Neuro Flashcards
1
Q
Sensory (Afferent) Division
A
- Ascending: sensory receptors → spinal column
- Conducts: signals from receptors to CNS
- Composed of: sensory neurons
2
Q
Motor (Efferent) Division
A
- Descending: innervates muscles and glands
- Conducts: signals from CNS to effectors
- Composed of: motor neurons
- Continues to have Autonomic Nervous System (ANS) & Somatic Nervous System (SNS):
- ANS: controls involuntary responses
- Sympathetic Division: “fight or flight” response that mobilizes body systems (epi/norepi)
- Parasympathetic Division: “rest and digest” responses that conserves energy (acetylcholine)
- SNS: controls voluntary movements
- ANS: controls involuntary responses
3
Q
Stroke Identification
A
- BE FAST
- Balance Issues
- Eyesight Changes
- Facial Drooping
- Arm Weakness
- Speech Difficulties
- Time to Call 911
4
Q
Stroke Causes
A
- Ischemic: interruption of blood circulation ⇒ occlusion of cerebral artery ⇒ brain partially deprived of oxygen and nutrients
- Caused mainly by: A-fib & atherosclerosis ⇒ makes thrombosis made of fibrin
- A-fib bc it’s a dysrhythmia of heart where 2 top chambers are just shaking bc of continuous firing of atrial nodes ⇒ forms clots that lodges itself on vessels ⇒ occlusion of arteries to brain ⇒ stroke
- Caused mainly by: A-fib & atherosclerosis ⇒ makes thrombosis made of fibrin
- Hemorrhagic: extreme amts of pressure on small vessels feeding brain stem ⇒ ruptures cerebral artery wall (vessel rupture) ⇒ bleeding into brain
- Caused mainly by: uncontrolled HTN
5
Q
Stroke Risk Factors
A
- Age: affects all range
- Sex: males >
- Race: African Americans >
- HTN: bc of persistent vasoconstriction and actively forms clots
- A-fib: bc it actively forms clots
- Asymptomatic carotid stenosis: bc of atherosclerotic buildup in carotid arteries that supply brain cells
- Sickle cell disease: bc of abnormal sickle shape that makes it easier for RBCs to lodge itself in vessels and cause occlusion
- Hyperlipidemia: bc of cholesterol buildup that can lodge itself in vessels to cause occlusion
- Smoking: bc of damage to blood vessels
- FHx
- DM
6
Q
Management of Acute Strokes (goals for ischemic vs hemorrhagic)
A
- Goal: determine cause (ischemic or hemorrhagic) → CT Scan First !!!
- If ischemic → thrombolytics within 4. 5 hr window to try and re-establish perfusion to affected brain area to prevent and reduce irreversible ischemic damage
- If hemorrhagic → get BP down + prevent expansion of bleeding, reduce intracranial pressure, and address the cause
7
Q
Thrombolytic Therapy Treatment
A
- For ischemic strokes only !!!
- MOA: dissolves blood clots that causes ischemic
- Goal: re-establish perfusion to affected brain area to prevent irreversible ischemic damage and reduce disability extent
- Time-Sensitive Treatment:
- Most effective when given as soon as possible after symptom onset.
- Give within time window of within 4.5 hours from Sx onset
8
Q
Transient Ischemic Attack (TIA)
A
- What: temporary interruption of blood flow to brain ⇒ causing stroke-like Sxs that resolves within 24 hrs
- Duration of Sxs: mins-hrs
- Severity of Sxs: mild-moderate
- Risk of recurrence: high
- Prognosis: usually good
9
Q
Cerebrovascular Accident (CVA)
A
- What: sudden interruption of blood flow to brain ⇒ can cause permanent damage
- Duration of Sxs: permanent
- Severity of Sxs: can be severe
- Risk of recurrence: high
- Prognosis: can be poor
10
Q
Neurotransmitters: Dopamine
A
- Produced by brain’s basal ganglia’s substantia nigra’s dopaminergic neurons
- Causes:
- Vasoconstriction bc they’re alpha adrenergics
- ↑ BP & HR
- Fluid coordination/movement
- No dopamine ⇒ no fluidity or coordination ⇒ extrapyramidal (or involuntary/automatic) motor function impairment
11
Q
Neurotransmitters: Acetylcholine (ACh)
A
- Depending on receptor type:
- Muscarinic receptors (parasympathetic effects): Slows heart rate, stimulates digestion, and increases glandular secretions.
- Nicotinic receptors (somatic and autonomic effects): Excitatory effects like muscle contraction
- The relaxation of muscles after contraction is due to acetylcholine esterase (AChE) that cleans up remaining ACh ⇒ restores resting conditions
12
Q
Parkinson’s Disease (Pathophysiology, Types)
A
- Motor problem
- Pathophysiology: lack of/reduced dopamine level
- Types:
- Dysfunction/degeneration of brain’s substantia nigra’s dopaminergic neurons that normally secretes dopamine ⇒ lacks dopamine secretion ⇒ not enough dopamine binds to receptors (dopamine deficiency)
- Not enough receptors to bind w/ normal amt of secreted dopamine
- Imbalance of both receptors and dopamine neurotransmitters
13
Q
Parkinson’s Treatment Med + Considerations (MOA, Toxicity Signs, Nurs Considerations)
A
- Treatment: Levodopa Considerations
- MOA: crosses BBB to be converted to dopamine ⇒ ↑ dopamine lvls ⇒ ↓ Sxs
- Toxicity Signs
- Dyskinesias: involuntary movements like ticks or chorea
- Neuropsychiatric: hallucinations, confusion, or psychosis
- NV, esp early in treatment
- Nurs Considerations
- Dark colored urine is normal and harmless
- Contraindicated w/ MAOIs or any other meds that ↑ dopamine bc they allow for more dopamine ⇒ increases HR and BP ⇒ risks for HTN crisis
- Heavily protein-bound med ⇒ so if pt is HYPERalbumic ⇒ doesn’t allow carbidopa-levodopa to reach therapeutic effectiveness
- Adherence of taking it at same time everyday important bc if you abruptly halt ⇒ dopamine receptors don’t have enough dopamine ⇒ prior Parkinson’s Sx onset recurs
- Full therapeutic effect may take 3+ wks - months
14
Q
Myasthenia Gravis (MG) (Pathophysiology + S&S)
A
- Autoimmune disease
- Pathophysiology: specific antibodies along skeletal muscles that destroys acetylcholine receptors (AChRs) ⇒ prevents ACh from binding ⇒ impaired transmission of nerve signals to muscles ⇒ prevents skeletal muscle contraction ⇒ muscle weakness bc ACh can’t sufficiently stimulate muscle
- Weakness worsens with activity
- Weakness improves with rest
- S&S: WEAKNESS
- Weakness of face, neck, arms, legs
- Eyelid drooping (ptosis)
- Appearance of blank expression
- Keeps choking or gagging
- No energy
- Extraocular movement like diplopia
- Slurred speech
- SOB
15
Q
Multiple Sclerosis (MS) (Pathophysiology)
A
- Autoimmune disease
- Pathophysiology: attacks myelin sheaths that’s needed for fast and efficient nerve signal transmission ⇒ degraded myelin sheaths ⇒ pot holes along axon ⇒ doesn’t allow for smooth signaling pathway transmission bc it’s all jagged up ⇒ interruptions of muscle contractions occur
