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1

what r the protecting structures

Skull

Meninges

Protecting structures

Cerebro-spinal fluid

Arrangement of Blood supply

Blood-Brain Barrier

2

what r the cranial bones

3

what r the facial bone

4

layers of the brain

5

what is CSF,where is it produced at what rate

CSF is the fluid that flows through and protects the 4 ventricles of the brain, the subarachnoid spaces and the spinal cord.

Produced by choroid plexis in ventricles 21mls/hr

6

circle of willis - main blood supply to the brain

the arteries compose the circle of Willis are the 2 anterior cerebral arteries joined to each other by the anterior communicating cerebral artery and to the posterior cerebral arteries by the posterior communicating arteries.

7

what is neurological assessment for

Determine whether the patient has a neurological problem

Establish what impact the condition has on the patient’s independence and daily life

 Baseline assessment

 Determine changes

 Detect life threatening situations

8

what is the goal of neurological assessment

To standardise clinical observations, always conduct a set of neurological observations with the oncoming nurse to minimise subjectivity

Monitor progress, a neuro patient often deteriorates slowly and an accurate neuro assessment can identify a deterioration very early

Provide a guide to estimate a patient’s prognosis

9

what is consciousness

It is an active process

Wakefulness or alertness must be present

Potential for self-awareness

Perceived sensation of internal and external stimuli

Memory can be used, recovered and displayed

Decision making capacity

Cognitive functioning

- Consciousness is more than being awake. It is a complex and multifaceted condition that is present in health.

10

dbescrie consciousness as a continuum? what is its component

The reality is that consciousness can be located along a continuum between two extremes

Consciousness has 2 distinct components

Arousal
Awareness

11

what is arousal

The arousal component of wakefulness is dependent on the reticular activating system.

This system is found in the upper brainstem and diencephalon ascending the brainstem, through the thalamic region and to the cerebral cortex, with the thalamus acting as a ‘gate’ between both areas

12

what is awareness

Awareness relates to the capacity of the brain to select and direct

Sensation is the awareness that something is happening and perception is the appropriate processing of this information

13

what part of brain response for conciousness?

Prefrontal lobe primary centre for consciousness

 Rest of activity at the subconscious level

 Involves sensory input as well as motor output

Frontal lobes: Control and awareness (cognition)

Parietal, temporal and occipital lobes: Awareness,

Association areas: Making sense of stimuli

14

what is conciousness depend on?

Is dependent on oxygen and glucose supply

Auto regulation of blood flow: Effective in a wide range of blood pressures as well as the maintenance of an appropriate environment.

Metabolic regulation

15

what is cerebrl perfusion pressure

Mean Arterial Blood Pressure and Intracranial pressure

MAP- ICP = CPP

CPP less than 40mmHg leads to severe compromise of cerebral tissue

16

what os unconsciousness

A physiological and psychological state in which the patient is not responsive to sensory stimuli and lacks awareness of self and the environment

17

what cause impairment of consciousness? and what does it interfere

Injury, lesions or pressure occurring anywhere within the RAS can impair consciousness.

Interference with the electrical activity of the brain, brain metabolism or the neurotransmitters required for impulse transmission

18

what is the effect of altered consciousness?

Reduced or lost protective reflexes

Potential for harm if heightened consciousness

19

what is the mechanism of the cause of unconsciousness

The cells of the Reticular Activating system are sensitive to alterations in biochemistry and haemodynamic status therefore the causes of unconsciousness are varied and extend beyond structural cerebral lesions

20

what is the causes of unsciousness

1. infective: meningitis, encephalitis

2. neuplasia: gliomas (primary), metastatic cancer

3. trauma: cerebral oedema

4. haemorrhage: extradural, subdural, subarachnoid,intracerebral

5. vascular: TIA (transient ischaemic attack), CVA

6. hydrocephalus: increase ICP

7. metabolic: hypoxic, hypercapnia, hypoglycemia, uraemia.

- other causes: shock, drug overdose, anaesthetics, alcohol

21

shock cut to the causes of unconsciousness

AEIOU TIPS

22

how does alcohol cause unconsciousness

23

how does epilepsy cause unconsciousness

24

how does insulin cause unconsciousness

25

how does overdose cause unconsciousness

26

how does ureamia cause unconsciousness

27

how does temperature cause unconsciousness

28

how does infection cause unconsciousness

29

how does psychogenic cause unconsciousness

30

how does septicaemia cause unconsciouness