid intake also decreases the chance of getting a spinal headache. VS need to be monitored and watch for signs such as headache, stiff neck, fever, and photophobia. |
|
|
Term
| complications following Lumbar puncture |
|
Definition
to withdraw CSF for analysis
Post lumbar puncture headache
Herniation of intracranial contents
Spinal epidural abscess
Spinal epidural hematoma
Meningitis
Temporary voiding problems
Stiffness of neck
Slight elevation of temp
Backache or spasms |
|
|
Term
|
Definition
Should be clear and colorless
Check for: cell count, culture, glucose, protein… |
|
|
Term
| Lumbar puncture positioning |
|
Definition
On one side with back facing dr. fetal position. Small pillow under pt head – keeps spine in horizontal position
Pt instructed to lie prone for 2-3 hr post look at chart…………………………………………….complication/headache |
|
|
Term
| Lumbar puncture – nursing management |
|
Definition
Instruct pt to void before procedure
Assist pt to maintain position to avoid sudden movement
Encourage to relax and breathe normally
Describe procedure
Monitor for complications
Encourage increased fluid intake |
|
|
Term
|
Definition
Aneurysm: a weakening in the arterial wall
AVM: arteriovenous malformation |
|
|
Term
|
Definition
(CVA, “brain attack”) – disruption of the cerebral blood flow d/t obstruction of a blood vessel.
Embolism
thrombus |
|
|
Term
|
Definition
| bleeding into the brain tissue, the ventricles, or the subarachnoid space |
|
|
Term
| Intracerebral hemorrhage: |
|
Definition
| bleeding into the brain tissue. Most common in pts with hypertension and cerebral atherosclerosis d/t they cause rupture of the blood vessel. |
|
|
Term
|
Definition
| dilation of the walls of a cerebral artery that develops as a result of weakness in the arterial wall. |
|
|
Term
| Arteriovenous Malformation (AVM): |
|
Definition
| tangle of arteries and veins in the brains that lack a capillary bed – leads to dilation of the arteries and veins and eventual rupture – common cause in young people. |
|
|
Term
|
Definition
| d/t an AVM, intracranial aneurysm, trauma or hypertension (Circle of Willis) |
|
|
Term
| Nursing interventions of strokes Acute: |
|
Definition
Airway & Respiratory status
Neurological status and v.s. frequently
For signs of increased intracranial pressure
Intake and output
Swallowing abilities
Fluid balance
Potential for seizures |
|
|
Term
| Nursing interventions of strokes long term |
|
Definition
Provide assistance with ADL’s
Mobility
Bowel & bladder function
Nutrition
Skin integrity
Family coping
Assist with communication skills
Provide safe environment
Provide emotional support
Prevent complications
Sexual dysfunction |
|
|
Term
| Non-modifiable Risk factors in Ischemic strokes |
|
Definition
|
|
Term
| Modifiable Risk factors in Ischemic strokes |
|
Definition
Hypertension
Arteriosclerosis
Atrial fibrillation
Asymptomatic carotid stenosis
Hyperlipidemia
Smoking
Diabetes mellitus
Sedentary lifestyle
Obesity
Coagulation disorders
Hypothyroidism
Substance abuse
Sickle cell disease
Oral contraceptives |
|
|
Term
| Risk factors in Hemorrhagic strokes |
|
Definition
Increased age
Male
Excessive alcohol intake
Hypertension |
|
|
Term
|
Definition
Altered LOC
Confusion
Pupillary abnormalities (changes in shape, size, and response to light)
Altered or absent gag reflex
Absent corneal reflex
Sudden onset of neurologic deficits
Changes in vs (altered respiratory pattern, widened pulse pressure, bradycardia, tachycardia, hypothermia, or hyperthermia
Vision and hearing impairment
Sensory dysfunction
Headache
Seizures |
|
|
Term
| Nursing Dx – brain injury |
|
Definition
Ineffective airway clearance and impaired gas exchange r/t brain injury
Ineffective cerebral tissue perfusion r/t increased ICP, decreased CPP, and possible seizures
Deficient fluid volume r/t decreased LOC and hormonal dysfunction
Imbalanced nutrition, less than body requirements, r/t increased metabolic demands, fluid restriction, and inadequate intake
Risk for injury r/t seizures, disorientation, restlessness, or brain damage
Risk for imbalanced body temp r/t damaged temperature regulating mechanisms in the brain
Risk for impaired skin integrity r/t bed rest, hemiparesis, hemiplegia, immobility, or restlessness
Disturbed thought processes r/t brain injury
