Summary of Clinical Issue (200-250 words): Central line associated infections can happen in the ICU setting and can lead to poor patient outcomes, longer complicated hospital stays, and increased cost in hospital stays.

Literature Evaluation Table

Student Name: Student Example

Summary of Clinical Issue (200-250 words): Central line associated infections can happen in the ICU setting and can lead to poor patient outcomes, longer complicated hospital stays, and increased cost in hospital stays. Education is a crucial way to inform frontline staff about how to prevent these infections. The creation of a bundle of ways for nurses to care for central lines and incorporating it into their protocols and daily routine can decrease the rate of infections. As a nurse in the ICU, it is helpful for staff to have direct and clear instructions to make sure their responsibilities and skills are being performed according to best practice and per protocol per facility. Nurses are at the bedside and are frequently interacting with central lines on a daily basis in the ICU. Making simple changes such as proper hand hygiene before and after use of a central line can have a very positive result on the rate of the infection. The Joint Commission has included central line-associated bloodstream infections (CLABSIs) in their National Patient Safety Goals. It is a problem that can cause critical issues for patients and event result in death. Nurses can have an impact on reducing CLABSIs by implementing evidence-based interventions, such as hand hygiene, proper education on central line care, visual reminders for staff in unit with key points, proper catheter access protocol, disinfecting caps, dressing changes, and frequent assessment of the continued need for the central line. As a nurse in the ICU, I want to establish a central line care bundle using evidence-based research that can reduce CLABSIs and improve patient outcomes.

 

PICOT Question: Does the implementation and use of a central line care bundle compared to a non-standardized routine reduce the rate of central line blood stream infections (CLABSIs) in adult ICU patients during their hospital stay?

In _______(P), what is the effect of _______(I) on ______(O) compared with _______(C) within ________ (T)?

In Adult Intensive Care Unit patients, what is the effect of central line care bundle on central line blood stream infections (CLABSIs) compared with non-standardized routine care during the hospital stay.

 

 

Criteria Article 1 Article 2 Article 3
APA-Formatted Article Citation with Permalink Scheck McAlearney, A., & Hefner, J. L. (2014). Facilitating central line-associated bloodstream infection prevention: A qualitative study comparing perspectives of infection control professionals and frontline staff. American Journal of Infection Control42(10), S216–S222. doi: https://doi.org/10.1016/j.ajic.2014.04.006

 

Scheck, M. A. A., Hefner, J. L., Robbins, J., Harrison, M. I., & Garman, A. (2015). Preventing central line-associated bloodstream infections: a qualitative study of management practices. Infection Control Hospital Epidemiology36(5), 557–563. doi: 10.1017/ice.2015.27

 

 

Damschroder, L. J., Banaszak-Holl, J., Kowalski, C. P., Forman, J., Saint, S., & Krein, S. L. (2009). The role of the “champion” in infection prevention: results from a multisite qualitative study. BMJ Quality and Safety18(6). doi: http://dx.doi.org/10.1136/qshc.2009.034199

 

 

How Does the Article Relate to the PICOT Question? Reiterates how frontline staff are responsible for delivering direct and ongoing care for central lines. It helps discuss the different perspectives about challenges of central-line associated bloodstream infection prevention program successes. It discusses how management and hospital-level differences can affect the outcome of patients who have central line-associated bloodstream infections. It gives me more of an idea of how my hospital performs due to their level of performing. I can recognize these barriers to help implement change to reduce infection rates. It explores types and numbers of champions who lead efforts to implement best practices to prevent infections. It gives me ideas on how to implement practices to prevent CLABSIs and the characteristics is takes to promote change and improve patient outcomes.
Quantitative, Qualitative (How do you know?) Correct Qualitative- it describes quality and characteristics of frontline staff through observation and interviews Correct Qualitative- it interviews people and receives their nonnumeric data through descriptive characteristics. Correct Qualitative- it gathers data about characteristics of people and observes behaviors not numeric type of data.
Purpose Statement Infection control professionals play a critical role in implementing and managing healthcare-associated infection reduction interventions, whereas frontline staff are responsible for delivering direct and ongoing patient care. To identify factors that may explain hospital-level differences in outcomes of programs to prevent central line-associated bloodstream infections. Although 20% or more of healthcare-associated infections can be prevented, many hospitals have not implemented practices known to reduce infections. We explored the types and numbers of champions who lead efforts to implement best practices to prevent hospital-acquired infection in US hospitals.
Research Question To determine if ICPs and frontline staff have different perspectives about the facilitators and challenges of central-line associated bloodstream infection prevention program success. How can management practices reflect CLABSI rates and what can be implemented to streamline the reduction rate of CLABSIs with appropriate and effective central line care. Observing how champions can promote and create change regarding CLABSIs or other hospital acquired infections/
Outcome Study shows the need to include nurses in the implementation of infection control initiatives. Frontline staff contribute a critical real-world perspective that may facilitate the success of patient safety interventions. A main theme that differentiated higher from lower performing hospitals was as distinctive framing of the goal of “getting to zero” infections. Although all sites reported this goal, at the higher performing sites the goal was explicitly stated, widely embraced, and aggressively pursued; in contrast, at the lower-performing hospitals the goal was more of an aspiration and not embraced as part of the strategy to prevent infections. The types and numbers of champions varied with the type of practice implemented and effectiveness of champions was affected by the quality of organizational networks. For practices that require significant behavioral changes, however, a coalition of champions may be needed.
Setting

(Where did the study take place?)

