Alterations in Neurological Function Flashcards
Multiple sclerosis
- progressive demyelination of the white matter of brain and spinal cord
Guillain Barre
- acute autoimmune associated with demylination of peripheral nerves
Amyotrophic Lateral Sclerosis
neurodegenerative disease affects nerve cells of the brain and spinal cord
Parkinsons disease
- motor disorder accompanied by systemic nonmotor and neurological symptoms
Dymylinating disorders
Centrally: MS
Peripherally: Gullain Barre
what is myelin
insulating layer around nerves which allow electrical impulses to transmit quickly and efficiently along the nerve cells
MS is more common in
women 20-40 age
MS
- autoimmune response
- loss of oligodendrocytes
MS risk factors
smoking, vitamin D deficiency, Epstein Barr virus, family history
which country has the highest rate of MS in the world
canada
- higher in the northern hemisphere
MS progression
- T cells and B cells cross the blood-brain barrier
- Inflammation-induced loss of oligodendrocytes
- Activation of microglia cells: macrophages
- Disrupted nerve conduction with death of neurons and brain atrophy
- Formation of lesions
MS signs and symptoms
- vidual disturbances
- paresthesia of face, trunck, or limbs
- weakness
- impaired gait
Remitting-relapsing MS
- never knew disability between attacks
- 85%
- exacerbation and remission
Progressive relapsing MS
- progressice onset with superimposed relapses
Secondary progressice relapsing MS
- initial remitting and relapsing
- steady decline
primary progressice MS
- steady decline
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what can be found in an MRI during the diagnosis of MS
- most sensitive
- detects lesions and evaluates disease process
What can be found with evoked response (ER) studies following the diagnosis of MS
- measure electrical activity to the brain
- can show slowing electrical conduction
what can be found eith elevated IgG in the CSF in the diagnosis of MS
- indicate hyperactivity of the immune system
what is Guillain Barre syndrome
acute inflammatory demylinating polyneuropathy
- rare disorder caused by an autoimmune reaction directed at the peripheral nerves
Guillain Barre syndrome occurs after
a respiratory or gastrointestinal infection
Guillian Barre syndrome acute phase
- ends in 1-3 weeks
- no further deterioration
Guillain barre plateau phase
- lasts for several days or 2 weeks
Guillian barre recovery phase
- remylination and axonal process regrowth
- can last from 4months to 2 years
Guillian Barre syndrome sings and symptoms
- starts with numbness and tingeling progressing to paresis of the legs to complete quadriplegia
- respiratory insufficiency
- ANS instability
Motor Neuron Disease (MND)
- progressive neurodegenerative disease: affects nerve cells of the brain and spinal cord
- notor neurons eventually die and voluntary muscle movement is impacted
lateral sclerosis
scarring of the carticospinal tract
- lose the ability to eat, speak, move and breath
mtor neuron disease prognosis
- progressively debilitating disease
- rapidly fatal
- survivial tine is < 3 years
who are the famous figures who have MND
- Lou Gehrig
- stephan hawking
what is a primary sign of ALS
muscle weakness
- trouble lifting cur or holding pen, trouble speaking or swallowing, chocking, excessive drooling, depression, inappropriate laughter
ALS diagnosis
electromyography (nerve damage)
- muscle biospy
- neuromuscular system exam
what is parkinsons disease
dopamine deficency that occurs in the basal ganglia
dopamine is responsible for
smooth muscle movement
primary parkinsonism
- complex motor disorder accompanied by systemic nonmotor and neurological systems
- benign after the age of 40
primary parkinism is more common in
males
what is the leading cause of neurological disability in individuals older than 60
primary parkinism
secondary parkinsonism is caused by
other factors
- trauma, infection, intoxication
what are the famous figures who have parkinsons disease
- Muhamad Ali, Micheal J fox
signs and symptoms of parkinsons disease
TRAP
- temor
- regidity
- akinesia/bradykinesia
- postural disturbances
- dysarthria
- dysphagia
akinesia / bradykinesia
absense or slowing
dysarthria / dysphagia
- muscle control loss of ability to speak and swallow
what is delirium
abrupt change in the brain that causes mental confusion and emotional disruption
- makes it difficult to think, remeber, sleep and pay attention
what is dementia
general term for loss of memory, language, problem solving, and other thinking abilities that are severe enough to interfere with daily life
what neurotransmitters are involved in delerium
several
- dopamine and acetylcholine
delerium is caused by
- substance intoxication
- drug induced
- substance withdrawl
- general medical conditions (UTI, meningitis, diabetes, hypothermia, electrolyte imbalances, heat stroke)
delirium signs and symptoms
reduced motor activity, lethargy, withdrawal, drowsiness and starting into space , forgetfulness, slowed speech
Excited delirium
- agitated delirium hyperkinetic that can lead to sudden death
excited delirium signs and symptoms
- altered mental status, combativeness, aggressiveness, tolerance to pain, rapid breathing, diaphoresis, severe agitation, increased temperature, noncompliance
- “superhuman strength”
delirium onset
acute
delirium course
fluctuating
delirium duration
days to weeks
