Neuro

Question 1

what are the receptors for the sympathetic and parasympathetic NS?

Answer 1

-sympa: epi,norepinephrine, dopamine which attach to ADRENERGIC receptors (alpha,beta)
-parasympathetic: acetylcholine attach to cholinergic (muscaritic , nicotinic)

Question 2

what do anticholinergic meds do?

Answer 2

they stop the para system so it stops digestion and activates sympathetic

Question 3

what are considered white matter? gray matter?

Answer 3

white matter are schwann cells which contain myelin, cell bodies are gray

Question 4

where can you find csf?

Answer 4

its in the subarachnoid space

Question 5

which meninge holds the cerebral arteries?

Answer 5

pia meninge

Question 6

how does csf move?

Answer 6

lateral–> 3–>4th

Question 7

what is nociceptive pain?

Answer 7

aching, stabbing, throbbing,pulsating

Question 8

What type of pain is in the joints, muscles, and skin?

Answer 8

somatic pian

Question 9

-unilateral, worsens w/movement
-N/V, photophobia
-triggers:alcohol, nitrates
-in women

Answer 9

migraines

Question 10

what are the phases of migraines?

Answer 10

premonitory (days before), aura (right before), headache, recovery

Question 11

cluster headaches

Answer 11

-in the eye, in men
-ptosis (dropping of eyelid),redeye, treating, stuffy nose

Question 12

tension headache

Answer 12

-most common
-has to happen at least 15 days per month for 3 months

Question 13

Myasthenia Gravis

Answer 13

-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

Question 14

how do you test for myasthenia graves?

Answer 14

-tensilon test which tests positive if patient improves
-its anticholinergic which allows acetylcholine to accumulate allowing for a better contractioni

Question 15

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 ___.

Answer 15

-acetylcholine, increased , low, worsens

Question 16

Guillain Barre syndrome

Answer 16

-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

Question 17

Parkinsons

Answer 17

-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

Question 18

In a man with Parkinson’s, what will you see?

Answer 18

lewy bodies (clumps of protein)

Question 19

ALS amyotrophic lateral sclerosis

Answer 19

-neurodegenerative of motor neurons but NOT sensory/autonimic
-symp: weakness of muscles, normal intellectional function
-treat:2-5 yrs life expectactny , antiglutamtte

Question 20

Multiple sclerosis

Answer 20

-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

Question 21

spinal shock

Answer 21

-COMPLETE loss of reflex, motor, sensor and autonomic below lesion
-regain everything, may take to 3 months

Question 22

Autonomy dysreflexia

Answer 22

-happens if injury is at T6 or above
-can’t empty bladder/rectum, high sympathetic NS= high BP, low HR
-symp: sweating

Question 23

what is the normal level of CSF?

Answer 23

5-15

Question 24

Increased Intercranial pressure

Answer 24

-symp:vomiting, sluggish, dilated pupils, cushing triad (high systolic, bradycardia , irregular respirations

Question 25

in children what type of hydrocephalus do they have?

Answer 25

noncommunicating which means theres an obstruction
in adults its due to lack of reabsorption

Question 26

epidural hematoma

Answer 26

period of lucidity with loss of unconsciousness due to meningeal arteries

Question 27

subdural

Answer 27

due to bridging veins, high mortality

Question 28

subarachnoid

Answer 28

-either aneurysm or trauma
RF: alchohol , HTN
-changes in pupil

Question 29

what are the Glasgow levels

Answer 29

13-15 mild
9-12 moderate
3-8 severe

Question 30

decorticate vs decerebrate

Answer 30

decorticate is flexion, bending hangs in
decerebrate is hand being extending out

Question 31

CVA stroke

Answer 31

-there are two types ischemic or hemorrhagic
-RF: hyperlipidemia, HTN, smokin, diabetes, a fib

Question 32

In ischemic ones, there are two, what are they?

Answer 32

-thromotic
-embolic: a fib, valvular prosthesis, MI

Question 33

what are the hemorrhagic ones?

Answer 33

due to HTN /ruptured aneurysms
-can have hemiparesis, aphsia

Question 34

Meningitis

Answer 34

-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

Question 35

bacterial vs viral

Answer 35

bacteria: turbid, protein is high, low glucose,
viral: clear, low protein, and normal glucose

Question 36

what are the classifications of seizures?

Answer 36

A.focal
-simple partial
-complex partial: losses consciousness, hallucinates
B. generalized
-absense, tonic clonic, myoclonic, atonic

Question 37

tonic clonic

Answer 37

tonic phase: back is arched, tense
clonic phase: limbs jerk
post ictal: awake but confused

Question 38

myoclonic

Answer 38

head/limb drop

Question 39

status epilepticus

Answer 39

seizures longer than 5 min
could lead to resp failure/death
give lorazepam
-aura means its coming NOW
-prodromal: early signs, few days before

Question 40

alzheimer’s

Answer 40

-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