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Transcript of Intro,Obj,Ana Physio FINAL
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RATIONALE
For all individuals, mental, physical and social healths are vital and interwoven strands of
life. As our understanding of this relationship grows, it becomes ever more apparent that mental
health is crucial to the overall well-being of individuals, societies and countries. The
leukodystrophies are rare diseases that affect the cells of the brain. Specifically, the diseases
affect the myelin sheath, the material that surrounds and protects nerve cells. Damage to this
sheath slows down or blocks messages between the brain and the rest of the body. This leads
to problems with movement, speaking, vision, hearing, mental and physical development. Acute
Gastroenteritis is common in children and in developing countries. It is marked by inflammation
of the gastrointestinal tract involving both the stomach and small intestine resulting in
diarrhea, vomiting and abdominal cramps. In the pediatric population acute gastroenteritis
remains a significant cause of pediatric patient morbidity and mortality. For these patients, oral
rehydration therapy is an intervention that should be initiated with the first signs and symptoms.
Hand washing is the most basic practice in preventing infection. Gastrointestinal infections are
infectious diseases that can spread from one person to another by contaminated hands.
Washing hands properly after using the toilet, handling animals and before and after handling
food helps prevent a range of diseases, including various forms of gastroenteritis. Some forms
of gastroenteritis can cause serious complications, especially for young children, the elderly, or
those with a weakened immune system.
Our group has been exposed to Holy Child Ward for our Pediatric rotation. In our three
weeks duty we are expected to have a client as a subject for case study. We chose our client
V.C. because he was having a condition that is new to us. He was diagnosed with
leukodystrophy, acute gastroenteritis with mild dehydration. Our group wants to have a case
that is not common to challenge us and to learn new things. We want to have a case that will
practice our research abilities. Our patients parents were very cooperative and they permitted
us that their child will be the subject of our case study.
Mental and neurological disorders are highly prevalent worldwide. The Global
Burden of Disease report drew the attention of the international health community to the fact
that the burden of mental and neurological disorders has been seriously underestimated by
traditional epidemiological methods that took into account only mortality, but not disability
http://en.wikipedia.org/wiki/Gastrointestinal_tracthttp://en.wikipedia.org/wiki/Stomachhttp://en.wikipedia.org/wiki/Small_intestinehttp://en.wikipedia.org/wiki/Diarrheahttp://en.wikipedia.org/wiki/Vomitinghttp://en.wikipedia.org/wiki/Gastrointestinal_tracthttp://en.wikipedia.org/wiki/Stomachhttp://en.wikipedia.org/wiki/Small_intestinehttp://en.wikipedia.org/wiki/Diarrheahttp://en.wikipedia.org/wiki/Vomiting -
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rates. This report specifically showed that while the mental and neurological disorders are
responsible for about one per cent of deaths, they account for almost 11 per cent of disease
burden the world over. (www.who.int) In the Philippines there is an extrapolated prevalence
of 862 all in the estimated population used which is 86,241,697. (www.rightdiagnosis.com)
Worldwide, Acute Gastroenteritis (AGE) provokes an estimated 125 million physician visits, 9
million hospital admissions and 1.8 million annual deaths in children less than 5 years of age.
Although worldwide mortality from this illness remains a significant challenge, pediatric death
rates from diarrheal illnesses have recently been substantially reduced, largely secondary to
worldwide campaigns for treatment of affected children with oral rehydration therapy.
(www.medscape.com) In the Philippines there are 562 cases of AGE in male and 449 in female,
there is a total of 1,038 in both sexes having Acute gastroenteritis in 100,000 population and a
percentage of 12.18 in the year 2006. (www.doh.gov.ph) Diarrhea and Gastroenteritis are one
of the leading causes of morbidity in all ages here in Davao City. There are 4,205 reported
cases in 100,000 populations with a rate of 310.7 last 2010 according to the City Health
Office. (www.davaohealth.brinkster.net)
In the context of nursing education this study can contribute new learning regarding
patients having leukodystrophy and acute gastroenteritis. This study is significant in nursing
research because it trains us to become better researchers whose study could be of good use
at present and future studies. Furthermore this study enables us to know and learn newinformation that will be of help to us in the future. This case study can be used as a data for
research and future reference. By having this case study it practices our ability in doing
research and it also gains us new learning.
http://www.who.int/http://www.rightdiagnosis.com/http://www.medscape.com/http://www.doh.gov.ph/http://www.who.int/http://www.rightdiagnosis.com/http://www.medscape.com/http://www.doh.gov.ph/ -
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OBJECTIVES
General objectives
After a 3-week span of pediatric rotation; our group the BSN 2a group3 subgroup1 of
San Pedro College starting to learn more about pediatric patients by finishing our case study
that will also improve our knowledge, skills, and attitude.