8 various sites in Ohio with approval of the Institutional Review board of Ohio State University Eight US hospitals that had participated in the federally funded On the CUSP-Stop BSI initiatives. 14 hospitals from all over the US were sent surveys, telephone interviews, sit down interviews, and some on-site visits.
Sample Across the 8 sites in the study, they interviewed 194 key informants with different jobs and roles in the hospitals. Among these informants were 50 frontline nurses, and 26 ICPs. They focused on the comments from these 76 informants because their roles in the organizations are relevant to their research question focusing on the perspectives of ICPS and frontline staff. 194 interviewees including administrative leaders, clinical leaders, professional staff, and frontline physicians and nurses. Survey responses were used to select a stratified purposive sample of 14 hospitals for in-depth semistructured telephone interviews. These hospitals were selected for their potential to further our understanding of organizational barriers and facilitators in implementing infection prevention practices.
Method They conducted interviews at 8 hospitals that participated in the Agency for Healthcare Research and Quality CLABSI prevention initiative called {On the CUSP: Stop BSI.” They analyzed interview data from 50 frontline nurses and 26 ICPs to identify common themes related to program facilitators and challenges. Interviews lasted 30-60 minutes, and the majority were conducted with at least 2 interviewers. Extensive qualitative case study comparing higher and lower performing hospitals on the basis of reduction in the rate of central line-associated bloodstream infections. In-depth interviews were transcribed verbatim and analyzed to determine whether emergent themes differentiated higher from lower performing hospitals. Qualitative analyses were conducted within a multisite, sequential mixed methods study of infection prevention practices in Veteran Affairs and no-Veteran Affairs hospitals in the USA. The first phase included telephone interviews conducted in 2005-2006 with 38 individuals at 14 purposively selected hospitals. The second phase used findings from phase 1 to select six hospitals for site visits and interviews with another 48 individuals in 2006-2007.
Key Findings of the Study Identified 4 facilitators of the CLABSI program success: education, leadership, data, and consistency. We also identified 3 common challenges: lack of resources, competing priorities, and physician resistance. However, the perspectives of ICPs and frontline nurses differed. Whereas ICPs tended to focus on general descriptions, frontline staff noted program specifics and often discussed concrete examples. Five additional management practices were nearly exclusively present in the higher-performing hospitals: 1) top-level commitment, 2) physician-nurse alignment, 3) systematic education, 4) meaningful use of data, and 5) rewards and recognition. They present these strategies for prevention of healthcare-associated infection as a management “bundle” with corresponding suggestion for implementation. It was possible for a single well-placed champion to implement a new technology, but more than one champion was needed when an improvement required people to change behaviors. Although the behavioral change itself was often more complicated than changing technology because behavioral changes required interprofessional coalitions working together.
Recommendations of the Researcher Their results suggest ICPs need to take into account the perspectives of staff nurses when implementing infection control and broader quality improvement initiatives. Further, the deliberate inclusion of frontline staff in the implementation of these programs may be critical to program success. Adding a management practice bundle may provide critical guidance to physicians, clinical managers, and hospital leaders as they work to prevent CLABSIs. Merely appointing champions is ineffective; rather, successful champions tended to be intrinsically motivated and enthusiastic about the practices they promoted. Create enthusiasm about the topic because champions can implement change within their own sphere of influence.

 

 

Criteria Article 4 Article 5 Article 6
APA-Formatted Article Citation with Permalink Atilla, A., Doganay, Z., Kefeli Celik, H., Tomak, L., Gunal, O., & Kilic, S. S. (2016). Central line-associated bloodstream infections in the intensive care unit: importance of the care bundle. Korean Journal of Anesthesiology69(6), 599–603. doi: 10.4097/kjae.2016.69.6.599

 

 

Berenholtz, S. M., Lubomski, L. H., Weeks, K., & Goeschel, C. A. (2014). Eliminating Central-Line Associated Bloodstream Infections: A National Patient Safety Imperative. Infection Control and Hospital Epidemiology35(1), 55–62. doi: https://doi.org/10.1086/674384

 

 

Guerin, K., Rains, K., & Bessesen, M. (2010). Reduction in central-line associated bloodstream infections by implementation of a postinsertion care bundle. American Journal of Infection Control38(6), 430–433. Doi: https://doi.org/10.1016/j.ajic.2010.03.007

 

