CNS infections, Cerebral palsy & Hematomas Flashcards
routine bacteria is referred to as a _________ infection
pyogenic
viruses are referred to as a _____________ infection
lymphocytic
yeast, fungi, molds, and super bacteria are referred to as _____________ infections
granulomatous
an infection in the brain parenchyma is known as ____________
encephalitis
an infection in the brain-protective membranes is known as __________
meningitis
an infection in the spinal cord parenchyma is known as ________
myelitis
an infection in the spinal cord protective membranes is known as _________ ____________
spinal meningitis
T/F all types of CNS infections have similarities to the flu at onset
true
there is a concern that there can easily be a ____________ of “bad flu” in a situation that is time sensitive
misdiagnosis
fever, fatigue, anorexia, digestive upset, headache, muscle and joint achiness/pain are all symptoms of a possible ___ __________
CNS infection
T/F it is important to be alert for any presence of neurological signs, which immediately suggest a more ominous problem
true
photophobia, phonophobia, altered vision, altered speech, disorientation, and motor weakness are all __________ symptoms that can be considered something that may need immediate medical attention
neurological
in the context of the onset of flu S/S, the presence of one or more _________ ______ (indicating meninges inflammation) can also be an indicator
meningeal signs
sudden onset unexplained severe neck pain & immobility, a positive brudzinski’s or kernig’s sign are all examples of _________ ______
meningeal signs
T/F skin rash, petechiae and localized sepsis are all possible meningeal signs
true
___________ sign is positive when forward neck flexion creates “explosive” pain in the head that often also shoots down the spine, person reflexively goes into the fetal position (traction on the upper meninges)
Brudzinkis
_________ sign is positive when hip flexion + knee extension (unilateral or bilateral) causes intense pain along the spine that may also shoot into the head - the person reflexively goes into the fetal position (traction on the lower meninges)
Kernig’s
the ________ and __________ types of CNS infection typically have sudden, acute onsets
pyogenic and lymphocytic
_____________ infections sometimes have acute onset but most times it is a gradual onset
granulomatous
there is a significant incidence of __________ _____________ infections (young children, elderly, immunocompromised, very ill are most vulnerable)
opportunistic granulomatous
some organisms such as ___________ have the capacity to make a healthy adult dangerously ill
meningococcus
T/F the lymphocytic types have the best survival and recovery rate
true
for meningitis - when the disease is diagnosed early and adequate tx is started __ - ___% of patients die, typically within 24-48 hours after the onset of symptoms
5-10%
when meningitis is diagnosed late or left untreated up to __% of patients may die
50%
for encephalitis, diagnosed early and treated the death rate is __-__%, diagnosed late or untreated is __-__%
3-20% treated 50-75% untreated
______________ types have the highest fatality rate, in part because they are often occurring in the immunocompromised
granulomatous
the following are examples of _______ impairments following CNS infections: mental health disorders/personality change, cognitive memory issues, epilepsy and headaches/pain syndromes
ongoing
_________ ______ is a general term that describes a group of disorders that appear during the first few years of life and affect a child’s motor abilities
cerebral palsy
cerebral palsy damage can occur during _______ ________
fetal development
in cerebral palsy, the ________ ________ centers are primarily affected
higher motor
T/F cerebral palsy is easily curable
false
T/F cerebral palsy is usually congenital
true
for many years, doctors and researchers believed that cerebral palsy was almost exclusively caused by lack of _________ (hypoxia, anoxia) during the birth process
oxygen
abnormal brain development before birth, disturbance to brain circulation before birth, maternal infection during pregnancy, high fever, and severe jaundice in newborns may be alternative causes for ________ ________
cerebral palsy
although less common, cerebral palsy may also result from occurrences affecting the CNS through ______ _______ or toxicity
head trauma
T/F most children with cerebral palsy do not have any clinically apparent problems during development in the womb
true
there are _______ major types of cerebral palsy
three
________ cerebral palsy; occurring in 60% of patients with CP, muscles tend to be hypertonic, and also have spastic episodes - can affect both legs or one side of the body but more commonly the whole body is affected
spastic
__________ cerebral palsy; about 1 in 5 people with cerebral palsy have this form which is also referred to as extrapyramidal cerebral palsy. Usually affects the whole body and causes slow BL involuntary movements where the limbs appear to “Writhe”
athetotic
_________ cerebral palsy is the least common of the major types. It affects balance and coordination and has the characteristic ataxic gait
ataxic
some children have signs and symptoms of more than one type of CP, which may be referred to as a ________ form of the condition
mixed
in addition to the primary motor dysfunction already mentioned, CP may include ________ gait, _________ and ________
scissors gait, dysarthria, tremors
T/F cerebral palsy is not a progressive condition, however health status may deteriorate over time as a result of effects of the condition
true
contracture and arthritic changes in patients with CP also create higher ______ levels and reduced ________ ability
pain, functional
individuals with severe cases may need a _________ and extensive _________ care but many mild or moderate cases require little or no special assistance for daily activities
wheelchair, lifelong
the two most common traumatic bleed types are _______ and ________ hematomas, both are dangerous and important for the RMT to be alert about
epidural, subdural
our focus is twofold; _____of S/S and awareness of what makes someone more high risk
onset
___________ hematoma; is a higher pressure arterial l bleed, often from one of the meningeal artery branches, caused by a skull fracture or other traumatic impact
epidural
the blood forces its way between the _______ skull bone periosteum and the _______ ______, snapping the sharpey’s fibers and disrupting the structural support that holds it to the skull
internal, dura mater
in an epidural hematoma, brain tissue _______ as blood rushed into the enlarging space
collapses
with epidural hematomas, brain damage can ensue, and there is a __________ of time in which medical treatment can be successful in evacuating blood and controlling flow and tissue damage
window
T/F epidural hematomas are likely to be fatal when the window of time is lost
true
S/S onset of an epidural hematoma occurs within a few hours to 3 ____ from the impact, bleeding may start right away or the injured vessel may take a bit of time to “blow”
days
epidural hematoma S/S onset is usually a very intense “unusual” ________ accompanied by nausea/vomiting
headache
onset of S/S of shock is typical in an _________ hematoma
epidural
altered consciousness and the patient eventually slipping into a coma are S/S of an _________ hematoma
epidural
T/F people are awakened regularly after a concussion to ensure they do not slip into a coma
true
a _________ hematoma is a slower, lower-pressure bleed, typically venous or microvascular
subdural
the blood accumulates in the space between the dura mater and the brain, sometimes staying above the arachnoid mater, sometimes seeping below - this is a typical presentation of a ____________ hematoma
subdural
T/F it can take some time before enough blood accumulates to pressurized the brain; therefore it can be days or weeks before S/S appear in cases of a subdural hematoma
true
T/F in a subdural hematoma the brain tissue typically collapses in the epidural hematoma manner
false
pressure from sufficient accumulating blood can cause damage - this is indicative of a _________ hematoma
subdural
the most common first S/S of a subdural hematoma is ________
dystaxia
another very common symptom of a subdural hematoma is a _________
seizure
T/F subdural hematomas have the potential to be fatal, but there is more time and opportunity for successful medical treatment
true
T/F as an RMT you may be massaging someone with a developing subdural hematoma - therefore it is important to be alert for subtle signs
true
people most at risk for head impacts and or “whiplash” mechanisms include which of the following
a) frequent fallers
b) professional drivers (taxis etc)
c) construction workers
d) all of the above
d) all of the above
