Exam 5 - Cognition and Neuro pt. 2 Flashcards
ataxia
loss of full control of body movements
clonus
like a muscle spasm
dysarthria
slow and slurred speech that is hard to understand
fasciultations
small quick muscle contractions
hemiparesis
right or left side of body
hemiplegia
paralysis of one side of the body
Homonymous hemianopsia
eyes only see out of one eye
obtundation
altered loss of consciousness
nuchal rigidity
inability to flex head forward
dysphonia
difficulty speaking
ictus
sudden attack of stroke or seizure
personality IQ judgement attention span moral ethical behaviors long term memory level of consciousness voluntary movement brocas area (motor speech)
frontal lobe
sensory interpretation including: - size, shape, feel - calculation - R/L discrimination - proprionception and speech including wernicke's fluency speech
parietal lobe
sensory speech interpretation of sounds taste and smell memory short term seizure focus
temporal lobes
primary visual cortex
CNS and PNS
occipital lobe
what does the glasgow coma test include
eye opening
verbal response
motor response
stupor
uncoordinated and can’t form many things
semicomatose
may be roused by stimuli
transient ischemic attack
mini stroke
minimal damage
progressive stroke
clot is getting bigger and may cause stroke or it has dislodged
completed stroke
clot is huge and does not need to grow to cause stroke
what are the two types of strokes
ischemia
hemorraghic
what is an ischemic attack
thrombotic or embolic
what is the most common stroke
ischemic
what is the thrombotic ischemic attack
atherosclerosis
what is the embolic ischemic attack
MI CHF valve disease Afib TIA
what is the hemorrhagic stroke
aneursym
hypertension
leading cause of stroke
CAD
signs of ischemic attack
transient hemiparesis
loss of speech
hemisensory loss
signs of hemorrhagic
headache vertigo syncope paresthesia transient paralysis epistaxis retinal hemorrhages
fast test
facial drooping
close eyes and hold arms out straight
slurring and cognition
time to act
akinesia
loss or impairment of voluntary movement
akinesia hyporeflexia dysphasia hypo or hypertonia hemiparesis hemiplegia sensory deficit behavioral changes incontinence visiual change
all may be found when?
as a stroke manifestation on the neuromotor
aphasia
dysarthria
all may be found when?
during a stroke
memory and judgement and ability to learn may be found when?
during a stroke
agnosia and apraxia and spatial orientation and unilateral neglect may be found when
during a stroke
stroke diagnostics
angiography (the best)
CT scan
PET scan
MRI
what should we keep the CVA blood pressure when they are recovering
140/90
what are the management of the dysphagic pt for the mouth and throat
swallow pudding forecfully
what are the management of the dysphagia person for epiglottis
taking deep breath with mouth closed and hold it
how to strengthen the tongue
push tongue depressor down and push tongue up
what is brocas aphasia
expressive aphasia
what is wernickes aphasia
receptive aphasia
what can brocas aphasia do?
can’t get words out! but can understand
what can wernicke’s aphasia do?
form words but they don’t make sense
medications for CVA
thrombolytic therapy anticonvulsant antihypertensive steroids stool softeners analgesic vasoactive drugs diuretics anticoagulants antiplatelet blood sugar drugs minocylcine botox
what does 2 seizures mean
epilepsy
do febrile seizures count during epilepsy suspcision?
no
what is epilepsy or seizure
sudden excessive abnormal electrical discharge of neurons altering brain function
what is the period following after a seizure?
postical state
what kind of imbalance may lead to a seizue
electrolyes
what are the two types of seizures
generalized
focal
what are the types of generalized seizures
tonic clonic and absense
what is the tonic clonic seizure
grand mal muscle stiffening and periods of shaking, fall to ground and lose consciousness
what is atonic
relaxed muscles
what is clonic
periods of shaking
what is myoclonic
short jerking or muscle
what is tonic
muscle stiffening
what is a focal seizure
area where seizure is happening
what are the types of focal seizure
simple
complex
secondary generalized
what is a simple seizure
small change in sensation and affects small area of brain
what is a complex seizure
dazed confused, no answers
what is secondary generalized
starts in one part of the brain and then turns on another part of the brain and travels
what is an aura when seizures?
