Episode Details

🧠 High-Yield Neurology Study Guide (RN Prep)

1️⃣ Neuron Basics & Injury Patterns

• Neurons: Excitable cells that transmit impulses via action potentials & neurotransmitters.
• Glial cells: Support neurons. 🧩 Astrocytes form scar tissue; Oligodendrocytes (CNS) + Schwann cells (PNS)make myelin.
• UMN Lesions: Weakness, spasticity, hyperreflexia, ↑ tone. (Think: stroke, SCI.)
• LMN Lesions: Flaccid paralysis, atrophy, fasciculations, ↓ reflexes. (Think: Guillain-Barré, spinal root injury.)

2️⃣ Neuro Protection & Fluid

• Meninges: Dura → Arachnoid → Pia.
• CSF: 150 mL circulates; cushions brain; made in choroid plexus.
• BBB: Blocks toxins; lipid-soluble drugs cross easiest.

3️⃣ Neuro Assessment Essentials

• Vitals: HR 60–100 bpm, RR 15–20, SpO₂ > 95%, BP 100–140/60–90.
• LOC: GCS = Eyes + Verbal + Motor.
• Pupils: PERRLA = equal, round, reactive, accommodate.
• Language: • Broca = expressive (can’t speak) 🗣️ • Wernicke = receptive (word salad).
• Speech Motor: Dysarthria; often w/ dysphagia.

4️⃣ Red-Flag Findings ⚠️

• Nystagmus: Cerebellar/brainstem lesion or toxicity.
• Areflexia: LMN issue.
• Hyperreflexia/Clonus: UMN lesion.
• Analgesia/Anesthesia: Sensory tract damage.
• Astereognosis: Parietal cortex lesion.

5️⃣ Cranial Nerves 🧩 (key ones) I = Smell 👃 II = Vision 👁️ III, IV, VI = Eye movement/pupil V = Face sensation + chew VII = Expression/taste (ant 2/3) X = Gag, swallow, voice

6️⃣ Diagnostics & Nursing Pearls

• Lumbar Puncture: L3-L5; flat after, ↑ fluids 💧. ⚠️ Contra: ↑ICP, anticoag use.
  • Post-LP HA: from ↓ CSF pressure.
  • CSF: • Bacterial: ↑P, ↑WBC (poly), ↓glucose • Viral: ↑mono cells, nml glucose • SAH: RBCs + xanthochromia (yellow).
• CT: Fast for bleed/TBI; if contrast → hold Metformin 48 h.
• MRI: No metal! (pacers, implants, shrapnel).
• Angiography: NPO; monitor site/bleeding; leg flat 4-6 h.

7️⃣ Labs & Metabolic Links

• Na⁺↓ (SIADH/CHF) → confusion/seizure.
• Na⁺↑ (dehydration) → irritability.
• K⁺↓ (diuretics) → muscle weakness.
• K⁺↑ (renal fail, ACEi) → arrhythmias.
• Vit B₁₂↓ → neuropathy + megaloblastic anemia.
• Thiamine (B₁)↓ → Wernicke’s encephalopathy (alcohol use).
• Ammonia ↑ → hepatic encephalopathy (liver fail).