neuro Flashcards
epilepsy
Seizure: sudden , abnormal, disorderly discharge of neurons within the brain that is characterized by a sudden, transient alteration in brain function
Aura: occurs before a seizure
Perception of a strange light, unpleasant smell, or confusing thoughts or experiences
generalized onset seizures
Motor symptoms: clonic, tonic, myoclonic muscle activity, atonic or epileptic spasms
non-motor symptoms:Absence seizures
focal onset seizures
can cause motor, sensory, autonomic, or psychic symptoms with or without impairment of cognition
Automatisms: repeated automatic movements like clapping or rubbing of the hands, lip-smacking or chewing, or running
Non-motor symptoms: changes in sensation, emotions, thinking or cognition, autonomic functions, or lack of movement (Behavior arrest)
trigeminal autonomic cephalgia (cluster headache)
Excruciating unilateral headache with prominent cranial parasympathetic autonomic features
Activate a trigeminal parasympathetic reflex
Most common type: cluster headache
vasodilation responsible for autonomic features and pain
attacks of severe unilateral pain
agitation, restlessness
unilateral conjunctiva - blood shot eyes
orbital, suborbital temporal area
parkinsons disease
Combination of genetic, immunological and environmental factors
Mainly associated with progressive loss of dopamine producing cells in the substantia nigra, within the basal ganglia of the midbrain
Basal ganglia modulates movements like posture, standing, walking or writing
Reduction in dopamine leads to excess unopposed Ach, leading to tremors and spastic movements
Classic tremor is a resting “pill rolling” tremor, but other tremors exist as well
Rubbing the index finger and thumb together
Difficulty initiating gait or rising from a chair, take a long time to turn when walking
diagnosed with TRAP (tremor at rest, rigidity, bradykinesia, gait instability
relieve symptoms and maximize independence and mobility while preserving the quality of life
amyotrophic lateral sclerosis (ALS)
Lou Gehrig’s disease
Progressive neurodegenerative disorder characterized by a loss of upper and lower motor neurons and eventually resulting in respiratory failure
Muscles that are no longer receiving signals weaken and atrophy
Eventually the damage to the motor neurons becomes so great that the brain is unable to start or adequately control voluntary muscle movement
Positive babinski’s reflex: when stroking the bottom of the pts feet,the toes spread out and the big toe moves up
diffucully w speech, dysphagia, breathing
progressive loss of motor function.
Cognitive processing and sensation are intact.
no cure
multiple sclerosis
remissions and exacerbations
damage to the myelin caused by autoimmune disorder
Vision problems are the most common and first to be seen because the optic nerves are heavily myelinated
Motor symptoms: Hemiparesis (muscle weakness)
weakness, numbness, tingling sensation
MRI to see lesions
no cure meds to relieve symptoms
Corticosteroids used to reduce inflammation
Novantrone: reduces neurological disability
Huntingtons Disease
Inherited, progressively degenerative neurological
disorder that results in involuntary motor symptoms,
cognitive decline, and emotional and behavioral symptoms
dominant CNS disorder caused by cellular deterioration in specific areas of the basal ganglia and cortex
Chorea: brief, irregular and dancelike movements
Athetosis: twisting and writhing movements
irritability, mania, anger
cognitive symptoms - slow response and memory
difficult to make sound decisions
diagnosis - genetic testing
genetic disorder
gullian barre syndrome
Caused by an antecedent infection of either the respiratory or GI tract
Previous infection evokes an autoimmune response in the peripheral nerves
Macrophages attack the myelin
Reaction results in defects in the conduction of electrical nerve impulses
Eventual absence of conduction causing flaccid paralysis of the muscles
Recovery can occur with remyelination
Mycoplasma pneumoniae, EBV, C. jejuni, CMV
Cardinal sign: progressive, usually symmetric muscle weakness accompanied by absent or depressed deep tendon reflexes
myasthenia gravis
Autoimmune disease caused by the loss of functioning Ach receptor in the neuromuscular junction
Leads to insufficient neuromuscular transmission
Autoimmune disorder with loss of
functioning Ach receptors in neuromuscular junction.
Autoantibodies directed against muscle acetylcholine receptors are detected.
Ocular: muscle weakness only occurs in the eyelids and extra ocular muscles
Generalized form: weakness throughout the entire body
frontal lobe
consciousness, judgment, emotional responses (executive function)
temporal lobe
hearing ability and memory acquisition. Center of speech found in left hemisphere
parietal lobe
sensory discrimination, such as touch perception and manipulation of objects, proprioception (where you are in space)
occipital lobe
controls vision
components of TBI/neuro assessment
battle signs and raccoon eyes
Battle’s sign: dark bruising visible in the skin overlying the mastoid process (just behind the ears)
Raccoon eyes: dark bruising visible in the skin around the eyes
concussion
AKA mild TBI
Physiological disruption in brain function caused by traumatic forces
Results from a blow to the head or severe shaking of the head and neck
alteration in consciousness
brown sequard syndrome
Incomplete SCI commonly associated with penetrating injuries that lead to hemisection of the spinal cord
Damage of ascending and descending neural tracts on one side of the spinal cord
Interruption of the lateral corticospinal tract causes ipsilateral (same side) paralysis and the presence of a babinski’s sign on the side of the lesion
Interruption of dorsal spinal cord column results in ipsilateral loss of tactile discrimination, vibratory sensation and position sense
subarachnoid hemorrhage
bleeding that occurs in the space that surrounds the brain it occurs when a weak area in a blood vessel (aneurysm) on the surface of the brain bursts and leaks. The blood then builds up around the brain and inside the skull increasing pressure on the brain.
sudden one set headache out of no where
stiff neck
sensitive to light
double blurry vision
spinal shock
Primary injury to the spinal cord
that results in areflexia
brain herination
Pressure increase forcing
portion of the brain to be
displaced to other areas (mainly
brainstem)
hemorraghic stroke
Cerebral artery
ruptures, blood leaks
into brain tissue.
Most common is a
branch of the middle
cerebral artery.
Causes cerebral
edema, increased
intracranial pressure,
tissue ischemia,
destruction and death.
Anoxic encephalopathy
– decreased levels of
consciousness due to
lack of oxygen.
Cushing’s triad –
irregular respiratory
rate, bradycardia,
hypertension =
ominous finding
Macrophages
phagocytize cells,
cavity forms, astrocytes
form scar tissue to fill
cavity
TIA’s
A brief stroke-like attack that, despite resolving within minutes to hours signal impending stroke – brain attack, mini stroke
drooping of the face, slurred speech
Common risk factors – HTN, smoking, uncontrolled
diabetes
Temporary neurological deficits – lasts minutes to
hours
* Deficits commonly resolve within an hour
* May be noticed by those around the patient
* Patient may not be aware of what is going on
Caussed by embolus and arteriosclerosed vessel
Temporary blood flow occlusion in brain
Leads to anoxia and manifestations of stroke
Body’s fibrinolytic system – dissolves clot
ischemic stroke
Obstruction of cerebral blood flow – thrombus
or embolus
Causes ischemia of brain tissue
Leads to infarction – death of brain tissue
Common arterial vessels – internal carotid,
middle cerebral arteries
Common causes of thrombus or emboli
* Arteriosclerosis of a cerebral artery
* Atrial fibrillation which causes an
embolus
* Carotid stenosis which causes an
embolus
lacunar infarct
occurs when an artery that supplies blood to the deeper portions of the brain becomes blockedWeakness or drooping on one side of the body.
Ataxia (impaired coordination) on one side of the body.
Changes in sensations such as temperature, touch, or taste.
Facial weakness or drooping (especially in the tongue or larynx)