Disturbed sleep pattern r/t brain injury and frequent neuro checks
Interrupted family processes r/t unresponsiveness of patient, unpredictability of outcome, prolonged recovery period, and the patient’s residual physical disability and emotional deficit
Deficient knowledge about brain injury, recovery, and rehabilitation process |
|
|
Term
| Pharm treatment – brain injury |
|
Definition
Antiseizure meds
Benzodiazepines – agitation – to calm
Osmotic diuretic- manatol |
|
|
Term
| Nursing interventions – brain injury |
|
Definition
Monitor neurologic function – glascow coma scale/vs/motor function
Maintaining airway
Monitoring fluid and electrolyte balance
Promoting adequate nutrition
Preventing injury
Maintaining body temperature
Maintaining skin integrity
Improving cognitive functioning
Preventing sleep pattern disturbance
Supporting family coping
Monitoring and managing potential complications |
|
|
Term
|
Definition
Scalp injury (laceration and avusion)
Skull fracture
Simple: clean break
Comminuted: splintered / multiple fracture line
Depressed: bones forcibly displaced downward |
|
|
Term
|
Definition
| temporary loss of neurologic function with no apparent structural damage |
|
|
Term
|
Definition
| brain is bruised and damaged in a specific area d/t severe acceleration-deceleration force or blunt trauma |
|
|
Term
|
Definition
| widespread shearing and rotational forces that produce damage throughout the brain |
|
|
Term
|
Definition
| collection of blood in the brain |
|
|
Term
|
Definition
Unilateral and come in clusters of 1-8 daily, with excruciating pain localized to the eyes and orbit and radiating to the facial and temporal regions.
The pain is accompanied by watering of the eye and nasal congestion.
Each attack lasts 15 min-3 hours |
|
|
Term
|
Definition
| 4 phases: prodrome, aura, headache, recovery |
|
|
Term
|
Definition
| symptoms occur hours to days before headache. s/s: depression, irritability, feeling cold, food cravings, anorexia, change in activity level, increased urination, diarrhea or constipation |
|
|
Term
|
Definition
| (few experience): visual disturbances, numbness and tingling of lips, face, or hands; mild confusion; slight weakness of extremity; drowsiness; dizziness |
|
|
Term
|
Definition
| (few experience): visual disturbances, numbness and tingling of lips, face, or hands; mild confusion; slight weakness of extremity; drowsiness; dizziness |
|
|
Term
|
Definition
| throbbing headache (unilateral in 60%)x several hours. Often associated with photophobia, n/v. duration ranges from 4-72 hours |
|
|
Term
|
Definition
| patients may sleep for extended periods |
|
|
Term
|
Definition
Triptans (serotonin receptor agonists) – most specific antimigraine meds – cause vasoconstriction, reduce inflammation, may reduce pain transmission
Sumatriptan (Imitrex) – acute migraines and cluster headaches
Naratriptan (Amerge)
Rizatriptan (Maxalt)
Zolmitriptan (Zomig)
Almotriptan (Axert) |
|
|
Term
|
Definition
Quiet, dark environment
Elevation of head of bed to 30 degrees
Symptomatic
Antiemetics
Analgesics
Antidepressants
Muscle relaxants |
|
|
Term
| brain tumors classifications |
|
Definition
Benign or malignant
Location-supratentorial vs. infratentorial
Cell type or anatomic origin |
|
|
Term
|
Definition
Treatment:
Treatment goal
Decrease size
Improve quality of life
Improve survival time
Type of tx depends on location and size
Radiation
Chemotherapy
Surgery |
|
|
Term
|
Definition
5th cranial nerve
Paroxysm of pain w/ muscle twitching
Lip, chin, nostrils, teeth, eye, skin
Compression or irritation of nerve
Occurs with stimulation of the nerve
Few seconds to several minutes
Frequency-minutes to days
More frequent and painful with age |
|
|
Term
| Trigemenal neuralgia treatment |
|
Definition
Tegretol, Neurontin, Baclofen, Dilantin
Alcohol or phenol injection
Trigeminal nerve decompression
Percutaneous radiofrequency |
|
|
Term
|
Definition
7th cranial (facial) nerve
Unilateral weakness or paralysis
Possible causes-vascular ischemia, viral disease, autoimmune disease, Spontaneous recovery: 3-5 weeks |
|
|
Term
|
Definition
Distortion of face
Increased lacrimation
Pain in face, behind ear, and eye
Speech difficulties
Inability to eat
Eye may not close |
|
|
Term
|
Definition
Prednisone
Analgesics
Heat
Electrical stimulation
Surgical exploration |
|
|