How Does the Article Relate to the PICOT Question? Explains the importance and efficacy of a care bundle for preventing central line-associated blood stream infections in the Intensive Care Unit. Also reinforces why central lines should be assessed daily if they are essentially needed for care. It shows how the implementation of the “On the CUSP: Stop BSI” program with uniform and appropriate central line care can reduce the rate of CLABSIs. Studied how a post insertion bundle was effective in decreasing rates of infection. It also gives ideas of what post insertion interventions help prevent infections for nursing care.
Quantitative, Qualitative (How do you know?) Correct Quantitative- it evaluates numbers that result in measurable data Correct Quantitative- it evaluates using numbers and concludes with measurable data Correct Quantitative- they did measurable methods to gather data and evaluated using numbers.
Purpose Statement The importance and efficacy of a care bundle for preventing central line-associated bloodstream infections and infections complications related to placing a central venous catheter in the patients in the intensive care unit. Several studies demonstrating that central line-associated bloodstream infections are preventable prompted a national initiative to reduce the incidence of these infections. Central line-associated bloodstream infections cause substantial morbidity and incur excess costs. The use of a central line insertion and postinsertion bundle has been shown to reduce the incidence of CLABSI.
Research Question What is the effect of a central line care bundle in association with central line-associated bloodstream infections in the ICU. How can implementing a national program help decrease the rates of CLABSIs. Post insertion bundles need to be consistent and uniform to be effective.
Outcome The catherization duration was longer and femoral access was more frequently observed in patients with CLABSIs. CLABSI rates decreased with use of the care bundle. The overall mean CLABSI rate significantly decreased from 1.96 cases per 1000 catheter-days at baseline to 1.15 at 16-18 months after implementation. During the preintervention period, there were 4415 documented catheter-days and 25 CLABSIs, for an incidence density of 5.7 CLABSIs per 1000 catheter-days. After implementation of the interventions, there were 2825 catheter-days and 3 CLABSIs, for an incidence density of 1.1 per 1000 catheter-days.
Setting

(Where did the study take place?)

In a medical ICU and a surgical ICU Adult ICU patients in a total of 44 states, the District of Columbia, and Puerto Rico. Collectively more than 1000 hospitals and 1800 hospital units participated DVAMC-Denver is a university-affiliated acute care teaching hospital which includes a 10-bed medical intensive care unit and a 13-bed surgical intensive care unit.
Sample In total, 114 patients who had CVCs placed in a 22-bed medical ICU and a 12-bed surgical ICU from July 2013 to June 2014 were enrolled. Adult ICU patients in a total of 44 states, the District of Columbia, and Puerto Rico. Collectively more than 1000 hospitals and 1800 hospital units participated All ICU patients in both the medical and surgical ICU from October 1, 2006 to September 30, 2009 with a preintervention and a postintervention study completed.
Method A care bundle was implemented from July 2013 to June 2014 in a medical and surgical ICU. Data were divided into three periods and a post intervention period. A care bundle consisting of optimal hand hygiene, skin antisepsis with chlorhexidine (2%) allowing the skin to dry, maximal barrier precautions for inserting a catheter, choice of optimal insertion site, prompt catheter removal and daily evaluation of the need for the CVC was introduced. They conducted a collaborative cohort study to evaluate the impact of the national “On the CUSP: Stop BSI” program on CLABSI rates among participating adult intensive care units. The program goal as to achieve a unit-level mean CLABSI rate of less than 1 case per 1000 catheter days using standardized definitions from the National Healthcare Safety Network. Multilevel Poisson regression modeling compared infection rates before, during, and up to 18 months after the intervention was implemented. Surveillance for CLABSI was conducted by trained infection preventionists using National Health Safety Network case definitions and device-day measurement methods. During the intervention period, nursing staff used a postinsertion care bundle consisting of daily inspection of the insertion site; site care if the dressing was wet, soiled, or had not been changed for 7 days; documentation of ongoing need for the catheter; proper application of a chlorohexidine gluconate-impregnated sponge at the insertion site; performance of hand hygiene before handling the intravenous system; and application of an alcohol scrub to the infusion hub for 15 seconds before each entry.
Key Findings of the Study Infection rate increased when catheters remained in place longer than needed, when healthcare workers did not follow the care bundle practices, and when the catheter was placed via a femoral route. During first 6 months, there were difficulty complying with care bundle practices improved with regular coordination meetings. Coincident with the implementation of the national “On the CUSP: Stop BSI” program was a significant and sustained decrease in CLABSIs among a large and diverse cohort of ICUs, demonstrating an overall 43% decrease and suggesting the majority of ICUs in the US can achieve additional reductions in the CLABSI rates Findings demonstrate that implementation of a CVC postinsertion care bundle was associated with a significant reduction in CLABSIs. This study demonstrates that interventions developed by front-line nursing staff can be a highly effective response to a problem.
Recommendations of the Researcher Use of all barrier precautions and removal of catheters when they are no longer needed are essential to decrease the CLABSI rate. Have well-defined, evidence-based interventions. Build a solid implementation structure and project plan. Collect and use timely, accurate, and actionable data to improve performance. Tailor national program for local and unit audiences. Evolves project strategies and emphases over time. Staff education and reinforcement of proper CVC care after insertion, along with careful cleaning of the hub before access, might reduce the incidence of infection.