Specific objectives
1. Formulate specific, measurable, attainable, realistic and time-bounded goals andobjectives for this study;
2. select a suitable client for our pediatric concept;
3. establish an environment with good working and therapeutic relationship as well as trust
with the patient and with his significant others;
4. gather necessary data about the patients recent condition as well as his health history;
5. trace the clients family history up to the 3rd generation;
6. discuss the patients developmental data according to Erik Erikson and Robert
Havighursts theories;7. define the diagnosis of the patients condition;
8. perform a cephalocaudal and neurological assessment to determine the patients current
condition;
9. present the Anatomy and Physiology of the systems involved in the condition of the
patient;
10. list down the actual diagnostic examinations of our client;
11.present all the medications given and administered to the patient;
12. enumerate the medical management rendered to the patient upon hospitalization13. identify specific needs of the patient and provide specific nursing interventions;
14.present recommendations and further health teachings pertinent to the patient and
family;
15.evaluate the prognosis with its justification regarding the clients health condition in
relation with compliance, age, environment and family support and;
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16. list the references used in the completion of this case study.
ANATOMY AND PHYSIOLOGYOverview of the Digestive System
Overall, the digestive system performs six basic
processes.
1. Ingestion. This process involves taking liquids and
foods into the mouth.
2. Secretion. Process of producing a substance from the
cells and discharging it. Each day, cells within the walls
of the GI tract and accessory digestive organs secrete a
total of about 7 liters of water, acid, buffers and enzymes
into the lumen of the tract.
3. Mixing and propulsion. Alternating contractions and relaxations of the smooth muscle in the
walls of the GI tract mix food and secretions and propel them towards the anus. This capability
of the GI tract to mix and move material along its length is called motility.
4. Digestion. Mechanical and chemical processes break down ingested food into small
molecules. In mechanical digestion the teeth cut and grind food before it is swallowed, and then
smooth muscles of the stomach and small intestine churn the food. As a result, food molecules
become dissolved and thoroughly mixed with digestive enzymes. In chemical digestion the large
carbohydrate, lipid, protein and nucleic acid molecules in food are split into smaller molecules
by hydrolysis. Digestive enzymes produce by the salivary glands, toungue, stomach, pancreas
and small intestine catalyze these catabolic reactions. A few substances in food can be
absorbed without chemical digestion. These include vitamins, ions, cholesterol and water.
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5. Absorption. The entrance of ingested and secreted fluids, ions, and the products of digestion
into the epithelial cells lining the lumen of the GI tract is called absorption. The absorbed
substances pass into blood or lymph and circulate to cells throughout the body.
6. Defecation. Wastes, indigestible substances, bacteria, cells sloughed from the lining of the
GI tract, and digested materials that were not absorbed in their journey through the digestive
tract leave the body through the anus in a process call defecation. The eliminated material is
termed feces.
THE MOUTH
The mouth is the reservoir for the chewing and mixing of food with saliva. As food
particles become smaller and move around in the mouth, the taste
buds and olfactory nerves are continuously stimulated, adding to
the satisfaction of eating. The tongues surface contains thousands
of chemoreceptors, or taste buds, which can distinguish salty,
sour, bitter and sweet tastes. Tastes and food odors help to
initiate salivation and the secretion of gastric juice in the stomach.
There are 32 permanent teeth in the adult mouth, and they are
important for speech and mastication.
THE TONGUE
The tongue is an accessory digestive organ composed of skeletal muscle covered with
mucous membrane. On the upper surface of the tongue are small projections called papillae,
many of which contain taste buds. Together with its associated muscles, it forms the floor of the
oral cavity. The tongue is divided into symmetrical lateral halves by a median septum that
extends its entire length, and it is attached inferiorly to the hyoid bone, styloid process of the
temporal bone and mandible.
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THE TEETH
The teeth or dentes are accessory digestive organs located in sockets of the alveolar
processes of the mandible and maxillae. The alveolar processes are covered by the gingivae or
gums which extend slightly into each socket. The sockets are lined by the periodontal ligament
or membrane, which consists of dense fibrous connective tissue that anchors the teeth to the
socket walls.
