NEURO
● Function: eye movements
● Prob: Diplopia- double vision
Prof. VII. facial
● facial expression and taste a
● Prob: bell’s palsy
NERVOUS SYSTEM ○ Parang stroke per
niya. Normal lahat
VIII. acoustic/auditory
TWO DIVISIONS:
● Function: hearing
1. Central nervous system
● Prob: hearing loss, tinnitus,
● Nuclei -groups of neurons in the CNS
IX. glossopharyngeal
2. Peripheral nervous system
● Function:
● Ganglia - groups of neurons in PNS
○ Taste posterior 1-th
● Two functions:
○ Gag reflex
○ Somatic (voluntary movements)
● Prob: absence of taste post
■ Afferent
X. Vagus
● “Aray” message
● Longest nerves
■ Efferent
● Function:
● “Edi tanggalin” response
○ Gag reflex
○ Autonomic (involuntary nervous system)
○ PNS activation
■ Sympathetic
● Prob: dysphagia
● Emergency
XI. spinal accessory
● Fight or flight response
● Function: neck and shoulde
● Releases catecholamines: from the
● Prob: unable to move neck a
adrenal medulla
XII. hypoglossal
○ Epi
● Function: tongue movement
○ Norepi
● Prob: Tongue protrusion/dev
○ Dopamine
● Effects: increases body activities
PNS
except for GIT
● Increases blood flow to the brain,
Cervical: 8
heart, and skeletal muscles
● Sa leeg. Pag nasira patay agad patien
● anticholinergic/adrenergic: ● Controls: diaphragm, chest wall musc
○ Dilate pupils: mydriasis
○ BP and HR increase and Thoracic: 12
bronchodilation increases ● Controls: upper body & GIT function
○ RR increases
Lumbar: 5
○ Dry mouth
● Controls: lower body, bowel and blad
○ GIT: constipation
○ Urinary retention (FVE) Sacral: 1
■ Parasympathetic
● Para! = babagal ang jeep (babagal ang
lahat) INCREASE
● rest and digest response
● Release of acetylcholine Predisposing factors: STICHS
○ Konti nalang dugo sa muscle 1. Stroke (hemorrhagic)
kasi pupunta ang dugo sa 2. Tumor
GIT 3. Inflammation
● Encephalitis (inflammation o
● Cholinergic/vagal nerves
● meningitis (inflammation of t
○ Constricted pupils (miosis)
