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EMER 198 > LO1-2 Neurological Disorders > Flashcards

LO1-2 Neurological Disorders Flashcards

1
Q

Seizures

A

Sudden erratic firing of neurons
Abnormal electrical discharge from the brain
Signs and symptoms depends on the part of brain
Causes- we don’t really know why idiopathic

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2
Q

Generalized seizure

A

Affect large portion of the brain

Includes tonic-clonic and absence types

Tonic clonic: full body movement

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3
Q

Steps of a tonic clonic

A

Aura: pt experiences a sensation

Loss of cx: pt loses consciousness

Tonic: body wide rigidity

Hypertonic: arched back and rigidity

Clonic: rhythm contraction of major muscle groups

Post seizure: muscles relax

Postictal: “rest” period for the brain may last minutes to hours

Breathing will sound abnormal

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4
Q

Absence Seizure

A

Absence spells (thousand-mile stare)

Most common in children

Short duration

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5
Q

Partial seizures

A

affecting a limited portion of the brain

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6
Q

Complex partial

Simple partial (Jacksonian March)

A

Complex partial

  • Subtle loss of cx
  • Head or eyes make small movement

Simple partial (Jacksonian March)

  • Tonic clonic activity to one body part
  • No aura or loss of cx
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7
Q

Febrile seizures

A

Caused by high body temp

Neurons in the brain are highly sensitive to temperature changes

As the temp rises the effects on the neurons become more profound and if allowed to progress may lead to a seizure

Simple and short- if they’re long or hard to stop the seizure is probably in conjunction with an underlying problem

Very short to no postictal period

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8
Q

Status epilepticus

A

A seizure that last for longer than 4-5mins OR consecutive seizures that occur without return of cx between seizure episodes

True medical emergency!!

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9
Q

Convulsive Disorders ASSESSMENT

A

Stay calm

Communication

Questions 
--Where and what was the patient doing before the seizure  
--How long did it last 
What did it look like 
--Does the pt have a history of seizures 
------Are they like this one 
------Any medication changes 
-Pt have a fever 
-Was the pt apneic, cyanotic or vomiting 
-Incontinence? 
-SAMPLE 
-v/s
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10
Q

Convulsive Disorders- TREATMENT

A 
OPA/NPA 
Positioning  
Supplemental oxygen  
Don’t let tubing get tangled 
Suction ready 
Rule out treatable causes 
Temp  
BGL  
Pupils- drugs 
IV- med route 
Cardiac monitor  
ALS
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11
Q

Sinus headache

A

pain is usually behind the forehead and/or cheekbones

Caused by inflammation or infection of sinus cavities in the face

Increase with movement

Usually worse when person first wakes up

Can be flu symptoms

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12
Q

Cluster headache

A

pain is in and around one eye

Vascular type

Often start in face

Last 30-45 mins

Pain radiates to entire side of face

Can occur multiple times a day and then just go away

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13
Q

Tension headache

A

Pain is like a hand squeezing the head

Cause from stress

Tense muscles

Most common

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14
Q

Migraine headache

A

pain, nausea and visual changes are typical of classic form

Some patients experience aura before

Pain unilateral and focused

Pain will change or spread over time

Throbbing, pounding or pulsing in nature

Can last hours to days

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15
Q

cluster headache Treatment

A

Symptomatically

Supportive and comfort

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16
Q

Bell’s Palsy

A

Temporary paralysis of 7th cranial nerve

7th cranial nerve controls facial movement

Takes weeks to months to go back to normal

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17
Q

Bell’s Palsy Treatment

A

Symptomatically

Supportive and comfort

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18
Q

Trigeminal neuralgia

A

The normal function of facial blood vessels produces severe pain

As the blood vessel change in diameter to meet the needs of surrounding tissue their positions can irritate the trigeminal nerve

This nerve is responsible for receiving signals related to pain, temperature and pressure on the face

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19
Q 
Cerebrovascular Accidents (CVA)
2 types:
A

Ischemic stroke: blockage

  • Thrombotic
  • Embolic

Hemorrhagic: ruptured artery/vesel

  • Loss of blood flow to some part of the brain
  • Temporary or permanent damage from lack of oxygen
  • Signs and symptoms depends on artery and area of brain
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20
Q