SALIVATION
The three pairs of salivary glands, the submandibular, sublingual, and parotid glands
secrete about 1 L of saliva per day. Saliva consists mostly of water with mucus, sodium,
bicarbonate, chloride, potassium, and salivary a-amylase (ptyalin), and enzyme that initiates
carbohydrate digestion in the mouth and stomach.
SWALLOWING
The esophagus is a hollow, muscular tube approximately 25cm long that conducts
substances from the oropharynx to the stomach. Swallowed food is moved to the stomach by
peristalsis, the sequential contraction and relaxation of outer longitudinal and inner circular
layers of muscles.
Each end of the esophagus is opened and
closed by a sphincter. The upper esophageal
sphincter keeps air from entering the esophagus
during respiration. The lower esophageal
sphincter (cardiac sphincter) prevents
regurgitation from the stomach.
ESOPHAGUS
The esophagus is a muscular tube that
takes food from the pharynx to the stomach; no
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digestion takes place here. Peristalsis of the esophagus propels food in one direction and
ensures that food gets to the stomach even if the body is horizontal or upside down. The
esophagus is a collapsible muscular tube, about 25cm long, that lies posterior to the trachea.
The esophagus begins at the inferior end of the laryngopharynx and passes through the
mediastinum anterior to the vertebral column, then it pierces the diaphragm through and
opening called the esophageal hiatus, and ends in the superior portion of the stomach protrudes
above the diaphragm through the esophageal hiatus.
STOMACH
The stomach is a J-shaped enlargement of the GI tract directly inferior to the diaphragm
in the epigastric, umbilical and left hypochondriac regions of the abdomen. The stomach
connects the esophagus to the duodenum, the first part of the small intestine. Because a meal
can e eaten much more quickly than the intestines can digest and absorb it.
The stomach has four main regions: the cardia, fundus, body and pylorus. The cardia
surrounds the superior opening of the stomach. The rounded portion superior to and to the left
of the cardia is the fundus. Inferior to the fundus is the large central portion of the stomach
called the body. The region of the stomach that connects to the duodenum is the pylorus; it has
two parts, the pyloric antrum which connects to the body of the stomach, and the pyloric canal,
which leads into the duodenum. When the stomach is
empty, the mucosa lies in large folds called rugae.
The pylorus communicates with the duodenum of the small
intestine via a sphincter called the pyloric sphincter. The
concave medial border of the stomach is called the lesser
curvature and the convex lateral border is called the greater
curvature.
PANCREAS
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The pancreas is located in the upper left abdominal quadrant between the curve of the
duodenum and the spleen and is about 6 inches (15 cm) in length. The exocrine glands of the
pancreas
are called acini. They produce enzymes that are involved in the digestion of all three types of
complex food molecules. The pancreatic enzyme amylase digests starch to maltose. Lipase
converts emulsified fats to fatty acids and glycerol. Trypsinogen is an inactive enzyme that is
changed to active trypsin in the duodenum. Trypsin digests polypeptides to shorter chains of
amino acids.
SMALL INTESTINE
The major events of digestion and absortion occur
in a long tube called small intestine. Its length alone
provides a large surface area for digestion and
absorption and that area is further increased by
circular folds, villi and microvilli. The small intestine ifs
dived into 3 regions. It is composed of duodenum,
jejunum and ileum.
LARGE INTESTINE
The large intestine is the terminal portion of the GI tract. The overall functions of the
large intestine are the completion of absortion, the
production of certain vitamins, the formation of feces, and
the expulsion of feces from the body.
It is about 1.5m long and 6.5cm in diameter,
extends form ileum to anus. It is attached to the posterior
abdominal wall by its mesocolon, which is a double layer
of a peritoneum. Structurally the four major regions of the
large intestine are the cecum, colon, rectum and anal
canal.
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Summary
The processes of the digestion of food and the absorption of nutrients enable the body to
use complex food molecules for many purposes. Much of the food we eat literally becomes part
of us. The body synthesizes proteins and lipids for the growth and repair of tissues and
produces enzymes to catalyze all of the reactions that contribute to homeostasis. Some of our
food provides the energy required for growth, repair, movement, sensation, and thinking. In the
next chapter we will discuss the chemical basis of energy production from food and consider the
relationship of energy production to the maintenance of body temperature.
