EXAM #2: Pathologies Related to the Head and Neck (multiple sclerosis-hypo/hyperthyroid)

Question 1

What is multiple sclerosis?
-incidence

Answer 1

chronic and progressive neurodegenerative disorder of the CNS
-greatest in white females 20-50 yrs old.

Question 2

Etiology and Risk Factors of Multiple Sclerosis:

Answer 2

-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

Question 3

What are the 2 pathogenesis of multiple sclerosis:

Answer 3

-a classic example of demyelination
-plaques that block neural transmission

Question 4

Clinical manifestations and S&S:
-specific to the area of _____ involvement
-cycles of _____ and ______

Answer 4

CNS
exacerbation and remission

Question 5

Common S&S of Multiple Sclerosis: (2)
-____ to _____ variations
-MOST common?

Answer 5

-day to day
-Fatigue- MOST common and often disabling symptom and may worsen S&S

Question 6

What is the FIRST manifestation of Multiple Sclerosis?
-unilateral and p!ful ___________
-______ may develop

Answer 6

Optic neuritis
-visual disturbances
-vertigo

Question 7

What is Trigeminal neuralgia in relation to Common S&S of Multiple Sclerosis?

Answer 7

MOST widely disturbed nerves in the head and face
-Sudden and transient shock-like P!
-Typically unilateral

Question 8

Common S&S (Multiple Sclerosis) :
Generalized widespread neuromusculoskeletal weakness (NMSK) (4)

Answer 8

abnormal speech or swallowing; weak voice
balance with ataxia (incoordination) and abnormal muscle tone = fall risk
bowel and bladder dysfunction
sexual dysfunction

Question 9

TRUE OR FALSE: Should you include the list below in your systems review for Multiple Sclerosis:
-Hx and Observation
-Scan
-Special Test

Answer 9

TRUE

Question 10

What should be included in your SCAN and likely findings?

Answer 10

resisted testing: with multiple joints of weakness
neuro: cranial nn. signs, partially optic, vestibular and trigeminal

Question 11

What should be included in the special tests and likely findings?

Answer 11

special tests:
-balance test
-central vertigo
-Lhermitte’s sign- neck flexion or cough-producing spine and/or LE shock-like P!

Question 12

Thyroid Disorders
Location:
Function:

Answer 12

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

Question 13

The thyroid gland is regulated by the hypothalamus and pituitary gland and hormones act on ALL bodily tissues. T or F

Answer 13

True

Question 14

Thyroid disorders are _________ to detect in __________ individuals because it masquerades as other illnesses due to multi-system influence.

Answer 14

harder; older

Question 15

Thyroid disorders:
-increase with_________
-_______ practically in middle ages

Answer 15

-age
-women > men

Question 16

Hyperthyroidism _______ metabolic activity in every system

Answer 16

elevates

Question 17

What is the MOST common form of autoimmune condition related to hyperthyroidism

Answer 17

Graves disease

Question 18

Pathogenesis of hyperthyroidism anti-bodies developed from

Answer 18

dysfunctional suppressor T-cells and allow excess secretion

Question 19

These are common S&S of ________________
-possible auto-immune S&S
-symmetric enlargement of the thyroid (goiter) and possible dysphagia
-HIGHER metabolic activity

Answer 19

hyperthyroidism

Question 20

What are the symptoms relating to HIGHER metabolic activity of hyperthyroidism: (5)

Answer 20

-heat and exercise intolerances, excessive fatigue
-weight loss despite increased appetite; DIFFERENT from cancer
-nervousness, hyperactivity, insomnia, and mood alterations
-palpitations
-low endurance

Question 21

What is exophthalmos?

Answer 21

eye protrusion resulting from hyperthyroidism

Question 22

what is enlarged thyroid?

Answer 22

goiter from hyperthyroidism

Question 23

what is the most common thyroid disorder in North America? what does it do?

Answer 23

Hypothyroidism
slows body metabolism

Question 24

what are the two most common causes of hypothyroidism?
what are other causes?

Answer 24

genetic and auto immune
surgical ablation, radiation therapy, medications that damage thyroid

Question 25

Hypothyroidism is more common in ______ and those with ______

Answer 25

women
RA

Question 26

how does hypothyroidism develop?

Answer 26

decreased hormonal secretion

Question 27

what are S&S of hypothyroidism?

Answer 27

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

Question 28

what is myxedema?
what does it impair?

Answer 28

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

Question 29

what kind of referral would hypothyroidism be?

Answer 29

urgent referral