things that happen that exacerbates them
what may an aura include?
nausea vomitting indigestion smell dreamy visual light
what is status ecliptics
serious condition that causes damage and may lead to death
what may a status electipus include
tachy hypertension hyperthermia hypoglycemia acidosis
treatment for status electicups
lorazepam and diazepam
tests for seizure and epilepsy
eeg (brain activity)
CT and MRI (for blood flow)
management during seizure
anticonvulsant IM or IV
don’t hold down!
suction and o2 as needed
recovery position
anticonvulsant management
can be used in combo, do not stop abruptly!
what are the types of anticonvulsants?
drugs that potentiate GABA
drugs that suppress sodium influx
drugs that suppress calcium influx
what are drugs that potentiate GABA
barbiturates
benzodiazepines
what are drugs that suppress sodium influx
hydantoin (dilantin)
what are drugs that suppress calcium influx
succinimides (zarotin)
epilepsy outcome management
diet and surgery
what kind of diet is important for epileptics
high fat, low carb
what is the primary pathophys for parkinson?
idiopathic
what is the secondary pathophys for parkinson?
head trauma or drugs
what is the believed etiology of parkinson
loss of neurotransmistter dopamine
what are the 6 cardinal features of parkinsons
tremor at one side at rest akinesia bradykinesia flexed posture of trunk limbs and neck loss of postural reflexes freezing movement
how to diagnose parkinson?
exclusion, rule out other diseases
meds for parkinsons
levadopa
what should you watch for for levodopa?
wearing off phenomenon
what are side effects of levadopa
intensifying narrow angle or psychiatric disturbances long term
artain cargentin arkineton parsidil benadryl
all are used for what? and what do they do
antihistamines and anticholinergic for parkinsons
reduce excessive cholinergic activity
what are cautions for antihistamines and anticholinergic for parkinsons
narrow angle glaucoma
dry mouth
constipation and urinary retention
what are dompamine agonists
parlodel
permax
mirapex
what do MAOI’s do for parkinson?
increase activity of dopamine
what do anticholinergic drugs do during parkinsons
decrease muscle rigidity
and tremors
what drug has a narrow thera index for parkinsons pateints
anticholinergic
geriatric considerations for anticholinergic meds
reduced renal and liver failure
what is the critical adverse effect of anticholinergic meds
tachycardia
what is ALS
amytrophic lateral sclerosis
ALS etiology
unknown
what happens in ALS
decrease in anterior horn cells corticospinal
lifespan of ALS
3-5 yr
fatigue when talking muscle weakness fasciculations spasticity increased difficulty with chewing, swallowing, choking, excess drooling, slurred speech difficulty breathing inappropriate laughing crying spells
all may be a sign of what
ALS
diagnostic of ALS
emg
ncs
CLINICAL PRESENTATIONS
rule out OTHER DISEASES
also drug?
riluzole
what are other management of ALS
supportive care
conserving energy
major cause of chronic disability in people between ages 20-40
ms
etiology of ms
unknown
pathyphys of ms
autoimmune
what happens during ms
attacks brain and spinal cord white matter
what nerves are usually affected by ms
oculomotor and optic
does ms affect the pns?
no
risk factors of ms
genetics
living farther from equator
types of ms
relapsing remitting
secondary progressive
primary progressive
progressing relapsing
steady decline since onset with superimposed attacks are what kind of ms
relapsing remitting
initial relapsing remitting ms that suddenly begins to have decline without periods of remission is what kind of ms
secondary progressive
steady increase without attacks is what kind of ms
primary progressive
unpredictable attacks that may or may not leave permanent deficits followed by periods of remission
progressing relapsing
Visual changes/loss Weakness of extremities Loss of DTR’s Scanning speech, Ataxia Dysarthria Dysphagia Paresthesia Dyscoordination /spasticity Bowel and bladder dysfunction Fatigue Emotional labiality
are all what
ms manifestations
outcome management for ms
prevent or postpone long term disability
drugs for acute relapse of ms
iv or oral corticosteroids
disease management drugs for ms
interferon
copaxone
symptoms of ms
bladder dysfunction
constipation
trigem neuralgia
dysthesias