 

 

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. Explain the agonist-to-antagonist spectrum of action of psychopharmacologic agents.

· Review this week’s Learning Resources ( below)

· Reflect on concepts of foundational neuroscience.

To DO

1. Explain the agonist-to-antagonist spectrum of action of psychopharmacologic agents.

2. Compare and contrast the actions of g couple proteins and ion gated channels.

3. Explain the role of epigenetics in pharmacologic action.

4. Explain how this information may impact the way you prescribe medications to clients. Include a specific example of a situation or case with a client in which the psychiatric mental health nurse practitioner must be aware of the medication’s action.

Resources for reference ( 3 + references needed).

Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press *Preface, pp. ix–x

Note: To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.

  • Chapter 1, “Chemical      Neurotransmission”
  • Chapter 2, “Transporters,      Receptors, and Enzymes as Targets of Psychopharmacologic Drug Action”
  • Chapter 3, “Ion Channels as Targets of      Psychopharmacologic Drug Action”

Required Media

Laureate Education (Producer). (2016i). Introduction to psychopharmacology [Video file]. Baltimore, MD: Author.

Note: The approximate length of this media piece is 3 minutes.

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Name two different methods for evaluating evidence. Compare and contrast these two methods.

Submit a summary of six of your articles on the discussion board. Discuss one strength and one weakness for each of these six articles on why the article may or may not provide sufficient evidence for your practice change.

2.

Name two different methods for evaluating evidence. Compare and contrast these two methods.

The post Name two different methods for evaluating evidence. Compare and contrast these two methods. appeared first on Infinite Essays.

Nervous System

Chapter 10
Nervous System

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Learning Objectives

  • Name, locate, and describe the functions of the major organs and parts of the nervous system.
  • Recognize nervous system combining forms and make terms using them with new and familiar suffixes.
  • Define several pathological conditions affecting the nervous system.

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Learning Objectives (cont’d.)

  • Describe some laboratory tests, clinical procedures, and abbreviations that pertain to the system.
  • Apply your new knowledge to understanding medical terms in the proper contexts, such as medical reports and records.

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Chapter 10
Lesson 10.1

 

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Introduction

Nervous system:

  • Complex: 100 billion nerve cells
  • Voluntary and involuntary functions
  • Nerves carry electrical messages
  • External and internal receptors

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What are external stimuli?

How can internal chemicals be stimuli?

What are some of the involuntary body functions controlled by the nervous system?

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Introduction (cont’d.)

Nerve cells (neurons):

  • Microscopic
  • Collected into macroscopic nerves
  • Carry electrical messages all over the body

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Internal and external stimuli activate the cell membranes to release stored electrical energy called the nervous impulse.

External and internal receptors receive and transmit these impulses to the brain and spinal cord (central nervous system).

The central nervous system recognizes, interprets, and relays impulses to other nerve cells that extend through parts of the body such as muscles, glands, and organs.

What is the scope of influence nerve cells have on bodily function?

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General Structure of the Nervous System

Two major divisions:

  • Central nervous system
  • Brain
  • Spinal cord
  • Peripheral nervous system
  • cranial nerves
  • spinal nerves
  • Autonomic nervous system

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Cranial nerves carry electrical impulses between the brain and the head and neck (except vagus nerve).

Spinal nerves carry impulses between the spinal cord and the chest, abdomen, and extremities.

Why is the 10th cranial nerve called the vagus nerve? What does it do?

 

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General Structure of the Nervous System (cont’d.)

  • Cranial and spinal nerves
  • Sensory nerves carry messages toward the brain (afferent)
  • Motor nerves carry messages from the brain (efferent).
  • Mixed nerves carry both sensory and motor fibers.
  • Sensory receptors

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What is the difference between voluntary and involuntary functioning?

What are parasympathetic and sympathetic nerves?

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General Structure of the Nervous System (cont’d.)

Autonomic nervous system:

  • Carries impulses from the central nervous system to organs.
  • Sympathetic nerves stimulate body under stress.
  • Parasympathetic nerves balance sympathetic system.
  • Slow heart rate
  • Lower blood pressure

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The autonomic nervous system contains a large group of nerves that function automatically.

It controls heart, blood vessels, glands, and involuntary muscles like intestines, and hollow organs such as stomach and urinary bladder.

Why is the autonomic nervous system necessary?

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Divisions of the Central and Peripheral Nervous System

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How are stimuli processed by the nervous system?

What are the parenchymal cells of the nervous system?

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Neurons, Nerves, and Glia

Neuron = individual nerve cell

  • Dendrites
  • Cell nucleus
  • Axon
  • Myelin sheath
  • Terminal end fibers (secrete neurotransmitters)
  • Neurotransmitters (transfer impulse across synapse)

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What structure carries the nerve impulse away from the cell body?

What substances are examples of neurotransmitters?

What is the singular form of “ganglia”?

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Neurons, Nerves, and Glia (cont’d.)

Label the parts of a neuron and review the path of a nervous impulse.

