nervous system Flashcards
meningitis
-inflammation of meninges of brain and spinal cord
-common form viral
-positive Kernig’s sign (when the tight is flexed at the hip and knee at 90, and knee extension is painful.
-vaccine for Hib
cardinal sign for meningitis
headache (from stretch or pressure on meninges)
other symptoms: fever, vomiting, stiff/painful neck
encephalitis
-acute inflammatory disease of parenchyma (tissue) of brain (mostly grey matter)
-cause: viral (mosquitos and ticks- west nile)
-headache, N&V, altered consciousness
-no antiviral treatment -except for herpes simplex virus
***(acyclovir) S/E: Nausea, diarrhea, headache, or vomiting may occur.
amyotrophic lateral sclerosis (ALS) (Lou Gehrigs Disease)
-*weakness, fasciculations, cramping
-most devastating neurodegenerative disease
-bulbar palsy= if cranial nerve nuclei involved (swallowing, chewing, facial gestures)
-death within 2-5 years due to pneumonia
alzheimer disease/dementia
-decline in memory results in dementia
-hereditary, HTN, high cholesterol
-no cure
*** donepezil (aricept) S/E: Nausea, vomiting, diarrhea, loss of appetite/weight loss, dizziness, weakness.
memory loss, visuospatial deficits, abnormal drawing, mood swings, anomia, difficult comprehending
s/s of dementia
dystonia
-involuntary muscle contractions (twisting and repetitive movements)
-cervical dystonia is most common focal dystonia (painful), deterioration of hand writing
** botulinum toxin, therapies surgery
**bacoflen S/E: weakness, N/V, diarrhea, headaches.
huntington’s disease (CHOREA-dance)
-progressive hereditary disorder (autosomal dominant)
-abnormalities of movement, personality disturbances, dementia
-movement is brief, purposeless, involuntary
-staggering gait
-treatment is symptomatic (anticonvulsants, antipsychotics) S/E: tardive dyskinesia.
abnormalities in eye movement, dysarthria, dysphagia, cachexia, sleep disorders, urinary incontinence are symtoms of what
hungtigtons’s disease
multiple sclerosis
-sclerotic plaques throughout CNS= hallmark
-optic neuritis first manifestation
-demyelination
-lesions block neural transmission/ sensory changes- leads to weakness, sensory loss, visual dysfunction
-treatment: immune modulation
ABC drugs (interferon- Betaseron) S/E: headache, increase in your muscle tension, pain, rash, problems sleeping, stomach pain, weakness
-symptom managment: botox, corticosteroids
FATIGUE, weakness, UMN signs, coordination problems, depression, cranial nerve involvements are all symptoms of what
multiple sclerosis
parkinsons disease
-chronic-progressive of motor component of CNS
-loss of midbrain dopamine neurons, presence of lewy body inclusions
-Smoking, exposure, more years of education equals increase risk
- most common initial manifestation is tremor at rest or stressful periods
-Stereotypical Gait: decrease trunk movements decrease step length in arm swing, narrow based, decrease speed, flexed posture
-basal ganglia and converted to dopamine- long term of med can cause increase dyskinesia or chorea- like movement
Stroke
-Interruption of blood supply to Brain (hemorrhage or ischemia)
-Leading cause of disability. Cause: cerebrovascular disease
-Weakness no malicious confusion difficulty speaking difficulty seen loss of power balance see if your headache severe
-s/s: weakness, numbness, confusion, difficulty speaking, dizziness, loss of balance and vision, headache
ischemic stroke:
-occlusion of major vessel caused by thrombosis or embolism
-embolitic occlusion: from heart due to atrial fib causes thrombus formation.
=syndromes: MCA, ACA, internal carotid, PCA, basilar artery
TREMORS, rigidity, bradykinesia, postural instability are all symptoms of what disease
parkinsons disease
Akinesia
-freezing
-disorder of movement initiation
manage blood pressure, thrombolytic and antithrombotic agents, t PA within 3 hours
-prophylactic anticoagulation therapy (aspirin)
-coumadin 2x prevent stroke is pt has atrial fib
-lipid lowering agents
are all examples of treatment for what condition?
ischemic stroke
-bleeding from arterial source into brain parenchyma
-primary-spontaneous bleeding due to microvascular dis from HTN- age
-adverse effect of thrombolytic therapy and long-term anticoagulant therapy
-hematoma, edema
intracranial hemorrhage
-sudden onset of headache with searing pain
-results in frank blood in subarachnoid pain
-types: berry aneurysm, venous malformations
subarachnoid hemorrhage
-tearing of bridging veins between brain surface and dural sinus
-accumulation of flood in dural space
-can become space-occupying lesion
subdural hemorrhage
TIA
-MINI STROKE
-focal neurological symptoms that resolve whitin 1 to 24 hrs
-predictor of stroke (1/3)
Traumatic brain injury
-External physical force with potential to cause alterations in brain functions
-Open or close
-falls are leading cause, then MVA
-Axonal injury
*mild is concussion
* levels of consciousness: coma, persistent vegetable state
- chyene-strokes breathing, ataxic breathing
-cognitive/behavioral impairments (RLA scale), cranial nerve damage, motor deficits, heterotopic ossificans
*elevations of intracranial pressue (ICP) of more than 20mmHg is a predictor of poor outcome.
concussion (link)
Spinal cord injury
-Primary cause: MVAs, second is falls
- classifications: concussions, contusions, laceration
-50% from excessive flexion (hangman’s fracture C2)
-emergency care: stabilize/immobilize, surgery, meds
-corticosterosids (methylyprednisone) to control edema, blood flow, secondary sequelae
–S/E: upset stomach, vomiting, headache, dizziness.
