Chaper 18-Disorders of the Central and Periperhal Nervous Systems and the Neuromuscular Junction Flashcards
An alteration in brain function or other evidence of brain pathology caused by an external force
Traumatic Brain Injury
Classifications of Primary Brain Injury:
(1) affects one are of the brain
(2) affects more than one area of the brain
Focal
Diffuse
Injury at site of impact
Coup Injury
Injury from brain rebounding and hitting opposite side of skull
Contrecoup Injury
LOC followed by a lucid period, Increasingly severe HAs, N/V, drowsiness, confusion, seizure, and hemiparesis. Medical Emergency
Epidural Hematoma
Headache, drowsiness, restlessness or agitation, slowed cognition, and confusion
Subdural Hematoma
Treatment for Subdural Hematoma
Burr Hole to remove clot
Damage to delicate axonal fibers and white matter tracts that project to the cerebral cortex
Concussion
Loss of the continuous tonic discharge from the brain or brainstem and an inhibition of suprasegmental impulses, complete loss of reflex function, flaccid paralysis, sensory deficit, and loss of bladder and rectal control, transient drop in blood pressure and poor venous circulation, loss of thermal control, causing the body to assume air temperature, resolving when reflexes return or bladder relaxes
Spinal Shock
4 clinical manifestations of Neurogenic Shock
Vasodilation
Hypotension
Bradycardia
Hypothermia
Syndrome of sudden massive reflex sympathetic discharge associated with a spinal cord injury at the T6 or above
Autonomic Dysreflexia
Autonomic Dysreflexia BP =
up to 300 mmHg systolic
Treatment for Autonomic Dysreflexia
1) elevate HOB
2) Stimulus should be found and removed (empty bladder or bowel)
3) Administer topical nitro paste above the level of the lesion
Three types of strokes
Hemorrhagic
Ischemic
Crytogenic
Congenital abnormality and degenerative changes
Saccular (berry) aneurysms
Diffuse arteriosclerotic changes:
Fusiform (giant) aneurysms
Arteritis caused by bacterial emboli
Mycotic Aneurysms
What type of hemorrhage would you find a Positive Kernig and Brudzinski sign?
Subarachnoid Hemmorhage
When thigh is flexed a the hip and knee @ 90 degree then subsequent extension in the knee is painful
Kernig’s Sign
What would a positive Kernig sign show
May indicate Subarachnoid Hemorrhage or Bacterial Meningitis
What is a positive Brudzinski sign
Severe neck stiffness causes a patient’s hips and knees to flex when the neck is flexed
What would positive Brudzinski sign show
Bacterial Meningitis
Progressive, chronic, inflammatory, demyelinating autoimmune disorder of the CNS (affects more women)
Multiple Sclerosis
Acquired, acute inflammatory autoimmune disease causing demyelination of the peripheral nerves or axonal disorder
Guillain-Barre Syndrome
Treatment for Guillain-Barre Syndrome
Ventilator Support
IV immunoglobulin, plasmapharesis
Has autoantibodies, defect in nerve impulse transmission at the neuromuscular junction
Myasthenia Gravis
Tx for Myasthenia Gravis
Anticholinesterase drugs
Corticosteroids
Immunosuppressant drugs
Treatment for Myasthenic crisis
Plasmapharesis
