-Mgt. Rise slowly. Assist in ambulation.
CNS (brain & spinal cord)
I. Cells – A. neuronsProperties and characteristicsa.Excitability – ability of neuron to be affected in external environment. b.Conductivity – ability of neuron to transmit a wave of excitation from one cell to another c.Permanent cells – once destroyed, cant regenerate (ex. heart, retina, brain, osteocytes)Regenerative capacityA. Labile – once destroyed cant regenerate- Epidermal cells, GIT cells, resp (lung cells). GUTB. Stable – capable of regeneration BUT limited time only ex salivary gland, pancreas cells cell of liver, kidney cellsC. Permanent cells – retina, brain, heart, osteocytes can’t regenerate.3.) Neuroglia – attached to neurons. Supports neurons. Where brain tumors are found.Types:1.Astrocyte2.OligodendriaAstrocytoma – 90 – 95% brain tumor from astrocyte. Most brain tumors are found at astrocyte.Astrocyte – maintains integrity of blood brain barrier (BBB).BBB – semi permeable / selective-Toxic substance that destroys astrocyte & destroy BBB.Toxins that can pass in BBB:1.Ammonia-liver cirrhosis.2.2. Carbon Monoxide – seizure & parkinsons.3.3. Bilirubin- jaundice, hepatitis, kernicterus/hyperbilirubenia.4.4. Ketones –DM.OLIGODENDRIA – Produces myelin sheath – wraps around a neuron – acts as insulator facilitates rapid nerve impulse transmission. No myelin sheath – degenerates neuronsDamage to myelin sheath – demyellenating disordersDEMYELLENATING DSE1.)
– atrophy of brain tissue due to a deficiency of acetylcholine.S&Sx:A – amnesia – loss of memoryA – apraxia – unable to determine function & purpose of objectA – agnosia – unable to recognize familiar objectA – aphasia – - Expressive – brocca’s aphasia – unable to speak - Receptive – wernickes aphasia – unable to understand spoken wordsCommon to Alzheimer – receptive aphasiaDrug of choice – ARICEPT (taken at bedtime) & COGNEX.Mgt: Supportive & palliative.Microglia – stationary cells, engulfs bacteria, engulfs cellular debris.II. Compositions of Cord & Spinal cord80% - brain mass10% - CSF10% - bloodMONROE KELLY HYPOTHESIS: The skull is a closed vault. Any increase in one component will increase ICP. Normal ICP: 0-15mmHgBrain mass1. Cerebrum – largest - Connects R & L cerebral hemisphere- Corpus collusum