4. Trauma
○ BP, HR, RR, 5. Cerebral edema
bronchoconstriction = 6. Hydrocephalus
decreases 7. Surgery can cause ICP
○ Moist mouth → Increase
salivation Composition of brain and spinal cord
● 80% brain mass
○ GI → diarrhea
● 10% CSF
○ Urinary emptying → FVD ● 10 % blood
Monroe Kelie Hypothesis
CRANIAL NERVE ASSESSMENT ● The skull is a closed vault. An increas
● Compensatory mechanism wherein
changes, the other will change to bala
, 5. Projectile vomiting ● Dahl nasira ang myelin sheath, babag
6. Papilledema ● Most common in women: 20-50 yrs.
● edema of the optic disk- the outer surface of the retina ● Inflamed neurons
○ causes edema blindness ● Decreases nerve impulse transmissio
7. Abnormal posturing ● Most common type
● Decorticate ○ relapsing-remitting
○ Abnormal flexion ■ Occurs when p
○ Problem in the Spinal cervical tract exacerbation (relap
○ parang pa “C” yung kamay of partial or comple
■ Cause: unknown/id
● Decerebrate
○ Abnormal extension Pathophysiology
○ Problem in Pons and midbrain ● Immune system attacks → myelin sh
○ parang pa “e” yung kamay oligodendrocytes tapos magtatawag
8. (+) Babinski Reflex myelin sheath kaya hnd na m
● > 12mons age: Stroke the feet of the patient to J shape, if nag (communication breakdown) kaya m
fanning of toes there’s a brain herniation ng patient → sensory problem →
affecting frontal lobe → CNS/cognitiv
HEADS
● Hob:
○ Semi-fowler’s: Lung expansion (CI: on spinal injury) SIGNS AND SYM
○ Head and neck neutral position: venous drainage
● Evaluate neuro status q1-2hrs 1. Charcot’s triad: SIN
● Airway - Scanning of speech
○ check RR (NSG priority!) → prepare for intubation - Intentional tremors
○ Avoid: - Nystagmus
■ Cough (INC. pressure)
● Give antitussive- vicks formula 44 Dysarthria
■ Straining of stool/Valsalva maneuver ○ Scanning/difficulty/
● Give laxative/stool softener ○ Due to plaques in t
○ DOC: Docusate sodium (Colace) ○ Interferes:
■ Excessive vomiting ■ eating & t
● Give anti-emetics ■ swallowin
○ DOC: Ondansetron (Zofran)
● Drainage Nystagmus
○ From ears → to check, sterile gauze/dressing ang gagamitin para ○ Involuntary rapid ey
hnd mag cause ng meningitis ○ Due to a plaque in
■ Signs of meningitis: ○ Optic nerves
● Brudzkinski ■ Blurring o
● Kernig ■ Diplopia
■ Scotoma
●
Intentional tremor
○ Due to plaque in m
○ Pag mag tuturo siy
○ TAMP
■ Tremors
■ Ataxia
●
○ The drainage is CSF if (+) for glucose
●
● Safety
○ Seizure precaution ●
■ DOC: Phenytoin (Dilantin)
■ side rails ■ Muscle w
■ No sedatives or narcotics!!! ■ Paralysis
● Except. Codeine sulfate (for headache)
2. Plaques in sensory pathways
● numbness and paresthesia
MANAGEMENT FOR ICP 3. Plaques in the Autonomic nervo
kapag may ginagawa ka. Hnd siya ma
● Limit fluid- 1.2L/day ● Urinary retention or incontine
● Prevent hypoxia- dec. tissue oxygenation and hypercarbia (Co2 retention) ● Constipation
● Decreased sexual ability
Medications for ICP
1. corticosteroids 4. High-order activities
● Function: eye movements
● Prob: Diplopia- double vision
Prof. VII. facial
● facial expression and taste a
● Prob: bell’s palsy
NERVOUS SYSTEM ○ Parang stroke per
niya. Normal lahat
VIII. acoustic/auditory
TWO DIVISIONS:
● Function: hearing
1. Central nervous system
● Prob: hearing loss, tinnitus,
● Nuclei -groups of neurons in the CNS
IX. glossopharyngeal
2. Peripheral nervous system
● Function:
● Ganglia - groups of neurons in PNS
○ Taste posterior 1-th
● Two functions:
○ Gag reflex
○ Somatic (voluntary movements)
● Prob: absence of taste post
■ Afferent
X. Vagus
● “Aray” message
● Longest nerves
■ Efferent
● Function:
● “Edi tanggalin” response
○ Gag reflex
○ Autonomic (involuntary nervous system)
○ PNS activation
■ Sympathetic
● Prob: dysphagia
● Emergency
XI. spinal accessory
● Fight or flight response
● Function: neck and shoulde
● Releases catecholamines: from the
● Prob: unable to move neck a
adrenal medulla
XII. hypoglossal
○ Epi
● Function: tongue movement
○ Norepi
● Prob: Tongue protrusion/dev
○ Dopamine
● Effects: increases body activities
PNS
except for GIT
● Increases blood flow to the brain,
Cervical: 8
heart, and skeletal muscles
● Sa leeg. Pag nasira patay agad patien
● anticholinergic/adrenergic: ● Controls: diaphragm, chest wall musc
○ Dilate pupils: mydriasis
○ BP and HR increase and Thoracic: 12
bronchodilation increases ● Controls: upper body & GIT function
○ RR increases
Lumbar: 5
○ Dry mouth
● Controls: lower body, bowel and blad
○ GIT: constipation
○ Urinary retention (FVE) Sacral: 1
■ Parasympathetic
● Para! = babagal ang jeep (babagal ang
lahat) INCREASE
● rest and digest response
● Release of acetylcholine Predisposing factors: STICHS
○ Konti nalang dugo sa muscle 1. Stroke (hemorrhagic)
kasi pupunta ang dugo sa 2. Tumor
GIT 3. Inflammation
● Encephalitis (inflammation o
● Cholinergic/vagal nerves
● meningitis (inflammation of t
○ Constricted pupils (miosis)
