Exam 2- Altered Nurological Function Flashcards
Autonomic Dysreflexia
Massive, uncompensated cardiovascular response to stimulation of the sympathetic nervous system.
T6 or above
HTN, HA, sweating about the level of the lesion with flushing of the skin, bradycardia
Cerebral edema
Accumulation of fluid in the brain tissue.
Motor changes related to brain function
Loss of cortical inhibition associated with decreased consciousness includes abnormal flexor and extensor movements.
Cerebral death
Irreversible coma. Represents permanent brain damage with an ability to maintain cardiac, respiratory, and other viral functions. Inability to maintain internal homeostasis.
Seizures
Abnormal, excessive hypersynchronus discharges of cerebral neurons with transient alterations in brain functions. Generalized or focal.
Epileptic syndrome
Location-related
Generalized
Undetermined
Dysmnesia and amnesia
Some memories are not retrieved and new memories cannot be stored.
Frontal areas mediate vigilance, detection, and working memory. With vigilance deficit, the person can’t maintain search and scanning activities. Since this is a detection deficit, the person is unmotivated to use feedback.
Agnosia
Defect of recognition. Tactile, visual, or auditory.
Caused by dysfunction in the primary sensory or interpretive areas of cerebral cortex.
Dysphasia
Impairment of comprehension or production of language. Expressive or sensory.
Aphasia
Loss of language comprehension or production.
Tension-type HA
most common. Central and peripheral mechanisms.
Bilateral HA with sensation if band around the head. May last for hrs or days.
Cluster HA
occur in episodes several times during a day for a period of days at different times of year.
Pain is unilateral, intense, tearing, and burning. Eye sx associated.
Chronic paroxysmal hemicrania- cluster HAs with more frequent daily attacks. Primarily in women. Respond to indomethacin.
Migraines
HA with and without aura and precipitated by triggering event.
Familial episodic d/o. Marker is HA.
Phases: premonitory, migraine aura, headache phase, recovery phase.
Extramural hematoma
Temporal fossa most common site, caused by injury to the middle menigeal artery or vein.
85%arterial
15% meninges vein or dural sinus injury
90% have skull fx
Subdural
Acute or chronic. Develop within 48 hrs. Often located st top of head.
MVA most common cause. 50% associated with skull fx.
Diffuse axonal injury (DAI)
Results from head rotation. Brain experiences shearing stress.
CVA
Most frequently occurring neurological d/o. Any abnormality of vessels of brain is referred to as cerebrovascular dz.
Scheming or hemorrhagic
Risk factors for TBI
15-35 years of age >70 yo Male gender Living in high-crime area Military Professional sports players
Neurogenic shock
Loss of sympathetic outflow: Vasodilation Hypotension Bradycardia Hypothermia
Axon
Extension of the neuron that carries impulses away from the cell body. The tail.
Axon hillock
Where the action potential begins. Usually travels away from the neuron.
Multipolar neuron
Multiple dendrite sand single axon . Most common type.
Node of ranvier
Neurilemma and myelin sheath are separated by the nodes, allowing ions to flow between segments rather than along an entire length of membrane, resulting in increased. Eli city of neuronal conduction.
Gray matter
Contains cell bodies of interneurons.
Contains cell bodies of spinal lower motor neurons. Their axons synapse with skeletal muscles.
White matter
Contains tracts of axons, many of which are myelinated.
Neurons
can be separated by their relative functionality. Sensory neurons carry impulses from peripheral sensory receptors to the CNS. Interneurons transmit impulses from neuron to neuron, for example from sensory to motor. Motor neurons transmit impulses away for the CNS to an effector organ. The interneurons are the go-between to make sure the two are communicating.
Glucose is its fuel source.
Central Nervous System (CNS)
Brain and spinal cord.
Neural plasticity indicates that it is capable of change.
Oligodendroglia form the myelin sheaths.
Groups of cell bodies are called nuclei.
Peripheral Nervous System
Cranial nerves and spinal nerves. Broken into sensory (afferent) and motor (efferent). Motor broken down into somatic and autonomic. Autonomic broken into sympathetic and parasympathetic.
31 pairs of spinal nerves and 12 pairs of cranial nerves.
Schwann cells for the myelin sheaths.
Groups of cell bodies are called ganglia.
Divergence
Primary effect of. Europe whose axons synapse with several spinal cord neurons at different levels of he spinal cord.
Convergence
Numerous neurons converging on and influencing one or a few neurons.
Epidural space
A potential space in the skull and a real space in the spinal cord.
Basal ganglia
Part of the extrapyrimidal pathways.
the major cerebral nuclei (a cluster of neurons in the CNS) of varied origin. Include the corpus striatum, the subthalamic nucleus of the diencephalon and the substania nigra of the mesencephalon. They, combined with the interconnections with the thalamus, premotor cortex, red nucleus, reticular formation, and the spinal cord, are part of the ganglia system (extrapyramidal system). It is believed to exert a fine-tuning effect on fine motor movements. Parkinson disease and Huntington’s disease are conditions associated with defects of the basal ganglia.
Sympathetic Nervous System
Fight or flight.
Adrenergic.
Nerves that are postganglionic.
Bridgman area
Voluntary muscle movement
Visual cortex
In the occipital region. Responsible for vision.
Prefrontal area
Goal-oriented behavior, decision-making.
