chapter 13 & 14, sensory & neuro
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chapter 13 & 14, sensory & neuro - Leaderboard
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| 🇬🇧 | 🇬🇧 |
| The sitter also structure of the eye include the | Eyebrows, eyelashes, lids, and the lacrimal apparatus |
| Tears are made of | Watery secretions that contain salt, mucus, and a bactericidal enzyme |
| The sclera gives shape to the eye and, | Because of its toughness, protects the intraocular structures |
| The cornea is the | Central anterior portion of the sclera |
| Four basic processes necessary to form an image: | 1. refraction 2. accommodation 3. constriction 4. convergence |
| Refraction | The eye is unable to bend light rays so that the rays fall onto the retina |
| Accommodation | The eye can focus on objects at various distances it focuses the image of an object on the retina by changing the curvature of the lens |
| Constriction | The size of the pupil, which is controlled by the dilator and contractor muscles of the iris’s, regulates the amount of light entering the eye |
| Convergence | Medial movement of both eyes allows light rays from an object to hit the same point on both retinas |
| Distant vision | 20/20 (able to read line 11 of eye chart at a distance of 20 ft) |
| Near vision | Able to read newspaper print at 14 inches |
| Peripheral vision | Side vision 90 degrees from central visual axis; upward 50 degrees, downward 70 degrees |
| Eye movement | Coordinated eye movement bilaterally |
| Color perception | Able to properly identify colors of major groups: red, blue, and green |
| The most commonly performed examination is the snellen test, which | Assesses visual acuity, which the patient is placed 20 feet from the snellen chart and asked to read lines |
| A centralized black dot is used as the point of reference, the patient asked to view the grid, concentrating on | The dot, and report areas of discoloration |
| Today the measurement of intraocular pressure (tanometry) is done | Most commonly by puffing air onto the surface of the open eye |
| Exotropia | A form of strabismus in which one or both eyes form outward, away from the conea |
| Esotropia | A form of strabismus in which one or both eyes turn in the direction of the nose |
| Hyperopia | Condition of farsightedness |
| Myopia | Condition of nearsidedness |
| Congenital blindness | Results from various birth defects |
| Acquired blindness in adults occurs as a result | Of disorders such as diabetic retinopathy, glaucoma, cataracts, retinal degeneration, infections, tumors, and acute trauma |
| Laser-assisted in situ keratomileusis (LASIK) is a procedure in which first a norneal flap is folded back and | Then an axcimer laser removes some of the internal layers of the cornea |
| Commonly called pinkeye, causes of conjunctivitis may be | Bacterial or viral infections, allergies, or environmental factors |
| Pink eye involved inflammation of the | Conjunctiva |
| Complaints of dry eye, caused by a variety of ocular disorders, are characterized by decreased tear secretion or increased tear film evaporation | Keratoconjuctivits wicca (dry eye) is caused by lacrimal gland dysfunction, usually a result of an autoimmune dysfunction |
| Increased ICP occurs in patients with acute neurological conditions such as | Brain tumor, hemorrhage, anoxic brain injury, and toxic or viral encephalopathies |
| ICP is most commonly associated with | Head injury |
| Subjective data for a diagnosis of ICP include the patients understanding of the condition, and | Any visual changes such as diploia (double vision) |
| The earliest sign of ICP is | Change in LOC |
| Nursing interventions for ICP to reduce venous volume include: | Elevate the head of the bed 30-45 degrees to promote venous return & place the neck in a neutral position |
| Types of seizures | Generalized tonic clinic (grand mal) absence (petit mal) psychomotor (automatisms) jacksonian (focal) miscellaneous (myoclonic and akinetic) |
| Aura is | A sensation (of light or warmth) or emotion (such as fear) that may precede an attack of migraine or epileptic seizure |
| Types of strokes | Ischemic stroke thrombotic stroke embolic stroke hemorrhagic stroke transient ischemic attack |
| A TIA should be considered a | Forerunner of a stroke |
| Central nervous system is made up of the | Brain and spinal cord |
| The peripheral nervous system includes | All the nerves that lie outside the CNS |
| The 2 broad categories of cells within the nervous system are | 1. neurons 2. neurolglia or glial cells |
| Nerve 1: | Olfactory |
| 1. olfactory impulses and functions | From nose to brain sense of smell |
| Nerve 2: | Optic |
| 2. optic impulses and functions | From eye to brain vision |
| Nerve 3: | Oculomotor |
| 3. oculomotor impulses and functions | From brain to eye muscles eye movements, extraocular muscles, pupillary control |
| Nerve 4: | Trochlear |
