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Gen Med Test 3 > Chapter 11 > Flashcards

Chapter 11 Flashcards

1
Q

Facial skeleton

A
  • mandible
  • 2 zygomatic
  • 2 maxillary
  • 2 nasal bones
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2
Q

Cerebral cranium

A
  • protects the brain and brainstem, and the anterior facial bony structure
  • 8 bones
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3
Q

Meninges

A
  • lies just beneath the skull and provide 3 protective layers
  • dura, arachnoid, pia
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4
Q

Cerebrum

A
  • two cerebral hemispheres are composed of neural tissue

- the two hemispheres are divided into four principal lobes: frontal, temporal, parietal and occipital

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5
Q

Brainstem

A
  • main conduit for information between the brain and the spinal cord by way of cerebellar peduncles
  • ascending and descending tracts
  • contains all cranial nerve nuclei and controls: respiration, CV system functions, level of consciousness, sleep, and alertness
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6
Q

Autonomic nervous system

A
  • innervates glands, smooth muscle, and cardiac muscle

- divided into parasympathetic and sympathetic nervous systems

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7
Q

Cerebellum

A
  • controls function in the higher level of coordination or voluntary movements and in the maintenance of balance, equilibrium, and muscle tone
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8
Q

Broca’s area

A
  • frontal lobe (primary mortar cortex)

- speech

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9
Q

Wernickes area

A
  • parietal lobe/ temporal
  • speech comprehension
  • located in the dominant hemisphere only
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10
Q

Spinal Cord

A
  • body’s communication system
  • transmits nerve impulses
  • white matter (myelinated) and grey matter (neurons or nerve cells)
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11
Q

Spinal Nerves

A
  • 31 pairs

- ventral or dorsal roots

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12
Q

Warning signs of neurological diseases (positive)

A
  • hypersensitivity
  • seizures
  • movement disorders that include tremor, spasm, and tics
  • upper motor neuron signs: spasticity, hypertonicity, and hyperreflexia
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13
Q

warning signs of neurological diseases (negative)

A
  • represent loss of function
  • paresis
  • paralysis
  • hyposensitivity
  • dementia
  • aphasia
  • syncope
  • neck stiffness
  • gait dysfunction
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14
Q

Red flags for urgent intervention

A
  • alteration in level of consciousness
  • fixed or abnormal pupils
  • abnormal eye movements
  • acute visual impairments
  • focal neurological symptoms occurring after head trauma
  • paralysis or progressive muscle weakness
  • bowel or bladder incontinence
  • acute severe headache, especially associated with nausea and vomiting or focal neurological deficits
  • prolonged or recurrent generalized seizures
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15
Q

Stroke

A
  • cerebrovascular accident (CVA)

- caused by a lack of oxygen to the brain that may lead to reversible or irreversible paralysis, hemorrhagic, embolic

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16
Q

Red flags for stroke

A
  • numbness or weakness of the face, arm, or leg on one side of the body
  • confusion, trouble speaking, or understanding
  • vision difficulties in one or both eyes
  • problem with speaking, slurred speech
  • trouble walking, dizziness, loss of balance or coordination
  • severe headache with no cause
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17
Q

Stroke causes

A
  • cardiac embolism
  • hematological stroke
  • lacunar stroke
  • intracerebral hemorrhage: meth, cocaine, ecstasy
  • younger population (15-45 years) accounts for 3% of strokes
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18
Q

Stroke referral/diagnosis

A
  • medical emergency

- diagnosis: hx, CT scan, MRI, EEG, doppler flow stuides

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19
Q

Stroke Treatment & RTP

A
  • antihypertensives
  • anticoagulants
  • anti platelet agents
  • heparin ASA
  • rehabilitation
  • level of recovery
  • residual impairment
  • type of sport
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20
Q

Guillain-Barre Syndrome

A
  • acute, diffuse demyelinating disorder of the spinal roots and peripheral nerves
  • either gender at any age but uncommon in early childhood
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21
Q

Red flags for GB syndrome

A
  • progressive weakness beginning distally and moving proximally
  • areflexia
  • afebrile state
  • pain with slightest movement of affected area
  • nocturnal muscular cramps
  • patients with recent hx of URI or gastro illness
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22
Q

GB syndrome S&S

A
  • progressive distal muscle weakness
  • loss of DTRs on both sides
  • weakness evolves quickly over hours or days
  • paresthesia & numbness
  • may progress to respiratory paralysis
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23
Q

GB syndrome treatment

A
  • EMG
  • CSF analysis
  • elevated protein levels
  • NCV
  • supportive care
  • rehabilitation
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24
Q

GB prognosis & RTP

A
  • 85% recovery completely or nearly completely
  • 30% still have residual weakness after 3 years
  • 3% have relapse
  • > 5% mortality rate
  • RTP depends on level of symptom resolution and release by medical provider
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25
Q

Headaches (vascular)

A

caused by spasms of the vessels surrounding the brain, and include migraines, fever-inducing toxic headaches, headaches as a result of high blood pressure

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26
Q

Headaches (contraction/tension)

A

result from muscular tension on the cervical spine and cranium

27
Q

Headaches (traction/inflammatory)

A

result from other disorders that could include stroke or a sinus infection

28
Q

Sinus headache

A

pain is usually behind the forehead or cheekbones

29
Q

Cluster headaches

A

pain is in and around one eye

30
Q

Tension headaches

A

pain is like a band squeezing the head

31
Q

Migrane headaches

A

pain, nausea, and visual changes are typical of classic form

32
Q

Medical evaluation of headaches

A
  • new or unusual
  • sudden onset of severe headache
  • change in pattern
  • chronic headache with localized pain
  • interrupts sleep or present in the morning
  • associated with nausea or vomiting
  • visual disturbance
  • associated with numbness, paralysis or weakness
  • head ache associated with stiff neck, fever, weight loss, neurological S&S
33
Q

