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neuro abnormalities Flashcards

1
Q

multiple sclerosis patho

A

progressive autoimmune disorder
- combo of inflammation and degeneration of the myelin of the brain’s white matter, leading to decreased brain mass and obstructed transmission of nerve impulses

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2
Q

multiple sclerosis subjective

A

fatigue
urinary freq, urgency, or hesitancy
sexual dysfunction
vertigo, weakness, numbness
blurred vision, diplopia, loss of vision
emotional changes
relapse symptoms develop rapidly over hours or days

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3
Q

multiple sclerosis objective

A 
muscle weakness, ataxia 
hyperactive DTR
paresthesia, sensory loss
intention tremor
optic neuritis
cognitive changes
MRI: brain lesions
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4
Q

intracranial tumor patho

A

abnormal growth within the cranial cavity that may be a primary or metastatic cancer

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5
Q

intracranial tumor subjective

A 
persistent HA
nausea, early morning vomiting
unsteady gait, impaired coordination 
memory loss and confusion 
reduced vision acuity, visual loss, diplopia
behavior or personality change
seizure
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6
Q

intracranial tumor objective

A 
s/s vary by location of tumor 
altered consciousness, confusion 
papilledema
cranial nerve impairment
aphasia, language disorder
vision loss- hemianopia, nystagmus 
gait disturbances, ataxia
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7
Q

pseudotumor cerebri patho

A

clinical syndrome of intracranial HTN that mimics brain tumors

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8
Q

pseudotumor cerebri subjective

A 
severe daily HA, throbbing
pain behind eye
vomiting
short episodes of blurred vision, double vision 
whooshing in ears
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9
Q

pseudotumor cerebri objective

A 
papilledema, retinal hemorrhages on fundoscopic 
inferior nasal vision field defect
dec. visual acuity 
alert, unimpaired consciousness 
absence of focal neurologic signs
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10
Q

Sz disorder (epilepsy) patho

A

chronic disorder characterized by recurrent, unprovoked seizures secondary to an underlying brain abnormality
- episodic abnormal electrical discharges

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11
Q

Sz disorder subjective

A 
hx of prior sz 
premonition or aura
body is stiff and rigid, followed by rhythmic jerking movements 
eyes roll upward
drooling
loss of bladder or bowel control
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12
Q

sz disorder objective

A

tonic phase:

  • brief flexion and characteristic cry with contraction of abdominal muscles, followed by generalized extension for 10-15 minutes; loss of consciousness for 1-2minutes, eyes deviated upward, dilated pupils
  • Clonic phase: contractions alternate with muscle relaxation
  • postictal state: coma followed by confusion and lethargy
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13
Q

encephalitis patho

A

acute inflammation of the brain and spinal cord involving the meninges, often due to a virus

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14
Q

encephalitis subjective

A

mild viral illness with fever

recovery and quiet stage followed by onset of lethargy, restlessness, and mental confusion

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15
Q

encephalitis objective

A

altered mental status, confusion, stupor, coma
photophobia
stiff neck
muscle weakness, paralysis, ataxia

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16
Q

meningitis patho

A

inflammation of the meninges of the brain or spinal cord

- bacterial, viral, or fungal infection crosses the BBB

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17
Q

meningitis subjective

A 
fever, chills
HA, stiff neck
lethargy, malaise
vomiting
irritability
sz
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18
Q

meningitis objective

A 
altered mental status, confusion 
nuchal rigidity
fever
brudzinski and kernig signs
petechiae and purpura with meningococcal meningitis
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19
Q

myasthenia gravis patho

A

autoimmune disorder of neuromuscular junction involved with muscle activation
- autoantibodies directed against the acetylcholine Rc in the neuromuscular junction -> destruction and inflammatory changes in the postsynaptic membranes -> muscle dysfunction

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20
Q

myasthenia gravis subjective

A

drooping eyelids
double vision
diff. swallowing or speaking
fluctuating fatigue or weakness; worse with exercise
inability to work with arms raised above head
difficulty walking
s/s worse later in the day and improve with rest

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21
Q

myasthenia gravis objective

A

ptosis that develops within 2 minutes of upward gaze
facial weakness w/ puffing out cheeks
hypophonia
difficulty managing secretions
resp. compromise or failure
weakness of skeletal muscles without reflex, sensory, or coordination abnormalities

22
Q

guillain-barre syndrome patho

A

postinfectious disorder following a nonspecific GI or respiratory infection that causes an acute neuromuscular paralysis
- autoimmune disorder triggered by bacterial or viral infection -> peripheral nerve denervation and atrophy

23
Q

guillain-barre syndrome subjective

A

hx of recent illness and recovery
progressive weakness, more in legs than arms
difficulty walking
paresthesia
pain in the shoulder, back, or posterior thigh
double vision

24
Q

guillain-barre syndrome objective

A

distal weakness, usually bilateral and symmetric
diminished rerlexes in ascending pattern
ataxia, progressing to flaccid paralysis
facial nerve weakness, diplopia
dysphagia, difficulty handling secretions
resp. distress

25
Q

trigeminal neuralgia (tic douloureux) patho

A

recurrent paroxysmal sharp pain that radiates into one or more branches of CN V
- compression the nerve -> demyelination

