MT M 4.6 Nervous System conditions and procedures Flashcards
Disorders of the nervous system
Disorders of the nervous system occur when there is damage to the brain, spinal cord, or nerves. Physical examination of a patient with a neurological complaint involves a detailed history of the complaint, assessment of the patient’s mental status and memory, cranial nerve testing, muscle tone and gait observation, reflexes, sensation, and coordination.
Dementia
Dementia is a progressive deterioration of a patient’s cognitive abilities and memories that then impairs the performance of activities of daily living (ADLs), thinking, reasoning, and remembering.
These causes of dementia are not reversible, and there is no cure. The strongest risk factor for dementia is advancing age, and the frequency of dementia increases with each decade of life.
The progression of some dementias may be slowed with medications called cholinesterase inhibitors.
Alzheimer’s dementia (AD)
One of the most common causes of dementia.
Four were identified.
vascular dementia,
One of the most common causes of dementia.
Four were identified.
frontotemporal dementia
One of the most common causes of dementia.
Four were identified.
Parkinson’s disease
One of the most common causes of dementia.
Four were identified.
mini-mental state examination
The mini-mental state examination (MMSE) is a screening tool used to help with the diagnosis of dementia, and it assesses the patient’s memory, orientation, language comprehension, naming, and copying.
Brain Tumors
Tumors that develop in the brain either arise from the brain tissue itself or metastasize to the brain from other primary tumors. Primary brain tumors can either be benign or malignant. The symptoms of a brain tumor include progression of a neurological deficit, seizures, or nonspecific neurological symptoms such as headache dementia, personality change, or gait disorder. Figure 4.9A shows an illustration of a brain tumor, specifically a glioma, which is a tumor that is made of neurological tissue.
positron emission tomography scan
a positron emission tomography scan (PET) showing a brain tumor in the frontal lobe.
Brain tumor imaging
Brain tumors can be seen on images of the brain with a CT scan, PET scan, or MRI.
neuroma
Brain tumors
A neuroma is a tumor of nerve cells and nerve fibers
astrocytoma
Brain tumors
An astrocytoma is a tumor of the brain that is made up of astrocytes. Astrocytomas are the most common primary metastatic brain tumors, and they carry a poor prognosis, as they are difficult to surgically remove and respond poorly to radiation.
oligodendroglioma
Brain tumors
Another malignant tumor of the nervous system is an oligodendroglioma, which is located in the central nervous system. However, these tumors are more easily removed via surgery and respond better to chemotherapy.
Cerebrovascular accidents (CVA)
Cerebrovascular accidents (CVA) occur when blood flow to the brain is disrupted. The term CVA refers to conditions such as strokes or aneurysms.
meningioma
A meningioma is a benign tumor of the meninges and can be cured by surgical removal.
Strokes
Strokes can be hemorrhagic or ischemic.
Hemorrhagic strokes occur when a blood vessel in the brain ruptures,
Ischemic strokes occur when blood clots block the flow of blood to the brain, and these blood clots are either an embolism or a thrombosis.
embolism
An embolism (Figure 4.10C) is a clot that travels to the brain from another area of the body
thrombosis
a thrombosis (Figure 4.10B) is a clot that develops in the cerebral artery.
aneurysm
An aneurysm is a weakness in the blood vessel wall that is at risk for hemorrhage.
symptoms and damage to the brain depends upon where the injury is and the size of the hemorrhage or infarct
An infarct is an area of tissue damage or death due to a lack of blood supply. The saying “time is brain” is appropriate for these patients, as the longer the blood supply to the brain tissue is blocked, the more permanent the injury to the brain and the resulting symptoms. The goal for treatment is to reestablish blood flow to the brain as quickly as possible either by stopping the hemorrhage, removing the blood clot, or relieving the compression of the artery. CVAs are critical conditions requiring rapid medical support and intervention and can lead to permanent neurological damage or even death.
seizure
A seizure is an episode where there is sudden, abnormal, and excessive activity of the central nervous system leading to changes in attention and/or behavior that the patient is unable to control.
Epilepsy
Epilepsy is a chronic disorder of the brain where the patient experiences recurrent seizures
Multiple sclerosis (MS)
Multiple sclerosis (MS) is a chronic disease of the central nervous system that is commonly caused by the immune system. It is characterized by inflammation, demyelination, and then scarring of the nerves. The damage to the myelin sheath is called a plaque, and these plaques develop in the neurons of the brain and spinal cord. This causes tremors and spasms, muscle weakness in the limbs, incoordination, paresthesia, and visual and speech disturbances. MS symptoms can range from mild to severely debilitating, and they can be progressive or relapsing and remitting. Figure 4.11 shows the extensive symptoms that may be experienced by a patient with multiple sclerosis.
Treatments for MS
Treatments for MS include oral steroid medication for acute attacks or worsening symptoms. Disease-modifying agents that act on the immune system are used to prevent the progression of the disease.
