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Nervous system

Nervous system. Learning outcomes Discuss the physiology and pathophysiology of the nervous system Use GCS to assess the neurological status. Head injuries in UK. Approx 1m people sustain a head injury every year 90% are minor injuries 10% need hospital admission

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Nervous system

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  1. Nervous system Learning outcomes Discuss the physiology and pathophysiology of the nervous system Use GCS to assess the neurological status.

  2. Head injuries in UK • Approx 1m people sustain a head injury every year • 90% are minor injuries • 10% need hospital admission • 1% of admissions need specialist neurosurgical care • 5000 people a year die from head injury • 63% moderate and 85% severe head injury patients will be disabled 1 year after accident

  3. Facts • The total surface area = 25, 000 square cm. • 13, 500,00 neurons in the spinal cord. • makes up only 2 % of our body weight. • Brain utilizes 20 % of our body's energy • 60 % white matter and 40 % grey matter. • transmits messages to the brain at the speed of 180 miles per hour • Men listen with the left side of the brain and women use both sides of the brain.

  4. Nervous System Divided into: • Central Nervous System: brain and the spinal cord • Peripheral Nervous System • Somatic Nervous System • Autonomic Nervous System

  5. ANS: MAINTAINING HOMEOSTASIS IN ORGANS OF THE BODY

  6. Functions: Movement Balance Posture Functions: Breathing Heart Rate Blood Pressure Functions:Thought Voluntary movement Language Reasoning Perception

  7. The Coverings of the Brain The meninges PAD the brain Pia; Arachnoid; Dura.

  8. Blood supply • Oxygen and nutrients are supplied to the brain by blood vessels that form the cerebral arterial circle (circle of Willis) • Brain is divided into 2 hemispheres • The right hemisphere controls the left side and vice versa • Blood CSF and brain tissue all exert pressure in the skull – together they make up the intracranial pressure

  9. CSF • Protection: from damage by "buffering" the brain. • Buoyancy: immersed in fluid, the net weight of the brain is reduced from about 1,400 gm to about 50 gm. Therefore, pressure at the base of the brain is reduced. • Excretion of waste products: harmful metabolites, drugs and other substances • Endocrine medium for the brain: transport hormones to other areas of the brain.  Hydrocephalus Overproduction of CSF or obstruction or Problems with CSF absorption

  10. ICP is • The measurable pressure exerted by the cerebrospinal fluid within the ventricles of the brain. • Raised ICP is when the pressure is elevated as a result of trauma or disease and remains so for a period of time. Causes of increased ICP • Swelling of the brain (tumour, cerebral oedema) • Raised CSF volume (compression of brain tissue) • Raised blood volume (vasodilatation of the cerebral vessels associated with trauma.)

  11. Effects of raised ICP • Raised blood pressure • Decreased pulse rate • Decreased respiratory rate • Raised core temperature • Changes in pupillary sizes. • Headache • Restlessness • Decreased levels of consciousness • Vomiting • Loss of motor function • Loss of sensory function

  12. Vital Signs monitoring • The brain stem controls centres that regulate • Respiration • Pulse • Blood pressure • Temperature • Therefore pressure on the centres from cerebral oedema or an alteration in blood supply may result in vital changes.

  13. Glasgow Coma Scale • Assessment Areas :- • Eye opening • Best Verbal Response • Best motor Response • Pupil Reactions • Limb movement • Vital signs

  14. The Glasgow Coma Scale is used to quantify the severity of a coma. There are three components to the score: Eye opening response, Verbal response, and Motor response. • E1 = None; E2 = To pain; E3 = To speech; E4 = Spontaneous • V1 = None; V2 = Incomprehensible; V3 = Inappropriate; V4 = Confused; V5 = Oriented • M1 = None to pain; M2 = Extension to pain (decerebrate posturing); M3 = Flexion to pain (decorticate posturing); M4 = Withdrawal to pain; M5 = Purposeful movement/localized response to pain; M6 = Obeys commands. • A score of E4V5M6 indicates the normal state; a score of E1V1M1 indicates complete un-responsiveness

  15. Head Injury Classification: • Severe Head Injury----GCS score of 8 or less • Moderate Head Injury----GCS score of 9 to 12 • Mild Head Injury----GCS score of 13 to 15

  16. Special investigations • computer-axial tomography be made, or a so-called CAT scan brain might be bruised or hovers a blood clot, either external to the brain or internal to it. • elevated intra-cranial pressure” or “ICP • Magnetic resonance imaging, or “MRI”

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