THE NERVOUS SYSTEM

AND
UNCONSCIOUSNESS(INSENSIBILITY)
Anatomy :-Nervous system consists of Brain, Spinal cord,
Peripheral Nerves and Autonomic nerve cell collection called
Ganglia.
A Central Nervous System
BrainCerebrum
--Cerebellum
Brain stem(Medulla )
Spinal cordcervical
--thoracic
--lumber
--caudal
B Peripheral nervous system
Peripheral Nerves Motor
--Sensory
--Mixed Nerves
C Autonomic nervous system
Nerve cells collection called Ganglia ,Controls Heart,liver
Intestine etc.
Physiology:- How it works?
Voluntary act- One can carry out various actions at his own will
Sensory input Sensations from various sensory organs
Reflex act- its a reaction to the surrounding e.g. touching a hot
object .

Contd2

==2==

Unconsciousness
Any interference with the normal functioning of the brain and
the nerves brings about loss of sensibility.
Unconsciousness can be partial called as Stupor or Semi
consciousness or Complete called as coma.

How to know?
1)When spoken to the casualty may not respond, while in
stupor he can be aroused with difficulty .and in coma there is
no response at all.
2) In stupor one can not open the eyelids as casualty will resist
this attempt. But in coma eye lids can be opened without
resistance.
3)PupilTest Pupil reacts to light in stupor and they are
dialated in coma .

Causes of Unconsciousness:1)Brain injuries

2)Apoplexy (C V E ) 3)Convulsion

4) Fainting

5)Heat stroke

6) Diabetes

Hypo/Hyperglycemia 7)Epilepsy

8)Shock

9)Poisons

11)Hysteria

10)Hysteria

GENERAL MANAGEMENT OF UNCONSCIOUS PATIENT:1)See that there is free supply of fresh air.
==3==
2)See that airway /respiratory passage is clear.
3)Loosen the clothings at neck, chest and waist.
4)In cold weather maintain body temperature .
5)If breathing has stopped then give artificial respiration.
6)Try to position the casualty in a position where in he can
breath easily. At times three quarter prone position or tonsillar
position.
7)Nothing should be given orally.
8)Lastly the firstaid of the cause.
9) Arrange for shifting the casualty to hospital.

Specific cause and their Firstaid:(1) Concussion:- It is due to injury to brain.It is more a
shake up of the brain as a whole rather than actual
injury to the brain substance.
It can occur due to blow on the head,fall from height,
even a blow on the jaw.
Signs and symptoms:-There can be stupor or coma ,
There can be black out of short duration.During
recovery there can be nausea or vomiting.
Firstaid:- same as general firstaid.
(2) Compression:-It is due to injury and there is pressure on
the part of the brain either by a blood clot or by fracture
segment.
Contd =4
==4==
Signs and symptoms:- There will be E/o external injury if
there is fracture .Stupor and coma may follow .Pulse rate
may be slow ,temperature may be raised,pupils may be
unequal,dialated. There can be paralysis of one side ,There
may be convulsions in rare case.
Firstaid :- Same as general firstaid .

(3) Apoplexy (Stroke ) It is due to increase in B.P. ,Blood

vessel in the brain bursts and bleeding occurs in the
substance of the brain .
No specific management in the firstaid.
(4) Fainting :- It is very common and is always due to
reduced blood supply to the brain,fear,pain prolonged
standing as in parades can cause fainting
Signs and symptoms- Person all of a sudden falls down ,
face appears pale ,pulse is weak and slow or even may not
be felt , Skin is cold.
Firstaid- Raise the foot end above the level of brain,then
manage as general. Once patient settles give him tea or
coffee.
(5) Heat Stroke :-It occurs in the mid summer when the
temperature is high , exposure to Sun is there
Body temperature is high <103 o F
Basic first aid will be to brimg down the temperature at its
earliest by tapid sponging . NEVER EVER USE ICE COLD
WATER
==5==
(6)Diabetic coma It is very difficult to differentiate between
coma due to hyperglycemia or hypoglycemia.

(7)Heart Attack :- There mat be a past history . There is

pain on left side of chest which may get referred to left
forearm or hand .Sweating is an important feature.
First aid:- Make him breath easily. Dont allow him to get up
,walk.
(8) Epilepsy:- In epilepsy there is sudden loss of
consciousness and patient may fall down on the ground.
His body becomes rigid,tonic and clonic spasms of muscles
may occur all over the body . Patient may injure himself by
striking against hard and sharp objects, Froth may appear
at mouth . It may be red in colour. He may bite his tongue .
He may pass urine and motion.
After few minutes the convulsions stop. The patient is
confused and after some time he becomes normal.
First aid:-Just keep the casualty under control,donot use force to
stop convulsions. Remove objects that may cause injuries.
- Prevent biting of tongue by inserting a spoon wrapped in
a handkerchief in between the molar teeth
- Wipe the froth from the mouth
- Follow the general rule for firstaid in unconsciousness.
==6==

- Watch for recurrance.Leave the patient only when he is

fully recovered.
(9) Hysteria:- More common in women because they are
emotionally unstable . Emotional stress brings on the
attack.
Signs symptoms:- There is rigidity of the body and patient
seems to be unconscious.
Convulsions may occur but these are not typical
Patient may shout,cry tear her hair, keeps eyes tightly
closed. But basic is she requires an audience
She falls down deliberately so that minimum or no injury is
caused. Many a times situation is difficult to diagnose even
to a doctor.
First aid :- is to pretend to ignore the attack.
Be firm in dealing but kind. Keep the patient mentally busy.