Exam 3 - Multiple Sclerosis Flashcards
Inflammatory disorder of the nervous system causing scattered, patchy demyelinization of the CNS. Myelin is a fatty sheath that allows nerve impulses to travel quickly through CNS. Demyelinization occurs in response to an inflammation of myelin nerve sheaths, results in separation of the myelin from the axon cylinders and interruption of nerve transmission.
Multiple Sclerosis
Progression for MS is characterized by what
Remissions and exacerbations
What occurs during a remission?
Myelin goes back to baseline with no inflammation but there is damage from last exacerbation. Can regenerate and transmission of nerve impulse is restored.
What occurs during an exacerbation?
myelin gets damaged and inflamed. If severe, can cause plaques that permanently damage the CNS
most common progression. Clearly acute attacks with full recovery between these exacerbations.
RRMS - relapsing remitting
no remission, progresses from beginning with accumulated damage. No remission with repair of myelin sheath.
PPMS - primary progressive
starts out as relapsing-remitting, transitions into progressive at some point in course of disease. Stop having remissions.
SPMS - secondary progressive
not a lot of regeneration, clearly acute relapses without recovery.
PRMS - progressive relapsing
Interventions to improve physical mobility
Relaxation and coordination exercises
Progressive resistive exercises to improve weakened muscles
Walk to improve gait and help with loss of sense of position
Warm packs on joints to help spasticity
Daily exercises - stretch-hold-relax routine, swimming, biking
Interventions to prevent injury
Walk with feet apart to widen base of support and increase stability
Watch feet while walking
Use assistive devices
Interventions to enhance bladder and bowel control
Pee when you need to pee, apply manual pressure on bladder when need to urinate is present
Voiding schedule
Drink measured amounts of fluid q2h and attempt to void 30 min later
Get adequate fiber
Bowel-training program
Interventions to improve sensory and cognitive function
Eye patch or covered eyeglass lens to block abnormal visual impulses
Prism glasses
Use memory aids
Triggers of exacerbations
Heat, stress, extreme cold
What are the ABCs for RRMS?
Interferon beta 1a (Avonex, Rebif)
Interferon beta 1b (Betaseron)
Glatiramer acetate (Copaxone)
Meds for spasticity
Baclofen
Tizanidine
Diazepam
Dantrolene
