Module 7 Neuro Flashcards
What are local (focal) effects
Signs related to specific area of brain or spinal cord in which lesion is located. Ex: paralysis of right arm results from damage to section of left frontal lobe
What loss is experienced when the Left Hemisphere is damaged?
Loss of logical and analytical thinking ability and loss of communication skills
What happens when there is damage to the right hemisphere?
Impairs appreciation of art and music, causes behavioural problems, spatial orientation and recognition of relationships may be deficient
What may levels of reduced conciousness lead to?
Confusion/disorientation, memory loss, unresponsiveness to verbal stimuli, loss of consciousness or coma
What happens during a vegetative state?
Loss of awareness and mental capabilities Result of diffuse brain damage Brain stem function continues Appearance of sleep wake cycle Unresponsive to external stimuli
What is Locked In syndrome?
Aware and capable of thinking but paralyzed and cannot communicate
What is the criteria for brain death?
Cessation of brain function (flat EEG)
Absence of brain stem reflexes
Absence of spontaneous respirstions
Certainty of irreversible brain damage by confirmation of cause of the dysfunction
Evaluation twice by difference physicians
What is Aphasia/Dysphasia
Inability to comprehend or Express language
What is Dysarthria
Motor dysfunction affecting muscles used in speech
What is Non- Fluent aphasia
Expressive
Slow and labored with short phrasee
Associated with damage to Broca area
What is Fluent Aphasia
Receptive
Pace of speech relatively normal
Includes made up words
Associated with damage to Wernicke area
What is a Seizure?
Spontaneous, excessive discharge of neurons causes by inflammation, infection, brain bleed and drug abuse
What test indicates the type of seizure ?
EEG Electroencephalogram
What can trigger a seizure ?
Seizures are idiopathic but triggers include physical stimuli such as lights & noise, and Biochemical stimuli such as stress, excessive premenstrual fluid retention, hypoglycemia, change in medication, hyperventilation
Describe the Seizure pattern
Prodromal signs hours before seizure An aura precedes the loss of consciousness Loss of consciousness Strong tonic muscle contractions A cry The clonic stage follows Contractions gradually subside Postictal period-confusion, fatigue, aching muscles and sleep
What are the treatments for seizures ?
Anticonvulsant medications combined with sedatives, Surgery to remove area where seizure begins, implanted devices to deliver electrical stimulation and dietary therapy such as ketogenic
What happens during increased intracranial pressure ?
Increase in fluid or mass
Ischemia and eventual infarction of brain tissue
Causes: hemorrhage, trauma, edema, infection, tumors
What are signs of Increased Intercranial Pressure?
Decreasing level of consciousness
Headache & Vomitting
Increased BP & Pulse
Change in vision and pupil
What does increased intracranial pressure lead to?
Systemic vasoconstriction
Increase of systemic blood pressure to provide more blood to brain to relieve ischemia
What are diagnostic tests used to diagnose Intracranial Pressure
CT & MRI cerebral angiography Doppler ultrasound EEG Radionuclide to track perfusion in CNS Lumbar Punturr to check pressure and analyze CSF
What happens during a Transient Ischemic Attack
Temporary localized reduction of blood flow
What is the pathophysiology of a TIA
Partial occlusion if a cerebral artery
Atherosclerosis
Small Embolus
What are the signs and symptoms of a TIA
Intermittent short episodes of impaired function such as arm/leg weakness, visual disturbance, numbness in face, transient aphasia, transient conduction
Repeated attacks a warning sign of obstruction
What does CVA stand for?
Cerebrovascular Accident
What happens during a stroke (CVA)
Infection of brain tissue from lack of blood
Occlusion or rupture cerebral blood vessel
5 mins of ischemia causes irreversible damage
Necrosis develops
Function is lost
Surrounded by an area of inflammation
What are 3 types of CVAs
Occlusion of artery by atheroma
Sudden obstruction by embolus
Intracerebral hemorrhage
What are risk factors of CVA
Diabetes, hypertension, lupus, atherosclerosis, history of TIAs, increasing age, sleep apnea, heart disease, smoking, sedentary lifestyle, saturated fat diet
Combo of oral contraceptives and smoking
Congenital malformation of blood vessels
How are CVAs treated
Clot busting agents Glucocorticoids OT, PT, SLP Treatment of underlying problem Rehabilitation begins immediately
What are characteristics of a severe brain injury
Destruction of brain tissue
Massive swelling of the brain
Life threatening
What is a concussion
Minimal brain trauma
Mild blow to head or whiplash
Amnesia and headaches may follow
Recovery usually within 24 hr without permanent damage
What is a contusion
Bruising with rupture of small blood vessels and edema
Possible residual damage
What is a closed head injury
Skull not fractured
Brain tissue injured and blood vessels may be ruptured
Extensive damage may occur when head is rotated
What is an open head injury
Involves fractures or penetration
What is a depressed skull fracture
Involve displacement of bone below the skull
Compression of brain tissue
Impaired blood supply
Define cervical spine injuries
Hyperextension or hyperflexion of neck
Define dislocation of vertebrae
May crush or compress spinal cord
Define compression injury to spinal cord
Injury to spinal cord when force applied to skull or feet
Define Quadriplegia/ Tetraplegia
Paralysis of all four extremities
Define Paraplegia
Paralysis of the lower part of the trunk and legs
What is Autonomic Dysreflexia
Massive sympathetic reflex response that cannot be controlled from the brain caused by infection, bladder/bowel distension and can lead to increase in BP, vasoconstriction below injury, vasodilation above injury and tachycardia
Whag are some complications of a spinal cord injury?
