NERVOUS SYSTEM

DIAGNOSTIC TESTS

PRESENTED BY:
MELVIN D. CADAO, MAN
GERALD A. MERCADO RN, CARMA
 WHAT IS NERVOUS SYSTEM?
• The nervous system is the body’s command center.
Originating from your brain, it controls the movements,
thoughts and automatic responses.
• It also controls other body systems and processes, such
as digestion, breathing and sexual development
(puberty).
WHAT DOES THE NERVOUS SYSTEM DO?
• The nervous system uses specialized cells called
neurons to send signals, or messages, all over the body.
• These electrical signals travel between the brain, skin,
organs, glands and muscles.
• The messages help to move your limbs and feel
sensations, such as pain.
WHAT DOES THE NERVOUS SYSTEM DO?
• The eyes, ears, tongue, nose and the nerves all over the
body take in information about the environment.
• Then nerves carry that data to and from your brain.
PARTS OF THE NERVOUS SYSTEM
A. Central nervous system (CNS)
• Brain and spinal cord make up the CNS. Brain uses
nerves to send messages to the rest of body. Each nerve
has a protective outer layer called myelin. Myelin
insulates the nerve and helps the messages get through.
PARTS OF THE NERVOUS SYSTEM
B. Peripheral Nervous System (PNS)
• Peripheral nervous system consists of many nerves that branch out
from CNS all over the body. This system relays information from the
brain and spinal cord to the organs, arms, legs, fingers and toes.
PNS contains:
• Somatic Nervous System- guides the voluntary movements
• Autonomic Nervous System- controls movements that cannot control
NERVOUS SYSTEM DIAGNOSTIC
TESTS
X-RAY
An x-ray of the skull or spine is done to determine
the presence of fracture, certain tumors and other
abnormal masses, types of injuries, dislocation,
calcification into soft tissue areas, degree of curvature
(normal antero-posterior curve of areas of the spine,
versus lateral curvature of scoliosis).
CT Scan with or without Contrast
• Practitioner may do an initial test without contrast for first images and then give
contrast and repeat images to compare. Done to check for bleeding, tumor,
abscess, infarction, and hydrocephalus.
HEMORRHAGIC STROKE ISCHEMIC INFARCT MENINGIOMA
NORMAL PLAIN CRANIAL CT SCAN NORMAL CRANIAL CT
WITH
CONTRAST
COMPUTED TOMOGRAPHY
ANGIOGRAPHY (CTA)
• A type of medical test that combines a CT scan with an
injection of a special dye to produce picture of blood
vessels and tissues in a part of your body.
• The dye is injected through an intravenous line started in
the arm or hand
• This creates a three-dimensional reconstruction of the
vasculature within the area imaged.
CEREBRAL ANGIOGRAPHY
• This test is done to identify aneurysms, arteriovenous
malformations, traumatic injuries, strictures, occlusions,
and tumors.
• Contrast is injected to visualize the cerebral circulation,
carotid, and vertebral arteries.
CEREBRAL ANGIOGRAPHY
• The head is immobilized during the test.
• Wire is inserted via the femoral arterial site and passed
to the carotid or vertebral vessel under fluoroscopic
guidance.
• Contrast dye is injected so three-dimensional images
can be obtained.
After the test
a. Monitor vital signs
b. Perform neurologic checks
c. Neurovascular checks of the extremity (capillary refill,
peripheral pulses, skin color, and temperature).
d. Check for bleeding at the site.
ELECTROENCEPHALOGRAM (EEG)
• This test records the electrical activity from the cerebral
hemispheres of the brain and creates a graphic
recording.
• It determines general brain activity as well as the site of
origin of seizure activity.
• It is also used to diagnose sleep disorders and determine
brain death.
LUMBAR PUNCTURE
• Also known as Spinal tap
• A medical procedure in which a needle is inserted into the spinal
canal, most commonly to collect cerebrospinal fluid for
diagnostic test.
• The main reason for a lumbar puncture is to help diagnose
diseases of the central nervous system, including the brain and
spine.
LUMBAR PUNCTURE
• A spinal needle is inserted into subarachnoid space at level of
L3–L4 or L4–L5 with patient lying on side with knees drawn up
to chest.
• This test is performed under local anesthesia.
• It is done to obtain pressure readings, obtain cerebrospinal fluid
for analysis, inject contrast medium or air for diagnostic tests,
inject medications, or reduce increased intracranial pressure.
After the test