Overview of the Nervous System
The nervous system is an organ system containing a network of specialized cells
called neurons that coordinate the actions of an animal and transmit signals between different
parts of its body.
http://en.wikipedia.org/wiki/Biological_systemhttp://en.wikipedia.org/wiki/Neural_networkhttp://en.wikipedia.org/wiki/Neuronhttp://en.wikipedia.org/wiki/Animalhttp://en.wikipedia.org/wiki/Biological_systemhttp://en.wikipedia.org/wiki/Neural_networkhttp://en.wikipedia.org/wiki/Neuronhttp://en.wikipedia.org/wiki/Animal -
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Nerve Cells
Neurons
Neurons can be distinguished from other cells in a
number of ways, but their most fundamental property is that
they communicate with other cells via synapses, which are
membrane-to-membrane junctions containing molecular
machinery that allows rapid transmission of signals, either
electrical or chemical Many types of neuron possess
an axon, a protoplasmic protrusion that can extend to
distant parts of the body and make thousands of synaptic contacts. Axons frequently travel
through the body in bundles called nerves.
a. Dendrites- are the branched projections of a neuron that act to conduct the electrochemical
stimulation received from other neural cells to the cell body, orsoma, of the neuron from which
the dendrites project.
http://en.wikipedia.org/wiki/Synapsehttp://en.wikipedia.org/wiki/Axonhttp://en.wikipedia.org/wiki/Neuronhttp://en.wikipedia.org/wiki/Electrical_conductionhttp://en.wikipedia.org/wiki/Electrochemistryhttp://en.wikipedia.org/wiki/Stimulationhttp://en.wikipedia.org/wiki/Soma_(biology)http://en.wikipedia.org/wiki/Synapsehttp://en.wikipedia.org/wiki/Axonhttp://en.wikipedia.org/wiki/Neuronhttp://en.wikipedia.org/wiki/Electrical_conductionhttp://en.wikipedia.org/wiki/Electrochemistryhttp://en.wikipedia.org/wiki/Stimulationhttp://en.wikipedia.org/wiki/Soma_(biology) -
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b. Soma- is the central part of the neuron. It contains the nucleus of the cell, and therefore is
where most protein synthesis occurs. The nucleus ranges from 3 to 18 micrometers in diameter.
c. Axon- is a finer, cable-like projection that can extend tens, hundreds, or even tens of
thousands of times the diameter of the soma in length. The axon carries nerve signals away
from the soma (and also carries some types of information back to it).
d. Axon terminal- contains synapses, specialized structures where neurotransmitterchemicals
are released to communicate with target neurons.
Glial Cells
are non-neuronal cells that provide support and nutrition, maintainhomeostasis,
form myelin, and participate in signal
transmission in the nervous system.[9]In
the human brain, it is estimated that the
total number of glia roughly equals the
number of neurons, although the
proportions vary in different brain areas.
A very important type of glial cell
(oligodendrocytesin the central nervous
system, and Schwann cells in the
peripheral nervous system) generates layers of a fatty substance calledmyelinthat wraps
around axons and provides electrical insulation which allows them to transmit action potentials
much more rapidly and efficiently.
2 Parts of the Nervous System
1. Central Nervous System
The central nervous system (CNS) is the largest part, and includes the brain andspinal
cord. The spinal cavity contains the spinal cord, while the head contains the brain. The CNS is
enclosed and protected by meninges, a three-layered system of membranes, including a tough,
leathery outer layer called the dura mater. The brain is also protected by the skull, and the
http://en.wikipedia.org/wiki/Cell_nucleushttp://en.wikipedia.org/wiki/Protein_biosynthesishttp://en.wikipedia.org/wiki/Nerve_signalhttp://en.wikipedia.org/wiki/Axon_terminalhttp://en.wikipedia.org/wiki/Neurotransmitterhttp://en.wikipedia.org/wiki/Homeostasishttp://en.wikipedia.org/wiki/Myelinhttp://en.wikipedia.org/wiki/Nervous_system#cite_note-Allen2009-8http://en.wikipedia.org/wiki/Human_brainhttp://en.wikipedia.org/wiki/Oligodendrocytehttp://en.wikipedia.org/wiki/Schwann_cellhttp://en.wikipedia.org/wiki/Myelinhttp://en.wikipedia.org/wiki/Central_nervous_systemhttp://en.wikipedia.org/wiki/Brainhttp://en.wikipedia.org/wiki/Spinal_cordhttp://en.wikipedia.org/wiki/Spinal_cordhttp://en.wikipedia.org/wiki/Spinal_cavityhttp://en.wikipedia.org/wiki/Headhttp://en.wikipedia.org/wiki/Meningeshttp://en.wikipedia.org/wiki/Dura_materhttp://en.wikipedia.org/wiki/Cell_nucleushttp://en.wikipedia.org/wiki/Protein_biosynthesishttp://en.wikipedia.org/wiki/Nerve_signalhttp://en.wikipedia.org/wiki/Axon_terminalhttp://en.wikipedia.org/wiki/Neurotransmitterhttp://en.wikipedia.org/wiki/Homeostasishttp://en.wikipedia.org/wiki/Myelinhttp://en.wikipedia.org/wiki/Nervous_system#cite_note-Allen2009-8http://en.wikipedia.org/wiki/Human_brainhttp://en.wikipedia.org/wiki/Oligodendrocytehttp://en.wikipedia.org/wiki/Schwann_cellhttp://en.wikipedia.org/wiki/Myelinhttp://en.wikipedia.org/wiki/Central_nervous_systemhttp://en.wikipedia.org/wiki/Brainhttp://en.wikipedia.org/wiki/Spinal_cordhttp://en.wikipedia.org/wiki/Spinal_cordhttp://en.wikipedia.org/wiki/Spinal_cavityhttp://en.wikipedia.org/wiki/Headhttp://en.wikipedia.org/wiki/Meningeshttp://en.wikipedia.org/wiki/Dura_mater -
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spinal cord by the vertebrae.Its main job is to get the information from the body and send out
instructions.
Brain
The brain keeps the body in order. It helps to control all of the body systems and organs,
keeping them working like they should. The brain also allows us to think, feel, remember and
imagine. In general, the brain is what makes us behave as human beings. The brain
communicates with the rest of the body through the spinal cord and the nerves. They tell the
brain what is going on in the body at all times. This system also gives instructions to all parts of
the body about what to do and when to do it.
The brain is made of three main parts: the
forebrain, midbrain, and hindbrain. The
forebrain consists of the cerebrum, thalamus,
and hypothalamus (part of the limbic system).
The midbrain consists of the tectum and
tegmentum. The hindbrain is made of the
cerebellum, pons and medulla. Often the
midbrain, pons, and medulla are referred to
together as the brainstem.
a. Ventricles- The ventricles are four cavities within the brain: two lateral ventricles, the third
ventricle, and the fourth ventricle. Each ventricle contains a capillary network called a choroid
plexus, which forms cerebrospinal fluid (CSF) from blood plasma. Cerebrospinal fluid is the
tissue fluid of the central nervous system.
b. Medulla- The medulla extends from the spinal cord to the pons and is anterior to the
cerebellum. Its functions arethose we think of as vital (as in vital signs). Themedulla contains
cardiac centers that regulate heartrate, vasomotor centers that regulate the diameter ofblood
vessels and, thereby, blood pressure, and respiratorycenters that regulate breathing.
e. Pons- bulges anteriorly from the upper part of the medulla. Within the pons are two
respiratory centers that work with those in the medulla to produce a normal breathing rhythm.
d. Midbrain- extends from the pons to the hypothalamus and encloses the cerebral aqueduct, a
tunnel that connects the third and fourth ventricles.
http://en.wikipedia.org/wiki/Vertebrahttp://en.wikipedia.org/wiki/Vertebra -
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e. Cerebellum- separated from the medulla and pons by the fourth ventricle and is inferior to
the occipital lobes of the cerebrum. Many of the functions of the cerebellum are concerned with
movement.
f. Hypothalamus- Located superior to the pituitary gland and inferior to the thalamus, the
hypothalamus is a small area of the brain. It produces the growth hormone releasing hormone
(GHRH), antidiuretic hormone (ADH) and oxytocin. It regulates the body temperature and
stimulates the visceral responses during emotional situations. It regulates the body rhythms
such as secretion ofhormones, sleep cycles, changes in mood, or mental alertness.
g. Thalamus- It is superior to the hypothalamus and inferior to the cerebrum. Many of the
functions of the thalamus are concerned with sensation.
h. Cerebrum- The largest part of the human brain is the cerebrum, which consists of two
hemispheres separated by the longitudinal fissure. Cerebral cortex is the gray matter surface
of the cerebrum.
Frontal Lobes- are the motor areas that generate
the impulses for voluntary movement.
Parietal Lobes- The general sensory areas in the
parietal lobesreceive impulses from receptors in the
skin and feeland interpret the cutaneous sensations.
Temporal Lobes- The olfactory areas in the
temporal lobes receive impulses from receptors in
the nasal cavities for thesense of smell.
