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Neurologic Conditions > Autonomic Disorders > Flashcards

Autonomic Disorders Flashcards

1
Q

What is the hx of Non-neurogenic orthostatic hypotension?

A
  • Dimming of vision
  • Dizziness or lightheadedness
  • Sweating
  • Pallor
  • Paroxysmal weakness
  • Loss of consciousness
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2
Q

What do pt w/ non-neurogenic orthostatic HOTN frequently have?

A
  • Hx of HTN or heart dz
  • Take meds that cause orthostatic HOTN
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3
Q

What is Orthostatic HOTN?

A

Drop in systolic BP of >20mmHg d/or a drop in diastolic BP >10mmHg w/in 3min of standing from a supine position. Compensatory inc in pulse rate of >15 BPM

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4
Q

What is the cause of Orthostatic HOTN?

A

Reduction in perfusion to the brain upon standing resulting in sx

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5
Q

What is the tx of Orthostatic HOTN?

A
  • Meds adjustment
  • Correct hypovolemia
  • Exercise
  • Correct anemia
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6
Q

Who gets Orthostatic HOTN assoc w/ brain disorders?

A

Older adults

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7
Q

What is the duration of orthostatic HOTN assoc w/ brain disorders?

A

Subacute or chronic

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8
Q

What is the hx of orthostatic HOTN assoc w/ brain disorder?

A
  • Neuro sx
  • Parkinsonian-like sx freq
  • Cerebellar dysfxn
  • Other autonomic sx
  • CNS disturbances
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9
Q

What are Autonomic sx?

A
  • Diarrhea
  • Constipation
  • Urinary retention
  • ED
  • Sweating disturbances
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10
Q

What are the CNS distrubances?

A
  • Language
  • Memory
  • Speech
  • Swallowing
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11
Q

What are the PE findings of orthostatic HOTN w/ brain disorders?

A
  • Orthostatic HOTN
  • No compensatory in in HR
  • Neuro findings suggestive of CNS distrubance
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12
Q

What are the neuro findings of CNS distrubances?

A
  • ABN of muscle tone
  • Ataxia
  • Tremor
  • ABN pupillary light reflexes
  • Gait disorder
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13
Q

What are the tech findings of orthostatic HOTN w/ brain disorder?

A

ABN autonomic testing

ABN findings on brain MRI

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14
Q

What is the tx of orthostatic HOTN w/ brain disorders?

A
  • Check meds
  • Hydration
  • Exercise as tolerated
  • Libral salt
  • Alpha sympathetic agonist
  • Pressure hose to promote venous return to the hear
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15
Q

What are the hx/sx of orthostatic HOTN assoc w/ peripheral nerve dysfxn?

A
  • Stocking glove sensory disturbances
  • Peripheral weakness
  • Autonomic sx
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16
Q

What are the tech features of orthostatic HOTN assoc w/ peripheral neuropathy?

A

ABN autonomic testing

17
Q

What causes orthostatic HOTN assoc w/ peripheral neuropathy?

A

Post-ganglionic autonomic fibers PNS are subject to same dz processes that motor & sensory fibers subject to

18
Q

What are the PE findings of Horner’s synd?

A
  • Ptosis
  • Miosis
  • Anyhdrosis
19
Q

What are the sx of ANS disturbance?

A
  • Anhydrosis
  • Orthostatic hypotension *MC!
  • ABN pupillary reflexes
  • Dec lacrimation/salivation
  • ED
  • Bowel/bladder dysfunction
20
Q

What is the craniosacral ANS?

A

PNS

21
Q

What is the thoracolumbar ANS?

A

SNS

22
Q

How does the SNS innervate the pupil?

A

SC→ sympathetic chain ganglion→Post ganglionic fibers→ Dilator pupillae→ DILATE

23
Q

How does the PNS innervate the pupil?

A

CN III→ ciliac ganglion→ short ciliary n.→ciliary muslce of the pupil→ CONSTRICT

24
Q

What muscle raises the eyelid?

A

Muller’s muscle innervated by the SNS

25
Q

What are the peripheral PNS fibers vulnerable to?

A

COMPRESSION

(Hematoma, herniation, tumor, abscess)

26
Q

What are the interior PNS fibers vulnerable to?

A

ISCHEMIA

(supplied by perforating BV)

27
Q

What causes mononeuropathy muliplex?

A

DM, SLE, AI dz

28
Q

What can cause ptosis?

A
  • Horner’s synd
  • CN III lesion
  • Myasthenia gravis
  • Trauma or post op
  • Aging
29
Q

What can cause ptosis AND affect the pupil?

A

Horner’s synd & CN III lesion

(NOT MG–afects skm ONLY)

30
Q

What is the hemodynamic response to standing?

A

Dec BP & Inc HR

31
Q

What is the hemodynamic reponse to standing in a hypovolemic state?

A

BIG dec in BP & BIG Inc in HR

32
Q

What is the hemodynamic response to standing in autonomic failure?

A

Big dec in BP & no change in pulse (don’t get reflex tachycardia)

33
Q

What are the peripheral ANS disorders or Pandyastonia?

A
  • Acute inflammatory neuropathy: GBS
  • Diabetic neuropathy
  • Amyloidosis
  • Acute AI Polyneuropathy: Porphyria
  • Tetanus
34
Q

What is complex regional pain synd?

A

Injury to a part, long after there has been healing, the patient continues to feel pain in the limb

35
Q

What drugs can cause orthostatic HOTN?

A

Amlitryptine (SSRI) & Hydrocholorthiazide

Neurologic Conditions (15 decks)

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