4. Trauma
○ BP, HR, RR, 5. Cerebral edema
bronchoconstriction = 6. Hydrocephalus
decreases 7. Surgery can cause ICP
○ Moist mouth → Increase
salivation Composition of brain and spinal cord
● 80% brain mass
○ GI → diarrhea
● 10% CSF
○ Urinary emptying → FVD ● 10 % blood
Monroe Kelie Hypothesis
CRANIAL NERVE ASSESSMENT ● The skull is a closed vault. An increas
● Compensatory mechanism wherein
changes, the other will change to bala
, 5. Projectile vomiting ● Dahl nasira ang myelin sheath, babag
6. Papilledema ● Most common in women: 20-50 yrs.
● edema of the optic disk- the outer surface of the retina ● Inflamed neurons
○ causes edema blindness ● Decreases nerve impulse transmissio
7. Abnormal posturing ● Most common type
● Decorticate ○ relapsing-remitting
○ Abnormal flexion ■ Occurs when p
○ Problem in the Spinal cervical tract exacerbation (relap
○ parang pa “C” yung kamay of partial or comple
■ Cause: unknown/id
● Decerebrate
○ Abnormal extension Pathophysiology
○ Problem in Pons and midbrain ● Immune system attacks → myelin sh
○ parang pa “e” yung kamay oligodendrocytes tapos magtatawag
8. (+) Babinski Reflex myelin sheath kaya hnd na m
● > 12mons age: Stroke the feet of the patient to J shape, if nag (communication breakdown) kaya m
fanning of toes there’s a brain herniation ng patient → sensory problem →
affecting frontal lobe → CNS/cognitiv
HEADS
● Hob:
○ Semi-fowler’s: Lung expansion (CI: on spinal injury) SIGNS AND SYM
○ Head and neck neutral position: venous drainage
● Evaluate neuro status q1-2hrs 1. Charcot’s triad: SIN
● Airway - Scanning of speech
○ check RR (NSG priority!) → prepare for intubation - Intentional tremors
○ Avoid: - Nystagmus
■ Cough (INC. pressure)
● Give antitussive- vicks formula 44 Dysarthria
■ Straining of stool/Valsalva maneuver ○ Scanning/difficulty/
● Give laxative/stool softener ○ Due to plaques in t
○ DOC: Docusate sodium (Colace) ○ Interferes:
■ Excessive vomiting ■ eating & t
● Give anti-emetics ■ swallowin
○ DOC: Ondansetron (Zofran)
● Drainage Nystagmus
○ From ears → to check, sterile gauze/dressing ang gagamitin para ○ Involuntary rapid ey
hnd mag cause ng meningitis ○ Due to a plaque in
■ Signs of meningitis: ○ Optic nerves
● Brudzkinski ■ Blurring o
● Kernig ■ Diplopia
■ Scotoma
●
Intentional tremor
○ Due to plaque in m
○ Pag mag tuturo siy
○ TAMP
■ Tremors
■ Ataxia
●
○ The drainage is CSF if (+) for glucose
●
● Safety
○ Seizure precaution ●
■ DOC: Phenytoin (Dilantin)
■ side rails ■ Muscle w
■ No sedatives or narcotics!!! ■ Paralysis
● Except. Codeine sulfate (for headache)
2. Plaques in sensory pathways
● numbness and paresthesia
MANAGEMENT FOR ICP 3. Plaques in the Autonomic nervo
kapag may ginagawa ka. Hnd siya ma
● Limit fluid- 1.2L/day ● Urinary retention or incontine
● Prevent hypoxia- dec. tissue oxygenation and hypercarbia (Co2 retention) ● Constipation
● Decreased sexual ability
Medications for ICP
1. corticosteroids 4. High-order activities