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Answers are on the next slide.

What are the parts of the neurons shown in this slide?

What structures comprise the parenchymal cells of the nervous system?

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Neurons, Nerves, and Glia (cont’d.)

Image shows the parts of a neuron. Review the path of a nervous impulse.

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What are the parts of the neurons shown in this slide?

What structures comprise the parenchymal cells of the nervous system?

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Neurons, Nerves, and Glia (cont’d.)

Glia cells:

  • Maintain health of nervous system
  • Do not transmit impulses

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How do the glia cells keep the nervous system healthy?

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Neurons, Nerves, and Glia (cont’d.)

Four types:

  • Astrocytes (astroglial cells)
  • Microglia (microglial cells)
  • Oligodendroglia (oligodendroglial cells)
  • Ependymal Cells

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These are the supportive, protective, and connective cells of the central nervous system.

(recap) What purpose does stromal tissue serve?

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Chapter 10
Lesson 10.2

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The Brain

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The Cerebrum

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The brain is divided into right and left hemispheres.

The brain consists of four major lobes, including the frontal lobe, parietal lobe, temporal lobe, and occipital lobe.

What are the parts of the left cerebral hemisphere as shown in the diagram?

What primary functions are carried out by the different lobes of the brain?

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The Brain (cont’d.)

  • Cerebrum
  • Largest section of brain
  • Surface has nerve cells called cerebral cortex (sulci are grooves, gyri are folds).
  • Manages speech, vision, smell, movement, hearing, and thought
  • 4 lobes: Frontal, Occipital, Parietal, Temporal

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What is the purpose of the cerebral cortex?

How many major divisions can be applied to the entire cerebral cortex?

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The Brain (cont’d.)

  • Cerebellum
  • Coordinates voluntary movements
  • Maintains balance
  • Thalamus
  • Integrates and monitors impulses from skin (pain)

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What is the value of the ability to sense pain?

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The Brain (cont’d.)

  • Hypothalamus
  • Controls body temperature, sleep, appetite, sexual desire, and emotions
  • Regulates release of hormones from pituitary gland
  • Monitors sympathetic and parasympathetic nervous systems

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How do messages travel from one side of the brain to another?

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The Brain (cont’d.)

The Brainstem

  • Pons
  • Bridges cerebrum and cerebellum with rest of the brain
  • Houses nerves for face and eyes

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The Brain (cont’d.)

The Brainstem

  • Medulla oblongata
  • Connects spinal cord to brain
  • Nerve tracts cross from side to side
  • Regulates:

Blood vessels

Heart

Respiratory system

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How does the word “crossover” apply to a function of the medulla oblongata?

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The Spinal Cord and Meninges

Spinal cord

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The spinal cord is the column of nervous tissue from the medulla oblongata to second lumbar vertebra.

It serves as a pathway for impulses to and from the brain.

The inner section of the cross-section of the spinal cord is gray matter.

The outer section of the cross-section of the spinal cord is white matter.

What is the difference between efferent and afferent neurons?

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The Spinal Cord and Meninges (cont’d.)

Meninges

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Meninges are the three layers of connective tissue membranes that surround the brain and spinal cord.

What is the function of the outer dura mater? (channels blood to brain tissue)

What fluid lies between the arachnoid membrane and the subarachnoid space?

The inner pia mater offers a rich supply of blood vessels.

Where are the layers of the meninges in the figure?

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The Spinal Cord and Meninges (cont’d.)

Meninges

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Meninges are the three layers of connective tissue membranes that surround the brain and spinal cord.

What is the function of the outer dura mater? (channels blood to brain tissue)

What fluid lies between the arachnoid membrane and the subarachnoid space?

The inner pia mater offers a rich supply of blood vessels.

Where are the layers of the meninges in the figure?

Meninges

    • Dura mater
    • Arachnoid membrane
    • Pia mater

 

 

  • CSF= Cerebrospinal fluid

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VOCABULARY

  • acetylcholine
  • afferent nerves
  • arachnoid membrane
  • astrocyte
  • autonomic nervous system

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Reference pages 260-262 for definitions of vocabulary terms

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  • axon
  • blood-brain barrier
  • brainstem
  • cauda equina
  • cell body

VOCABULARY

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Reference pages 260-262 for definitions of vocabulary terms

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  • central nervous system
  • cerebellum
  • cerebral cortex
  • cerebrospinal fluid (CSF)
  • cerebrum

VOCABULARY

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Reference pages 260-262 for definitions of vocabulary terms

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  • dendrite
  • dura mater
  • ependymal cell
  • efferent nerves
  • ganglion/ganglia
  • glial cells
  • gyrus

VOCABULARY

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Reference pages 260-262 for definitions of vocabulary terms

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  • hypothalamus
  • medulla oblongata
  • meninges
  • microglial cell
  • motor nerves
  • myelin sheath

VOCABULARY

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*

Reference pages 260-262 for definitions of vocabulary terms

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  • nerve
  • neuron
  • neurotransmitter
  • oligodendroglial cell
  • parasympathetic nerves
  • parenchyma
  • peripheral nervous system

