Exam 2 Study Sheets Chapter 21: The Neurologic System 1. Protection of the CNS: a. Skull and vertebral column b. Meninges: membranes that cover the brain & spinal cord i. Pia mater: covers the brain ii. Arachnoid: encases the entire CNS iii. Dura mater: tough outer membrane of brain & spinal cord c. CSF: cushions & protects the brain & spinal cord i. Formed in the choroid plexus ii. Reabsorbed by the arachnoid at rate of formation so CSF volume normally remains constant 2. Aging related changes in the nervous system: a. Loss of neurons, ↓ brain weight > 70 yrs, but no loss of intellectual function b. ↓ Number of dendrites slower impulse transmission, reaction time, & ↓ efficiency of the autonomic nervous system c. ↓ Blood flow to the brain causing more damage from strokes d. Slower movement & ↓ sensation, tremors w/o rigidity, & hypoactive tendon reflexes e. Homeostasis takes longer & recovery can be incomplete f. Affects short-term but not long-term memory and it takes longer to process new information; slower learning. Give them more time to process new info. g. ↓ Secretion of norepinephrine and dopamine h. Motor nerves & the myelin sheath degenerate and reflexes can become diminished or absent i. ↓ Size of pupils means they need more light to read j. Keeping the brain active promotes intellectual function 3. Prevention of neurologic disorders: a. Educate about dangers of drugs and alcohol abuse b. Promote vaccines to protect from infectious diseases c. Control of HTN & cholesterol to reduce strokes d. Avoid contact with pesticides & other chemicals 4. Diagnostic tests: a. Lumbar puncture: determines whether CSF pressure is ↑ & to obtain a CSF specimen for culture i. Requires consent ii. Side-lying with head and knees flexed toward trunk iii. Keep pt flat for ≥ 1 hour to reduce HA, & encourage fluids iv. Observe site for signs of drainage & inflammation b. EEG: detects abnormal brain wave patterns i. No sedatives, restrict caffeine & alcohol ii. Wash hair to remove the electrode paste c. Electromyography (EMG): measures electrical activity of muscles at rest & flexed i. Requires consent ii. Discomfort when electrodes are placed iii. No muscle relaxers, cholinergics, or anticholinergics d. Myelography: detects spinal lesions, tumors, & cysts i. Requires consent ii. Contrast precautions: check allergies, nephrotoxic: check BUN/creatinine & push fluids, contraindicated with Metformin (causes severe liver damage) iii. May require bowel prep, NPO 4-8 hrs before iv. Post-op regimen, assess for signs of meningitis e. Cerebral angiography: checks for tumor, aneurysms, and hematomas. i. Requires consent 1
Exam 2 Study Sheets ii. NPO 8-12 hrs before & D/C anticoagulants iii. Pressure dressing and post-op regimen iv. Bed rest for 24 hrs f. MRI: visualize soft tissues without use of contrast i. Requires consent ii. Remove all metal objects g. Positron emission tomography (PET): assesses damage to brain tissue & cell death i. Requires consent ii. Put in 2 IVs, avoid sedatives, & empty bladder h. PLAC: Lipoprotein-associated phospholipase A 2 : enzyme responsible for atherosclerosis formation i.
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- Spring '20