nursing care of patients with neurological disordes

8/8/2019 Nursing Care of Patients With Neurological Disordes

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NURSING CARE OF PATIENTS

WITH NEUROLOGICAL DISORDES


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NEUROLOGICAL FUNCTION

Receives stimuli or information from theinternal and external environment over varied,afferent or sensory pathways

Communicates information between distantparts of the body (periphery) to the CNS

Computes or processes the information

received at various reflex Transmits information rapidly over varied

efferent or motor


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STRUCTURESNeuron- is the basic unit of the nervous system

Parts:

Dendrites- is the processes that conduct

information toward the cell body

Axons- the single long processes that

conduct information away from the cell

body

Cell body- containing cell nucleus, center of

cell metabolism

Myelin sheath- outer covering for most

axons by nervous system support cells


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DIVISION OF NERVOUS SYSTEM

1. Central Nervous System

A. Brain

B. Spinal Cord2. Peripheral Nervous System

A. Cranial nerves

B. Spinal nerves


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BRAIN

It accounts for approximately 2% of the total body weightof an adult (3 lbs.)

It receives approximately 20% of the cardiac output,demands 20% of the bodys oxygen use and requires about

400 kcal of energy daily Most energy consuming tissue in the entire body and is

primarily sustained by oxidative metabolism of glucose

Parts of the Brain

Cerebrum forebrain

Diencephalon brainstem midbrain, pons and medulla

Cerebellum hindbrain


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A. CEREBRUM (Cerebral Cortex)

A. CEREBRUM (Cerebral Cortex)

Is the largest and most prominent part of the

brain It accounts for the 80% of the brains weight


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The 4 Lobes of the Cerebrum


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1. Frontal Lobe

Largest lobe

Location: front of the skull.

Contains theprimary motor cortex and responsiblefor functions related to motoractivity.

The left frontal lobe contains Brocas area (controlthe ability to produce spoken words)

The frontal lobe controls higher intellectual function,awareness of self, and autonomic responses relatedto emotions


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2. Parietal Lobe

Sensory lobe

Location: near the crown of the head. Contains theprimary sensory cortex.

One of its major functions is to process

sensory input such asposition sense, touch,shape, and consistency of objects.


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3. Temporal Lobe

Location: around the temples.

Contains theprimary auditory cortex. Wernickes area is located on left temporal

lobe.

Contains the interpretative area whereauditory, visual and somatic input are

integrated into thought and memory


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4. Occipital Lobe

Location: lower back of the head

Contains theprimary visual cortex Function: responsible for visual

interpretation.


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B. DIENCEPHALON

o Thalamus Relay station for all sensation

except smell.

Allmemory, sensation and pain impulsespass through this section.

o Epithalamus contain pineal body orepiphysis

o Subthalamus Part of the extrapyramidalsystem of the autonomic nervous system and the

basal ganglia.o Hypothalamus controls vital functions, waterbalance, BP, sleep, appetite, body temp, andpituitary function


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C.BRAIN STEM (Mesencephalon)

oM

idbrain righting and postural reflexo Pons rhythmic quality of RR

o Medulla vital centers, cardiac, respiration,

vasomotor - controlling swallowing,hiccoughing, gag and cough reflex


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Structures Protecting the Brain

A.Brain. The brain is contained in the rigid skull,which protects it from injury.

B.Meniges. The meninges (fibrous connective

tissues that cover the brain and the spinal cord) provide protection, support and nourishment to the

brain and the spinal cord.

Layers of the meninges:

a. Dura mater

b.Arachnoid

c. Pia mater


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C. CEREBROSPINAL FLUID

o Found in the ventricles of the brain, in thecentral canal of the spinal cord and on thesubarachnoid space

o Fluid cushion

o Helps to support the weight of the braino Carries nutrients to the brain

o Removes metabolites

o After circulating around the brain and spinalcord, CSF returns to the brain and is absorbedby the arachnoid villi CSF venous system SVC systemic circulation


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SPINAL CORD

Approximately 45 cm long (18 inches) long.

Acts as apassageway for condition of

sensory information from the periphery ofthe body to the brain (via afferent nerve

fibers).

Serve as the connection between the brain

and the periphery.

Mediates the reflexes.


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Peripheral Nervous System

Somatic Nervous System

A. Cranial nerves-12 pair of cranial nerves

B. Spinal nerves-31 pairs of spinal nerves

Autonomic Nervous System

A. Sympathetic nervous system

B. Parasympathetic nervous system


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A. Cranial nerves CRANIAL NERVES

1

2 pairs Cranial nerve conducts impulses (motor and sensory information)

between the brain and various structures of the head, neck,thoracic cavity and abdominal cavity.

I Olfactory nerve

II Optic nerve

III Oculomotor nerve IV Trochlear nerve

V Trigeminal nerve

VI Abducens nerve

VII Facial nerve

VIII Acoustic/Vestibulocochlear IX Glossopharyngeal nerve

X Vagus nerve

XI Accessory nerve

XII Hypoglossal nerve


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B. SPINAL NERVES

31 pairs of SPINAL NERVES 8 cervical, 12 thoracic, 5 lumbar, 5 sacral, 1

coccygeal

Two roots

Dorsal and Ventral - Each spinal nerve has aventral root (motor) and a dorsal root (sensory)

Dermatome distribution

The dorsal roots contains sensory fibers that relay

information from sensory receptors to the spinalcord

The ventral root contains motor fibers that relayinformation from the spinal cord to the bodysglands and muscles.


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Dermatome distribution


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Autonomic Nervous System

Controls:

Smooth Muscles

Cardiac Muscles

Glands


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Parasympathetic vs Sympathetic

Sympathetic nervous system


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Parasympathetic Nervous System

Conserving energy.

Acetylcholine

Pupil constricts

Decreased HR

Decreased BP

Decreased RR

Diarrhea Increased salivation

Urinary frequency


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Sympathetic Nervous System

Expenditure of energy

Catecholamines: Epinephrine; norepinephrine;dopamine

Fight or flight response.

Pupil dilates Increased HR

Increased BP

I

ncreased RR Constipation

Dry mouth

Urinary retention

nursing care of patients with neurological disordes

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