VOCABULARY

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*

Reference pages 260-262 for definitions of vocabulary terms

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  • pia mater
  • plexus
  • pons
  • receptor
  • sciatic nerve
  • sensory nerves
  • spinal nerves

VOCABULARY

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*

Reference pages 260-262 for definitions of vocabulary terms

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  • stimulus/stimuli
  • stroma
  • sulcus
  • sympathetic nerves
  • synapse
  • thalamus
  • Vagus nerve
  • ventricles of the brain

VOCABULARY

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*

Reference pages 260-262 for definitions of vocabulary terms

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QUICK QUIZ:

1. A sheet of nerve cells that produces a rounded fold on the surface of the cerebrum

 

A. microglial

B. gyrus

C. parenchyma

D. stroma

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*

CORRECT Answer is B, gyrus

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2. The thin, delicate inner membrane of the meninges

 

A. pia mater

B. dura mater

C. parenchyma

D. stroma

QUICK QUIZ:

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*

CORRECT Answer is A, pia mater

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COMBINING FORMS
AND TERMINOLOGY

ORGANS AND STRUCTURES

 

  • cerebell/o cerebellum
  • cerebr/o cerebrum
  • dur/o dura mater
  • encephal/o brain
  • gli/o glial cells

Combining Form Meaning

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*

 

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*

 

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ORGANS AND STRUCTURES

 

  • lept/o thin, slender
  • mening/o, meningi/o membranes, meninges
  • my/o muscle
  • myel/o spinal cord
  • neur/o nerve

Combining Form Meaning

COMBINING FORMS
AND TERMINOLOGY

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*

 

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ORGANS AND STRUCTURES

 

  • pont/o pons
  • radicul/o nerve root
  • thalam/o thalamus
  • thec/o sheath (refers to meninges)
  • vag/o vagus nerve

Combining Form Meaning

COMBINING FORMS
AND TERMINOLOGY

Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.

*

 

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SYMPTOMS

 

  • alges/o, -algesia
  • -algia
  • caus/o
  • comat/o
  • esthesi/o, -esthesia
  • kines/o, -kinesia

excessive sensitivity to pain

pain

burning

deep sleep

feeling, nervous sensation

movement

Combining Form Meaning

COMBINING FORMS
AND TERMINOLOGY

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*

 

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*

 

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SYMPTOMS

 

  • -kinesis, kinetic
  • -lepsy
  • lex/o
  • -paresis
  • -phasia

movement

seizure

word, phrase

slight paralysis

speech

Combining Form Meaning

COMBINING FORMS
AND TERMINOLOGY

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*

 

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SYMPTOMS

 

  • -plegia
  • -praxia
  • -sthenia
  • syncop/o
  • tax/o

paralysis

action

strength

cut off

order, coordination

Combining Form Meaning

COMBINING FORMS
AND TERMINOLOGY

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*

 

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QUICK QUIZ:

3. Which term means nerve pain?

 

A. cephalgia

B. analgesia

C. hypalgesia

D. neuralgia

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*

CORRECT Answer is D, neuralgia

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QUICK QUIZ:

4. Which type of hematoma occurs between the skull and the dura as a result of a ruptured meningeal artery, usually after a fracture of the skull?

 

A. subdural

B. epidural

C. intracerebral

 

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*

CORRECT Answer is C, epidural. See page 346, figure 10-11 for more information.

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Chapter 10
Lesson 10.3

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*

 

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Pathologic Conditions

Congenital Disorders

  • Hydrocephalus
  • Spina bifida
  • Spina bifida cystica
  • Spina bifida occulta

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*

How is hydrocephalus treated?

What are the two types of spina bifida? Ask students to describe the differences between the two types.

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*

 

Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.

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*

 

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Degenerative, Movement, and Seizure Disorders

  • Alzheimer disease (AD)
  • Amyotrophic lateral sclerosis (ALS)
  • Epilepsy
  • Huntington disease
  • Multiple sclerosis (MS)
  • Myasthenia gravis (MG)
  • Palsy
  • Parkinson disease
  • Tourette syndrome

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*

Which conditions are movement related?

Which conditions are degenerative?

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*

 

Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.

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*

 

Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.

*

 

Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.

*

 

Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.

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*

 

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Infectious Disorders

 

  • Herpes zoster (shingles)
  • Meningitis
  • Human immunodeficiency virus (HIV) encephalopathy

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*

What is a viral infection caused by chickenpox?

What types of meningitis exist, and how is meningitis treated?

What is the most malignant form of brain tumor?

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Traumatic Disorders

  • Cerebral concussion:
  • Temporary brain dysfunction after injury
  • Usually clears within 24 hours
  • Cerebral contusion:
  • Bruising of brain tissue through direct trauma to head
  • Neurological deficits persist longer than 24 hours

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*

What is the primary difference between a concussion and a contusion?

