1. CHAPTER 19 NERVOUS SYSTEM Lesson 2
Journal question: What are the signs of Parkinsonism disease?

2. Chapter 19 Learning Objectives
Identify at least three methods used to assess the function of the nervous system.
Describe at least five disorders of the nervous system.
After students finish reading the chapter, remind them to re-read and fully answer each learning objective.

3. Assessment Techniques
Evaluation of the nervous system includes assessment of the following:
Mental status
Cranial nerve function
Motor and sensory nerve function
Reflexes
Coordination
Gait (walking)
Balance
Internal body processes

4. Assessment Techniques
Electroencephalography (EEG)
Lumbar puncture
Myelography
Nerve conduction velocity
Computed tomography (CT)
Positron emission tomography (PET)
Magnetic resonance imaging (MRI)
Magnetic resonance angiography (MRA)
Discuss each of the assessment techniques for the nervous system, and describe what each assesses.

5. Electroencephalogram Showing Waves
FIGURE 19-9 A, Electroencephalogram showing wave types. (From Thibodeau GA, Patton KT: Human body in health and disease, ed 5, St Louis, 2010, Mosby.)

6. Scalp Electrodes
FIGURE 19-9  B, Scalp electrodes detect electrical voltage changes in the cranium. (From Thibodeau GA, Patton KT: Human body in health and disease, ed 5, St Louis, 2010, Mosby.)

7. Magnetic Resonance Imaging
FIGURE 19-10 Magnetic resonance imagery allows the visualization of the body without use of radiation. (From Elkin MK, et al: Nursing intervention and clinical skills, ed 4, St. Louis, 2008, Mosby.)

8. Disorders of the Nervous System
Alzheimer’s disease
Form of senile dementia
Cerebrovascular accident (CVA)
Commonly called a stroke, it is caused by loss of oxygen to an area of the brain when a clot blocks a vessel or when a vessel breaks.
Down syndrome
Genetic disorder caused by the presence of an extra chromosome
Discuss the signs, symptoms, and treatment of these disorders.

9. Warning Signs of Alzheimer’s
Ask students if they have anyone in their families or know anyone with signs of Alzheimer’s disease. What signs did they notice? How did the student react to the person?

10. Disorders of the Nervous System
Encephalitis
Inflammation of the brain caused by a viral or bacterial infection or by a chemical agent
Guillain-Barré syndrome
Also called infectious polyneuritis, it may appear shortly after a viral immunization or infection
Headache
The muscles around the occipital area of the brain constrict the blood flow to the area.
Discuss the signs, symptoms, and treatment of these disorders.

11. Disorders of the Nervous System
Migraine headaches
Vascular headaches of unknown cause
Pain results from narrowing of blood vessels in the brain
Sinus headaches
Caused by swelling of the membranes that line the sinus cavities
Head injury
Occurs when the brain impacts the skull as a result of a blow or rapid movement
Discuss the signs, symptoms, and treatment of these disorders.

12. Disorders of the Nervous System
Huntington’s chorea
Degenerative neural disorder that affects brain tissues
Hydrocephalus
More cerebrospinal fluid is produced than is absorbed into the circulatory system.
Excess fluid increases intracranial pressure and may enlarge the head.
Intracranial tumors
Usually involve neuroglia, blood vessels, or membranes rather than neurons
Discuss the signs, symptoms, and treatment of these disorders.

13. Disorders of the Nervous System
Meningitis
Serious inflammation of the meninges caused by a bacterium, virus, or fungus
Meningocele
Birth defect that occurs when the membranes covering the brain or spinal cord protrude through a congenital defect in the skull or spinal column
Multiple sclerosis
Defect in electrical transmission of the neurons caused by degeneration of the myelin sheath
Discuss the signs, symptoms, and treatment of these disorders.

14. Disorders of the Nervous System
Neural tube defect
Abnormal formation of the skull and spinal column
Neurofibromatosis
Defect in an autosomal dominant gene
Parkinson’s disease
Degeneration of certain brain cells
Discuss the signs, symptoms, and treatment of these disorders.

15. Tumors of Nervous System Tissue
FIGURE 19-12 Tumors of nervous system tissue develop with neurofibromatosis. (From Patton KT, Thibodeau GA: Anatomy & physiology, ed 7, St. Louis, 2010, Mosby.)

16. Signs of Parkinsonism
FIGURE 19-13 The signs of Parkinsonism include rigidity and trembling of the head and extremities. (From Thibodeau GA, Patton KT: Human body in health and disease, ed 4, St Louis, 2005, Mosby.)

17. Disorders of the Nervous System
Poliomyelitis
Caused by a virus that spreads from the nose and throat to neural tissue
Sciatica
Usually a ruptured intervertebral disk and osteoarthritis, producing pressure on the nerve or other nerve injury
Seizure
Results from injury, infection, or epilepsy
Discuss the signs, symptoms, and treatment of these disorders.

18. Disorders of the Nervous System
Spina bifida
Birth defect involving a malformed spinal column resulting from neural tube defects
Spinal cord injuries
Trauma occurring in the cervical and lumbar area of the spinal column
Transient ischemic attack (TIA)
Decreased blood supply to an area of the brain resulting from a small clot that temporarily lodges in a vessel
Discuss the signs, symptoms, and treatment of these disorders.

19. Disorders of the Nervous System
Trigeminal neuralgia
Sudden, intense, unpredictable pain on one side of the face caused by pressure on or deterioration of the trigeminal facial nerve
Refer to the next slide to discuss the location of trigeminal neuralgia or figure in the student’s textbook.

20. Trigeminal Neuralgia
FIGURE 19-14 One method used to relieve the pain of trigeminal neuralgia is surgically to remove the ganglion on the end of the nerve. (From Patton KT, Thibodeau GA: Anatomy & physiology, ed 7, St. Louis, 2010, Mosby.)

21. Issues and Innovations
Memory research
Memories are retained differently and in different parts of the brain.
Ribonucleic acid (RNA) may play a role in storing and recalling information.
Most memory research uses a marine slug called Aplysia or people who have sustained neurologic loss
Slugs are used because their ganglia are large and their behavior pattern is limited.
Computer networks are being designed to simulate actions of the brain.
Discuss memory research and its impact .
Why are slugs used in research on memory?

22. Issues and Innovations
Correction of Parkinson’s disease
Transplantation of adrenal cells to stimulate production of dopamine
Fetal tissue research
Deep brain stimulation
Autologous neural stem cell transplantation
Discuss each of the nervous system innovations

23. Summary Methods of assessment of the nervous system EEG
Lumbar puncture
Myelography CT
PET