Medical Issues Ch. 11

Question 1

S/S of neurological pathology

Answer 1

syncope
coma
paresthesia
abnormal motor control, coordination, or tone
headache
changes in senses
changes in mental status

Question 2

types of paresthesia

Answer 2

numbness
-anesthesia
burning and tingling
hyperesthesia
hypoesthesia

Question 3

abnormal motor control, coordination, or tone types

Answer 3

diminished deep tendon reflexes
muscle weakness
tremors
atrophy

Question 4

ALS
-cause
-S/S
Tx

Answer 4

fatal, progressive neurological disease that slowly attacks neurons responsible for voluntary muscle actions
S/S
-tired or clumsy, often begin in one limb, difficulty with swallowing and speech
-may be spasticity or hyperflexia
-weight loss
Tx
-can be treated with drugs but is not curable

Question 5

Bell’s Palsy

Answer 5

disease typically affects CN 7
S/S
-bilateral or unilateral facial weakness
Tx
-corticoseroids

Question 6

epilepsy

Answer 6

> 2 seizures in lifetime
caused by abnormal activity in brain
Tx
-combo of medicine or surgery

Question 7

multiple sclerosis

Answer 7

neurodegerative lifelong chronic disease
-can lead to permanent disability in affected nerves
S/S
-problems w/ balance and coordination
-spasticity and fatigue, visual problems, dizziness, pain, numbness, bladder + bowel dysfunction
-cognitive and emotional changes
Tx
-relapsing + progressing symptom management w/ medication

Question 8

vascular headache

Answer 8

caused by spasms of the vellels surrounding the brain
include migraines
S/S: rapid onset, unilateral throbbing pain in frontal or temporal area
-start in morning and peak 2 hrs later (migraine)
-begins with aura and accompanied w/ increased sensitivity to light/sound (migraine)

Question 9

migraine

Answer 9

type of vascular headache that may present w/ or w/o neurological symptoms

Question 10

stroke (CVA)

Answer 10

lack of oxygen to the brain - may lead to reversible or irreversible paralysis and other damage
S/S
-numbness or weakness on one side of the body
-confusion, trouble speaking or understanding
-headache, dizziness
Tx
-acute: designed to reverse or lessened the amount of tissue death
-rehab to improve function so that the stroke survivor can continue an independent lifestyle

Question 11

GBS (Guillain-Barre)

Answer 11

acute demyelinating disorder of the spinal roots and peripheral nerves
S/S
-progressive weakness distal to proximal pain in movement of the affected area and nocturnal muscle cramps
Tx
-no cure
-rehab to make things better and lessen severity of symptoms

Question 12

bacterial and viral miningitis

Answer 12

inflammation of the meninges by bacteria or viruses

Question 13

medical history of a neurological exam

Answer 13

family and personal history

-neurological diseases with genetic factors

Question 14

inspection during a neurological exam

Answer 14

selective atrophy
tremors
gait changes
gross movement changes
posturing

Question 15

posturing type

Answer 15

decorticate rigitidy

decerebrate rigidity

Question 16

docorticate rigidity

Answer 16

indication of cerebral cortex damage

arms in flexion, legs in extension

Question 17

decerebrate rigidity

Answer 17

indication of cerebellum damage

arms and legs in extension

Question 18

sensation

Answer 18

generally unnecessary to test the entire body
focus on symptomatic area
bilateral comparison
dermatomes: an area of skin supplied by a particular spinal nerve
test over skin whenever possible

Question 19

motor function

Answer 19

myotomes
-group of muscles innervated by nerve fibers from a nerve root
compare strength bilaterally

Question 20

meningeal irritation

Answer 20

meninges can become inflames

• meningitis
• vertebral disc pathology
• any pathology causing inflammation in the spinal canal

Question 21

meningeal irritation tests

Answer 21

kernig test
-patient in supine
-passively raising one leg at a time
-keep knee fully extended
-raise leg until symptoms are felt
-flex knee to relieve symptoms
-dorsiflex foot
-if dorsiflexion recreates symptoms, meningeal irritation is present
Brudzinski Test
-perform the above test with neck passively or actively flexed

Question 22

cranial nerves

Answer 22

status of the medulla oblongata

any sign of impairment = urgent referral

Question 23

balance testing

Answer 23

rhomberg test
have patient stand with eyes closed, feet together and arms crossed across chest
look for any swaying or balance correction