URSING 2060exam 4 MED SURG.
EXAM 4 –
Chapter 41: Assessment of the neurological system
• Nervous system cells
o Neurons transmit impulses
o Motor neurons (efferent) cause physical movement or
mobility
o Sensory neurons (afferent) result in the ability to perceive
stimulation through one’s sensory organs or perception
o Neurons receive impulses that can have an effect of
excitation or inhibition
o Each neuron has a cell body (soma), branching processes
called dendrites, and a single axon that can be covered
by myelin sheath
- Myelin sheath is a white, lipid covering and makes the
axons appear white, so they’re referred to as “white
matter”
- “gray matter” are nonmyelinated axons
- Synaptic knobs at the end of the axons are the
mechanisms for manufacturing, storing and releasing a
transmitter substance
- Impulses are transmitted through synapses
o Neuroglia cells provide protection, structure, and nutrition
for the neurons (4 kinds) and are part of the BBB, help
regulate CSF
- Astroglial cells
- Ependymal cells
- Oligodendrocytes
- Microglial cells
• Central nervous system
o Composed of the brain and spinal cord
o Brain
- Meninges form the protective covering of the brain and
spinal cord
- Subdural space is located in between the dura mater and
the arachnoid
- Pia mater is the inner most layer
,URSING 2060exam 4 MED SURG.
- Subarachnoid space is between the arachnoid and the
pia mater, CSF circulates here
- Epidural space is between the skull and the outer layer of
the dura mater, extends down the spinal cord and is used
for epidural analgesia/anesthesia
- Main parts of brain: forebrain, cerebellum, brainstem
⟶ Forebrain includes diencephalon, cerebrum, and
cerebral cortex
- Diencephalon includes the thalamus, hypothalamus, and
epithalamus
⟶ Thalamus is the major relay station
⟶ Hypothalamus plays a role in autonomic nervous
system (temperature) and cognition
⟶ Epithalamus regulates emotion and contributes to
smooth voluntary motor function
- Cerebrum controls intelligence, creativity and memory
- Cerebral cortex processes and communicates all
information coming from the PNS
⟶ Further divided into 4 lobes: frontal (Broca’s speech),
parietal, temporal (Wernicke’s speech), occipital
- Brainstem includes midbrain, pons, medulla
o Circulation of the brain
- Circulation originates from the carotid and vertebral
arteries
- BBB keeps substances in the bloodstream out of the
cerebrospinal circulation and out of the brain tissue
⟶ Oxygen, glucose, CO2, alcohol, anesthetics, and
water can pass through the BBB
- Cerebrospinal fluid circulates, surrounds and cushions the
brain and spinal cord
⟶ Lumbar cistern is one of the areas that collects the
largest amount of CSF and is the site of a lumbar
puncture
o Spinal cord
- Controls mobility, regulates organ function, processes
sensory perception information from extremities, trunk,
and many internal organs and also transmits information
to and from the brain
, URSING 2060exam 4 MED SURG.
- Ascending tracts go from spinal cord to the brain
- Descending tracts go from the brain to spinal cord
• Peripheral nervous system
o Composed of the spinal nerves, cranial nerves, and
autonomic nervous system
o 31 pairs of spinal nerves
- 8 cervical
- 12 thoracic
- 5 lumbar
- 5 sacral
- 1 coccygeal
o Dermatomes represent sensory input from spinal nerves to
specific areas of the skin
o 12 cranial nerves
EXAM 4 –
Chapter 41: Assessment of the neurological system
• Nervous system cells
o Neurons transmit impulses
o Motor neurons (efferent) cause physical movement or
mobility
o Sensory neurons (afferent) result in the ability to perceive
stimulation through one’s sensory organs or perception
o Neurons receive impulses that can have an effect of
excitation or inhibition
o Each neuron has a cell body (soma), branching processes
called dendrites, and a single axon that can be covered
by myelin sheath
- Myelin sheath is a white, lipid covering and makes the
axons appear white, so they’re referred to as “white
matter”
- “gray matter” are nonmyelinated axons
- Synaptic knobs at the end of the axons are the
mechanisms for manufacturing, storing and releasing a
transmitter substance
- Impulses are transmitted through synapses
o Neuroglia cells provide protection, structure, and nutrition
for the neurons (4 kinds) and are part of the BBB, help
regulate CSF
- Astroglial cells
- Ependymal cells
- Oligodendrocytes
- Microglial cells
• Central nervous system
o Composed of the brain and spinal cord
o Brain
- Meninges form the protective covering of the brain and
spinal cord
- Subdural space is located in between the dura mater and
the arachnoid
- Pia mater is the inner most layer
,URSING 2060exam 4 MED SURG.
- Subarachnoid space is between the arachnoid and the
pia mater, CSF circulates here
- Epidural space is between the skull and the outer layer of
the dura mater, extends down the spinal cord and is used
for epidural analgesia/anesthesia
- Main parts of brain: forebrain, cerebellum, brainstem
⟶ Forebrain includes diencephalon, cerebrum, and
cerebral cortex
- Diencephalon includes the thalamus, hypothalamus, and
epithalamus
⟶ Thalamus is the major relay station
⟶ Hypothalamus plays a role in autonomic nervous
system (temperature) and cognition
⟶ Epithalamus regulates emotion and contributes to
smooth voluntary motor function
- Cerebrum controls intelligence, creativity and memory
- Cerebral cortex processes and communicates all
information coming from the PNS
⟶ Further divided into 4 lobes: frontal (Broca’s speech),
parietal, temporal (Wernicke’s speech), occipital
- Brainstem includes midbrain, pons, medulla
o Circulation of the brain
- Circulation originates from the carotid and vertebral
arteries
- BBB keeps substances in the bloodstream out of the
cerebrospinal circulation and out of the brain tissue
⟶ Oxygen, glucose, CO2, alcohol, anesthetics, and
water can pass through the BBB
- Cerebrospinal fluid circulates, surrounds and cushions the
brain and spinal cord
⟶ Lumbar cistern is one of the areas that collects the
largest amount of CSF and is the site of a lumbar
puncture
o Spinal cord
- Controls mobility, regulates organ function, processes
sensory perception information from extremities, trunk,
and many internal organs and also transmits information
to and from the brain
, URSING 2060exam 4 MED SURG.
- Ascending tracts go from spinal cord to the brain
- Descending tracts go from the brain to spinal cord
• Peripheral nervous system
o Composed of the spinal nerves, cranial nerves, and
autonomic nervous system
o 31 pairs of spinal nerves
- 8 cervical
- 12 thoracic
- 5 lumbar
- 5 sacral
- 1 coccygeal
o Dermatomes represent sensory input from spinal nerves to
specific areas of the skin
o 12 cranial nerves