UTI, Pneuminia, Skin breakdown, Spasm and Pain and Depression
What are treatments for a spinal cord injury?
Immobilize spine Maintain breathing Traction or surgery Glucocorticoids Stabilize vascular system Ongoing care to prevent complications related to immobility
What is Multiple Sclerosis
Progressive demyelination of neurons
Loss of myelin interferes with conduction of impulses in affected fibers
Affects motor, sensory and autonomic fibers
What are signs and symptoms of MS
Blurred vision Weakness in legs Diplopia Dysarthria Paresthesia Progressive weakness extending to upper limbs Loss of bladder & bowel control Chronic fatigue
What is treatment for MS
No definitive treatment approved
Corticosteroids to treat nerve inflammation
PT & OT
What is Parkinsons Disease
Progressive Degenerstive Disorder
Excess stimulation of motor system affecting movement and posture
What are signs and symptoms of Parkinson’s
Fatigue Muscle weakness Muscle aching Decreased flexibility Less spontaneous changes in facial expression Tremors
What are later signs and symptoms of parkinsons
Tremors affect hands feet face tongue and lips Increased muscle rigidity Difficulty initiating movement Slow movement Stooped leaning forward Propulsive gait
What are treatments for Parkinsons
Dopamine replacement therapy
SLP,OT & PT to improve speech balance and coordination
Monitoring and treatment of respiratory and urinary tract infections
What is Amyotrophic Lateral Sclerosis (ALS)
Lou Gehrig disease No identified cause Affects motor neurons in cerebral cortex, brain stem and spinal cord No indication of inflammation Cognition unimpaired Death occurs due to respiratory failure
What is treatment for ALS
No treatment to slow degeneration Medication to slow damage Respiratory therapy SLP, OT & PT Psychological support
What is Dementia
Progressive chronic disease impairing brain function such as Alzheimers
What are signs and symptoms of Alzheimers
Extends over 10 to 20 years Behavioral changes Decline of cognitive function Changes in food intake Inability to recognize family Incontincence
What is Vasculat Dementia
Cause by Cerebrovascular Disease Results from multiple small infractions Common in persons over 70 yrs Onset Insidious Memory Loss, apathy, inability to manage daily routines
What is AIDS Dementia
Common in later stages of AIDS
Virus invades brain tissue
Gradual memory loss
Impaired motor function
What are X-rays used for
To look at heart issues such as bone they can identify fractures of the skull or spine
What are CT scans used for
Use as many pictures to compile an image that can be viewed from multiple perspectives can be used to evaluate soft tissue. If used with IV contrast can identify damaged blood vessels. Used to diagnose tumors inflammation edema hematomas and infarctions.
Whag are MRIs used fo
Creates images of intracranial structures without radiation. Can be used to evaluate smaller defects such as multiple sclerosis lesions smaller tumors and blood vessels
What is a cerebral angiography
Uses computer-based images taken after injection of contrast medium to assess abnormalities in cerebral carotid and vertebral blood vessels. Can identify a Christians and aneurysms angioplasty can sometimes be done
What is am EEG
Monitors electrical activity in the brain used to detect seizure activity or brain wave activity if someone is in a coma
What is a lumbar puncture
A sample of cerebrospinal fluid is taken through a puncture in the lumbar area of the spine the CSF is an analyzed for abnormalities. Useful in diagnosing infections bleeds and some central nervous system disorders
What is Atelectasis
Nonaeration or collapse of a lung or part of a lung leading to decreased gas exchange and hypoxia
What is Pulmonary Edema
Fluid collection in a alveoli and interstitial area
Reduces amount of O2 diffusing into the blood and interferes with lung expansion
Can result from left sided CHF