Occipital Lobes- Impulses from the retinas of the
eyes travel along theoptic nerves to the visual areas in the occipital lobes.
Basal Ganglia- are paired masses of gray matter within the
white matter of the cerebral hemispheres. Their functions are
certain subconsciousaspects of voluntary movement, and they
workwith the cerebellum.Corpus Callosum- is aband of nerve fibers that connects the
left and rightcerebral hemispheres.
Spinal cord
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Nerves divide many times as they leave the spinal cord so that they may reach all parts of
the body. The thickest nerve is 1 inch thick and the thinnest is thinner than a human hair. Each
nerve is a bundle of hundreds or thousands of neurons (nerve cells). The spinal cord runs down
a tunnel of holes in your backbone or spine. The bones protect it from damage. The cord is a
thick bundle of nerves, connecting your brain to the rest of your body.
Spinal Nerves
There are 31 pairs ofspinal nerves, those that emerge from the spinal cord. The nerves are
named according to their respective vertebrae: 8 cervical pairs, 12 thoracic pairs, 5 lumbar
pairs, 5 sacral pairs, and 1 very small coccygeal pair.
Nerve Spinal Nerves That
Contribute
Distribution
Phrenic C3C5 Diaphragm
Radial C5C8, T1 Skin and muscles of posterior arm, forearm, and hand;
thumb and first 2 fingers
Median C5C8, T1 Skin and muscles of anterior arm, forearm, and hand
Ulnar C8, T1 Skin and muscles of anterior arm, forearm, and hand
Intercostal T2T12 Intercostal muscles, abdominal muscles; skin of trunk
Femoral L2L4 Skin and muscles of anterior thigh, medial leg, and foot
Sciatic L4S3 Skin and muscles of posterior thigh, leg and foot
Table 83 MAJOR PERIPHERAL NERVES
2. Peripheral nervous system
The peripheral nervous system (PNS) is a
collective term for the nervous system structures
that do not lie within the CNS. The large majority
of the axon bundles called nerves are considered
to belong to the PNS, even when the cell bodies of
the
neurons to
which they
belong
http://en.wikipedia.org/wiki/Peripheral_nervous_systemhttp://en.wikipedia.org/wiki/Peripheral_nervous_system -
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Cranial Nerves
The 12 pairs ofcranial nerves emerge from the
brain stem or other parts of the brain. The name cranial
indicates their origin, and many of them do carry
impulses for functions involving the head. Some,
however, have more far-reaching destinations.
Number and Name Function(s)
I Olfactory Sense of smell
II Optic Sense of sight
III Oculomotor Movement of the eyeball; constriction of pupil in bright light or for near
vision
IV Trochlear Movement of eyeball
V Trigeminal Sensation in face, scalp, and teeth; contraction of chewing muscles
VI Abducens Movement of the eyeball
VII Facial Sense of taste; contraction of facial muscles; secretion of saliva
VIII Acoustic
(vestibulocochlear)
Sense of hearing; sense of equilibrium
IX Glossopharyngeal Sense of taste; sensory for cardiac, respiratory, and blood pressure
reflexes;
contraction of pharynx; secretion of saliva
X Vagus Sensory in cardiac, respiratory, and blood pressure reflexes; sensory
and motor
to larynx (speaking); decreases heart rate; contraction of alimentary tube
(peristalsis); increases digestive secretions
XI Accessory Contraction of neck and shoulder muscles; motor to larynx (speaking)
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PATHOPHYSIOLOGY
Intestinal Flora
Antibiotic Harmful Bacteria and
Causes damage andinflammation through
invading and destroying
Releases
Stimulates mucosal linin of
Greater secretion of water
and electrolytes in the
Active secretion of
sodium carbonate and
Inhibits reabsor tion of
Large amounts of protein
rich fluids are secreted into
Bleedin and
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REFERENCES
Ackley, Betty J. (2009); Medical-Surgical Nursing: Clinical Management for Positive
Outcomes; 8th edition; St. Louis, Missouri; Elsevier Inc.
Black, Joyce M. (2008); Nursing Diagnosis Handbook: An Evidence-Based Guide to
Planning Care; St. Louis Missouri; Mosby Inc.
Scanlon, Valerie (2007); Essentials of Anatomy and Physiology; 5th edition; Arch Street
Philadelphia; F.A. Davis Company
Woolley, Wendy L. (2009); retrieve on February 28, 2012 from www.medscape.com
Balance excess
Overwhelming of large
bowels ability to
Diarrhe