Ischemic CVA

A

75% most common

Caused when a blood vessel becomes occluded and blocked blood flow

Only the tissue on the blockage will be affected

Eventually will plateau
Severity depends on part of brain

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21
Q

Hemorrhagic

A

Bleeding that has interfered with the brains ability to function

20% less common

More devastating because it worsens overtime

Can start to see signs and symptoms of ICP

Pressure on them medulla oblagata results in Cushing’s reflex

Common complaint “worst headache they’ve ever experienced”

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22
Q

Transient ischemic attack (min stroke)

A

Temporary artery blockage

s/s resolve within 24hrs

warning sign of a larger CVA to come

present similar to CVA except s/s resolve

encourage transport for further assessment

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23
Q

signs and symptoms of CVA/ TIA

A 
slurred speech 
unilateral weakness or paralysis 
facial droop 
arm drift 
headaches 
decreased LOC 
seizures 
N/V
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24
Q

CVA/ TIA ASSESSMENT

A 
LOC ABCs  
mental status  
AOX4? 
GCS 
BGL 
FAST VAN
CHECK PUPILS
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25
Q

CVA/ TIA Treatment

A 
Secure airway 
Suction ready 
Positioning 
Constant reassessment of ABC 
Supplemental oxygen  
BGL 
IV try 2 large bore  
Avoid using the affected limb 
Cardiac monitoring  
COMMUNICATE KEEP THEM INFORMED THEY CAN STILL HEAR YOU 
ALS 
Get to hospital with abilities
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26
Q

Syncope

A

Sudden temporarily loss of consciousness and lose all postural tone

Older people: dysrhythmias

Younger: vagal

Short in nature usually only a matter of seconds

No postictal period 
Causes 
Cardiac rhythm 
Cardiac muscle 
Dehydration 
Hypoglycemia 
Vasovagal
27
Q

Abscess in the brain

A

Occurs when and infectious agent invades the CNS

Over time swelling may occur causing neural tissue damage and increased ICP

Signs and symptoms gradual and subtle, signs indicating infection

28
Q

AEIOU TIPS

A 
Alcohol 
Epilepsy 
Insulin 
Overdose 
Uremia (build up of toxins from renal disease) 
Trauma 
Infection 
Psychiatric or poisons 
Stroke
29
Q

altered mental status Treatment

A 
Hallmarks of ICP 
Cushings reflex 
Bradycardia 
Slow resps 
Hypertension  
ABCs 
Rule out treatable causes 
Symptomatically 
IV 
Cardiac monitor 
ALS if needed 
Transport
30
Q

Amyotrophic Lateral Sclerosis (ALS)

A

Lou Gehrig’s Disease

Involves the death of voluntary motor neurons

There is no effect on the patients consciousness

In most cases it is fatal

Progression of ALS is patient dependent

31
Q

Cerebral Palsy

A

Is a developmental condition that causes damage to the brain, typically the frontal lobe

It is a self limiting condition and doesn’t worsen over time

Begins in infancy, milestones like walking, crawling and talking maybe delayed

70-80% of CP cases are “spastic” (near constant state of contraction)

32
Q

Multiple Sclerosis (MS)

A

Autoimmune condition that attacks the myelin sheath of neurons in the brain and spinal cord

MS presentation usually follows a pattern of attacks and remissions

The initial attack double vision and blurred vision or common reports other symptoms include muscle weakness impairment of pain, temperature and touch, tremors, speech disturbances, vertigo, bladder or bowel dysfunction, depression, euphoria, cognitive abnormalities and fatigue

33
Q

Muscular Dystrophy (MD)

A

A non neurological condition of genetic origin marked by degeneration of muscular tissue

Many forms of MD exist

May affect all types of muscles including respiratory and cardiac muscles

Mostly males

Diagnosed before 5 years old

Life expectancy not past 20 years

34
Q

Parkinson Disease

A

The portion of the brain that produces dopamine becomes damaged

Dopamine is responsible for smooth muscle contraction and other things

The classical presentation is: 
Tremor 
Postural instability 
Rigidity 
Bradykinesia- choppy movements

Continues to advance and worsen

35
Q

Poliomyelitis

A

Viral infection

In children

Fecal oral route

Multiplies in intestine and moves to neuro system

Through vaccinations this disease has been almost eradicated from the world

36
Q

Poliomyelitis s/s

A 
NV 
Sore throat 
Diarrhea 
Stiff neck 
Weakness or paralysis
37
Q

Dystonia

A

Severe abnormal muscle spasms that caused bizarre contortions, repetitive motions or postures

