Cognitive systems Flashcards
Failure to recognize the form of an object
It can be tactile, visual, auditory
Agnosia
Defect of language comprehension or production.
Usually associated with cerebrovascular accident
Aphasia
You can not speak or write language
Expressive aphasia
When you can not understand writing or someone speaking to
You
Receptive aphasia
WORST type of aphasia. Patients can’t read or write and impaired comprehension. Usually due to stroke
Global aphasia
Acute confusional states arise from brain NETWORKS, not a discrete area of the brain
Know
2-3 days to develop, seen in ICU patients or patients who are just waking up from surgery, withdrawal, and elderly.
Restless, irritable, hallucinations, tremor, don’t sleep. Elevated HR, usually goes away in couple of days
type of delirium
Hyperactive
Seen in a patient with fever or metabolic disorder. All responses are going to be decreased.
type of delirium
Hypoactive
Do not give promethazine to elderly. It causes patients to lose it.
Know
Progressive failure of many cerebral functions, including
Orientation, memory, language, judgement, and decision making.
Mechanisms Neuron degeneration Brain tissue compression Atherosclerosis Brain trauma Infection and neuro inflammation
Dementia
Type of dementia, second most common type of progressive dementia. Due to protein deposit in the brain; alphasynuclein)
Lewy body dementia
Leading cause of severe cognitive dysfunction in older people
Alzheimer’s
70-90% fall under this category of Alzheimer’s
Non hereditary sporadic or late onset AD
Late day confusion during the evening
Sun downers syndrome
Alzheimer’s disease is due to:
Neuritic plaques: extra cellular, amyloid beta protein
Neurofibrillary tangles: intraneuronal
They disrupt neuron transmission they attack and cause neurons to die.
Early: forgetfulness, emotional upset
Over time: memory loss, disoriented, confusion, lack of concentration, decline in abstraction, problem solving, and judgement.
*Diagnosis is made by ruling out other causes of dementia
Know
Treatment for Alzheimer’s is supportive. No cure.
Know
Caused by cerebrovascular disease
Associated with poor blood flow in the brain..
Diabetes* Larger artery disease Cardio embolism (clot from heart) Small vessel disease of brain Stroke
- type of dementia
Vascular dementia
Most likely cause of new onset confusion of post op client
Hypoxia
Sudden, transient alteration of brain function cause by abnormal excessive discharges of cortical neurons
Manifestation of disease, not a disease itself
Seizure
Seizure classification
Clinical manifestations
Site of origin in brain
Eeg correlates
Response to therapy
Know
Also called partial seizures, no loss of consciousness, one sided of brain is effected
Focal
Result in consciousness and violent muscle contractions. Involves both sides of brain. Tonic clonic or grand mal seizures
Generalized seizure
Recurrent episodes of seizures. Maybe hypoxia at birth, brain tumor or infection can cause this.
Epilepsy syndromes
*phase of a seizure
___ phase is what happens before a seizure
Pre-ictal phase
** phase of seizure
This can happen hours to days before and it’s called ___ phase
During preictal phase
Prodroma
** phase of seizure
___ phase happens immediately before seizure
During preictal phase
Aura phase
___ phase is the phase that is actually happening during the seizure
Ictal phase
___ phase when the body is rigid
*stage of seizure
During ictal phase
Tonic phase
___ phase is the phase of a seizure where jerking comes into play
**stages of seizure
During ictal phase
Clonic
This usually happens during the ictal phase. It is a brief loud cry you hear due to sudden contraction of chest muscles during seizure
Epileptic cry
___ phase is after the seizure. Patient will usually be very weak and headache, confusion, temp paralysis.
Can last minutes to hours up to two days
Post ictal phase
___ ___ is the state of continuous seizures that last longer than five minutes
Status epilepticus
Treatment for seizure is to correct or control the cause. If you can’t then they have to be on seizure meds
Know
___ ___ ___ is caused by an increase in intracranial CONTENT.
- more fluid
- more blood/ bleeding
- more brain tissue/tumors
As pressure increases, circulating blood is squeezed out, leading to ischemia and hypoxia, brain damage.
