CBLcards3 Flashcards
“Pathways of Sensation to the Brain”
Different modalities sensed by specialized receptors, Sensory information transmitted via peripheral nerves to spinal cord or brainstem, Ascends via specific pathways (spinothalamic tract for pain and temperature, dorsal column-medial lemniscal pathway for touch and proprioception), Synapse in thalamus before reaching primary sensory cortex in the brain\
Sensory Loss Patterns and Pathology
Dermatomes and peripheral nerve distributions help localize pathology, Patterns of sensory loss (e.g., dermatomal, peripheral nerve distribution) indicate specific nerve or spinal cord involvement\
Symptoms and Signs of Peripheral Neuropathies
Paresthesia (tingling or burning sensation), Numbness, Sensory loss (glove-and-stocking distribution), Hypersensitivity to touch or pain, Weakness or muscle atrophy in severe cases\
Management of Pain
WHO Pain Ladder: Step 1: Non-opioid analgesics, Step 2: Weak opioids, Step 3: Strong opioids, Non-pharmacological approaches: physical therapy, cognitive-behavioral therapy, acupuncture, TENS\
Nociceptive vs. Pathological Pain
Nociceptive pain arises from tissue damage or inflammation, Neuropathic pain results from dysfunction or damage to the nervous system itself\
Mechanisms of Neuropathic Pain Drugs
Anticonvulsants (e.g., gabapentin, pregabalin): modulate neuronal excitability, Tricyclic antidepressants (e.g., amitriptyline): enhance descending inhibitory pathways, Local anesthetics (e.g., lidocaine): block sodium channels, reducing nerve excitability\
Effect of Opioids and Local Anaesthetics on Neurotransmission
Opioids act on opioid receptors, inhibiting neurotransmitter release and reducing pain transmission, Local anesthetics block sodium channels, preventing action potential propagation and pain signal transmission\
FAST Test
Face: facial droop or asymmetry, Arms: arm weakness or drift, Speech: slurred speech or difficulty speaking, Time: Time to call emergency services\
Features and Site of Stroke Pathology
Hemiparesis or hemiplegia, Facial droop, Aphasia (expressive or receptive), Visual field deficits, Asymmetrical reflexes\
Types of Dysphasia and Dysarthria
Expressive dysphasia: difficulty with speech production,
Receptive dysphasia: difficulty with comprehension,
Dysarthria: difficulty with articulation due to muscle weakness\
Pathological Basis of Strokes
Ischemic stroke: blockage of blood flow due to embolism or thrombosis, Hemorrhagic stroke: bleeding into brain tissue due to rupture of blood vessels\
Risk Factors, Investigations, and Management of Stroke
Hypertension, diabetes, hyperlipidemia, smoking, atrial fibrillation, Investigations: CT or MRI, carotid ultrasound, ECG, Management: thrombolysis, anticoagulants, antiplatelets, lifestyle modifications\
Role of Drugs in Stroke Management
Thrombolytics (e.g., alteplase): dissolve blood clots, Anticoagulants (e.g., warfarin, DOACs): prevent clot formation\
Scoring Systems for Anticoagulation
CHA2DS2-VASc Score: Used to assess stroke risk in atrial fibrillation (AF) patients, HASBLED Score: Used to assess bleeding risk in patients on anticoagulation therapy\
Significance of Prompt Recognition in Stroke
Time-sensitive treatments like thrombolysis are most effective within a narrow window, Early intervention can prevent or minimize disability and improve outcomes\