Nervous System Flashcards
Levels of consciousness
- Vegetative state
- Locked-in syndrome
- Brain death
Aphasia
inability to comprehend or express language(receptive and expressive)
Dysarthria
Motor dysfunction affecting muscles used in speech-cannot articulate clearly
Expressive aphasia(motor)
cannot speak or write fluently or approiatly
Receptive aphasia(sensory)
unable to understand written or spoken language
Global aphasia
combo of expressive and receptive aphasia, major brain damage.
Agraphia
Impaired writing ability
Alexia
Impaired reading ability
Agnosia
loss of recognition or association
Effects of Increased intracranial pressure
decreasing level of consciousness, headache, vomiting, increasing blood pressure w/increasing pulse pressure, slow heart rate, papilledema, pupil fixed and dilated
Vital signs of increased intracranial pressure
Development of cerebral ischemia, systemic vasoconstriction, baroreceptor response, chemoreceptor response, improved cerebral circulation, high BP, low pulse, low respiration, can result in herniation
Dx test for Intracranial pressure and herniation
CT, MRI, cerebral angiography, doppler ultrasound, electroencephalography, radionuclide to track perfusion in CNS, lumbar puncture used to check pressure and analyze CSF
Brain tumors
cause ICP, primary malignant tumors rarely metastasize outside of CNS. Secondary brain tumors from breast or lung. Invasive and have irregular projections into adjacent tissue
Transient Ischemic Attacks TIA
result from temporary localized reduction of blood flow in the brain
TIA S/Sx
difficult to diagnose, directly related to location of ischemia, intermittent short episodes of impaired function, visual disturbances, numbness and paresthesia in face, transient aphasia or confusion may develop.
Cerebrovascular Accidents- CVA’s
stroke-an infarction of brain tissue that results from lack of blood, occlusion of a cerebral blood vessel or rupture of cerebral vessel.
Types of CVA’s
- Occlusion of an artery by an atheroma-develops in lg arteries
- Sudden obstruction caused by an embolus-lodging in a cerebral artery.
- Intracerebral hemorrhage-caused by a rupture of a cerebral artery in patient w/severe hypertension
CVA risk factors
diabetes, hypertension, systemic lupus, increasing age, congenital malformation of blood vessels, atherosclereosis, history of TIA’s, smoking, sedentary lifestyle
CVA S/sx
Depends on the location of obstruction, size of artery involved, lack of voluntary movement or sensation on opposite side of body, initially flaccid paralysis, spastic paralysis develops weeks later.
CVA Treatment
clot busting agents, surgical intervention, glucocorticoids, supportive treatment, OT/PT, treat underlying problems to reduce recurrences, rehab begins immediately.
Cerebral aneurysms
localized weakness in the wall of an artery and frequently multiply. Usually at the points of bifurcation on the circle of willis, often aggravated by hypertension, slow bleed causes vascular type headache and rupture leads to sudden fatal increase in ICP and death.
Cerebral aneurysm S/sx
loss of visual field or visual disturbance, headache and photophobia, intermittent periods of dysfunction, nuchal rigidity caused by meningeal irritation. Tx surgical before rupture and anti hypertensive drugs.
Brain infections-Neisseria meningitidis or meningococci
Frequently carried in the nasopharynx of asymptomatic carriers, spread by respiratory droplets, occurs more frequently in late winter an dearly spring.
Meningitidis S/sx
sudden onset is common, severe headache, back pain, photophobia, nuchal rigidity, vomiting, irritability, lethargy, fever, chills w/leukocytosis, progression to stupor or seizures. Dx examination of CSF-lumbar puncture
Brain Abscess
localized infection, frontal or temporal lobes. Usually necrosis of brain tissue and surrounding area of edema. May spread from organisms in ear throat, lung, sinuses. May result from septic emboli, acute bacterial endocarditis, site of injury or surgery. Tx surgical drainage and antimicrobial therapy.
Encephalitis
infection of the parenchymal or connective tissue in the brain and spinal cord. Infection may include meninges, usually viral. Headache, stiff neck, lethargy, vomiting, seizures, fever
Types of head injuries
- Concussion
- Contusion
- closed head injury
- open head injury
- depressed skull fractures
- basilar fractures
- contrecoup injury
Hematomas
all types of hematomas lead to local pressure on adjacent tissue, general increase in ICP. Causes are sports injury, car or motor accident, falls are common.
Hydrdocephalus-congenital neurological disorder
Excess CSF accumulates within the skull, compresses brain tissue and blood vessels, CSF accumulates because more is produced than reabsorbed.
Spina bifida-congenital neurological disorder
group of neural tube defects of varying severity
Cerebral palsy-congenital neurological disorder
group of disorders with some degree of motor impairment, abnormal formation of functional brain areas, infection, brain damage in perinatal period.
MS
progressive demyelination of neurons in the brain, spinal cord and cranial nerves. Loss of myelin interferes w/conduction of impulses in affected fibers. May affect motor, sensory and autonomic fibers.
MS S/sx
manifestations determined by areas of demyelination, blurred vision, weakness in legs, diplopia, scotoma, dysarthria, paresthesia, progressive weakness and paralysis extending to upper limbs. No definitive test or treatment.
Alsheimers Disease
progressive cortical atrophy, neurofibrillary tangles and plaques. Gradual loss of memory and lack of concentration. No definite diagnostic tests, exclusion of other disorders. NO specific treatment.
seizure disorders
uncontrolled, excessive discharge of neurons in the brain, maybe localized or generalized
