nervous system Flashcards

Question

Hyperopia

Answer 1

farsightedness Light rays are focused behind the retina when a person is looking at a near object.

Answer 2

unequal curvature of the cornea Light rays are bent unevenly and do not come to a single focus on the retina Coexist with myopia, hyperopia, or presbyopia

Answer 3

eye discomfort due to light

Answer 4

drooping eye lid

Answer 5

aka tunnel vision – loss of peripheral sight

Answer 6

Acute confusional states - transient disorders of awareness and may have either a sudden or gradual onset Synonymous with delirium but also is a type of acute confusional state Types: excited delirium syndrome & hypoactive delirium NOT the same as dementia These states may occur due to disruptions in parts of the CNS such as: Reticular activating system of the upper brainstem Projections into the thalamus Basal ganglion Specific association areas of the cortex and limbic system Delirium It is a hyperactive confusional state Associated with right-upper middle-temporal gyrus or left temporal-occipital junction disruption and several NTs (acetylcholine and dopamine) are involved Excited delirium Aka agitated delirium Type of hyperkinetic delirium that can lead to sudden death Cardiac death due to electrolyte imbalances and rhabdo Treatment by police Clinical manifestations: Altered LOA Combativeness Aggressiveness Tolerance to significant pain Rapid breathing Sweating Severe agitation Elevated temperature

Answer 7

An acquired deterioration and a progressive failure of many cerebral functions that includes impairment of intellectual process with a decrease in orienting, memory, language, judgment, and decision making Usually due to environmental causes, genetic predispositions and sometimes CNS infections No cures

Answer 8

Neuromuscular junction disorder An acquired chronic automimmune disease mediated by antibodies against the acetylcholine receptor at the postsynaptic membrane of the neuromuscular junction Complications: myasthenic crisis and cholinergic crisis Treatments: anticholinesterase drugs, steroids, and immunosuppressant drugs, thymectomy Patho: The post-synaptic acetylcholine receptors on the muscle cell’s plasma membrane are no longer recognized as “self” and elicit T-cell-dependent formation of IgG autoantibodies. These block binding of acetylcholine and cause destruction of the sites. Not allowing nerve impulses to cross. Clinical manifestations: Muscles of the eyes, face, mouth, throat, and neck usually affected first Drooling, difficulty chewing and swallowing Aspiration risk Muscles of the neck, shoulder girdle, and hip flexors can occur after exercise and become progressively weak Respiratory muscles can become weak and impair ventilation Myasthenic crisis Severe muscle weakness cause: Extreme quadriparesis or quadriplegia Respiratory insufficiency with SOB could progress to respiratory arrest Extreme dysphagia Cholinergic crisis S/S mneumonic – DUMBELLS Diarrhea, urination, miosis, bradycardia, emesis, lacrimation, lethargy, salivation

Answer 9

A response to continuous vertical compression of the spine (axial loading) that includes disruption of normal building and maintenance of the lumbar disk cartilage Usually due to a genetic component and environmental interactions structural defect in the pars interarticularis of the vertebral arch L5 is most affected can lead to spondylolisthesis Lower back and lower limb pain

Answer 10

A response to continuous vertical compression of the spine (axial loading) that includes disruption of normal building and maintenance of the lumbar disk cartilage Usually due to a genetic component and environmental interactions An osseous defect of the pars iinterarticularis that allows a vertebra to slide anteriorly in relation to the vertebra below Commonly L5-S1 Can cause pain to lower back, legs, and buttocks

Answer 11

A response to continuous vertical compression of the spine (axial loading) that includes disruption of normal building and maintenance of the lumbar disk cartilage Usually due to a genetic component and environmental interactions Narrowing of the spinal canal that causes pressure on the spinal nerves or cord and can be congenital or acquired and associated with trauma or arthritis Can affect: cervical thoracic, or lumbar Caused by: Bulging disk Facet hypertrophy Thick ossified posterior longitudinal ligament Symptoms: Numbness or tingling in the neck, hands, arms, legs with weakness and difficulty walking

Answer 12

Right side Peripheral edema jvd left side crackles sputum both SOB Cyanotic

Answer 13

Defined as: chronic inflammatory disorder of the bronchial mucosa that causes bronchial hyperresponsiveness, constriction of the airways and variable airflow obstruction that is reversible Risk factors? Genetics play a heavy role & hygiene hypothesis Other risk factors: Age of onset of disease Levels of allergen exposure Urban residence Exposure to indoor and outdoor air pollution Tobacco smoke Recurrent respiratory tract viral infections GERD Obesity Combination of innate and adaptive immunity responding to a allergen or irritant. Early stage: Exposure causes activation of dendritic cells causing release of inflammatory cytokines and interleukins that activate B cells (plasma cells) and eosinophils Plasma cells produce IgE and bind to mast cells which causes degranulation of mast cells causing a couple of responses (look at the chart), generally releasing inflammatory mediators Histamine, ILs, prostaglandins, etc. **eosinophils cause direct damage to tissue and contribute to increased bronchial hyperresponsiveness, this also causes airway scarring. Once the damage is irreversible this is known as AIRWAY REMODELING. Late asthmatic response begins 4-8 hrs after the early response. The early immune response causes a delayed release of inflammatory mediators Causing more bronchospasm, edema and mucus secretion with obstruction to airflow During an attack: Chest constriction Expiratory wheezes Dyspnea Nonproductive coughing Prolonged expiration Tachycardia Tachypnea During SEVERE attack: Accessory muscles use increases Inspiratory and expiratory wheezes Pulsus paradoxus Decreases oxygen saturation Complication: STATUS ASTHMATICUS – may have silent chest at this point Showing respiratory failure = mechanical ventilation Acute attack -> oxygen + inhaled beta-agonists + oral corticosteroids Avoiding allergens and irritants FOR PARAMEDICS – bronchoconstriction directive

