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Nervous system

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& 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 ... – PowerPoint PPT presentation

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Title: Nervous system


1
Nervous system
  • Emergencies

2
Nervous System
  • Look up in text
  • Central Nervous System
  • Brain Spinal cord
  • Peripheral nervous system
  • All the rest of the nerves

3
Central Nervous System
  • Look up anatomy in TEXT!
  • Chapter 4

4
CNS Parts
  • Cerebrum - Center of intellect
  • Cerebellum - Balance, muscle coordination
  • Brainstem - Controls vital functions
  • CSF (cerebral spinal fluid) - Protection
  • Spinal cord - Transmits impulses

5
Lobes of cerebrum function
  • Frontal - Cognition and motor
  • Parietal - Touch and orientation
  • Temporal - Speech Hearing
  • Occipital - Sight

6
Brainstem is Location of
  • Cardiac center
  • Respiratory center
  • Vasomotor center
  • RAS - reticular activating system

7
and...
  • Blood supply carotids
  • Meninges - tissue layers(3) that cover
    brain spinal cord.
  • Dura mater
  • Pia mater
  • arachnoid

8
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.

9
The Nervous System
  • The nervous system controls the bodys voluntary
    and involuntary actions.
  • Somatic nervous system
  • Autonomic nervous system

10
Sympathetic
  • Fight or flight
  • pupils dilate
  • increased CNS stimulation
  • increased heart rate BP
  • bronchioles dilate
  • decreased GI activity

11
Parasympathetic
  • Passive mode
  • After eating a big meal
  • increased GI activity
  • constricted pupils
  • sleepy

12
Neurologic Emergencies
13
Neurologic Trauma
14
Concussion
  • Temporary loss or alteration in brain function
  • Brief loss of consciousness
  • Brain can sustain bruise
  • Not a problem unless there is bleeding

15
Intracranial bleeding
  • Subdural
  • Intracranial
  • Epidural
  • All bleeds causes increased intracranial pressure
    brain damage

16
EPIDURAL BLEED
17
Intracranial Bleed
18
signs of increasing intracranial pressure
  • ALOC
  • vomiting
  • unequal pupils
  • hypertension decreasing heart rate
  • expanding pulse pressure
  • Seizure
  • Abnormal respiratory patterns
  • Posturing

19
Posturing
  • Severe sign of increased intracranial pressure
  • Decerebate
  • Decorticate
  • will be unconscious !!

20
ALOC
  • Single most important observation
  • Use AVPU or GCS
  • Repetitive questioning
  • Level of consciousness
  • Decreasing? worry

21
Change in Pupil Size
  • Unequal pupil size may indicate increased
    pressure on one side of the brain.

22
Shock
  • If patient has signs/symptoms of shock, look
    elsewhere for cause!!
  • Abdomen or chest!

23
Basilar skull fracture
  • Indicates SIGNIFICANT force
  • CSF fluid in ears nose
  • battle sign
  • raccoon eyes

24
Signs and Symptoms of Spinal Injury
  • Pain, swelling, deformity
  • Tingling in the extremities
  • Paralysis or paresis
  • Incontinence
  • Injuries to the head

25
Spinal cord injury
  • Paraplegia paralysis of lower
    extremities
  • Quadriplegia paralysis of all extremities

26
Identifying C-spine candidates
  • Mechanism of injury
  • pain
  • numbness or tingling in extremities

27
Significant Mechanisms of Injury (MOI)
  • MVAs
  • Auto vs. Peds/bicycle/motorcycle
  • Falls
  • Blunt or penetrating trauma
  • Hangings
  • Recreational accidents

28
Rx for Head Spine Injury
  • Maintain airway (jaw thrust)
  • Oxygen
  • Hyperventilate
  • Stabilize C-spine

29
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

30
notes
  • PMSC before and after AND DOCUMENT!
  • Manual head stabilization

31
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.

32
More Neurologic Emergencies
  • Seizure
  • Stroke
  • Altered Mental Status (AMS)

33
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

34
Causes of Seizures
  • Congenital
  • High fevers
  • Structural problems in the brain
  • Metabolic disorders
  • Chemical disorders

35
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

36
Status Epilepticus
  • 1 seizure over 10 minutes
  • 2 seizures without regaining consciousness
  • 3 seizures within 1 hour

37
Complications
  • Hypoxia
  • Trauma
  • Hyperthermia
  • Hypoglycemia
  • Aspiration
  • Dehydration

38
Common medications
  • Dilantin
  • Tegretol
  • Pheno-Barbitol
  • and ...

39
Treatment
  • ABCs
  • Protect patient from injuring self
  • Oxygen
  • Supine or left lateral
  • Transport

40
Stroke
  • CVA
  • TIA
  • Hemorrhagic stroke
  • Ischemic stroke

41
Signs and Symptoms of Stroke
  • Left Hemisphere
  • Aphasia
  • Receptive aphasia
  • Expressive aphasia
  • Right Hemisphere
  • Dysarthria

42
Stroke Mimics
  • Hypoglycemia
  • Postictal state
  • Subdural or epidural bleeding

43
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

44
Cincinnati Stroke Scale
  • Facial droop
  • Arm drift
  • Speech

45
Altered Mental Status (AMS)
  • Hypoglycemia
  • Hypoxemia
  • Intoxication
  • Drug overdose
  • Unrecognized head injury
  • Brain infection
  • Body temperature abnormalities
  • Brain tumors
  • Glandular abnormalities
  • Poisoning

46
END
  • Questions?
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