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Patho 3 Exam 2 > Motor and Brain Function: Intracranial Regulation > Flashcards

Motor and Brain Function: Intracranial Regulation Flashcards

1
Q

Non-Surgical Interventions for Low Back Pain

A
  • Massage, spinal manipulation, heat and acupuncture
  • NSAIDS, Mild Opioids, Topicals
  • William’s Position: Semi Fowler with pillow under knees
  • Stress Reduction
  • Tramadol, duloxetine, SNRI, muscle relaxants
  • PT
  • Weight Reduction
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2
Q

Complications from Low Back Pain

A
  • Cerebrospinal Fluid Leak: Examine wound for drainage; halo like, sudden HA
  • Fat Emboli; Chest pain, SOB
  • Cauda Equina: Part of spinal cord that branches into bundle of free flowing nerve roots at L1-L2
    : CES, may cause neurologic impairment
    : Causes: Massive lumbar disc herniation, spinal stenosis, epidural hemotoma, trauma
    : Sym: Saddle area numbness, urinary/ fecal incontinence, sudden weakness, need surgery asap!
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3
Q

Parkinson Disease

A
  • Idiopathic, chronic, progressive degenerative disorder of CNS
  • Over age 50 ( Males )
  • Helps: Cig smoking, caffeine, high blood urate levels
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4
Q

Parkinson Disease Cause

A
  • Overstimulation of the basal ganglia by acetylcholine occurs because degeneration of the substantia nigra results in DECREASED dopamine production = Acetlycholine to dominate
  • Treatments focuses on increasing dopamine and decreasing acetylcholine
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5
Q

Parkinson Disease Manifestations

A
  • Insidious onset
  • ” Pill rolling “ resting tremor of hand
  • Rigidity
  • 4 Cardinal Signs: tremor, bradykinesia, rigidity, postural instability
  • Venus stasis ( brown )
  • Glossy look to leg bc of decreased protein
  • Ortho hypotension
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6
Q

Parkinson Disease Responding

A
  • Extra time to answer questions
  • Speak slow and clear
  • Monitor eating / swallowing
  • Do not focus on feet when walking!
  • No cure
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7
Q

Migraine H/A W / Aura

A

W / Aura
Prodromal Phase: Irritability, depression, food cravings, frequent urination
Aura ( 1 hr ) : Numbness, tingling of mouth, lips, face, hand, acute confusion, visual disturbances
Second Phase: HA ( Severe ) , N/V , Drowsiness, Vertigo
Third: Pain changes from throbbing to dull
Recovery: Muscle ache, sleep
- Avoid tyramine

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8
Q

Migraine H/A W / O Aura

A
  • Pain aggravated by physical activities
  • Unilateral
  • N/V
  • Photophobia
  • Phonophobia
  • Lasting 4 to 72 hrs
  • Cluster HA: Shorter, give 12l/min O2 15-20 min at onset of HA
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9
Q

Spinal Shock

A
  • Complete but temporary loss of motor, sensation, reflex and autonomic function that often lasts less than 48 hrs but may continue for several weeks.
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10
Q

Tissue Perfusion

A
  • Neurogenic Shock: Complication of spinal trauma, causes sudden loss of communication within the sympathetic nervous system
  • Greater risk for VTE
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11
Q

Monro- Kellie Hypothesis

A
  • If the volume of one component of intracranial pressure increases slightly it is offset by reduction in volume of the other two.
  • A brain tumor increases volume of brain tissue —> blood and csf volume are reduced in response
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12
Q

Early signs of ICP

A
  • HA , NV, Confusion, Visual Changes ( blurred / double )
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13
Q

Late signs of ICP

A
  • Cushings Triad: Include the widening of pulse pressure, bradycardia and irregular breathing
  • Pupils fixed and dilated, posturing, coma
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14
Q

Decorticate Posturing

A
  • Hands in
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15
Q

Decerebrate Posturing

A
  • Hands out
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16
Q

Treatments for ICP

A
  • Diuretics, osmotic ( mannitol ) , sedation, pain control, barbiturates, hemicraniectomy
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17
Q

