Review.docx - Review Cranial Nerves CN I CN II CN III CN IV...

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Review Cranial Nerves CN I Olfactory; Sensory CN II Optic; Sensory Snellen (20 ft) or Rosenbaum (14 in) CN III Occulomotor; Motor Cardinal Gazes, Pupillary constriction, Accommodation CN IV Trochlear; Motor Cardinal Gazes CN V Trigeminal; Both Mastication, TMJ, Jaw clench, facial sensation (sharp/dull) CN VI Abducens; Motor Cardinal Gazes CN VII Facial; Both Facial Expressions, taste anterior 2/3 of tongue, stimulates secretions from salivary glands CN VIII Acoustic; Sensory Hearing and Balance CN IX Glossopharyngeal; Both Taste to posterior 1/3 of tongue, swallowing, parotid, Gag Reflex CN X Vagus: Both sensation from throat, larynx, heart, lungs, bronchi, GI tract and abdominal viscera, swallowing, talking, digestive juice prod. CN XI Spinal Accessory; Motor Shoulder shrug, rotation CN XII Hypoglossal: Motor tongue protrusion Cerebrum (70% of neurons) Frontal Lobe: associated with reasoning, planning, parts of speech (Broca), movement, emotions, problem solving Parietal lobe: associated with movement, orientation, recognition and perception of stimuli Occipital Lobe: visual processing Temporal lobe: perception and recognition of auditory stimuli, memory and speech Cerebellum: coordination, balance, smooth movement Diencephalon: contains thalamus and hypothalamus, connects midbrain with cerebral hemispheres, controls many autonomic fxns of pns, works with limbic system Brainstem: breathing, heartbeat, BP (10 of the CN from here) (midbrain(hearing, movement), pons(LOC), medulla(vitals)) Intracranial Pressure: 7-15 mm Hg (Venous Pressure, atrial volume, brain and CSF); increased ICP can cause a herniation down into the brainstem affecting breathing, HR and BP, increase in CO2, decrease in O2 To reduce ICP… hyperventilate to reduce swelling, diuretics, hyperosmolar IV, raise the head of the bed Spinal cord terminates at the level of the 1 st lumbar V. with the conus medullaris that continues down as the cauda equine Ascending tracts: sensory Contralateral: pain, temp, light touch Ipsilateral: movement and proprioception, vibration, pressure
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Descending tracts: motor that carry voluntary and involuntary motor commands down from the brain contralaterally. Glasgow Coma Scale assesses the severity of a brain injury: eye opening, verbal response, motor response (3-15), 3 is absence of all activity Decerebrate posturing: extension (bad) Decorticate posturing: flexion Stroke Modifiable: smoking, obesity, cocaine use, sedentary lifestyle, ETOH, contraceptives, comorbidities (DM, a fib) Nonmodifiable: family history, racial and ethnic groups, SSD, prior stroke Length of time and amount of brain affected determines symptoms and prognosis Ischemic: obstruction (most common 85%) Atherosclerosis, A Fib, Carotid Stenosis Hemorrhagic: rupture of cerebral artery with compression, ischemia, edema, more compression and eventual death of brain tissue Ischemic Penumbra: brain cells that lie at perimeter – damage is reversible Anoxic encephalopathy and increased ICP that leads to a herniation down into brainstem both contribute to a decreased LOC (vital signs affected by herniation)
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  • Winter '17
  • Barbara Pieper
  • blood glucose, Seizures

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