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Medical-Surgical Nursing, 9th Ed., Ignatavicius & Workman, 2018
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41 - Assessment of the Nervous System

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Medical-Surgical Nursing, 9th Ed., Ignatavicius & Workman, 2018 | Registered Nurse (RN) School Study Aid

41 - Assessment of the Nervous System
35 Picmonics to Learn | 53 mins
Chemical Synapse
Voltage-Gated Calcium Channels Open
Ca2+ Influx
Vesicle-Membrane Fusion
Exocytosis of Neurotransmitter
Neurotransmitter Binds Post-Synaptic Receptors
Neurotransmitter Breakdown
Neurotransmitter Reuptake
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1 min
Electrical Synapse
Characteristics
Cardiac and Smooth Muscle Location
Fast Transmission
Bidirectional
Presynaptic Na+ Floods Through Gap Junction
Na+ Influx Initiates Postsynaptic Action Potential
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2 mins
Neuron Action Potential Initiation
Characteristics
Summation of Signals
-50 mV Threshold Value Reached
Voltage-Gated Sodium Channels Open
Local Depolarization
Na+ Influx
Potassium Channels open
Repolarization
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2 mins
Neuron Action Potential Propagation
Characteristics
Unidirectional Depolarization
Absolute Refractory Period In Preceding Na+ Channels
Neighboring Voltage Gate Channels Open
Nodes of Ranvier
Myelination Increases Propagation Speed
Saltatory Conduction
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3 mins
Central Nervous System (CNS)
Characteristics
Frontal Lobe
Parietal Lobe
Temporal Lobe
Occipital Lobe
Medulla Oblongata
Cerebellum
Pons
Spinal Cord
Dorsal Root Ganglia
Grey Matter
White Matter
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2 mins
Hypothalamus
Characteristics
Anterior Pituitary Stimulated Through the Hypophyseal Portal
GHRH
GnRH
TRH
PIF
CRF Released During Stress
Posterior Pituitary Stimulated Through Neural Control
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3 mins
Circle of Willis
Characteristics
Anterior Cerebral Artery (ACA) Supplies Motor/Sensory Parts of the Cortex for Lower Extremities
Anterior Communicating Artery (Acomm) Connects ACA to ACA
Internal Carotid Arteries (ICA)
Middle Cerebral Arteries (MCA) Supply Cortex for Upper Limbs and Face
Posterior Communicating Artery (Pcomm) Connects ICA to PCA
Posterior Cerebral Arteries (PCA) Supply Occipital Cortex
Basilar Artery Supplies Medulla, Pons, and PCA
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3 mins
Anterior Cerebral Artery
Contralateral paralysis of lower limb
Contralateral loss of sensation in lower limb
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1 min
Middle Cerebral Artery
Contralateral paralysis upper limb and face
Contralateral loss of sensation of upper limb and face
Affects Wernicke's area and Broca's area
Aphasia if Lesion in Dominant (Left) Hemisphere
Hemineglect if lesion in nondominant (right) hemisphere
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1 min
CSF Lab Values: Normal
Pressure: < 20 cm H2O
Color/Appearance: Clear or Colorless
Proteins: < 40 mg/dL
Lactate Dehydrogenase: 10% of Serum Level
Cells: 0-5 Small Lymphocytes
Glucose: 40-70 mg/dL
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2 mins
Spinothalamic Tracts
Ascending Pathway (Sensory)
Lateral
Temperature
Pain
Anterior
Crude Touch
Pressure
Decussates at Anterior White Commisure
Lesion
Contralateral Anesthesia
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2 mins
Posterior Column (Dorsal Column)
Ascending Pathway (Sensory)
Sensations
Proprioception
Fine Touch
Pressure
Vibration Sensation
Anatomy
Dorsal Root
Fasciculus Cuneatus
Arms
Fasciculus Gracilis
Lower Limbs
Lesions
Vitamin B12 Deficiency
Tabes Dorsalis
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2 mins
Dermatomes - Cervical
C2 - Posterior Cap Distribution
C3 - High Turtleneck
C4 - Low Collar Shirt
C5 - Anterolateral Shoulder
C6 - Thumb
C7 - Middle Finger
C8 - Pinky Finger
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1 min
Dermatomes - Thoracic
Characteristics
T1 - Medial Arm
T4 - Nipple
