EXAM #2: Pathologies Related to the Head and Neck (multiple sclerosis-hypo/hyperthyroid) Flashcards
What is multiple sclerosis?
-incidence
chronic and progressive neurodegenerative disorder of the CNS
-greatest in white females 20-50 yrs old.
Etiology and Risk Factors of Multiple Sclerosis:
-triggered by a virus leading to an auto-immune response or from the presence of another auto-immune condition
-genetic link
-low vitamin D, smoking, and obesity
What are the 2 pathogenesis of multiple sclerosis:
-a classic example of demyelination
-plaques that block neural transmission
Clinical manifestations and S&S:
-specific to the area of _____ involvement
-cycles of _____ and ______
CNS
exacerbation and remission
Common S&S of Multiple Sclerosis: (2)
-____ to _____ variations
-MOST common?
-day to day
-Fatigue- MOST common and often disabling symptom and may worsen S&S
What is the FIRST manifestation of Multiple Sclerosis?
-unilateral and p!ful ___________
-______ may develop
Optic neuritis
-visual disturbances
-vertigo
What is Trigeminal neuralgia in relation to Common S&S of Multiple Sclerosis?
MOST widely disturbed nerves in the head and face
-Sudden and transient shock-like P!
-Typically unilateral
Common S&S (Multiple Sclerosis) :
Generalized widespread neuromusculoskeletal weakness (NMSK) (4)
abnormal speech or swallowing; weak voice
balance with ataxia (incoordination) and abnormal muscle tone = fall risk
bowel and bladder dysfunction
sexual dysfunction
TRUE OR FALSE: Should you include the list below in your systems review for Multiple Sclerosis:
-Hx and Observation
-Scan
-Special Test
TRUE
What should be included in your SCAN and likely findings?
resisted testing: with multiple joints of weakness
neuro: cranial nn. signs, partially optic, vestibular and trigeminal
What should be included in the special tests and likely findings?
special tests:
-balance test
-central vertigo
-Lhermitte’s sign- neck flexion or cough-producing spine and/or LE shock-like P!
Thyroid Disorders
Location:
Function:
LOCATION:
-located in the anterior, lower neck on both sides of the trachea
FUNCTIONS:
-regulate metabolism and increases protein synthesis
-calcium and phosphate balance with bone, kidney, and GI tract together
The thyroid gland is regulated by the hypothalamus and pituitary gland and hormones act on ALL bodily tissues. T or F
True
Thyroid disorders are _________ to detect in __________ individuals because it masquerades as other illnesses due to multi-system influence.
harder; older
Thyroid disorders:
-increase with_________
-_______ practically in middle ages
-age
-women > men
Hyperthyroidism _______ metabolic activity in every system
elevates
What is the MOST common form of autoimmune condition related to hyperthyroidism
Graves disease
Pathogenesis of hyperthyroidism anti-bodies developed from
dysfunctional suppressor T-cells and allow excess secretion
These are common S&S of ________________
-possible auto-immune S&S
-symmetric enlargement of the thyroid (goiter) and possible dysphagia
-HIGHER metabolic activity
hyperthyroidism
What are the symptoms relating to HIGHER metabolic activity of hyperthyroidism: (5)
-heat and exercise intolerances, excessive fatigue
-weight loss despite increased appetite; DIFFERENT from cancer
-nervousness, hyperactivity, insomnia, and mood alterations
-palpitations
-low endurance
What is exophthalmos?
eye protrusion resulting from hyperthyroidism
what is enlarged thyroid?
goiter from hyperthyroidism
what is the most common thyroid disorder in North America? what does it do?
Hypothyroidism
slows body metabolism
what are the two most common causes of hypothyroidism?
what are other causes?
genetic and auto immune
surgical ablation, radiation therapy, medications that damage thyroid
Hypothyroidism is more common in ______ and those with ______
women
RA
how does hypothyroidism develop?
decreased hormonal secretion
what are S&S of hypothyroidism?
slow, steady weight gain
myxedema
large & spinal joint pain/stiffness - calcium deposits may damage joint
fatigue & lethargy
cold intolerances
dry skin, hair and nails
proximal weakness
what is myxedema?
what does it impair?
non-pitting boggy edema, around supraclavicular fossae, eyes and distal extremities due to lack of metabolism and build up of sugars & proteins attracting and retaining water
may also impair swallowing, breathing & speech
what kind of referral would hypothyroidism be?
urgent referral
