Nervous System

IAN PEATE is a Visiting Professor at Northumbria University, a Senior Clinical Fellow at the University of Hertfordshire, and a Professorial Fellow at the University of Roehampton. He is also the Editor-in-Chief of the British Journal of Nursing and the Consultant Editor of the Journal of Paramedic Practice and the International Journal of Advancing Practice.

• Preface viiiAcknowledgements x1 Anatomy and Physiology: The Nervous System 1Organisation of the Nervous System 1Sensory Division of the Peripheral Nervous System 1Central Nervous System 2Motor Division of the Peripheral Nervous System 2Neurotransmitters 5Neuroglia 5Meninges 7The Cerebrospinal Fluid 7Brain 7The Blood Supply to the Brain 11Circle of Willis 12The Peripheral Nervous System 14The Autonomic Nervous System 17Sympathetic Division 19Parasympathetic Division 20Conclusion 21Glossary of Terms 22Multiple Choice Questions 22References 242 Assessment of the Nervous System 25Assessing Needs 25Assessing the Level of Consciousness 26Vital Signs 30Assessment of Pupillary Reaction 31Motor and Sensory Assessments 31The Patient History 32Physical Examination 40Assessing Mental Status 41Cranial Nerve Assessment 41Evaluating the System: Diagnostic Tests 45Conclusion 45Glossary of Terms 45Multiple Choice Questions 46References 473 Stroke 49Pathophysiological Changes Associated with Stroke 49Ischaemic Stroke 50Haemorrhagic Stroke 51Cellular and Molecular Events 51Epidemiology 55Risk Factors 55Non-modifiable Risk Factors 56Modifiable Risk Factors 56Clinical Presentation 56Ischaemic Stroke 57Haemorrhagic Stroke 57Transient Ischaemic Attacks 57The FAST Acronym 57Clinical Investigations and Diagnosis 58Onset and Duration of Symptoms 58Nature of Symptoms 59Previous Strokes or Transient Ischaemic Attacks 59Medical History 59Risk Factors 59Medication and Allergies 59Social History 59Psychosocial History 60Pre-existing Conditions 60Recent Procedures or Surgeries 60Timing of Presentation to Healthcare Provider 60Patient’s Perspective 60Management 63Post-acute and Long-term Management 66Health Teaching 67Conclusion 69Glossary of Terms 69Multiple Choice Questions 70References 71Other Risk Factors 80Clinical Presentation 80Clinical Investigations and Diagnosis 84Management 87Caregiver Support 88Symptom Management 88Health Teaching 88Conclusion 90Glossary of Terms 90Multiple Choice Questions 91References 925 Multiple Sclerosis 94Pathophysiological Changes Associated with Acute Multiple Sclerosis 94Prognosis 96Epidemiology 96Risk Factors 97Clinical Presentation 97Clinical Investigations and Diagnosis 101Management 106Supportive Care 108Health Teaching 108Conclusion 110Glossary of Terms 110Multiple Choice Questions 111References 1124 Dementia 73Pathophysiological Changes Associated with Dementia 73Confusion 78Mild Cognitive Impairment 78Prognosis 78Epidemiology 78Risk Factors 806 Epilepsy 114Equality and Law 114Pathophysiological Changes Associated with Epilepsy 115Epidemiology 117Risk Factors 117Clinical Presentation 118Clinical Investigations and Diagnosis 119Management 123Seizure First Aid 123Mental Health and Well-being 124Equality and Diversity 124Treatment Goals 125Health Teaching 126Conclusion 128Glossary of Terms 128Multiple Choice Questions 129References 1307 Raised Intracranial Pressure 132Idiopathic Intracranial Hypertension 132Pathophysiological Changes Associated with Raised Intracranial Pressure 133Consequences of Raised Intracranial Pressure 135Epidemiology 136Socioeconomic Factors 136Risk Factors 137Clinical Presentation 138Clinical Investigations and Diagnosis 140Management 142Monitoring 142Medical Management 142Ventilation Management 143Surgical Interventions 143Cerebrospinal Fluid Drainage 143Psychological and Emotional Needs 144Multidisciplinary Approach 144Prognosis and Follow-up 145Health Teaching 145Conclusion 146Glossary of Terms 146Multiple Choice Questions 147References 1488 Traumatic Brain Injury 150Head Injury 150Pathophysiological Changes Associated with Traumatic Brain Injury 151Mechanisms of Injury 151Location of the Injury 151Open Versus Closed Brain Injuries 152Secondary Injuries 152Epidemiology 152Risk Factors 153Clinical Presentation 153Severity of Symptoms 154Symptoms of Specific Types of Traumatic Brain Injury 154Clinical Investigations and Diagnosis 154Management 160Health Teaching 161Understanding the Injury and Its Effects 161Medication Management 162Cognitive and Physical Rehabilitation 162Emotional and Psychological Support 163Preventing Complications 163Safety Measures 163Conclusion 163Glossary of Terms 164Multiple Choice Questions 165References 166MCQ Answers 167Index 168

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