Answer 14

S/S dyspnea minimal cough tachypnea decreased breath sounds pink skin and pursed lip breathing cachexia Hyperinflation / barrel chest skinny due to work of breathing pneumo due to bullae Defined as: the abnormal permanent enlargement of gas-exchange airways (acini) accompanied by destruction of alveolar walls without obvious fibrosis Cause: changes in lung tissues, specifically the elastic recoil of lung tissue, from damage from inflammation and mucous presence from exposure to cigarette smoking or pollution Patho: inherited alpha1-antitrypsin deficiency and infiltration of inflammatory cells and release of cytokines can cause increased protease activity with breakdown of elastin in connective tissue of lungs which destroys alveolar septa and loss of elastic recoil of bronchial walls leading to clinical presentations

Answer 15

risk factors: smoking age blood clotting disorder cardiovascular diseases like heart failure, a fib obesity cancer hormonal factors surgery dvt hx prolonged immobility CM: SOB Chest pain localized rapid or ireg HR cyanosis Cough Peripheral Edema Fainting or lightheadedness anxiety / insomnia

Answer 16

Typically presents in premature infants and is a significant cause of neonatal morbidity and mortality (29-30 weeks) Death rates have declined due to antenatal steroid therapy and postnatal surfactant therapy Cause: surfactant deficiency, leading to atelectasis Clinically presents with: tachypnea (>60), expiratory grunting, intercostal and subcostal retractions, nasal flaring, and cyanosis Preventative: corticosteroids Treatments after birth: mechanical ventilation, nebulized or CPAPed with exogenous surfactant Risk factors: Premature birth/low birth weight (30weeks) Male gender Cesarean delivery without labor Diabetic mother Perinatal asphyxia Increased pulmonary vascular resistance can cause a right-to-left shunt of blood through the ductus arteriosus and foramen ovale. Metabolic acidosis can result from the hypoxia and hypoxemia.

Answer 17

Autosomal recessive inherited disease (CF gene is on chromosome 7) that results from defective epithelial chloride transport Affects the lungs, digestive tract and reproductive organs Treatment: promotion of mucus clearance – chest therapy, mechanical devices, bronchodilators, aerosolized dornase alfa and hypertonic saline to liquefy mucus, antibiotics if needed, lung transplantation Bacterio: staphylococcus aureus, haemophilus influenzae Clinical manifestations: Persistent cough or wheeze Excessive sputum production Recurrent or severe pneumonia Chronic sinusitis Barrel chest Digital clubbing Nasal polyps Could be at risk for bronchial artery erosion, pulmonary hypertension and cor pulmonale.

Answer 18

Sudden death of an infant under 1 year of age which remains unexplained. Most frequent at 2-4 months old Risk factors: prone and side-lying sleeping positions, sleeping on soft bedding, overheated sleeping environment, lower socioeconomic status, mothers younger than 20, lower birth weight or growth restricted infants, male infants, preterm delivery, multiple gestations, sibling who died of SIDS, smoking during pregnancy, exposure to tobacco smoke, lack of prenatal care, illicit drug use or binge-drinking, larger family size

Answer 19

Common viral respiratory tract infection (RSV – respiratory syncytial virus) Infants and young toddlers Patho: Virus causes necrosis of bronchial epithelium and destruction of ciliated epithelial cells, leading to a inflammatory response Inflammation in the bronchioles causes air trapping, hyperinflation and increased FRC —> hypercapnia and increased WOB Prognosis: typically, the affected will make a full recovery but premature or those with bronchopulmonary dysplasia or heart disease struggle to recover Complications: increased risk for asthma Treatment: palivizumab(antibiotic) and other supportive treatments Clinical manifestations: Rhinorrhea Tight cough Decreased appetite Lethargy Fever Tachypnea Respiratory distress Wheezing, rales, ronchi Severe apnea Conjunctivitis Otitis media

Answer 20

Cause: Haemophilus influenzae Type B More common in adults now, but was very common in children 2-7 years Patho: inflammation in the posterior tongue base, covering the laryngeal inlet during swallowing and can cause life threatening upper airway obstruction Clinically: high fever, irritability, sore throat, inspiratory stridor, severe respiratory distress, drooling, absence of cough, preference to sit (sniffing position), dysphagia, high fever; toxic appearance; muffled voice; drooling; dyspnea; sits erect & quietly Complications: pneumonia, cervical lymph node inflammation, otitis, meningitis, septic arthritis DO NOT AGITATE, avoid laryngospasms

Answer 21

age 6months 12 years Types: acute laryngotracheobronchitis vs. acute tracheitis Typically caused by parainfluenza (virus)a Characterized as an infection causing obstruction of the upper airways Subglottic inflammation and edema from infection, leading to upper airway obstruction, increased resistance to airflow, increased intrathoracic negative pressure and then collapse of upper airway leading to respiratory failure Most common in winter months Clinically: rhinorrhea, sore throat, fever, hoarse voice, barking cough, inspiratory stridor SEVERE WHEN ++WOB As we know for treatment Dexamethasone and Epi Oxygen

Answer 22

Cause by: a virus, otherwise sometimes bacteria Spread: direct contact, droplet transmission, or aerosol exposure Treatment: supplemental oxygen, assisted ventilations, antibiotics (if bacterial), preventatively children should be receiving vaccines against influenza and pneumococcus