Postcentral gyrus
Touch and other sensations.
Superior temporal gyrus
Auditory
Cerebellum
Motor coordination
Broca area
Speech
Efferent neurons
Motor. Carry neurons impulses away from the CNS
Afferent
Sensory. Carry nerve impulses toward the CNS
Somatic Nervous System
Part of the PNS. Consists of motor and sensory pathways. Regulating voluntary motor control of skeletal muscle.
Autonomic Nervous System
Part of the PNS. Also consists of motor and sensory components and is involved with the regulation of the body’s internal environment through involuntary control.
Divided into sympathetic and parasympathetic.
Cranial nerves
Project from and pass through the foramina in the skull.
Spinal nerves
Pass through the intervertebral foramina of the vertebrae.
Neuroglia
Nervous system cells that are not neurons
CSF
Produced by choroid plexuses. Returns to the blood at the arachnoid villi.
Contained in the subarachnoid space.
Synapse
Space between 2 neurons called the synaptic cleft.
Melatonin
Secreted by the pineal body.
Wallerian degeneration
A process that happens when an axon in the PNS is severed. Causes the axon to disappear and the Schwann cells tonline up in the pathway that facilitates nerve regeneration.
Brainstem
Composed of the midbrain, pins, and medulla oblongata.
Dendrite
Neuron extension that carries impulses toward the cell body. More than one is multipolar.
Tract
A bundle of axons
Ipsp
The result of hyperpolarization of a post synaptic membrane.
Meninges
Protective membranes surrounding brain and spinal cord.
Limbic
Brain system that includes the amygdala, hippocampus, and thalamus.
Presynaptic
Neuron that relays impulses toward a synapse.
Epss
Result of depolarization of a postsynaptic membrane.
Corpus callosum
The structure that connects the cerebral hemispheres.
Myelin
Insulating lipid material that surrounds axons.
CNI
Olfactory
Function: sensory, carries impulses for sense of smell
Testing: asked to sniff something and identify it
CNII
Optic
Function: sensory, carries impulses for vision
Testing: Vision with eye chart. Visual field test by testing point at which person first sees an object moving into visual field. Inside of eye visualized with ophthalmoscope.
CNIII
Oculomotor
Function: motor fibers to inferior oblique and superior, inferior, and medial rectus extraocular muscles that direct eyeball; levator muscles of eyelid; smooth muscles of iris and ciliary body; sensory to brain from extraocular muscles.
Testing: examin pupils for size, shape, and equality; pupillary reflex tested with penlight; ability to follow moving objects.
CNIV
Trochlear
Function: proprioception and motor fibers for extraocular muscle
Testing: common to CN III, relative to ability to follow moving objects
CNV
Trigeminal
Function: motor and sensory for face. Sensory impulses from mouth, nose, surface of eye, and dura mater. Motor fibers that stimulate chewing muscles.
Testing: sensations of pain, touch, and temperature tested with safety pin and hot and cold objects. Corneal reflex tested with safety pin and hot and cold objects; motor branch tested by asking pt to clench teeth, open mouth against resistance, and move jaw from side to side.
CNVI
Abducens
Function: motor fibers to lateral rectus muscle and proprioceptor fibers from same muscle to brain.
Testing: tested in common with CN III relative to ability to move each eye laterally.
CNVII
Facial
Function
Supplies motor fibers to lateral rectus muscle and proprioceptor fibers from same muscle to brain.
Carries sensory fibers from taste buds of anterior part of tongue.
Testing: anterior ⅔ of tongue tested for ability to taste sweet, salty, sour, and bitter substances; symmetry of face; asked to close eyes, smile, whistle, etc.; tearing tested with ammonia fumes…??
CNVII
Vestibulocochlear (acoustic)
Function: sensory, vestibular branch transmits impulses for sense of equilibrium; cochlear branch transmits impulses for sense of hearing.
Testing: hearing checked by air and bone conduction by use of tuning fork; vestibular tests: Barany and caloric tests.
CNIX
Glossopharyngeal
Function:
Motor fibers serve throat and salivary glands
Sensory fibers carry impulses from pharynx, posterior tongue (taste buds), and pressure receptor of carotid arteries.
Testing: gag and swallow reflexes checked; asked to speak and cough.
CNX
Vagus
Function: fibers carry sensory and motor impulses for pharynx; large part of the nerve is parasympathetic motor fibers, which supply smooth muscles of abdominal organs; receives sensory impulses from viscera.
Testing: same as CNIX because they both serve muscles of the throat.
CNXI
Spinal Accessory
Function: provides sensory and motor fibers for sternocleidomastoid and trapezius muscles and muscles of soft palate, pharynx, and larynx.
Sternocleidomastoid and trapezius muscles checked for strength by asking subject to rotate head and shrug shoulders against resistance.
CNXII
Hypoglossal
Function: carries motor fibers to muscles of tongue and sensory impulses from tongue to brain.
Subject asked to stick out tongue, and any position abnormalities are noted.
Primary brain injury
Focal: specific brain lesions that occur in it precise location. Hemorrhage, hematoma.
Diffuse injuries: hypoxia, meningitis, encephalitis, and damage to the blood vessels,
Stroke
87% ischemic (thrombotic or embolic)
10% intracerebral hemorrhagic
3% SAH
Hypertension is the single greatest risk factor
