Nervous System

• The Nervous System is a complex network of nerves and cells that carry messages to and from the brain and spinal cord to various parts of the body.
• The Central Nervous System and Peripheral Nervous System are the two division of the nervous system.
• Parts of the Central Nervous System

  • Brain
  • Spinal Cord
• Brain

  Center of the Nervous System
• Parts of the Brain

  • Cerebrum
  • Cerebellum
  • Diencephalon
  • Midbrain
  • Pons
  • Medulla Oblongata
• The Cerebrum consist of four lobes known as:

  • Frontal Lobe
  • Parietal Lobe
  • Temporal Lobe
  • Occipital Lobe
• Spinal Cord

  is a long, thin, tubular structure made up of nervous tissue. It's function is to transmit nerve signals from the motor cortex to the body.
• Peripheral System

  refers to parts of the nervous system outside the brain and spinal cord.
• Identify:

  A) Olfactory

  B) Trochlear

  C) Abducens

  D) Vestibulocochlear

  E) Vagus

  
• Common Symptoms

  • Headaches
  • Mental Status Change
  • Dizziness, Vertigo, Syncope
  • Numbness
• Causes of Mental Status Change

  • neurologic problems,
  • fluid & electrolyte imbalance,
  • hypoxia,
  • low perfusion state,
  • nutritional deficiencies,
  • infections,
  • renal & liver disease, |
  • hyper or hypothermia,
  • trauma,
  • medications,
  • drug & alcohol abuse
• Dizziness - “fainting” sensation
• Objective vertigo – sensation that the surroundings are spinning around
• Syncope - temporary loss of consciousness
• Paresthesia – numbness or tingling sensation
• Causes:

  • diabetes
  • neurologic
  • metabolic
  • CV
  • renal
  • inflammatory
• Examination of the Neurological System

  • Level of Functioning
  • Mental Status
  • Cranial Nerves
  • Motor Function
  • Cerebral Function
  • Reflexes
• Areas of Focus (Level of Functioning)

  • Level of Consciousness
  • Assessing Orientation
  • Memory
• Alert – follows commands in a timely fashion

  Lethargic – appears drowsy, may drift off to sleep during examination

  Stuporous – requires vigorous stimulation (shaking, shouting) for a response

  Comatose – does not respond appropriately to either verbal or painful stimuli
• What are the 3 things to ask when assessing orientation?

  • Time, Place, Person
• Types of Memory

  • Immediate Memory
  • Recent Memory
  • Remote Memory
• Must be checked when doing an examination related to the mental status:

  • Known brain lesion(stroke, tumor, trauma)
  • Suspected brain lesion(new seizures, headaches)
  • Memory deficits
  • Confusion
  • Vague Behavioral complaints(by significant others)
  • Aphasia – inability to communicate
  • Irritability
  • Emotional lability – rapid exaggerated changes in mood 

• Sensation

  • Exteroceptive sensations – superficial sensations that originate in the skin and mucuos membranes. Ex. Light touch, superficial pain and temperature
  • Proprioceptive sensations – deep sensations, with sensory receptors in the muscles, joints, tendons and ligaments)
  • Cortical Sensations – those that require cerebral integrative and discriminative abilities.
• Reflex tests are performed as part of a neurological exam, either a mini-exam done to quickly confirm integrity of the spinal cord or a more complete exam performed to diagnose the presence and location of spinal cord injury or neuromuscular disease
• Neurologic Problems

  Agnosia - inability to recognize object
• Neurologic Problem

  Akinesia – complete or partial loss of voluntary muscle movement
• Neurologic Problem

  Aphasia – absence or impairment of ability to communicate through speech, writing, or signs
• Also known as Broca's - Expressive Aphasia
• Neurologic Problem

  Dysphasia – impaired or difficult speech
• Common Neurological Disorders

  • ADHD
  • Migraine
  • Alzheimer's disease
  • Parkinson's disease
• ADHD

  Also called Attention Deficit Hyperactivity Disorder is one of the most common neurodevelopmental disorders of childhood.
• Causes of ADHD

  • Brain injury
  • Exposure to environmental risks (e.g., lead) during pregnancy or at a young age
  • Alcohol and tobacco use during pregnancy
  • Premature delivery
  • Low birth weight
• A migraine is a headache that can cause severe throbbing pain or a pulsing sensation, usually on one side of the head.
• Risk Factors for Migraine

  • Sex
  • Age
  • Family History
  • Other medical conditions
  • Hormone Changes
  • Stress
  • Food
• Alzheimer's Disease

  is a progressive disease beginning with mild memory loss and possibly leading to loss of the ability to carry on a conversation and respond to the environment.
• Dementia

  Common type of Alzheimer's. It is the impaired ability to remember, think, or make decisions that interferes with doing everyday activities.
• The cause of dementia is the abnormal build up of protein (amyloid and tau) around the brain cells
• Parkinson's Disease

  a brain disorder that causes unintended or uncontrollable movements, such as shaking, stiffness, and difficulty with balance and coordination
• Cause of Parkinson's is -  a loss of nerve cells in the part of the brain called the substantia nigra.