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Vascular Disorders

  • Thrombotic — blood clot in artery leading to the brain
  • Embolic — dislodged clot that travels to cerebral arteries
  • Hemorrhagic — a blood vessel, such as the cerebral artery breaks, and bleeding occurs

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*

What is the primary difference between a concussion and a contusion?

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Vascular Disorders

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*

There are three types of cerebrovascular accident (CVA): thrombotic, embolic, and hemorrhagic.

What is another name for CVA?

What causes a transient ischemic attack (TIA)?

 

 

 

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Clinical Procedures

X-ray Tests

  • Cerebral angiography
  • Computed tomography (CT) of the brain

Other Procedures

  • MRI and MRA -Magnetic resonance Imaging and magnetic resonance angiography
  • EEG-Electroencephalography
  • Lumbar Puncture

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*

 

Which x-ray uses a contrast medium?

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Abbreviations

Abbreviations

  • AD
  • AFP
  • ALS
  • AVM
  • CNS
  • CT
  • CSF
  • CVA

Alzheimer disease

alpha-fetoprotein

amyotrophic lateral sclerosis

arteriovenous malformation

central nervous system

computed tomography

cerebrospinal fluid

cerebrovascular accident

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*

Which items are disorders or injuries, and which are procedures?

Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.

 

  • EEG
  • GABA
  • ICP

 

  • LP
  • MAC
  • MG
  • MRA
  • MRI

electroencephalogram

gamma-aminobutyric acid (neurotransmitter)

intracranial pressure; normal pressure is 5-15 mmHG

lumbar puncture

monitored anesthetic care

myasthenia gravis

magnetic resonance angiography

magnetic resonance imaging

Abbreviations

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*

Which items are pathologies, and which are tests?

What is an EEG used to measure?

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    • 1/2 P
    • PET
    • Sz
    • TBI
    • TENS

 

  • TIA
  • tPA
  • hemiparesis
  • positron emission tomography
  • seizure
  • traumatic brain injury
  • transcutaneous electrical nerve stimulation
  • transient ischemic attack
  • tissue plasminogen activator

Abbreviations

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*

Which of the items listed above are pathologies (describe them)?

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Practical Applications

  • What symptoms signal nervous system problems?
  • What tests are conducted to diagnose these problems?
  • Why are an MRI and an MRA ordered?
  • What are common pathologies of the nervous system?

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*

 

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REVIEW SHEET

COMBINING FORMS

 

 

    • alges/o ___________
    • angi/o ___________
    • caus/o ___________
    • cephal/o ___________
    • cerebell/o ___________
    • cerebr/o ___________

 

Combining Form Meaning

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*

 

Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.

COMBINING FORMS

 

 

    • alges/o sensitivity to pain
    • angi/o vessel, blood
    • caus/o burn, burning
    • cephal/o head
    • cerebell/o cerebellum
    • cerebr/o cerebrum

 

Combining Form Meaning

REVIEW SHEET

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*

 

Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.

COMBINING FORMS

 

 

  • comat/o ___________
  • crani/o ___________
  • cry/o ___________
  • dur/o ___________
  • encephal/o ___________
  • esthesi/o ___________

Combining Form Meaning

REVIEW SHEET

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*

 

Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.

COMBINING FORMS

 

 

  • comat/o deep sleep
  • crani/o skull
  • cry/o cold
  • dur/o dura mater
  • encephal/o brain
  • esthesi/o nervous sensation

Combining Form Meaning

REVIEW SHEET

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*

 

Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.

COMBINING FORMS

 

 

  • gli/o _________
  • hydr/o _________
  • kines/o _________
  • lept/o _________
  • lex/o _________
  • mening/o, meningi/o _________
  • my/o _________

Combining Form Meaning

REVIEW SHEET

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*

 

Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.

COMBINING FORMS

 

 

  • gli/o glue
  • hydr/o water
  • kines/o movement
  • lept/o thin, slender
  • lex/o word, phrase
  • mening/o, meningi/o membranes, meninges
  • my/o muscle

Combining Form Meaning

REVIEW SHEET

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*

 

Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.

COMBINING FORMS

 

 

  • myel/o ___________
  • narc/o ___________
  • neur/o ___________
  • olig/o ___________
  • pont/o ___________
  • radicul/o ___________

Combining Form Meaning

REVIEW SHEET

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*

 

Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.

COMBINING FORMS

 

 

  • myel/o spinal cord
  • narc/o sleep
  • neur/o nerve
  • olig/o scanty
  • pont/o pons
  • radicul/o nerve root

Combining Form Meaning

REVIEW SHEET

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*

 

Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.

COMBINING FORMS

 

 

  • spin/o ___________
  • syncop/o ___________
  • tax/o ___________
  • thalam/o ___________
  • thec/o ___________
  • troph/o ___________
  • vag/o ___________

Combining Form Meaning

REVIEW SHEET

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*

 

Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.

COMBINING FORMS

 

 

  • spin/o spine
  • syncop/o cut off
  • tax/o order
  • thalam/o thalamus
  • thec/o sheath (refers to meninges)
  • troph/o nourishment
  • vag/o vagus nerve

Combining Form Meaning

REVIEW SHEET

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*

 

*

 

*

 

*

 

*

 

*

What are external stimuli?

