1. The Nervous System Review and Neurologic Dysfunction N 331

6. Functional Organization of the Brain and Spinal Cord 4 major brain regions ▫Cerebrum ▫Diencephalon ▫Cerebellum ▫Brain stem  Pons  Medulla  Midbrain

7. Functions of the Diencephalon, Cerebellum, and Brainstem These 3 form the more primitive areas of the brain.

9. Meninges

10. Blood supply to the brain Brain receives 20% of cardiac output or 800 - 1000ml of blood per minute

11. Circle of Willis – serves as collateral flow

12. 12 Cranial Nerves

14. Alterations in Nervous System Functioning Manifestations of Global Brain Injury Consciousness Alterations in Neuro Function

15. Consciousness

16. Alterations in neurologic function Level of Consciousness Breathing Patterns Vomiting Pupillary Changes Oculomotor Responses Motor Responses

18. Glasgow Coma Scale Eye Opening Spontaneous4 To loud voice3 To pain2 None1 Verbal Response Oriented5 Confused, Disoriented4 Inappropriate words3 Incomprehensible words2 None1 Motor Response Obeys commands6 Localizes pain5 Withdraws from pain4 Abnormal flexion posturing3 Extensor posturing2 None1

19. Breathing patterns

20. Cheyne-Stokes Respirations https://www.youtube.com/watch?v=zrcXQh FK6ro

21. Brain stem damage Irregular and unpredictable breathing patterns https://www.youtube.com/watch?v=FpKdq-_ZvsI

22. Vomiting

23. Pupillary Changes & Oculomotor Responses

24. Motor Responses Posturing ▫Decorticate  Brain stem intact, loss of cerebral cortex functioning ▫Decerebrate  May indicate more serious damage and results from disruption of higher brain centers and the brainstem.

26. Alteration in Intracranial Pressure

28. Measuring ICP

30. Neurologic Death Cerebral death Brain death Persistent vegetative state

31. Traumatic Head & Spine Injuries

32. Scalp lacerations

33. Head Injuries Closed vs Open

34. Traumatic Brain Injury Major Head Trauma

35. Concussion

36.  Contusion

37. Coup/Contrecoup

39. Protective Coverings of Brain

40. Epidural hematoma

41. Subdural hematoma

44. Diffuse Axonal Injury

45. Shaken Baby Syndrome

46. Spinal Cord Trauma

48. Complete cord involvement

49. Paralysis

50. Partial cord involvement

51. Spinal shock

53. Low Back Pain

55. Aneurysm & AV Malformation

56. Subarachnoid hemorhhage

58. CVA

59. A Stroke is an Emergency act:  - Face ▫Ask the person to smile. Does one side droop? – Arms ▫Ask person to raise both arms. Does one drift downward? Is one arm weak or numb? – Speech ▫Ask person to repeat a simple sentence. Is speech slurred. – Tongue ▫Stick out tongue, Does it deviate from midline?

60. Ischemic Stroke Thrombolytic vs Embolytic

63. Visual Deficits

64. Intracranial Infections/Neoplasms

65. One of the physically demonstrable symptoms of meningitis is Brudzinski's sign. Severe neck stiffness causes a patient's hips and knees to flex when the neck is flexed. One of the physically demonstrable symptoms of meningitis is Kernig's sign. Severe stiffness of the hamstrings causes an inability to straighten the leg when the hip is flexed to 90 degrees.

66. Encephalitis

67. Abscess & Neoplasms

68. Seizures

70. Tonic Clonic Seizures

71. Nerve Conduction Disorders

72. Muscle tone Hypotonia and Hypertonia

73. Muscle movement Hypokinesia and Hyperkinesia

74. Muscular Dystrophy Normal skeletal muscle Muscular Dystrophy Deposition of collagenous scar tissue (RED)

76. Myasthenia Gravis

78. Multiple Sclerosis

80. Amotrophic Lateral Sclerosis

81. ALS

83. Cerebral Palsy