Final Flashcards
1
Q
nervous system
A
peripheral (PNS)
central (CNS)
2
Q
CNS
A
central nervous system
comprised of the brain and spinal cord
3
Q
PNS
A
peripheral nervous system
comprised of ganglions and nerves
4
Q
meninges
A
protects the brain, absorbs shock
skull -> epidural space -> dura (thick and strong) -> subdural space -> arachnoid (connecting) -> subarachnoid space (CSF is here) -> pia (thin and hugs the brain and spine)
5
Q
forebrain
A
cerebrum
thalamus
hypothalamus
pituitary gland
6
Q
midbrain
A
in between the forebrain and the hindbrain
7
Q
hindbrain
A
pons
medulla oblongata
cerebellum
8
Q
structures of the brain
A
outer layer (cortex) = grey matter
inner layer = white matter
spaces = ventricles
9
Q
dermatomes
A
areas of skin on your body that rely on specific nerve connections on your spine
can be used to determine whether the sensory loss on a limb corresponds to a signal spinal segment
10
Q
C3 to C5 verebrae
A
keep us alive
control the function of the body from the shoulders down
support the neck and head
11
Q
phrenic nerve
A
controls your diaphragm by sending signals to make it expand and contract
provides motor innervation to the diaphragm
12
Q
radiculopathy
A
aka. pinched nerve
a set of conditions in which one or more nerves are affected and don’t work properly
13
Q
cerebral cortx
A
divided into 4 lobes
frontal
parietal
temporal
occipital
14
Q
frontal lobe
A
motor function
motivation
agression
smell
moos
15
Q
parietal lobe
A
reception and evaluation of sensory info
16
Q
temporal lobe
A
smell, hearing, memory and abstract thought
17
Q
occipital lobe
A
visual proccessing
18
Q
left sided brain
A
more verbal, analytical, and orderly than right brain
better at reading, writing, and computations
speaking, reading, writing, number skills, logic
controls right side of body
19
Q
right sided brain
A
more creative artistic, and intuitive
abstract meaning, emotion, intuition, imagination, face/visual recognition
controls left side of body
20
Q
intracranial pressure
A
the pressure inside the cranial vault
is dependent on three volumes -> brain, CSF, and blood
volumes of cranial pressure = 80% brain, 10% blood, 10% CSF
21
Q
inter cranial pressure during brain bleed
A
increases
22
Q
effects on brain size (ICP)
A
atrophy - change with ageing, health conditions
tumor- takes up space
surgery - removal of tumor
health conditions- AD, stroke
23
Q
effects on blood (ICP)
A
stroke - clot or bleed
deformity- AVM (blood vessels form incorrectly), aneurysm
injury- subarachnoid hemorrhage (SAH), subdural hemorrhage 9SDA), epidural hemorrhage
24
Q
effects of CSF (ICP)
A
all of these changes occur in the subarachnoid space and ventricles
injury
surgery (cause) - can cause leak, complication of epidural (break through the dura - dural tear)
surgery (fix) - VP shunt to fix (hydrocephalus), EBP (epidural blood patch for dural tear)
25
CSF
cerebrospinal fluid
should be clear and colourless
26
PNS
peripheral nervous system
comprised of ganglions and nerves
27
afferent neurons
PNS to CNS
sensory neurons
28
efferent neurons
CNS to PNS
motor neurons
29
Autonomic nervous system
parasympathetic (PNS) -> far from the spine
sympathetic (SNS) -> close to the spine
30
grey matter
= neuron
31
white matter
= axon
32
ICP
increased cranial pressure
caused by increased blood, CSF, and brain
33
macular degeneration
leading cause of vision loss in > 50 yrs
incurable
34
cataracts
everyone will develop it with age, gradually without pain
blurs all vision
35
diabetic retinopathy
leading cause in vision loss <50 years
cause = uncontrolled diabetes
severe vision loss/blindness
36
glaucoma
second most common cause of vision loss >65
visual field loss, decreased acuity, halo, or blindness
37
refractive errors
myopia = nearsighted
hyperopia = farsighted
presbyopia = difficulty reading small print
38
conductive hearing loss
inefficient sound waves outer to inner ear
ear canal blockage -> cold, allergy, infection
39
central auditory processing disorder
auditory center damage -> pathway to medulla
central cortex pathway damage
TBI, tumor, heredity
40
otitis media
eardrum and middle ear damage
infection
can lead to permanent hearing loss
41
otosclerosis
hereditary
ossicle hardening
causes tinnitus (ringing, roaring buzzing, other people cannot hear it)
42
sensorineural hearing loss
cochlea or nerve damage
causes = excess noise, meds, virus
43
cerumen accumulation
wax build-up that can harden
common in elderly
44
presbycusis
low pitch sounds are heard better
muffles hearing
age related hearing loss
45
meniere's disease
inner ear disease
fluid in the ears
can cause tinnitus, hearing loss, vertigo
46
xerostomia
dry mouth
decreases saliva and thicker mucus
causes = medications, cancer, and ageing