Increased intracranial pressure
___ herniation is the worst type. Pushes brain to brain stem
Central
Manifestations of increased intracranial pressure is :
Change in level of consciousness
Headache nausea vomiting high BP.
If you see pupil changes it’s in late stages
Cushings triad (late sign): increase BP to push blood into brain, wide pulse pressure (high systolic low diastolic), low pulse rate, bounding, rapid respiratory rate (damage to central control of breathing)
____ is the Compensatory alteration in the size of the intracranial blood vessels. Tries to maintain constant blood flow due to changes in the head due to increased cerebral pressure
Autoregulation
Treatment ICP
Maintain blood flow and oxygen level
Deal with cause
Decompress the brain (surgery)
Usually use manitol and hypertonic saline
Know
___ ___ is the increase in fluid either intracellular or extracellular within the brain tissue. (Not cerebrospinal fluid)
Cerebral edema
Cerebral edema
What causes edema?
Trauma, infection, bleed, tumor, hypoxia
___ is the most important and common to type. Leak from blood vessels, extracellular.
Vasogenic.
Neurological deficits,decrease in LOC
___ ___ involves intracellular fluid
*cerebral edema types
Cytotoxic
_____ is the cerebrospinal fluid
That is pushed into brain.
- type of cerebral edema
Interstitial/hydrocephalic
Treatment:
*mainrain BP, osmolar (mannitol), reduce intracranial pressure.
___ is the increased cerebrospinal fluid in the ventricles of the brain.
Due to overproduction, blocked circulation, or no elimination of fluid.
Has many causes.
Treat by drain fluid.
Hydrocephalus
Decreased muscle tone
Hypotonia
Increased muscle tone
Hypertonia
You will see spasticity and rigidity.
___ is excessive, purposeless. Abnormal movement
Hyperkinesia
____ dyskinesia is rare. Episodic involuntary movements like spasms
Paroxysmal dyskinesia
___ dyskinesia involuntary movement of face lip tongue and extremities. Usually a side effect of certain antipsychotic drugs
Tardive dyskinesia
____ syndrome is Presence of motor tics and vocal tics. Sudden, rapid and repetitive
Tourette syndrome
___ ___ is an autosomal dominant hereditary degenerative disorder. Severe degeneration of the basil ganglia and cerebral cortex.
* the cause is Depletion of inhibitory GABA
Onset is 35-44 years old
Prominent jerking movements slow thinking can’t organize or plan.
No treatment
Huntington disease or Huntington chorea
___ is the decrease movement
Hypokinesia
___ is decrease in voluntary movements & caused by dopamine deficiency
Akinesia
___ is slowness of voluntary movements
Bradykinesia
____ __ ___ ___ is when the patient has movement but no movements that provide a skill or balance. Statue posture and no facial expression
Loss of associated movement
Degeneration of basil ganglia with loss of dopamine producing neurons
Low dopamine, relatively high acetylcholine.
Manifestations
Tremor, rigidity, bradykinesia, postural disturbances (forward), automatic and neuroendocrine symptoms, cognitive affective symptoms
Parkinson’s disease
There are meds for Parkinson’s disease
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___ is partial paralysis
Paresis
___ is loss of motor function
Paralysis
___ paralysis of upper and lower extremity on one side of the body
Hemiplegia or hemiparesis
___ is paralysis of lower extremities
Paraplegia or paraparesis
___ is paralysis of all four extremities due to a upper spinal cord injury.
Quadriplegia
In upper neuron motor syndrome the movement can return but may be spastic
Know
Lower motor neuron syndrome
Result in injury to alpha motor neurons from spinal cord to muscles
Impairs voluntary and involuntary movements
Know
___ loose floppy limbs
Flaccid
___ is when the muscle quivers under skin
Fasciculations
___ is what we can not see. Isolated contention of one muscle fiber due to metabolic issues.
Fibrillation.
___ ___ ___ is neurodegenerative disorder of upper and lower neurons. Starts with muscle weakness and progress to muscle atrophy, spasticity and loss of manual dexterity and gait.
Usually fatal from respiratory failure within a 3 year of diagnosis
Cause is unknown
Two drugs proved for treatment to prolong life & supportive
Amytrophic lateral sclerosis