How can internal chemicals be stimuli?

What are some of the involuntary body functions controlled by the nervous system?

*

Internal and external stimuli activate the cell membranes to release stored electrical energy called the nervous impulse.

External and internal receptors receive and transmit these impulses to the brain and spinal cord (central nervous system).

The central nervous system recognizes, interprets, and relays impulses to other nerve cells that extend through parts of the body such as muscles, glands, and organs.

What is the scope of influence nerve cells have on bodily function?

*

Cranial nerves carry electrical impulses between the brain and the head and neck (except vagus nerve).

Spinal nerves carry impulses between the spinal cord and the chest, abdomen, and extremities.

Why is the 10th cranial nerve called the vagus nerve? What does it do?

 

*

What is the difference between voluntary and involuntary functioning?

What are parasympathetic and sympathetic nerves?

*

 

*

 

*

The autonomic nervous system contains a large group of nerves that function automatically.

It controls heart, blood vessels, glands, and involuntary muscles like intestines, and hollow organs such as stomach and urinary bladder.

Why is the autonomic nervous system necessary?

*

How are stimuli processed by the nervous system?

What are the parenchymal cells of the nervous system?

*

What structure carries the nerve impulse away from the cell body?

What substances are examples of neurotransmitters?

What is the singular form of “ganglia”?

*

Answers are on the next slide.

What are the parts of the neurons shown in this slide?

What structures comprise the parenchymal cells of the nervous system?

*

What are the parts of the neurons shown in this slide?

What structures comprise the parenchymal cells of the nervous system?

*

How do the glia cells keep the nervous system healthy?

*

These are the supportive, protective, and connective cells of the central nervous system.

(recap) What purpose does stromal tissue serve?

*

 

*

.

*

The brain is divided into right and left hemispheres.

The brain consists of four major lobes, including the frontal lobe, parietal lobe, temporal lobe, and occipital lobe.

What are the parts of the left cerebral hemisphere as shown in the diagram?

What primary functions are carried out by the different lobes of the brain?

*

What is the purpose of the cerebral cortex?

How many major divisions can be applied to the entire cerebral cortex?

*

 

*

What is the value of the ability to sense pain?

*

How do messages travel from one side of the brain to another?

*

 

*

How does the word “crossover” apply to a function of the medulla oblongata?

*

The spinal cord is the column of nervous tissue from the medulla oblongata to second lumbar vertebra.

It serves as a pathway for impulses to and from the brain.

The inner section of the cross-section of the spinal cord is gray matter.

The outer section of the cross-section of the spinal cord is white matter.

What is the difference between efferent and afferent neurons?

*

Meninges are the three layers of connective tissue membranes that surround the brain and spinal cord.

What is the function of the outer dura mater? (channels blood to brain tissue)

What fluid lies between the arachnoid membrane and the subarachnoid space?

The inner pia mater offers a rich supply of blood vessels.

Where are the layers of the meninges in the figure?

*

Meninges are the three layers of connective tissue membranes that surround the brain and spinal cord.

What is the function of the outer dura mater? (channels blood to brain tissue)

What fluid lies between the arachnoid membrane and the subarachnoid space?

The inner pia mater offers a rich supply of blood vessels.

Where are the layers of the meninges in the figure?

*

Reference pages 260-262 for definitions of vocabulary terms

*

Reference pages 260-262 for definitions of vocabulary terms

*

Reference pages 260-262 for definitions of vocabulary terms

*

Reference pages 260-262 for definitions of vocabulary terms

*

Reference pages 260-262 for definitions of vocabulary terms

*

Reference pages 260-262 for definitions of vocabulary terms

*

Reference pages 260-262 for definitions of vocabulary terms

*

Reference pages 260-262 for definitions of vocabulary terms

*

CORRECT Answer is B, gyrus

*

CORRECT Answer is A, pia mater

*

 

*

 

*

 

*

 

*

 

*

 

*

 

*

 

*

CORRECT Answer is D, neuralgia

*

CORRECT Answer is C, epidural. See page 346, figure 10-11 for more information.

*

 

*

How is hydrocephalus treated?

What are the two types of spina bifida? Ask students to describe the differences between the two types.

*

 

*

 

*

Which conditions are movement related?

Which conditions are degenerative?

*

 

*

 

*

 

*

 

*

 

*

What is a viral infection caused by chickenpox?

What types of meningitis exist, and how is meningitis treated?

What is the most malignant form of brain tumor?

*

What is the primary difference between a concussion and a contusion?

*

What is the primary difference between a concussion and a contusion?

*

There are three types of cerebrovascular accident (CVA): thrombotic, embolic, and hemorrhagic.

What is another name for CVA?

What causes a transient ischemic attack (TIA)?

 

 

 

*

 

Which x-ray uses a contrast medium?

*

Which items are disorders or injuries, and which are procedures?

*

Which items are pathologies, and which are tests?

What is an EEG used to measure?

*

Which of the items listed above are pathologies (describe them)?

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