risks = food aversions, decreasing calorie intake
47
olfaction
action or capacity of smelling
decreased with age due to reduced sensory neurons and bulb cells
affects sensitivity to odours and taste discrimination
48
sensation in older persons
decreased blood flow = decreased cardiac output, decreased peripheral blood flow
changes to nervous system = decrease in nerve cells, myelin sheath degeneration, decreased neurotransmitters, and conduction rate
49
peripheral neuropathy
occurs when the nerves that are located outside the brain and spine are damaged
causes weakness, numbness, pain in hands and feet typically
can effect digestion and urination
50
nociceptive pain
somatic and visceral
arises in tissue -> trauma, surgery, chemical burns
sharp, aching, throbbing
51
neuropathic pain
nervous system
arises from diseases or damage to sensory nerves
shooting, radiating, burning
52
pain in older persons
they have an altered sensitivity to pain
increase in pain threshold
decline of painful sensations
decrease in pain tolerance
53
kinesthetic
movement awareness
54
proprioception
position awareness
55
stereognosis
recognition of object texture and size
56
cognition
the mental action of processing or acquiring information through thought and senses
consider culture, education, values, beliefs, and previous experience of the client
remember 3Ds
57
4 questions categories testing cognition
memory
knowledge
abstract thinking
judgement
58
cognition tests
GCS (consciousness)
MOCA (dementia)
AEIOUTIPS (altered mental status)
Neuro (general)
MMSE (assess mental status)
CAM/PRISME (delirium)
NIHHS (evaluate stroke severity)
59
CVA
cerebral vascular accident
aka stroke
includes TIA, ischemic stroke (blood clot), hemorrhagic stroke
60
CVA risk factors
atherosclerosis
HYPERTENSION
smoking
age >65yrs
diabetes
obesity
afib
loss of neurological function due to vascular injury
61
TIA
"mini-stroke"
its ischemic
lasts several minutes with no permanent damage
1 in 3 people who have TIA's will have a stroke
S/S and risk factors are the same as ischemic stroke but resolve without intervention
62
FAST VAN
face, arm, speech, time
Vision, aphasia, neglect (quickly assess functional neurovascular anatamy)
is a hot stroke (<6 hrs of symptoms) reference guide
63
ischemic stroke
thrombotic (stationary blood clot) or embolic (moving blood clot)
ischemia = reduced or restricted blood flow
64
ischemic stroke thromotic
in the blood vessels in the brain
risk factors same as all arterial diseases (smoking, hypertension, atherosclerosis)
atherosclerotic plaque
clot formation
the brain doesn't get enough O2
65
ischemic stroke embolic
blood clot moves to the blood vessels in the brain
afib is a very common cause
risk factors = atherosclerosis, smoking/ETOH (alcohol), obesity, high LDL (cholesterol), HTN
less commonly can be caused by air, vegetation, amniotic animals
66
treatment specific for ischemic stroke
open up the blood vessels
increase the odds of recovery and don't let it happen again
break up the clot = t-PA, a recombinant tissue plasminogen activator (thrombolytic)
remove clot = EVT (endovascular treatment) thrombectomy -> increases risk for intercerebral bleed
67
ichemic stroke prevention
prevents clots, but do not thin blood
antiplatelets = platelets won't stick as easily-> ASA, Plavix (clopidogrel)
anticoagulants = interfere with the coagulation cascade -> Heparin, Warfarin, Rivaroxaban, Apixaban
68
hemorrhagic stroke
intracerebral and subarachnoid
69
hemorrhagic stroke intracerebral
bleeding into the brain tissue
S/S = headache, nausea/vomiting, changes to LOC, seizure (ICP)
causes = HTN, trauma, tumor, infection, medication, AVM (arteriovenous malformations)
70
hemorrhagic stroke subarachnoid hemorrhage
bleeding into the subarachnoid space
S/S = worst headache ever, nuchal rigidity (stiff neck), photophobia (extreme sensitivity to light), nausea/vomiting
causes = AVM, aneurysm, trauma, bleeding disorder, medication
71
common symptom of increased ICP
headache
blurred vision
feeling less alert
72
treatment specific for hemorrhage stroke
coiling or clipping
NO ANTIPLATELETS OR ANTICOAGULANTS
73
CVA diagnostics
look for type of stroke and causes/risks
CT scan
lab work (ECG, INR, CBC)
74
TOR-BSST
stroke swallowing assessment
75
reticular activating system
a network of neurons located in the brain stem the project to the hypothalamus to mediate behaviour
76
apraxia
inability to perform particularly purposive actions, due to brain damage
77
expressive aphasia
Broca's aphasia
cant form sentences, controls ability to speak words
78
receptive aphasia
Wernicke's aphasia
cant understand words
79
Immediate stroke complications
airway
increased ICP - hemorrhagic stroke
seizure
death
infection - UTI/ urosepsis, pneumonia
80
