Study Guide NSG 550
Quiz 3
Nervous System
Anatomy of the Brain
o CSF is made by selective secretion from the plasma by the choroid plexus (a
group of small blood vessels) in the ventricles of the brain. There are three
membranes surrounding the brain and spinal cord. From inner to outer, ...
Study Guide NSG 550
Quiz 3
Nervous System
Anatomy of the Brain oCSF is made by selective secretion from the plasma by the choroid plexus (a group of small blood vessels) in the ventricles of the brain. There are three membranes surrounding the brain and spinal cord. From inner to outer, they are the pia mater, arachnoid, and dura mater. The CSF exists within the space between
the pia mater and the arachnoid (called the subarachnoid space).
ohttp://emedicine.medscape.com/article/1898830-overview#showall Anatomy of the Cervical Spine
ohttp://emedicine.medscape.com/article/1948797-overview#showall Anatomy of the Lumbar Spine
ohttp://emedicine.medscape.com/article/1899031-overview#showall Normal Lumbar Spine MRI
ohttp://www.youtube.com/watch?v=p4wVMHmGjAU When to order MRI vs MRA
oMagnetic Resonance Angiography (MRA):
This is a type of Magnetic Resonance Imaging (MRI) that allows for visualization and evaluation of blood vessels.
Both MRI and MRA are non-invasive; no catheter is placed into the body as is the case with traditional angiography.
Both MRI and MRA use no radiation and therefore these types of imaging are generally safe.
A normal result means that the blood vessels show no signs of abnormality, blockage, or narrowing oMRI
For when you don’t need to visualize vasculature
Electroencephalography (EEG):
oEpilepsy is known as the condition of unprovoked, recurrent seizures and is typically caused by an underlying dysfunction in the brain oThe diagnostic test of choice for epilepsy and other seizure disorders is the EEG. An EEG is a recording of the electrical activity of the brain oAn EEG is also helpful in diagnosing brain damage, brain tumors, inflammation of the brain, and sleep disorders oDuring the test a patient can expect for electrodes to be placed on the scalp with a special adhesive. A typical EEG typically lasts one hour or longer. Video is typically recorded throughout the test Evaluation of Uncomplicated Low Back Pain ( Imaging studies of back as ordered in primary care)
oLow back pain is one of the most commonly encountered patient complaints in primary care.
oIt is recommended to withhold all imaging of the spine in patients with non-
specific, uncomplicated acute low back pain in the absence of “red flags.” If “red flags” are present or if the pain persists for >6-8 weeks without improvement, then MRI and/or CT may be appropriate Evaluation of Neck Pain:
oSimilar to low back pain, uncomplicated neck/cervical pain without “red flags” and lasting <6 weeks in duration may not warrant initial imaging oIf the pain is persistent and/or accompanied by “red flags” MRI of the cervical spine, CT of the cervical spine, or CT with myelography of the cervical spine would all be appropriate imaging modalities to evaluate the pain Alzheimer’s Disease or Dementia Dx
oBefore jumping to a diagnosis of Alzheimer’s disease or dementia, nurse practitioners must rule out other causes of acute changes in mental status (altered cognition). Consider ordering the following tests to rule out underlying issues:
Complete Blood Count
Comprehensive Metabolic Panel
Vitamin B12 level
Syphilis (RPR) testing
Thyroid panel
Urinalysis, urine culture/sensitivity
If stroke (CV A) is suspected, the imaging of choice would be a non-
contrast computerized tomography (CT) scan Lumbar puncture
oDx: primary or metastatic brain or spinal cord neoplasm, cerebral hemorrhage, meningitis, encephalitis, degenerative brain disease, autoimmune diseases
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