Chap 26: Neurological Disorders

Question 1

What are the major categories of neurological disorders ?

Answer 1

1. TBI
2. Epilepsy
3. Tumors
4. Motor disorders of the spinal cord
5. Motor disorders of the basal ganglia
6. Headache
7. Infection
8. Cerebral Vascular (stroke)

Question 2

What is thrombosis ? Embolism ?

Answer 2

Thrombosis
- blood coagulation in a vessel that forms a plug or clot
Embolism
- when a clot from a large vessel is forced into a smaller one
- most often in the middle cerebral artery

Question 3

What is an Angioma ? Aneurysm?

Answer 3

Angiomas
- collection of abnormal vessels that divert normal blood flow
Aneurysm
- vascular dilations from weakened vessel elasticity (creates buldge that is at risk for bursting)

Question 4

When are anti-coagulants used for stroke treatment ?

Answer 4

• for ischemic stroke ONLY
• within 3-5 hours of onset

Question 5

What are the common symptoms of stroke (FAST) ?

Answer 5

1. Numbness in arm, face, leg especially on one side
2. Sudden confusion, trouble speaking or understanding language
3. Sudden trouble walking, dizziness, balance control
4. Sudden severe headache

Question 6

What is a hyperkinetic vs hypo kinetic motor disorder?

Answer 6

Hyper
- excessive movement
- includes Huntingtons and Tourettes

Question 7

Describe the cause and characterization of Huntingtons

Answer 7

Cause
- dominant allele when transferred through genetics
- decrease of activity in the inhibitory pathway (for motor movement) from loss of cells in putamen and globes pallidus
Characterization
- abnormal movements and intellectual decline
- patients live roughly 12 years from onset

Question 8

Describe the cause and characterization of Tourettes ?

Answer 8

Cause
- increase in size of putamen, decrease in size of thalamus (affects the basal ganglia loops)
Characterization
Stage 1: multiple tics
Stage 2: inarticulate cries w/ tics
Stage 3: emission of articulation words: echolalia and coprolalia

Question 9

What are the 4 main symptoms of Parkinsons ?

Answer 9

1. Muscle rigidity
2. Postular disturbance
3. tremor
4. involuntary movement

Question 10

What are 3 causes of Parkinson’s ?

Answer 10

1. Idiopathic: cause is unknown (random)
2. Postencaphalitic: unique pattern of brain damage to the substantial nigra
3. Drug-induced: from ingestion mainly of major tranquiliizers

Question 11

What are 4 motor disorders of the spinal cord?

Answer 11

1. Myasthenia Gravis
2. Para/quadra/hemiplegia
3. Brown-séquard syndrome
4. MS

Question 12

Describe Myasthenia Gravis

Answer 12

• failure of function in muscular neurotransmitters
• rapid muscular fatigue without activity or exercise
• symptoms: double vision, droopy eyes, weak voice, cant chew or swallow, cant hold head up

Question 13

What is the treatment course for Myasthenia Gravis ?

Answer 13

• acetylcholine therapy

Question 14

Describe MS & its treatment

Answer 14

• loss of myelination on the motor neurons
• degenerates motor functions, patient may lose sensation in the face, limbs and body
  Treatment
• immune surpassants (ex. Lemtrada) to restrict the body from attacking the myelin

Question 15

Describe para/quadra and hemiplegia

Answer 15

Paraplegia
- cut at the thoracic level
- loss of sensation in lower limbs
Quadraplegia
- cut at the cervical level
- loss of sensation of all extremities
Hemiplegia
- loss of sensation to contralateral half of body to which damage occurs

Question 16

Which 2 reflexes are lost in hemiplegia ?

Answer 16

1. abdominal
2. cremasteric

Question 17

Describe the two pathways of the Basal Ganglia ?

Answer 17

1. Indirect
   - when dominating, the thalamus shuts down and movement is not produced
2. Direct
   - when dominating, the thalamus becomes overactive and movement is amplified

Question 18

What is Brown-Séquard Syndrome ?

Answer 18

unilateral transection through the spinal cord
- same side as cut looses sensation of touch and pressure
- ipsilateral side of cut looses sensation of temperature and pain

Question 19

What are 3 main types of tumors ?

Answer 19

1. Glioma
   - 45% of brain tumors, arising from glial cells accumulating in brain substance
2. Meningioma
   - tumor of the meninges, growing outside of the brain benign
3. metastatic
   - tumor cells from elsewhere in the body that travel to the brain
   - commonly come from the lungs or breasts

Question 20

What are the 3 symptoms stages of seizures in epilepsy ?

Answer 20

1. onset of an aura
   - subjective experience classifying the onset of a seizure
2. loss of consciousness
   - complete collapse or staring off into space (non responsive)
3. movement
   - shaking and other movement associated with seizure episode

Question 21

What are the 4 classifications of seizures ?

Answer 21

1. Focal
   - starts in one area and spreads
2. Generalized
   - bilaterally symmetrical, stereotypical seizure
3. Akinetic
   - short duration, common in children
4. Dissociative
   - no discernible EEG change

Question 22

Who is most susceptible to TBI ?

Answer 22

• children and the elderly
• males between age 15 and 30

Question 23

What are 2 forms of closed-hear injuries and what are 2 repercussions ?

Answer 23

Types:
1. coup: Damage at the site of the blow
2. Countercoup: Damage that came from the site of the blow projecting the brain to hit the opposite side of the skull
Repercussions
1. impairment of specific functions associated with site of damage
2. generalized impairments from widespread trauma

Question 24

What brain area damage is associated with poorer outcomes ?

Answer 24

Damage to brainstem
- causes dysphasia, hemiparesis