2 - neurologic functions Flashcards
multiple condition may cause an insult to the nervous system
- trauma
- neoplasia
- stroke
- infection
- degeneration
dysfunction causes alterations in
- cerebral hemodynamics
- cognition, memory, attention, emotions
- motor function
- data processing
cerebral hemodynamics
- level of consciousness (LOC)
- pupillary responses
- vital signs
motor function
- tone
- movement
- paralysis
- posture
- gait
data processing
comprehension and communication
aphasia
severe impairment of language
dysphasia
mild impairment of language
agnosia
inability to interpret sensations and hence to recognize things
akinesia
loss or impairment of the power of voluntary movement
hyperkinesia
increase in muscular activity that can result in excessive abnormal movements, excessive normal movements, or a combination of both
hypokinesia
abnormal diminished motor activity
normal A&P
- normal component of the brain
- normal pressure
- monroe-kellie hypothesis
normal pressure
5 - 15 mmhg
cerebral hemodynamics
- multiple condition may cause a change in cerebral hemodynamics (blood flow/pressure)
- can be compensated
- compensation not effective with sustained long-term changes
cerebral hemodynamics: compensation by
- displacing CSF
- shifting blood volume
- compression brain tissue
secondary injury
- insult to brain days after the days or hours after primary injury
- long standing changes in pressure
insult to
inflammation and cerebral edema
inflammation and cerebral edema to
increased intra-cranial pressure
increased intra-cranial pressure to
compression of blood vessels
compression of blood vessels to
decreased cerebral blood flow
decreased cerebral blood flow to
cerebral ischemia and hypoxia
cerebral ischemia and hypoxia to
insult
Secondary injury leads to
increased intracranial pressure (ICP)
increased intracranial pressure
- caused by an increase in intracranial content
- can increase gradually or suddenly
- may decrease cerebral blow flow
example of primary injury
we had a trauma and injury to the head
ICP - manifestations
- altered level of consciousness
- pupillary alterations
- changes in vital signs
- seizures
- headaches
- vomiting
the earliest indicator of increased intracranial pressure?
changes in the level of consciousness
level of consciousness
- most critical index of nervous system function
- eye opening, verbal response and mobile response
level of consciousness can be assessed by
glasgow coma scale
level of consciousness: critical index
- arousal
- awareness
terms describing altered level of consciousness (LOC)
- confusion
- disorientation
- lethargy
- obtundation
- stupor
- coma
pupillary abnormalities
- initially change on same side of brain as insult
- eventually fixed and dilated pupils bilaterally
vital signs
- temperature
- respiration
- heart rate
- BP
hypothalamus controls
temp
brain stem, medulla and pons control
- respiratory rate
- heart rate
- BP
changes in vital signs
- late findings
- cushing’s triad
cushing’s triad
- bradycardia
- irregular respirations
- widening pulse pressure
seizures
- sudden, transient alterations of brain function cause by an abrupt explosive disorderly discharge of cerebral neurons
- causes involuntary movements, behavioural and sensory alterations as well as changes in LOC
seizure: a symptom of an underlying disorder
- infection
- cerebral lesions
- cerebral trauma
- biochemical disorders
classifications of seizures
- partial seizures
- generalized seizures
partial seizures
localized electrical discharges
generalized seizures
- tonic clonic
- absent
- myoclonic
- wide spread throughout the brain
tonic
stiffening
clonic
jerking and shaking
absent
zoning out and loose consciousness for 20 seconds then back to normal
myoclonic
a sudden jerk or spasm, usually no changes in awareness
seizures and children
- common for children because of fever or glucose
- febrile seizures
febrile seizures
associated with a high body temperature and most common in 3 mo to 5 years
epilepsy
- a chronic seizure disorder with recurrent, unprovoked seizures
- triggers
epilepsy: cause
genetic and environmental
status epilepticus
repeated
How is a seizure different from epilepsy?
- epilepsy is chronic, may or may not know cause
- seizures can pin point cause
Why is status epilepticus dangerous?
cause neutrons are using so much oxygen and if prolonged neutrons will become damages
cerebral palsy (CP)
- a group of non-progressive syndrome causing varying degrees of motor dysfunction
- due to brain damage often resulting from cerebral schema and or increased ICP before, during or shortly after birth
- one of the most crippling disorders of childhood
types of cerebral palsy
- spastic
- dystonic
- ataxic
- mixed
spastic
increased muscle tone, rigidity of extremities, scoliosis, contractures
dystonic
difficulty with fine motor coordination and purposful movements (stiff, uncontrolled and abrupt)
ataxic
unsteady uncoordinated gait; difficulty with maintaining balance
CP - diagnosis
typically diagnosed based on clinical signs at birth or early infancy
CP - treatment
- depends on extent impairment
- ongoing assessment, evaluation and revision of treatment
- interdisciplinary approach required (PT, OT, speech etc)
