1. Slide 1 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Textbook For Nursing Assistants Chapter 28 – The Nervous System

2. Slide 2 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Structure of the Nervous System

3. Slide 3 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The nervous system has two main divisions: The central nervous system The peripheral nervous system Structure of the Nervous System

4. Slide 4 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The central nervous system is protected by three layers: Connective tissue called meninges The bony skull Vertebrae The three meninges are the: Pia mater Arachnoid mater Dura mater The Central Nervous System

5. Slide 5 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The brain has four parts: Cerebrum Diencephalon Brain stem Cerebellum The Brain

6. Slide 6 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The cerebrum: Controls the voluntary movement of muscles Gives meaning to information received from the eyes, ears, nose, taste buds, and sensory receptors in the skin Allows us to speak, remember, think, and feel emotions The right and left hemispheres: Communicate with each other Are connected by a structure called the corpus callosum The Brain

7. Slide 7 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The diencephalon The thalamus  Sorts out the impulses that arrive via the spinal cord from other parts of the body  Sends them to the correct part of the cerebrum The hypothalamus  Controls body temperature, fluid balance, appetite, sleep cycles, and some of the emotions  Regulates the pituitary gland The Brain

8. Slide 8 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The brain stem connects the spinal cord to the brain and has three parts: The midbrain The pons The medulla The cerebellum helps to coordinate the brain’s commands to the muscles, allowing for smooth and orderly movement The Brain

9. Slide 9 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The spinal cord is the main connection between the brain and the rest of the body Pathways of nerve tissue in the spinal cord, called tracts, carry messages to and from the brain Ascending tracts carry information from the peripheral nervous system to the brain Descending tracts carry information from the brain to the peripheral nervous system The Spinal Cord

10. Slide 10 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The nerves that form the peripheral nervous system are Sensory nerves Motor nerves Sensory nerves carry information From the internal organs and the outside world To the spinal cord and up into the brain Motor nerves carry commands From the brain down the spinal cord To the muscles and organs of the body The Peripheral Nervous System

11. Slide 11 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Function of the Nervous System

12. Slide 12 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The nervous system regulates what is going on within the body and makes adjustments as necessary to keep things within the range of normal When the central nervous system detects an imbalance, a special part of the peripheral nervous system, called the autonomic system, is activated The sympathetic nervous system speeds things up The parasympathetic nervous system slows them back down Regulation Of Internal Environment

13. Slide 13 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The nervous system allows us to interact with the world around us Five special senses that provide the brain with information about the outside world: Touch Taste Smell Sight Hearing The brain responds to this information Interaction with the External Environment

14. Slide 14 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The Effects of Aging on the Nervous System

15. Slide 15 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Some elderly patients or residents are not as quick to react to things as they used to be The amount of myelin surrounding the axons decreases, reducing the speed of nerve conduction by approximately 10 percent Neurotransmitter imbalances can interfere with the ability of a nerve impulse to travel across a synapse, slowing conduction Slowed Conduction Times

16. Slide 16 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Many older people experience a mild loss of memory for recent events, while still having excellent long-term memory Dementia (a significant loss of mental capabilities) is a disorder, not a normal age-related change Memory Changes

17. Slide 17 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Disorders of the Nervous System

18. Slide 18 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Temporary (transient) episodes of dysfunction Caused by decreased blood flow (ischemia) to the brain Common symptoms may include: Dizziness Nausea Blurring or loss of vision Double vision Paralysis on one side of the body or face (with or without loss of sensation) The inability to speak or swallow The person usually recovers completely within 24 hours Transient Ischemic Attacks (TIAs)

19. Slide 19 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Also known as a “brain attack” or cerebrovascular accident (CVA ) Occurs when blood flow to a part of the brain is completely blocked, causing the tissue to die Signs of a stroke: Personality changes Drooping of the eyelid or corner of the mouth Slurring of speech Paralysis Severe headache Loss of consciousness Stroke

20. Slide 20 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Stroke is most often caused by a blood clot that blocks flow to part of the brain, or cerebral hemorrhage Smoking Atherosclerosis Hypertension Diabetes Causes of Stroke

21. Slide 21 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Hemiplegia: paralysis on one side of the body Aphasia: a general term for a group of disorders that affect the person’s ability to communicate with others Expressive aphasia- inability to speak or form sounds into meaningful words Receptive aphasia- inability to understand the meaning of words Effects of Stroke

22. Slide 22 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. A neurotransmitter called dopamine is not produced in sufficient amounts The brain’s instructions regarding muscle movement never reach the muscle A progressive disease Parkinson’s Disease

23. Slide 23 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. It starts with a faint tremor that gets worse over a long period of time The person may lose the ability to move the small muscles of the face (mask-like facial expression) The person’s ability to chew and swallow is affected, and drooling may occur The person may speak very slowly, in a voice that does not vary in tone The Effects of Parkinson’s Disease

24. Slide 24 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The muscles become weaker and rigid The person may walk with a shuffling, leaning gait It may be hard for the person to stop suddenly, once he has begun walking The Effects of Parkinson’s Disease

25. Slide 25 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Characterized by chronic seizure activity Grand mal seizures are characterized by generalized and violent contraction and relaxation of the body’s muscles Petit mal (absence) seizures are mild and hardly noticeable Causes of epilepsy Head injury Brain infection Stroke Difficult birth, resulting in the infant not receiving enough oxygen Often, the exact cause is never determined Epilepsy

26. Slide 26 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. An autoimmune disorder The immune system attacks and destroys the myelin sheaths that protect the nerves, resulting in faulty transmission of nerve impulses The nerves in the hands, feet, and eyes are usually affected first Muscle weakness, tingling sensations, twitching of the eyes, and visual disturbances may be early signs Multiple Sclerosis

27. Slide 27 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Also known as ALS or Lou Gehrig’s disease The nerves are destroyed, resulting in progressive muscle weakness People in the late stages of the disease are totally paralyzed, yet their minds remain sharp ALS is a terminal illness Amyotrophic Lateral Sclerosis

28. Slide 28 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Head injuries Often result in physical disability, loss of mental function, or both Spinal cord injuries Quadriplegia- paralysis from the neck down Paraplegia-paralysis from the waist down Head Injuries and Spinal Cord Injuries

29. Slide 29 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Diagnosis of Neurologic Disorders

30. Slide 30 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Imaging Studies Radiography (“x-rays”) Computed tomography (CT) Magnetic resonance imaging (MRI) Used to help locate tumors of the brain, spinal cord, or surrounding bony structures Useful for detecting fractures of the skull or vertebrae Types of Diagnostic Tests

31. Slide 31 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Electroencephalography (EEG) Records the electrical activity of the brain Used to pinpoint seizure activity within the brain Used to monitor the person’s brain activity when there is a possibility that the person is “brain dead” Types of Diagnostic Tests

32. Slide 32 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Rehabilitation

33. Slide 33 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Started as soon as possible after the person’s medical condition stabilizes One very important aspect of the rehabilitation effort is the prevention of complications of immobility, such as  Contractures  Muscle atrophy  Pressure ulcers Rehabilitation

34. Slide 34 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. For a person with a neurologic disorder, rehabilitation can be a very long, frustrating experience While caring for a person undergoing rehabilitation All successes, no matter how small, should be celebrated Reinforce the rehabilitation efforts and techniques that are being used Ask the nurse or physical therapist how to properly use any special equipment Make an effort to learn about any specific techniques that the person should be practicing Be patient and empathetic with the person Rehabilitation

35. Slide 35 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. End of Presentation