Ongoing stoke complications
nutrition
communication
motor function
behaviour
memory
81
GU system organs
kidneys
ureters
bladder
urethra
82
function of kidneys
waste removal
balance water, pH, electrolytes
urine formation
controls production of RBC's (erythropoietin)
controls BP (renin)
reabsorption of glucose
83
normal kidney changes with ageing
decreased tissue
decreased number of nephrons
decreased kidney function overall
hardening of kidney vessels -> slows filtration process
bladder muscles weaken
increased postvoid residual volume
increased risk of UTI, incontinence, leakage
84
normal post void residual volume
50 - 100mL in elderly
greater than 200 mL is abnormal
85
forebrain function in GU system
controls voluntary micturition
afferent signals result in simultaneous contraction of the bladder and relaxation of the sphincter
86
male vs female urethra
female = 3-4 inches
male = 18-20 inches
87
polyuria
excessive urination
= more than 2.5 L per day
88
Oliguria
urinary output less than 400 mL per day
89
hematuria
blood in urine
90
dysuria
sensation of pain or burning when urinating
91
kidney damage
feel pain under ribs, to the right or left of spine
fluid retention -> swelling in arms and legs
BP increases
Ca+ decreases (kidneys convert vitamin D to active form which helps absorb calcium)
RBCs decrease (anemia)
renin increases
92
renin
an enzyme made by kidneys
helps regulate blood pressure
controls the production of aldosterone
93
aldosterone
increases blood pressure and volume by casing kidneys to excrete potassium through urine and reabsorb sodium into the bloodstream with causes water retention
94
nocturia
waking at night to urinate
95
cystitis
the most common type of UTI, particularly in women
lower UTI
96
pyelonephritis
upper UTI
urinary infection -> one or two kidneys are infected
97
bacteremia
bacteria in the blood
when it it from a UTI it is called urosepsis
98
UTI S/S in adults
dysuria
nocturia
urgency
frequency
cloudy foul smell
fever/chills (later)
nausea/vomiting, fatigue (later)
99
UTI S/S older adults
change in LOC
confusion
delirium
agitation
behaviour change
falls
asymptomatic bacteriuria may not need to be treated
100
urinary cytology
invasive
sending in a tissue sample, often for cancer screening
101
non invasive urinary tests
urinalysis
ultrasound
ct scan
102
UTI treatment and prevention
treatment = fluids, antibiotics
prevention = adequate hydration, movement, incontinent care, caution with indwelling catheter
103
GI system
mouth (mechanical and chemical breakdown)
esophagus (transport to stomach)
stomach (pepsin and HCl, chemical and mechanical breakdown)
intestines and pancreas
104
small intestine
where majority of absorption and digestion occurs
105
Large intestine
absorbs remaining water and electrolytes and forms feces
106
normal bowel movements
3-4 BM/day
some people will only have 2/3 per/day
should be soft and brown
107
normal age related GI changes
sphincters weakened
reduced absorption
increase in peptic ulcers
decreased production of digestive enzymes
impact B12, Fe, Ca, and folic acid absorption
decreased saliva
increased constipation
108
black stool
indicates blood in the stool
upper GI bleed
109
pale stool
bile duct blocked
110
super green stole
too many greens
infection
111
red stool
hemorrhoids or bleeding in lower intestine
112
yellow stool
too much fat or malabsorption
113
factors influencing defecation
stress
diet
meds
viruses
age
enzymes
gut microbiome
114
Common GI alterations
norovirus -> contagious virus that causes vomiting and diarrhea
c.diff -> bacteria that causes diarrhea
rotavirus -> spreads through hand to mouth contact, it most serious for the kids under 2
115
constipation vs fecal impaction
constipation = when you aren't passing stool as often or as easily as usual -> stool is hard and dry
fecal impaction = when have been constipated for a long time and have been using laxatives, lump of dry hard stool stuck in the rectum
116
Constipation causes
acute = changes in diet, medication, lack of exercise, lack of fibre and water intake
chronic = IBS, medical conditions, pregnancy, lack of mobility
117
Constipation S/S in older adult
<3 BM per week
lump/hard stool
feeling of being blocked or not emptying
118
diarrhea
multiple loose stools/day
acute = food, travel, viruses
chronic = allergies/intolerances, medication, IBS
119
constipation complication
hemorrhoids
anal fissure
fecal impaction
rectal prolapse
bowel obstruction
120
diarrhea complication
dehydration
IAD (incontenenice associated dermatitis) type irritation
electrolyte imbalance
decreased intake
121
GI diagnostic tests
fecal specimens
x-ray
ct scan
colonoscopy
endoscopy
122
insoluble fibre
whole grains, wheat and veggies
pull in h20 and is better for constipation
