Neurological Observations

laura ginesi Parietal Lobe - two functional regions concerned with sensation and perception (somatosensory cortex) concerned with integrating sensory input, primarily with the visual system (association areas)

laura ginesi The occipital lobes are the center of the visual perception system Click here for Visual Illusions Michael Bach’s website: -

laura ginesi The temporal lobes auditory sensation attention visual perception verbal processing language comprehension memory (long-term) affective & sexual behavior organization of sensory input

laura ginesi The cerebellum coordination of voluntary motor functions Smooth movement balance and equilibrium kinesthetic memory

laura ginesi The brain stem Autonomic Nervous System – involuntary co-ordination Breathing & Heart Rates Swallowing Bladder Reflexes to seeing and hearing (Startle Response) Control - sweating, blood pressure, digestion, temperature level of alertness Ability to sleep Sense of balance The Brainstem song:

Why might we perform neurological observations? Determine whether the patient has a neurological problem Establish what impact the neurological condition has on a patient Establish a baseline assessment of a patient’s neurological function Determine any changes in a patient’s neurological condition Detect life threatening situations requiring medical intervention

What does the neurological assessment consist of? Level of consciousness Pupillary reaction Vital signs Motor function Sensory function

What does the Glasgow Coma Scale (GCS) assess? The conscious level of a patient by asking them to perform the following activities: Eye opening Motor response Verbal response

Glasgow Coma Scale Assesses two aspects of consciousness:  Arousal – being aware of the environment  Cognition – demonstrating an understanding by performing tasks Each activity is given a score from 3-15 Worst score =3 Best score =15 Score of 8 or less = deep coma

What can cause a decreased conscious level? Brain tumours, head injury Haematoma, haemorrhage Increase CSF (hydrocephalus) Hepatic, uraemic, diabetic coma Electrolyte inbalance Drugs e.g.sedatives, amphetamines (Raised intracranial pressure (ICP))

What’s the brain for? The juvenile sea squirt wanders through the sea searching for a suitable rock or hunk of coral to cling to and make its home for life. For this task it has a rudimentary nervous system. When it finds its spot and takes root, it doesn't need its brain any more so it eats it. Daniel C. Dennett (1991) from Consciousness Explained You have brains in your head. You have feet in your shoes. You can steer yourself any direction you choose Dr. Seuss (1990) from Oh, the places you'll go! A brain is worth little without a tongue. French Proverb The brain presents two seemingly irreconcilable aspects: It is a material body, exhibiting all the physical properties of matter, and it possesses a set of faculties and attributes, collectively called mind, that are not found in any other physical system. Erich Harth (1982) from Windows on the Mind, The brain is a complex biological organ of great computational capability that constructs our sensory experiences, regulates our thoughts and emotions, and control our actions. Eric R. Kandel (2007) from "The new science of mind" in Best of the Brain from Scientific American More brain quotes if you click here: