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Anatomy and Physiology > Nervous System Pathophysiology > Flashcards

Nervous System Pathophysiology Flashcards

1
Q

What is the cause of transient loss of consciousness?

A

Inadequate cerebral perfusion (flow of blood supplied to the brain)

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2
Q

What are three types of loss of consciousness resulting to inadequate cerebral perfusion?

A

Vasovagal syncope
Exercise related syncope
Epilepsy

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3
Q

What causes epilepsy?

A

Transient uncontrolled paroxysmal discharges of nerve tissue within the brain (high frequency discharge of action potentials in the brain)

A disturbance of electrical activity

Attacks needs to be recurrent to diagnose epilepsy

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4
Q

What percentage of seizures stop after ten minutes?

A

80%

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5
Q

What is the idiopathic cause of epilepsy?

A

Genetics

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6
Q

What does idiopathic mean?

A

Disease or condition arises spontaneously or the cause is unknown

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7
Q

What are the symptomatic causes of epilepsy?

A 
Head injury
Infections like meningitis 
Brain underdevelopment 
Stroke
Scaring
Tumors
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8
Q

What are some causes of epilepsy?

A

Genetics

Brain infection such as meningitis

Drug abuse such as angel dust (PCP), cocaine, amphetamines

Electric shock

Fever

Head injury

Heat related illness

Poisoning

Pregnancy related - eclampsia (seizure after giving birth)

Stroke

Toxin buildup in the body due to liver or kidney failure

Withdrawal from alcohol or certain medicines after using for a long time

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9
Q

What are the three types of epilepsy?

A

Focal
Generalised
Status epilepticus

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10
Q

What are the three types of focal (partial) epilepsy?

A

Simple focal
Complex partial
Secondary generalised

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11
Q

What are the types of generalised epileptic seizures?

A 
Absences
Tonic
Atonic
Myoclonic
Tonic clinic
Clonic
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12
Q

What’s the difference between focal seizures and generalised seizures?

A

Focal is where only a small part of the brain is affected whereas generalised involves the whole brain

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13
Q

How does simple focal seizures cause symptoms associated with the temporal lobe?

A

Deja vu getting an unusual smell or taste

Sudden intense feeling of joy or fear

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14
Q

How does simple focal seizures affect frontal lobe?

A

Stiffness or twitching in part of the body (such as an arm or hand)

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15
Q

How does simple focal seizures affect the parietal lobe?

A

Feeling of numbness or tingling

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16
Q

How does simple focal seizures affect the occipital lobe?

A

Visual disturbances

Hallucinations

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17
Q

How long does complex focal seizures typically last?

A

15-30 seconds

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18
Q

What lobe does complex focal seizures usually affect?

A

Temporal lobe

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19
Q

What symptoms are associated with complex focal seizures?

A

Repetitive movements such as fiddling with clothing

Chewing or lip-smacking movements

Muttering or repeating words that don’t make sense

Wondering around in a confused way

LOC may be affected and the patient may seem confused

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20
Q

What is a secondary generalised seizure?

A

Begins as focal seizure but spreads into the other hemisphere and becomes generalised

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21
Q

What are absent seizures also known as?

A

Petit mal

22
Q

How are tonic seizures characterised?

A

Person becomes rigid and usually falls over

Injuries are common

Usually brief and occur without warning

23
Q

How are tonic seizures characterised?

A

Complete and sudden loss of muscle tone

Often called a ‘drop attack’

May result in injuries

Last a few seconds

Recovery usually quick

24
Q

How are myoclonic seizures characterised?

A

Muscle jerking

Patient remains conscious

Usually has other generalised forms of epilepsy

Often occurs in clusters but are relatively short lived

25
Q

How are tonic clonic seizures characterised?

A

Person becomes unconscious

Body goes stiff and usually falls backwards

They may cry out

They may bite their tongue or cheek

They jerk and shake (convulse) as their muscles relax and tighten rhythmically

Breathing may be affected and become difficult or sound noisy

Pallor or cyanosed

Incontinence (lack of control over urination and voluntary control)

After seizure, breathing and colour return to normal and may feel tired, confused, headache and want to sleep (post ictal)

26
Q

How are clonic seizures different to tonic clonic seizures?

A

Similar but patient does not go rigid at the start

Limbs tend to jerk

27
Q

How are status epilepticcus seizures characterised?

A

Convulsions lasting longer than 30 minutes

Repeated seizures for over 30 minutes with no recovery in between

Potentially life threatening

28
Q

What are some causes of nonepileptiform seizures?

A 
Hypoxia 
Trauma
Stroke
Hypoglycaemia
Metabolic disturbances
Eclampsia
Fever (febrile)
Meningitis
Intracranial tumour 
Drug intoxication 
Septicaemia
Uraemia (High conc of urea in blood)
Hypertension
29
Q

What is the treatment for seizures?

A

ABCD

Access: blood glucose
Heart rate and rhythm
Temperature
Blood pressure
Alcohol or drug usage
Signs of injury

Airway: NP

O2 - 100% until reliable measurements can be gained

Position of comfort and try to minimise noise

Refer to treatment plan where possible

Buccal midazolam or diazemuls

30
Q

How is midazolam presented?

A

Ampule containinh 5mg in 5ml or buccal pre-filled syringes of 2.5mg, 5mg, 7.5mg and 10mg

31
Q

What are the three actions of midazolam?

A

Benzodiazepine derivative (imitates BZ)

Onset of action 2 mins and peak effect 5-10 mins

Short acting sedative decreasing from 15 mins onwards

32
Q

What are the side effects of midazolam?

A 
Respiratory depression 
Hypotension 
Reduced LOC
Confusion and increased agitation 
Amnesia in some patients
33
Q

How old to patient have to be to administer midazolam IV or IO?

A

Over 17 years old

34
Q

Through IV or IO how many grams of midazolam is administered? What is the time interval for doses? What is the max dose?

A

2mg
Repeat after 2 mins if needed
Max dose 10mg

35
Q

What is the mg dose of buccal midazolam for adults?
What is the time interval for dosage?
What is the max dose?

A

10mg
Repeat after 10 mins
Max dose 20mg

36
Q

What is the presentation of diazepam?

A

Ampoules containing 10mg in 2ml (IV preferred route)

37
Q

What is the actions of diazepam?

A

CNS depressant, anticonvulsant and sedative

38
Q

What are the indications for the use of diazepam?

A

Fits longer than 5 mins and still fitting

Repeated fits (not secondary to uncorrected hypoxia or hypoglycaemia)

Status epilepticus

Eclampsia fit (>2-3mins or recurrent)

39
Q

What cautions should be taken with diazepam?

A 
Respiratory depression 
Alcohol or CNS depressants
Recent dose
Hypotension 
Drowsiness
Lightheadedness
Confusion 
Unsteadiness
Amnesia
40
Q

What is the recommended dose IV or IO of diazepam for adults?
What is the time interval for dosage?
What is the max dose?

A

10mg
Repeat after 5 mins
Max dose 20mg

41
Q

What is a stroke also known as?

A

Cerebrovascular Accident (CVA)

42
Q

What is a stroke?

A

A loss of cerebral function works symptoms lasting more than 24 hours

43
Q

What is a transient ischaemic attack (TIA)?

A

An acute loss of cerebral or monocular function with symptoms lasting less than 24 hours

44
Q

What percentage of strokes are ischaemic?

A

85%

45
Q

What percentage of strokes are haemorrhagic?

A

15%

46
Q

What does ischaemic mean?

A

Clot blocks blood flow to an area of the brain

47
Q

What does haemorrhagic mean?

A

Bleeding occurs inside or around the brain tissue

48
Q

What five different categories are ischaemic strokes classified as?

A

Large-artery atherosclerosis = a clot from the arteries

Cardioembolism = a clot from the heart

Small-vessel occlusion = a narrowing it weakening of blood vessels

Stroke of other determined etiologies

Stroke of undetermined etiology

49
Q

What are the two types of haemorrhagic stroke?

A

Intracerebral haemorrhage (ICH) = bleeding within the brain

Subarachnoid haemorrhage (SAH) = bleeding on surface of brain

50
Q

What are the causes of ischaemic strokes?

A

Atherosclerotic (Thickened, hardened arteries narrowed by fatty deposits)

Thrombotic (blood clot)

Embolic (any foreign substances e.g. air)

Anatomy and Physiology (26 decks)

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