T7 - Xiphoid
T10 - Belly Button
T12 - Pubis
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58 secs
Dermatomes - Lumbosacral
L2 - Medial Thigh
L3 - Medial Knee
L4 - Kneecap, Medial Ankle, and Big Toe
L5 - Dorsum of Foot
S1 - Lateral Foot, Posteriolateral Thigh
S 2, 3, 4, 5 - Perianal and Genitals
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2 mins
Somatic Reflex Arc
Spinal Cord
Sensory (Afferent) Neuron
Interneurons Transmit
Motor (Efferent) Neuron
Effector Targets
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1 min
CN I
Olfactory Nerve
Sensory
Smell
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36 secs
CN II
Optic Nerve
Sensory
Vision
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35 secs
CN III
Oculomotor Nerve
Motor
Eye Movement
Accommodation
Eyelid Opening
Pupillary Constriction
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1 min
CN IV
Trochlear Nerve
Motor
Abducts, Depresses, Internally Rotates
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48 secs
CN V
Trigeminal Nerve
Sensory
Facial Sensation
Motor Function (Via Mandibular Nerve)
Mastication Muscles
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1 min
CN VI
Abducens Nerve
Motor
Abducts Eye
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48 secs
CN VII
Facial Nerve
Lacrimation
Salivation
Sensory
Taste from Anterior 2/3 of Tongue
Motor
Facial Movement
Stapedius Muscle
Eyelid Closing
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1 min
CN VIII
Vestibulocochlear Nerve
Sensory
Hearing
Balance
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55 secs
CN IX
Glossopharyngeal Nerve
Sensory
Taste from Posterior 1/3 of Tongue
Monitoring Carotid Body and Sinus
Motor
Stylopharyngeus
Swallowing
Salivation
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1 min
CN X
Vagus Nerve
Sensory
Aortic Arch Chemoreceptors and Baroreceptors
Taste from Epiglottic Region
Motor
Swallowing
Palate Elevation
Talking
Coughing
Midline Uvula
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1 min
CN XI
Accessory Nerve
Motor
Head Turning
Shoulder Shrugging
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36 secs
CN XII
Hypoglossal Nerve
Motor
Tongue Movement
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34 secs
Cranial Nerve Function
Sensory
CN I
CN II
CN VIII
Motor
CN III
CN IV
CN VI
CN XI
CN XII
Both
CN V
CN VII
CN IX
CN X
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1 min
Autonomic Nervous System
Characteristics
Sympathetic Nervous System
Fight or Flight
All Preganglionic Neurons Release Acetylcholine
Sympathetic Postganglionic Neurons Release Norepinephrine
Antagonistic Effects of Sympathetic and Parasympathetic Nervous Systems
Parasympathetic Nervous System
Rest and Digest
Parasympathetic Postganglionic Neurons Release Acetylcholine
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2 mins
Glasgow Coma Scale
LOC Assessment
Score of 3 to 15
8 or Less = Coma
Eye Opening
Verbal Response
Motor Response
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1 min
Level of Consciousness: Descriptive guide for Glasgow Coma Scale
Conscious
Confused
Delirious
Somnolent
Obtunded
Stuporous
Comatose
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3 mins
Depression Assessment
Physical Changes
Anergia
Self Neglect
Decreased Libido
Vegetative Signs
Mood
Sad Affect
Worthlessness
Guilt
Anger and Irritability
Cognitive
Ineffective Problem Solving
Slowed Thinking
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1 min
Magnetic Resonance Imaging (MRI)
Procedure
Internal Body Images
Detects Variations of Soft Tissues
Considerations
No Metal Objects
No Pacemakers
Contrast is Non-Iodine
Safe During Pregnancy
Long Procedure
Antianxiety Medications
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2 mins
Lumbar Puncture
Indications
CSF Sample
CSF Pressure
Considerations
Empty Bladder
Side-lying Position
Between 3rd and 4th Lumbar Vertebrae
Number Tubes
Supine Position After Procedure
Contraindications
Increased ICP (Intracranial Pressure)
Infection at Puncture Site
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2 mins

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