| 4. trochlear impulses and function | From brain to external eye muscles down and inward movement of eye |
| Nerve 5: | Trigeminal |
| 5. trigeminal impulses and functions | From skin to mucous membranes of head to brain, from teeth to brain, from brain to facial muscles sensations of face, scalp, teeth, and chewing movements |
| Nerve 6: | Abducens |
| 6. abducens impulses and functions | From brain to external eye muscles outward movement of eye |
| Nerve 7: | Facial |
| 7. facial impulses and functions | From taste buds of tongue to brain, from brain to facial muscles sense of taste, contraction of muscles of facial expression |
| Nerve 8: | Acoustic |
| 8. acoustic impulses and functions | From ear to brain hearing, sense of balance |
| Nerve 9: | Glassopharyngeal |
| 9. glassopharyngeal impulses and functions | From throat and taste buds of tongue to brain, from brain to muscles and salivary glands sensations of throat, taste, swallowing movements, gag reflex, sense of taste, secretion of saliva |
| Nerve 10: | Vagus |
| 10. vagus impulses and functions | From throat, larynx, and organs in thoracic and abdominal cavities to brain from brain to muscles of throat and to organs in thoracic and abdominal cavities secretions of throat, larynx, and thoracic, and abdominal organs, swallowing, voice production, slowing of heartbeat, acceleration of peristalsis |
| Nerve 11: | Spinal accessory |
| 11 spinal accessory impulses and functions | From brain to certain shoulder and neck muscles shoulder movements and turning movements of head |
| Nerve 12: | Hypoglossal |
| 12. hypoglossal impulses and functions | From brain to muscles of the tongue tongue movements |
| Glasgow coma scale eye-opening response | 4- spontaneous 3- to verbal stimuli 2- to pressure 1- no response |
| Glasgow coma scale verbal response | 5- oriented 4- confused but able to answer questions 3- words 2- sounds 1- no response |
| Glosgow coma scale motor response | 6- obeys commands for movement 5- movement to stimulus 4- withdraws in response to pain 3- flexion in response to pain 2- extension in response to pain 1- no response |
| Post procedure for lumbar puncture | Patient should lie flat in bed for several hours, assess site for leakage, pain numbness or tingling in extremities |
| Assess for CT scan if use of contrast medium and without use of contrast medium | If use of contrast medium check for allergies to iodine and seafood and without contrast medium pt may be NPO for 4-6 hours before |
| Primary goals for a patient having a seizure | Protection from aspiration and injury and observation and recording of the seizure activity |
| During the demylelination process, the myelin sheath and the sheath cells are destroyed, causing | An interruption or distortion of the nerve impulse so that it is slowed or blocked |
| Clinical manifestations for multiple sclerosis have a variety of s/s such as | Visual problems, urinary incontinence, fatigue, weakness or in coordination of an extremity, sexual problems such as impotence in men, and swallowing difficulties |
| Stoke is an abnormal condition of the blood vessels of the brain characterized by | Hemorrhage into the brain or the formation of an embolus or thrombus that occludes an artery, resulting in ischemia of brain tissue |
| The major importance of TIAs is that they | Warn the patient of an underlying pathologic condition |
| Hemorrhagic stoke vs ischemic stoke | Hemorrhagic stoke results from bleeding into the brain and an ischemic stoke results from deficient blood flow to the brain from a partial or complete occlusion of an artery |
| Pts with an acute ischemic stoke can benefit from throbolytics such as ______________ that do what | Tissue plasminogen activator (tPA, alteplase [Activasel]) which digests fibrin and fibrinogen and thus loses the clot |
| For stoke patient problem insufficient nutrition related to impaired ability to swallow, what are the nursing interventions | Thicken liquids with a commercially available thickening agent, do not use a straw |
| The most frequent long-term disabilities following a stroke are | He i paresis, inability to ambulate, aphasia, depression, and complete or partial dependence on ADLs |
| With Bell’s palsy clinical manifestations what differentiates it from a stroke | The inability to wrinkle the forehead |
| Two abnormal signs that occur with meningitis are | Kernig’s sign (inability to extend legs without extreme pain) and Brudzinski’s sign (flexion of hip and knee when neck is flexed) |
| S/s of meningitis | Severe headache, stiffness of neck, irritability, malaise, and restlessness |
| Autonomic dysreflexia is an abnormal cardiovascular response to | Stimulation of the sympathetic division of the autonomic nervous system |
| Autonomic dysreflexia s/s | Bradycardia, hypertension (up to 300mmhg), diaphoresis, “goose flesh”, flushing, dilated pupils, blurred vision, restlessness, nausea, severe headache, and nasal stuffiness |