• The patient must lie flat for several hours after the procedure to
reduce the risk of spinal headache due to leakage of spinal fluid.
• Monitor vital signs
• Encourage oral fluid intake.
MAGNETIC RESONANCE IMAGING (MRI)
• Test that uses a magnetic field and pulses of radio wave energy to make
pictures of organs and structures inside the body.
• In many cases, MRI gives different information about structures in the body
than can be seen with an X-ray, ultrasound, or computed tomography (CT)
scan.
• MRI also may show problems that cannot be seen with other imaging
methods.
• Contrast material may be used during MRI to show abnormal tissue more
clearly.
MAGNETIC RESONANCE IMAGING (MRI)

• It is used to find problems such as tumors, bleeding,

injury, blood vessel diseases, or infection.
• An MRI scan can be done for the:
•Head - brain for tumors, an aneurysm, bleeding in the
brain, nerve injury, and other problems, such as damage caused
by a stroke, problems of the eyes, optic nerves , ears and
auditory nerves.
MRI WITH GADOLINIUM
• This test is done to detect differences in tissue integrity, tumors,
and disc disease.
• Due to the use of a magnetic field to create images, an MRI is
not for patients with implanted hardware (pacemakers, etc.) or
for pregnant women.
MAGNETIC RESONANCE ANGIOGRAPHY
(MRA)
• A type of MRI that looks specifically at the body’s blood
vessels which requires inserting a catheter into the body.
• Uses a powerful magnetic field, radio waves and a computer to
evaluate blood vessels and help identify abnormalities.
• This is done to detect arterial blockages, aneurysm, and
arteriovenous malformations.
POSITRON EMISSION TOMOGRAPHY
(PET)
• A positron emission tomography (PET) scan is an imaging test that
can help reveal the metabolic or biochemical function of your
tissues and organs.
• The PET scan uses a radioactive drug (tracer) to show both normal
and abnormal metabolic activity.
• The patient is given a tagged isotope on deoxyglucose. There will
be increased glucose uptake by areas with increased metabolic
activity.
POSITRON EMISSION TOMOGRAPHY
(PET)
• The test detect early signs of cancer, heart disease and brain
condition.
• PET tells about the function of the brain involving glucose and
oxygen metabolism.
• The test is done to detect areas of altered metabolism such as
dementia, epilepsy, neoplasm, or degenerative disorders.
SINGLE PHOTON EMISSION
COMPUTED TOMOGRAPHY (SPECT
SCAN)
• A type of imaging test that uses a radioactive substance and a special camera
to create 3D pictures and it can show what the internal organs look like.
• SPECT involves an intravenous injection of a radiopharmaceutical to
enhance the image.
• It is done to detect cerebral blood flow, stroke, dementia, amnesia, neoplasm,
head trauma, seizures, persistent vegetative state, brain death, and
psychiatric disorders.
• This test is not for pregnant women.
GLASGOW COMA SCALE

• It was developed to predict recovery from a head injury and to

assess level of consciousness.
Three major areas: Eye response
Motor response
Verbal response
• Level of consciousness can lie anywhere along a continuum
from a state of alertness to coma.
LEVEL OF CONSCIOUSNESS ASSESSMENT
TERMS
• Alert
Awake, oriented, converses and responds appropriately.
• Confused
Disorientation, restless, agitated, difficulty following commands,
memory deficits.
• Lethargy
Oriented but slowed mental responses.
Speech may be sluggish, sleeps often, but easily arousable.
LEVEL OF CONSCIOUSNESS ASSESSMENT
TERMS
• Obtunded
Very drowsy, falls asleep easily, more difficult to awaken.
Limited verbal responses, follows simple commands.
• Stuporous
Difficult to arouse, only awakens briefly.
Displays very little motor movement.
• Coma
Does not arouse, does not respond to verbal stimuli.
May or may not display motor response to painful stimuli.
THANK YOU!!!