TIA

A

-Temporary episode of neurlogic dysfunction
- Caused by focal brain, spinal cord, or retinal ischemia without acute infarction
- Resolves in 1-24 hrs

18
Q

Stroke Risk Factors

A

Nonmodifiable:
- Age, family history, prior, race, sex, sickle cell

Modifiable:
- CV, diabetes, excess weight, high bp, high chol, smoking, drinking, no activity, poor nutrition, use of birth control

19
Q

Ishchemic Stroke

A

: Partial or complete occlusion of cerebral blood flow due to thrombus or emboli
1. Atherosclerosis
2. A Vib
3. Breakage of atherosclerotic plaque from carotid artery
- ***Most common: Emboli that pass through carotid arteries typically occlude the middle cerebral artery
- Less: Emboli that pass through vertebral / basilar lodge at apex of basilar artery

20
Q

Hemorrhagic Stroke

A
  • Bleeding into the brain from a burst blood vessel
  • 3: Intracerebral, Intraventricular, Extracerebral
21
Q

Hematologic Conditions that increase stroke risk….

A
  1. Thrombocytosis
  2. Hypercoagulable States - Med
22
Q

Diagnosis Stroke:

A
  • Exclusion of conditions that mimic TIA
  • Blood glucose
  • CBC
  • Noncontrast CT *** : First if bleeding
  • CT
  • Cartoid Doppler
  • Dysphagia screening
23
Q

Aphasia

A
  • Cerebral hem damage resulting in speech / language problems
24
Q

Expressive ( Brocca / Motor )

A
  • Motor speech problem, can understand but cannot speak
25
Q

Receptive ( Wernickle / Sensory )

A
  • Cannot understand spoken word
26
Q

Unilateral Neglect

A

Most common with right cerebral stroke

27
Q

Teach pt …

A
  • Touch and use both sides of body, dress affected side, turn head side to side, support affected arm b/c subluxation can occur from weigh of arm
28
Q

Mild TBI

A
  • LOC seconds to mins
  • Amnesia
  • Change in mental status at time of event
  • Sensitive to light
  • N/V
  • GCS 13-15
29
Q

Mod to Severe TBI

A
  • GCS 9-12
  • LOC for mins to hours
  • Seizures
  • Difficulty communicating / understanding
  • Long term disabilities as high as 50%
30
Q

Treatment

A

: Treat ICP / SAH with mannitol, hypertonic saline, barbiturates
- Sedation, pain
- Fever control
- Surgery: External ventricular drains or decompressive cranectomy

31
Q

End of Life Managing Symptoms

A
  • Pain, weakness, dyspnea, N/V, agitation, delirium, seizures
32
Q

End of life Managing Pain

A
  • Pain is the symptom that pt’s fear the most
  • Opiod / Non opiod used
  • CBMS: Only for refractory cancer pain as adjunct to other prescribed analgesics
  • Addresses fatigue, anorexia, sleep, anxiety, N/V
33
Q

Meningitis Treatment

A

: Vaccine for prevention
- Ceftriaxone, with Vanco
- Phenytoin for seizures
- Rifampin ( Otto Toxic )

34
Q

MS

A
  • Chronic inflammatory, demyelinating disorder of CNS
  • Autoimmune reaction
  • No cure
  • More common in females
  • Farther from equator
  • Viruses
35
Q

MS Most Common

A
  • Relapsing Remitting ***
36
Q

MS Features

A
  • Sensory, sym of extremities or face ( numb, tingling, drooping )
  • Visual problems
  • Vertigo
  • Pain
37
Q

MS Treatment

A
  • Comfort
  • Diplopia : Eye patch
  • Massage therapy
38
Q

Autonomic Dysreflexia

A

: Life threatening
- GOOSEBUMPS, high bp, flushed, something is not flowing right ( urine )

39
Q

Spinal Cord Injury Management

A
  • Bowel and Bladder program!
    Spastic: Upper motor neuron injuries
    Flaccid: Lower motor neuron injuries
40
Q
A

Patho 3 Exam 2 (2 decks)

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