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Nervous system. & Emergencies. Nervous System. Look up in text Central Nervous System Brain & Spinal cord Peripheral nervous system All the rest of the nerves. Central Nervous System. Look up anatomy in TEXT! Chapter 4. CNS Parts. Cerebrum - Center of intellect

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nervous system

Nervous system

& Emergencies

nervous system2
Nervous System
  • Look up in text
  • Central Nervous System
    • Brain & Spinal cord
  • Peripheral nervous system
    • All the rest of the nerves
central nervous system
Central Nervous System
  • Look up anatomy in TEXT!
    • Chapter 4
cns parts
CNS Parts
  • Cerebrum - Center of intellect
  • Cerebellum - Balance, muscle coordination
  • Brainstem - Controls vital functions
  • CSF (cerebral spinal fluid) - Protection
  • Spinal cord - Transmits impulses
lobes of cerebrum function
Lobes of cerebrum & function
  • Frontal - Cognition and motor
  • Parietal - Touch and orientation
  • Temporal - Speech & Hearing
  • Occipital - Sight
brainstem is location of
Brainstem is Location of
  • Cardiac center
  • Respiratory center
  • Vasomotor center
  • RAS - reticular activating system
slide7
and...
  • Blood supply = carotids
  • Meninges - tissue layers(3) that cover brain & spinal cord.

Dura mater

Pia mater

arachnoid

peripheral nervous system
Peripheral Nervous System
  • Links the organs of the body to the central nervous system.
  • Sensory nerves carry information from the body to the central nervous system.
  • Motor nerves carry information from the central nervous system to the muscles of the body.
the nervous system
The Nervous System
  • The nervous system controls the body’s voluntary and involuntary actions.
  • Somatic nervous system
  • Autonomic nervous system
sympathetic
Sympathetic
  • Fight or flight
    • pupils dilate
    • increased CNS stimulation
    • increased heart rate & BP
    • bronchioles dilate
    • decreased GI activity
parasympathetic
Parasympathetic
  • Passive mode
  • After eating a big meal
  • increased GI activity
  • constricted pupils
  • sleepy
concussion
Concussion
  • Temporary loss or alteration in brain function
  • Brief loss of consciousness
  • Brain can sustain bruise
  • Not a problem unless there is bleeding
intracranial bleeding
Intracranial bleeding
  • Subdural
  • Intracranial
  • Epidural
    • All bleeds causes increased intracranial pressure & brain damage
signs of increasing intracranial pressure
signs of increasing intracranial pressure
  • ALOC
  • vomiting
  • unequal pupils
  • hypertension & decreasing heart rate
  • expanding pulse pressure
  • Seizure
  • Abnormal respiratory patterns
  • Posturing
posturing
Posturing
  • Severe sign of increased intracranial pressure
  • Decerebate
  • Decorticate
  • will be unconscious !!
slide20
ALOC
  • Single most important observation
  • Use AVPU or GCS
  • Repetitive questioning
  • Level of consciousness

Decreasing? = worry

change in pupil size
Change in Pupil Size
  • Unequal pupil size may indicate increased pressure on one side of the brain.
shock
Shock
  • If patient has signs/symptoms of shock, look elsewhere for cause!!
    • Abdomen or chest!
basilar skull fracture
Basilar skull fracture
  • Indicates SIGNIFICANT force
  • CSF fluid in ears & nose
  • “battle” sign
  • “raccoon” eyes
signs and symptoms of spinal injury
Signs and Symptoms of Spinal Injury
  • Pain, swelling, deformity
  • Tingling in the extremities
  • Paralysis or paresis
  • Incontinence
  • Injuries to the head
spinal cord injury
Spinal cord injury
  • Paraplegia = paralysis of lower extremities
  • Quadriplegia = paralysis of all extremities
identifying c spine candidates
Identifying C-spine candidates
  • Mechanism of injury
  • pain
  • numbness or tingling in extremities
significant mechanisms of injury moi
Significant Mechanisms of Injury (MOI)
  • MVA’s
  • Auto vs. Peds/bicycle/motorcycle
  • Falls
  • Blunt or penetrating trauma
  • Hangings
  • Recreational accidents
rx for head spine injury
Rx for Head & Spine Injury
  • Maintain airway (jaw thrust)
  • Oxygen
  • Hyperventilate
  • Stabilize C-spine
stabilization of the cervical spine
Stabilization of the Cervical Spine
  • Do not force the head into a neutral, in-line position if:
    • Muscles spasm
    • Pain increases, resistance, crepitus
    • Numbness, tingling, or weakness develop
    • There is a compromised airway or breathing
notes
notes
  • PMSC before and after AND DOCUMENT!
  • Manual head stabilization
non traumatic brain injuries
Non-traumatic Brain Injuries
  • Not always caused by trauma.
  • Medical conditions may cause spontaneous bleeding in the brain.
  • S/S are the same
    • There is no mechanism of injury.
more neurologic emergencies
More Neurologic Emergencies
  • Seizure
  • Stroke
  • Altered Mental Status (AMS)
seizures nervous system disorder
Seizures – Nervous system disorder
  • Generalized (grand mal) seizure
    • Unconsciousness and generalized severe twitching
  • Petit mal seizure
    • a brief lapse of attention
  • Focal or Jacksonian
    • One area
causes of seizures
Congenital

High fevers

Structural problems in the brain

Metabolic disorders

Chemical disorders

Causes of Seizures
stages of seizure
Stages of seizure
  • Aura - prior sensory warning
  • Tonic - contraction phase
  • Clonic - alternating movements
  • Postictal - after seizure a period of ALOC with deep and labored respirations
status epilepticus
Status Epilepticus
  • 1 seizure over 10 minutes
  • 2 seizures without regaining consciousness
  • 3 seizures within 1 hour
complications
Complications
  • Hypoxia
  • Trauma
  • Hyperthermia
  • Hypoglycemia
  • Aspiration
  • Dehydration
common medications
Common medications
  • Dilantin
  • Tegretol
  • Pheno-Barbitol
  • and ...
treatment
Treatment
  • ABC’s
  • Protect patient from injuring self
  • Oxygen
  • Supine or left lateral
  • Transport
stroke
Stroke
  • CVA
  • TIA
  • Hemorrhagic stroke
  • Ischemic stroke
signs and symptoms of stroke
Signs and Symptoms of Stroke
  • Left Hemisphere
    • Aphasia
    • Receptive aphasia
    • Expressive aphasia
  • Right Hemisphere
    • Dysarthria
stroke mimics
Stroke Mimics
  • Hypoglycemia
  • Postictal state
  • Subdural or epidural bleeding
assessing the stroke patient
Assessing the Stroke Patient
  • Initial assessment
    • ABCs.
    • Obtain history if possible.
    • High flow O2
  • Focused history and physical exam
    • GCS
    • Perform neurologic exam.
      • Cincinnati Stroke Scale
cincinnati stroke scale
Cincinnati Stroke Scale
  • Facial droop
  • Arm drift
  • Speech
altered mental status ams
Hypoglycemia

Hypoxemia

Intoxication

Drug overdose

Unrecognized head injury

Brain infection

Body temperature abnormalities

Brain tumors

Glandular abnormalities

Poisoning

Altered Mental Status (AMS)
slide46

END

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