Lecture Notes

Classroom Activity to Accompany Medical Terminology Systems, Sixth EditionBarbara A. Gylys ∙ Mary Ellen Wedding

14Nervous System

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Structure of Nervous System•Central Nervous System (CNS)•Brain• Spinal cord

•Peripheral Nervous System (PNS)• Peripheral nerves

•Basic unit is the neuron

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Function of Nervous System •Central nervous (CNS) •Control center of the body.•Peripheral nervous system (PNS)•Consists of peripheral nerves and connect CNS to remote body parts to relay and receive messages.

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Structure and Function ExerciseQ: What are the two main divisions of the nervous

system?A: Central nervous system (CNS) and peripheral nervous

system (PNS).Q: What are the cells that transmit impulses called?A: NeuronsQ: What does the CNS consist of?A: Brain and spinal cordQ: What does the PNS consist of?A: Peripheral nerves that connect CNS to remote body

parts to relay and receive messages. Q: What is the function of neuroglia cells? A: They perform the function of support and protection,

but are not transmitters of messages.

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Spinal Cord Injuries Signs and Symptoms• Spinal cord injury

resulting in paraplegia or quadriplegia usually is a consequence of fracture, dislocation, or both of the vertebral column.

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Spinal Cord Injuries Signs and Symptoms (continued)• Location of spinal cord injury and severity of

trauma determines whether paraplegia or quadriplegia results.

• In paraplegia, there is loss of motor and sensory functions in the legs and trunk.

• In paraplegia, bowel, bladder, and sexual function may be lost.

• Complete spinal cord injury renders no feeling or function beneath the injury.

• Incomplete spinal cord injury renders some feeling and function remains beneath the injury.

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Spinal Cord InjuriesTreatment• Restoration and stabilization of the injured spinal area. • Decompression of compressed neurological structures.• Prevent progressive spinal cord tissue damage. • Surgery, drugs, or cooling the affected portion of the spine.

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Clinically Related ExerciseQ: Michelle’s daughter is diagnosed with a spinal cord injury and asks the nurse

to explain its cause.A: Acute traumatic injury of the spinal cord that results from automobile

accidents, sports injuries, falling, or violence.Q: Jena has a loss of motor and sensory functions in the legs and trunk

following an auto accident. This type of spinal injury is known as (paraplegia, quadriplegia, complete spinal injury)

A: paraplegiaQ: The nurse explains that a C6 injury results in paralysis of all four extremities

and usually the trunk. This type of impairment is called (paraplegia, quadriplegia, total paralysis).

A: quadriplegiaQ: The veteran presents to the clinic with paralysis of the lower portion of the

body and both legs. The medical term in the chart for this spinal cord impairment is (paraplegia, quadriplegia, total paralysis).

A: paraplegia

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Spinal Cord DefectsSigns and Symptoms• Developmental

defects of the first trimester of pregnancy, characterized by incomplete closure of the bones encasing the spinal cord.

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Spinal Cord DefectsSigns and Symptoms (continued)• Spina bifida occulta is the most common and

least severe spinal cord defect.• Incomplete closure of one or more vertebrae

without protrusion of spinal cord or meninges.

• Spina bifida cystica has two classifications:•Meningocele, sac contains only meninges and cerebrospinal fluid (CSF).•Meningomyelocele, sac contains meninges, CSF, and a portion of the spinal cord.

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Spinal Cord DefectsTreatment• Spina bifida occulta usually requires no

treatment.• Meningocele and meningomyelocele

require surgical repair of sac and supportive measures to promote independence and decrease possibility of complications.• Folic acid in diet of women in the

chilbearing age decreases risk of spina bifida.

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Clinically Related Exercise Q: Mrs. C asks about the importance of taking a folic acid

vitamin supplement during pregnancy.A: The MA explains that folic acid intake decreases risk of the

child being born with the congenital defect called spina bifida.

Q: The Smith baby is diagnosed with spina bifida cystica and the mother asks the physician to explain this congenital defect.

A: The doctor states that spina bifida cystica involves protrusion of the meninges (meningocele), or spinal cord (myelocele), or both (meningomyelocele).

Q: The parents ask the nurse to explain the type of treatment recommended for spina bifida occulta.

A: She explains that spina bifida occulta does not require surgery and there is little or no treatment.

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Clinically Related Exercise(continued)Q: Baby Mary is diagnosed with spina bifida that involves

protrusion of the meninges. The medical term for this is (meningocele, meningomyelocele, myelocele).

A: meningoceleQ: Baby Mark is diagnosed with spina bifida cystica that

involves the protrusion of the meninges and spinal cord. This diagnosis is charted as (meningocele, meningomyelocele, myelocele).

A: meningomyelocele

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Medical Vocabulary•angioma•anorexia•aphasia•cognition•craniotomy•dementia

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Medical Vocabulary(continued)• dysphasia• epilepsy• hydrocephalus• neurolysis• neurosis• oxytocin

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Medical Vocabulary(continued)• neurotransmitter• palsy• parapleglia• psychosis• quadriplegia• shingles

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Diagnostic Procedures •Cerebrospinal fluid (CSF) analysis•Lumbar puncture• Sample of CSF is withdrawn for laboratory analysis as shown in the illustration.

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Word Building ExerciseQ: Pertaining to the cerebrum and spine:A: cerebrospinalQ: Incision of the cranium (skull):A: craniotomyQ: Crushing a nerve:A: neurotripsyQ: Hernia of meninges and spinal cord:A: meningomyeloceleQ: Inflammation of gray matter of spinal cord:A: poliomyelitisQ: Paralysis of four (limbs):A: quadriplegia

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Medical and Surgical Procedures

• Craniotomy • Thalamotomy• Tractotomy• Vagotomy

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Clinically Related ExerciseQ: Susan is diagnosed with ulcers in the stomach and duodenum that do

not respond to medication or changes in diet. Dr. S. recommends a surgical procedure of the vagus nerve to relieve her peptic ulcer disease. This is known as a (thalamotomy, tractotomy, vagotomy).

A: vagotomyQ: John suffers from chronic pain caused by an injury to his back from an

auto accident 10 years ago. The doctor performs a partial destruction of the thalamus to treat his chronic pain. This is charted in the medical record as a __________________.

A: thalamotomyQ: Zia is having surgery to remove a brain tumor. The surgeon needs to

create an opening in the skull to gain access to the tumor. This surgery is known as a (craniotomy, thalamotomy, tractotomy).

A: craniotomyQ: The neurosurgeon performs a transection of a nerve tract in the spinal

cord to resolve the patient’s chronic pain. This surgical procedure is charted as a (craniotomy, thalamotomy, tractotomy).

A: tractotomy

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Pharmacology•Anesthetics• general• local

•Anticonvulsants•Antiparkinsonian agents

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Clinically Related ExerciseQ: To control Parkinsonian tremors, the physician prescribes an

(anticonvulsant agent, antibiotic agent, antiparkinsonian agent).

A: antiparkinsonian agentQ: Pat is scheduled for a craniotomy. The anesthesiologist

informs her that she will be unconscious during the procedure and a (general, central, local, ___________ anesthetic will be administered.

A: generalQ: To control seizures, the physician prescribes an (anesthetic,

anticonvulsant, antiparkinsonian) A: anticonvulsantQ: Mrs. C is informed that she will be under local anesthesia for

her minor procedure and asks if she will be unconscious. A: The nurse explains that anesthetics that produce loss of

feeling only affect a local area; there is no loss of consciousness.

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