Involuntary and often painful

Sometimes caused by medication’s

38
Q

Spasmodic torticollis

A

is a primary dystonia in which the neck muscles contract twitching the head to one side and pulling it forward or backward the head then remains painfully frozen in that position

39
Q

Bell palsy

A

Temporary paralysis of the facial nerve seventh cranial nerve

This facial nerve controls the muscles on each side of the face transmits taste sensations from the tongue

And the talk is very sudden and can easily be confused with a stroke

Find and symptoms include eyelid drooping, facial droop or weakness, drooling and loss of the ability to taste

Will often resolve within two weeks

40
Q

The damage of these invaders (bacteria) inflict occurs due to one of the two mechanisms:

A

the body’s reaction to the infection

the activities of the attacking organisms

41
Q

endotoxins

exotoxins

A

endotoxins: are proteins that are released by Graham negative bacteria when they die
exotoxins: are proteins that are secreted by some bacteria or fungi to aid in the death and digestion of other cells

42
Q

Guillain- Barre Syndrome

A

Rare condition

Causes is unclear

Condition is frightening for patients

It begins with weakness in the legs the progresses to the thorax and finally arms

Onset times is rather short- some cases hours from full mobility to complete paralysis requiring ventilator support

43
Q

Meningitis

A

Infection or inflammation of the meninges

Caused either by bacteria or virus

Viral more common

True diagnosis comes fro CSF exam

Can be contagious

Signs and symptoms start with flu symptoms

Tell-tale sign is stiff neck

44
Q

Encephalitis

A

Acute inflammation or infection ofnthe brain

Differs from menigitis because it effects brain tissue rather that the meninges

May be cause by
Meningitis
Virus
Bacteria

Can be contagious

45
Q

Neoplasm

A

Cancer in the brain or spinal cord
Two basic types:
Primary: began in nervous system
Metastatic: began else where and metastasized to nervous system

46
Q

Causes Neoplasm

A

Degenerative: results were normal structure is altered overtime

Developmental: arise in portions of the nervous system are not formed correctly

The earlier the errors the more severe than damage

47
Q

s/s Neoplasm

A

headache

changes of mental status (behaviour personality)

n/v

stroke like symptoms

seizures

may present like brain abscess but no signs of infection]

can be rapid or gradual

48
Q

nerves are responsible for airway control

A

The trigeminal, glossopharyngeal, Vagus and hypoglossal nerves

49
Q

Coma

A

a state in which the patient does not respond to verbal or painful stimuli

50
Q

Agnosia

A

patient will be unable to name common objects because connections between visual interpretation of objects in the words that name them have been damaged

51
Q

Apraxia

A

refers to the inability to know how to use a common object

52
Q

Receptive aphasia

A

the patient cannot understand or receive speech but is able to speak clearly
This form of aphasia indicates damage to the temporal lobe

53
Q

Expressive aphasia:

A

the patient cannot speak or expressed some selves clearly but is able to understand speech
This form of aphasia indicates damage to the frontal lobe which controls the motor portion of speech

54
Q

Global aphasia

A

this form of aphasia is a combination of expressive and receptive patient will not follow commands and cannot answer your questions but they can think clearly

55
Q

Anisocoria

A

unequal pupils with greater than 1 mm difference- can be a sign of increased ICP

56
Q

Nystagmus

A

The involuntary, rhythmic movement of the eyes can be caused by seizures, vertigo and MS

57
Q

Hemiparesis

A

weakness of one side of the body

58
Q

Hemiplegia

A

paralysis of one side of the body

59
Q

Decussation

A

in which nerves cross as they leave the cerebral cortex move through the brain stem and arrive at the spinal cord
Left cerebral stroke with therefore result in right side arm and leg weakness but left side facial droop

60
Q

Ataxia:

A

the term used to describe changes in a persons ability to perform coordinated motions like walking

61
Q

Myoclonus

A

is a type of involuntary contraction of the muscles that is rapid and jerky nature

62
Q

Intension tremors

Postural tremors

A

Intension tremors: occur when the patient tries to reach out and grab an object

Postural tremors: occur when a body part is required to maintain the same position for a long period of time

63
Q

Paraesthesia

A

sensation of numbness or tingling

64
Q

Anaesthesia

A

if the patient can feel nothing within a body part

EMER 198 (4 decks)

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