Neuro Flashcards
what are the receptors for the sympathetic and parasympathetic NS?
-sympa: epi,norepinephrine, dopamine which attach to ADRENERGIC receptors (alpha,beta)
-parasympathetic: acetylcholine attach to cholinergic (muscaritic , nicotinic)
what do anticholinergic meds do?
they stop the para system so it stops digestion and activates sympathetic
what are considered white matter? gray matter?
white matter are schwann cells which contain myelin, cell bodies are gray
where can you find csf?
its in the subarachnoid space
which meninge holds the cerebral arteries?
pia meninge
how does csf move?
lateral–> 3–>4th
what is nociceptive pain?
aching, stabbing, throbbing,pulsating
What type of pain is in the joints, muscles, and skin?
somatic pian
-unilateral, worsens w/movement
-N/V, photophobia
-triggers:alcohol, nitrates
-in women
migraines
what are the phases of migraines?
premonitory (days before), aura (right before), headache, recovery
cluster headaches
-in the eye, in men
-ptosis (dropping of eyelid),redeye, treating, stuffy nose
tension headache
-most common
-has to happen at least 15 days per month for 3 months
Myasthenia Gravis
-type II hypersensitivity AI that makes antibodies to acetylcholine receptors causing weakness in muscle
- symp: progressive weakness, ptosis, diplopia (seeing double),dysphagia, DIAPHRAGM STOPS WORKING
how do you test for myasthenia graves?
-tensilon test which tests positive if patient improves
-its anticholinergic which allows acetylcholine to accumulate allowing for a better contractioni
in cholinergic cris, there will be too much ___, causing ___ GI/GU, with __ HR,RR,BP. this will happen if a patient with the tensilon test ___.
-acetylcholine, increased , low, worsens
Guillain Barre syndrome
-demyelinating syndrome in PERIPHERAL NERVES
-starts from bottom to top, due to infection and will have resp infection or GI after
-symp: paresthesia, resp arrest
-treatment: ventilator, IVIG, plasmaphereis
Parkinsons
-chronic/progresive in basal ganglia,substantia nigra which produce dopamine
-this causes low levels of dopamine compared to acetylcholine
-symp: TRAD (tremors @ rest, rigidity, bradykinesia, postural disturbance)
-treatment: replace dop, anticholinergic drugs
In a man with Parkinson’s, what will you see?
lewy bodies (clumps of protein)
ALS amyotrophic lateral sclerosis
-neurodegenerative of motor neurons but NOT sensory/autonimic
-symp: weakness of muscles, normal intellectional function
-treat:2-5 yrs life expectactny , antiglutamtte
Multiple sclerosis
-demyelinating in CNS; T helps mark myelin as foreign
-symp:paresthesia, hard to walk, loss of eye movement, impaired gait
-lesions present, high IgG
treatment: avoid extreme temp, immunosuppressants
spinal shock
-COMPLETE loss of reflex, motor, sensor and autonomic below lesion
-regain everything, may take to 3 months
Autonomy dysreflexia
-happens if injury is at T6 or above
-can’t empty bladder/rectum, high sympathetic NS= high BP, low HR
-symp: sweating
what is the normal level of CSF?
5-15
Increased Intercranial pressure
-symp:vomiting, sluggish, dilated pupils, cushing triad (high systolic, bradycardia , irregular respirations
in children what type of hydrocephalus do they have?
noncommunicating which means theres an obstruction
in adults its due to lack of reabsorption
epidural hematoma
period of lucidity with loss of unconsciousness due to meningeal arteries
subdural
due to bridging veins, high mortality
subarachnoid
-either aneurysm or trauma
RF: alchohol , HTN
-changes in pupil
what are the Glasgow levels
13-15 mild
9-12 moderate
3-8 severe
decorticate vs decerebrate
decorticate is flexion, bending hangs in
decerebrate is hand being extending out
CVA stroke
-there are two types ischemic or hemorrhagic
-RF: hyperlipidemia, HTN, smokin, diabetes, a fib
In ischemic ones, there are two, what are they?
-thromotic
-embolic: a fib, valvular prosthesis, MI
what are the hemorrhagic ones?
due to HTN /ruptured aneurysms
-can have hemiparesis, aphsia
Meningitis
-bacterial which enters through CSF or resp tract
-signs: fever, tachycardia, petechiae rash, photophobia
KERNIG : extend leg when sitting
BRUDZINSKI: flexion of legs and of neck
bacterial vs viral
bacteria: turbid, protein is high, low glucose,
viral: clear, low protein, and normal glucose
what are the classifications of seizures?
A.focal
-simple partial
-complex partial: losses consciousness, hallucinates
B. generalized
-absense, tonic clonic, myoclonic, atonic
tonic clonic
tonic phase: back is arched, tense
clonic phase: limbs jerk
post ictal: awake but confused
myoclonic
head/limb drop
status epilepticus
seizures longer than 5 min
could lead to resp failure/death
give lorazepam
-aura means its coming NOW
-prodromal: early signs, few days before
alzheimer’s
-will have amyloid plaques, and neurofibrillary tangles
-low acetylcholine
3 stages: in stage 2 theres sundown, loss of abstract thinking
-death happens to pneumonia/ pulmonary embolism
-TREATMENT: ACHE INHIBITORS