Seizure Disorder and Epilepsy

A
  • caused by abnormal discharges of electrical activity in the brain, and may arise from a number of pathologies
  • outward manifestation of seizure is altered awareness, involuntary movement, and/or convulstions
34
Q

Seizure disorders intermittent tonic-clonic

A
  • pre octal aura of smells or sounds
  • tonic-clonic muscle contractions
  • tongue biting
  • incontinence (not always)
  • postictal: confusion, disorientation, exhaustion & lethargy
35
Q

Seizure disorders absence (focal) seisures

A
  • brief episode (3-10) seconds
  • loss of attention or awareness
  • more pre or postictal states
  • automatisms: chewing, lip smacking, swallowing, facial twitching
36
Q

Treatment of seizure disorders

A
  • anticonvulsant medications
  • barbiturates: phenobarbital
  • benzodiazepines: valium
  • carboxamides: carbamazepine
  • plus 14 other classes of drugs
37
Q

Seizure RTA

A
  • consideration of risk
  • seizure free for 1 year on medication
  • seizure free for 2 years without medication
  • avoid high risk sports: gymnastics, high diving, sky diving, rock climbing, motor sports
  • avoid some non contact sports as well
38
Q

Multiple Sclerosis

A
  • neurodegenerative, lifelong chronic disease diagnosed primarily in young adults, characterized by the gradual accumulation of focal plaques of demyelination in the brain
39
Q

Forms of MS

A
  • Relapsing remitting MS: cyclic episodes of worsening neurological function followed by complete remission. 85% of people diagnosed with MS
  • Primary progressive: gradually worsening neurological function without remission. 10% of people diagnosed with MS
40
Q

Other forms of MS

A
  • secondary progressive

- progressive relapsing

41
Q

Treatment for MS

A
  • no cure
  • categories of treatment
  • disease modifying: inferno beta - 1a/b
  • symptom relieving: corticosteroids, muscle relaxants, immunosuppressants
  • mild to moderate exercise
42
Q

ALS (amyotrophic lateral sclerosis)

A
  • lou gehrig’s disease
  • fatal, progressive, neurological disease that slowly attacks neurons responsible for voluntary muscular actions; there are no effective treatments to stop or reverse the progression
  • prognosis: certain death 50% are dead within 3 years of diagnosis
43
Q

Bell’s Palsy

A
  • disease that typically affects one nerve, the facial cranial nerve, resulting in unilateral or bilateral facial weakness or paralysis; it has a rapid onset and most always spontaneously resolves
  • recovery completely within 1-8 weeks
44
Q

Complex regional pain syndrome

A
  • complex regional pain syndrome is a condition involving over activity of the sympathetic nervous system that can occur after minor injury, due to trauma to a nerve
  • type 1: follows an injury to soft tissue or bone
  • type 2: previously called causalgia follows documented injury to a nerve
45
Q

CRPS S&S

A
  • severe burning pain
  • hyperhidrosis
  • pain beyond what would be expected for an injury
  • local edema
  • pathological changes in skin
  • radiographic changes to bone
  • DD: raynauds, gout, myositis ossificans, compartment syndrome
46
Q

CRPS treatment

A
  • desensitization of the effected extremity
  • joint mobilization and PROM/AROM
  • pain reduction techniques
  • tens, e-stim, hydrotherapy
  • edema control
  • restore strength and function
  • medication for pain control
47
Q

CRPS prognosis and RTP

A
  • can be reversible in early stages (4-6)
  • may become irreversible after 8-9 months
  • RTP depends on severity of symptoms and level of recovery
48
Q

Upper motor neuron

A
  • brain or spinal cord
  • damage presents as weakness, paralysis, increased muscle tone, hyperactive DTRs, babinskis reflex
  • DO NOT regnerate
49
Q

Lower Motor neuron

A
  • relate to nerve cell bodies or axons or both
  • located in the anterior horn and peripheral nerves
  • damage presents as decreased muscle tone, diminished or absent DTRs, muscular twitching, progressive atrophy of the affected muscles
50
Q

Parts of a neuron

A
  • Dendrites
  • Axon
  • Myelin sheath
  • schwann cell
  • node of ranvier
  • terminal branches
51
Q

Chemical synapse

A
  • presynaptic terminal
  • terminal vesicles
  • synaptic cleft
  • neurotransmitters
  • receptor proteins
  • postsynaptic neuron
52
Q

CN 1: olfactory

A

smell

sensory

53
Q

CN2: optic

A

vision (diplopia)

sensory

54
Q

CN 3: Oculomotor

A

opening/closing of eyelids
motor movements
parasympathetic - pupil constriction
both

55
Q

CN 4: trochlear

A

down and inward movement of the eye

motor

56
Q

CN 5: trigeminal

A

muscle of mastication

mixed

57
Q

CN 6: abducens

A

lateral movement of eye

motor

58
Q

CN 7: facial

A

taste, facial muscles, open and close mouth

- mixed

59
Q

CN 8: vestibucochlear (acoustic)

A

snapping fingers

sensory

60
Q

CN 9: glossopharyneal

A

swallowing

mixed

61
Q

CN 10: vagus

A

swallowing

mixed

62
Q

CN 11: spinal

A

shrugging shoulders
SCM
motor

63
Q

CN 12: hypoglossal

A

movement of tongue

motor

Gen Med Test 3 (5 decks)

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