delirium conciouness
altered
delirium attention
impaired
delirium psychomotor changes
increased or decreased
delirium reversibility
usually
dementia onset
insidious
dementia course
progressive
demetria duration
months to years
dementia conciouness
clear
dememtia attention
normal, except in severe dementia
dementi phychomotor changes
often normal
dementia reversibility
rarely
what is dementia caused by
neuron degration, compression of the brain tissue, atherosclerosis of cerebral vessels
dementia is associated with
neuro-degenerative diseases like parkinsons disease and alzheimers disease, HIV
what is the cause of half of adult demetia
alzheimers
late onset alzheimers
70-90%
early onset demetia
familial
what is the cause of alzheimers
cause is not clear
- build-up of proteins around the brain area
- accumulation of neuritic plaques, interneuronal neurofibrillary tanges
- cause the disruption of nerve impulses transmission
brain atrophy in alzheimers results deom
the loss of neurons
what contributes to the decline in cognition in alzheimers
synapses, acetylcholine, and neurotransmitters
alzheimers disease early symptoms
- memory loss affects job
- difficulty preforming familar tasks
- learning difficulties
- deterioration of appearance and personal hygiene
alzheiners late signs and symptoms
- difficultly with abstract thinking
- difficulty with communication
- deterioration of memory, language, and motor function
- repetitive actions, restlessness, wandering
- irritability, mood swings, depression
- disorientation
sundowners syndrome
- increase in dementia type symptoms in the evenings or night
risk factors for dementia
- age
- family history
- hypertension
- smoking
- diabetes
- high cholesterol
- obesity / sedentary lifestyle
- cognitive activity
- depression
- head injuries
cataracts
are protein that is normally found on the lens, as we age it start clumping together
what is the leading cause of blindness in the world
cataracts
cataracts developes because of
- alteration of metabolism and transportion of proteins within the lens
- ifection, radiation, trauma, mefication or DM
risk factors for cataracts
age, diabetes, trauma, exposure to UV light, genetics
cataracts signs and symptoms
cloudy or opaque area in the lens = vision loss
cataracts early stage
some light transmitted though the lens - useful vision
cataracts seond stage
vision significantly decrease
- lens appears opaque
cataracts third stage
lens starts to increase in size
cataracts fourth stage
lens may start to leak protein as it breaks down
- increase in intraocular pressure as well as blocking of the trabecular meshwork
trabecular meshwork
located around the base of the corna
- responsible for aqueous humor from the eue
risk factors for glaucoma
- hypertension, cardiovascular disease, obesity, DM
- smoking, caffine, alcohol, and illicit drugs
glaucoma
- increased intraocular pressure
glaucoma vision lost starts at the
periphery
open angle glaucoma
slow and progressive, bilatterally
closed angle glaucoma
sudden, acute, unilaterally
what is blocked in open angle glaucoma
trabecular meshwork
what is blocked in closed angle glaucoma
displaced iris pushes the ciliary body and blocks fluid from entering the trabecular meshwork
people with close angled glaucoma may see
rainbow in their vision
Glaucoma diagnositica
- ophthalmoscopic exmination
- measuring visual feild
- tonometery (air puff)
Macular degeneration
- deteriation od tissue in the macula
- severe and irreversible loss of central vision
dry stage macular degeneration
- eye tissue starts to degenerate
- epithelial cells produce yellowish- white spots
- deposited on retina
- calcify, enlarge and multiply
wet stage of macular degeneration
- newly developed vessels beneath the epithelial cells
- weak and leak serous fluid or blood
- central vision is lost
macular degeneeration risk factors
- hypertension, smotin, DM, and family distory
macular degeneration ussually occur in
after the age of 60
- more common in caucasioans, women
macular degeneration diagnostics
- ophthalmoscopic examination
- patient report loss of central vision
sensorineual hearing loss
impairment of the organ of corti
what is the most common cause of hearing loss
prebycusis or age related sensorineural hearing loss
sensorineural hearing loss causes
- noise exposure, aging, ototoxicity, systenic disease (DM, neoplasma, autoimmune processes)
what are the early signs or sensorineural hearing loss
tinnitus or ringing in the ear
conductive hearing loss causes
- impacted cerumen, foreign bodies, tumours in the middle ear, ruptured tympanic membrane, or otitis media
conductive hearing loss symptoms
- diminished hearing and soft speaking voice
why is otitis media common in children and infant
eustachian tube is shorter, wider, and more horizontal
what are predisosing factors for otitis media
- allergies, sinustis, cleft palate, hypertrophy or the adenoids, eustachian tube dysfunction and immune deficency
Acute otitis media (AOM)
tympanic membrane changes from convex pearky grey to buldging pink/red
AOM symptoms
- ear pain, irritability, inflammed TM and fluid in the middle ear
- pain, fever, purulent dischage
Otitis Media with Effusion (OME)
accumulation of fluid in the middle ear with symptoms of acute infection
OME can be caused by
flying
- changes in air pressure
- fluid is present but is not infected
