neurosensory

• 1- mental status
• 2- cranial nerves
• 3- motor
• 4-sensory
• 5-cerebellar(balance and gait)
• 6- reflex

• -asses LOC
• -8 or less indicate coma
• -15 is high
• -3 is dead
• -eyes open, best verbal and motor responses

• -risk factor for stroke or CVA
• -caused by focal brain, spinal cord or retinal ischemia
• -WITHOUT infarction of the brain
• -less than 1 hour

• -inadequate blood flow to the brain from artery occlusion
• -results in infaction(cell death)

location and extent

• glasscow
• neuro
• physical and hx

injury to a blood vessel wall and formation of blood clot

• HTN and DM
• -no LOC for 24hrs

embolus lodges in and occuludes a cerebral artery resulting in infarction and edema

-afib, MI, heart disease

• rapid onset
• S/S are less common

• -state of temporary but acute confusion
• -brain gets less o2
• -neurot abdormalitites

yes normally

• -multiple
• -cholergenic deficiency
• -drug and ETOH abuse
• -post op
• -ICU

• acute
• secondary to

dysfunction or loss of memory, orientation, attention, language, judgemnet and behavior

• chronic
• progressive
• decline in memory
• late onset

• AD 
• vascular stroke

• chronic and progressive neurodegenerative disease of the brain
• -most common form of dementia

change in brain structure with amyloid plaques, neurofib tangles, loss of connection b/t neurons and neuron death

• -early onset
• mutation w/ 1, 14 and 21
• -late onset
• inherited ApoE-$

-unknown

• -doubled after 65
• -50% after 80
• -smoking, DM, htn, cardiac dysrhythmia, head trauma, age

diff w/ motor skills

diff w/ balance

inability to recognize things

• -clusters of protein deposit b amyloid
• -cell membrane
• -memory and cognition

• -protein thread inside nerve cell
• -protein tau
• -cns
• -support intracellular structures
• -hold tubules together

• -MRI
• -non contrast(hemmorage)
• -CT angio(cerebral BV)
• -MRA(vascular lesion)
• -angiography
• -TCD(blood velocity)
• -lumbar puncture(RBC in CSF)
• -LICOX( brain o2 and temp)

• -cbc
• -lipid
• -electrolyte
• -blood glucose
• -csf
• -renal/hepatic

hoarse voice

muscles for speech are weak

impaired ability to communicate

• receptive: loss of comprehension
• expressive: inability to produce language

• -med and phys hx
• -CAM
• -ECG
• -Drugs and ETOH

• CBC
• serum electrolyte
• -blood urea
• creatine
• liver/thyroid
• csf

• determine cause
• med, neuro, physc hx
• ct
• mri
• b12 and hypothyroidism

• no definitive
• ct or mri
• pet
• csf
• b amyloid
• tau protien

• -motor deficit
• -communication
• -aphasia, dysphasia, dysarthia
• -opposite of affected hemisphere
• -affect
• -memory and judgement
• -elimination

• hypo/hyper activity
• agitation
• hallucinations
• hours to days
• ABRUBT

• gradual
• progressive

• cog
• progressive
• behavior
• dysphasia
• apraxia
• dysgraphia

• anticoagulant
• platelet inhibitors
• tPA

• -produces localized fibrinolysis by binding to fibrin in thrombus
• -breaks down blood clot
• -iv
• -w/in 3-4 hours
• -reestablish blood flow and prevent cell death

• used cautiously
• sedation
• antiphyc meds

• benzos
• cholinesterase inhibitors
• nmda
• antiphyc
• antidep

• Ativan and valium
• -for sleep

• -Aricept, razadyne, Exelon and cognex
• -decreased memory or cog
• -increases acetylcholinesterase at synapse

• nameda
• for decreased memory and cog

Risperdal, zyprexa

Zoloft, luvox, celexa, Prozac, remeron, trazadone