26
Q

trigeminal neuralgia subjective

A
  • sharp pain episodes on one side of the face that lasts seconds to minutes; rarely bilateral
  • potential pain triggers: chewing, swallowing, talking, washing face, brushing teeth, exposure to cold
  • episodes may occur several times a day to several times a month followed by a pain free period
27
Q

trigeminal neuralgia objective

A

may be normal neurologic findings
may have slight sensory impairment in the regions of pain
pain occurs in the distribution of one or more divisions of the facial nerve

28
Q

peripheral neuropathy patho

A

disorder of the peripheral nervous system that results in motor and sensory loss in the distribution of one or more nerves

29
Q

peripheral neuropathy subjective

A
  • gradual onset of numbness, tingling, burning, and cramping, most commonly in the hands and feet
  • night pain in one or both feet
  • early s/s: may be unusual sensations of walking on cotton, floors feeling strange, or inability to distinguish between coins by feel.
  • sensations of burning accompanied by hyperalgesia and allodynia: all sensation painful
30
Q

peripheral neuropathy objective

A
  • reduced sensation in the foot with the monofilament, dec. sensation of pain or touch sensation.
  • distal pulses may be present or diminished
  • diminish or absent ankle and knee reflexes
  • dec. or no vibratory sensation below the knees
    temperature sensation may be less impaired
  • distal muscle weakness, inability to stand on toes or heels
  • skin ulceration or injuries to extremities the pt does not feel
31
Q

cerebral palsy patho

A

group of permanent disorders of movement and posture development associated with nonprogressive disturbances that occurred in the developing fetal or infant brain.
- infection, trauma, anoxia in perinatal period, intracranial hemorrhage in fetus or premature infant

32
Q

cerebral palsy subjective

A
  • delays in gross motor development that become more obvious as the infant ages
  • activity limitation, stiff joints and positioning
  • may have hearing, speech, and language disorders
  • feeding diff., poor sucking and swallowing coordination
  • sz
33
Q

cerebral palsy objective

A
  • cognitive impairment or learning disabilities
  • spastic
  • dyskinetic
  • ataxic
34
Q

spastic CP

A 
hypertonicity
tremors
scissor gait
toe walking
persistent primitive reflexes
exaggerated DTR
35
Q

dyskinetic CP

A

involuntary slow writhing movements of the extremities, tremors may be present

  • exaggerated posturing
  • inconsistent muscle tone that varies during the day
36
Q

ataxic CP

A

abnormalities of movement involving balance and position of trunk and extremities

  • intention tremors, past pointing
  • inc. or dec. muscle tone, may have hypotonia as infant
  • instability, wide-based gait.
37
Q

myelomeningocele (spina bifida) patho

A

congenital vertebral defect that allows spinal cord content to protrude

38
Q

myelomeningocele subjective

A

may have loss of bowel control or constipation
may have loos of bladder control
mobility problems

39
Q

myelomeningocele objective

A

exposed meningeal sac filled with fluid and nerves is apparent at birth

  • sensory deficit and paralysis or weakness are dependent on level of defect (higher = greater)
  • rapidly inc. head circumference (hydrocephalus)
  • may have hip or foot abnormalities
  • learning disability and perceptual motor skills
40
Q

shaken baby syndrome patho

A

severe form of child abuse resulting form the violent shaking of infants younger than 1 year old

41
Q

shaken baby syndrome subjective

A 
fever
irritability or lethargy
dec. food intake
breathing difficulty or apnea
sz
loss of consciousness
42
Q

shaken baby syndrome objective

A

reported HPI does not match nature and severity of findings
altered LOC
sz
bilateral retinal hemorrhages with retinal detachments
absence of visible trauma to head
possible fingerprints on arms and body
bruising, bite marks, or burns possible

43
Q

parkinsons disease patho

A

slowly progressive, degeneration neurologic disorder in which motor function is primarily affected along with behavioral and cognitive problems
- destruction of neurons that transmit dopamine -> poor communication between parts of the brain that coordinate and control movement and balance

44
Q

parkinson’s disease subjective

A
  • tremors occur initially at rest and with fatigue, disappearing with intended movement and sleep, progress to pill-rolling movement of fingers bilaterally and tremor of head
  • slowing of voluntary and automatic movements, “feel wooden” freezing or unable to continue movements
  • numbness, aching, tingling, and muscle soreness
  • difficulty swallowing, drooling
45
Q

parkinson disease objective

A

tremors
muscular rigidity, cogwheel rigidity with jerks
stooped posture, balance and postural instability
short steps, shuffling, freezing gait, gait may accelerate to maintain upright posture
slow, slurred, monotonous speech, voice softening
impaired cognition, dementia

46
Q

normal pressure hydrocephalus patho

A

syndrome simulating degenerative disease that is cuased by noncommunicating hydrocephalus (dilated ventricles with ICP nml)

47
Q

normal pressure hydrocephalus subjective

A

gait impairment is 1st s/s
unsteady and difficulty turning
forgetfulness, cognitive impairment
urinary freq. that progresses to urgency and incontinence over time

48
Q

normal pressure hydrocephalus objective

A

gait impairment, wide-based stance, short, small-steps
no tremor
no sensory impairment
cognitive impairment, attention and executive function impaired
impaired memory recall for recent events

49
Q

postpolio syndrome patho

A

reappearance of neurologic signs 10 or more years after an acute poliomyelitis infection

50
Q

postpolio syndrome subjective

A 
hx of paralytic or nonparalytic polio 
new onset muscle weakness, muscle cramps
inc. pain sensitivity
fatigue
cold intolerance
difficulty with swallowing or speaking
SOB 
difficulty sleeping
51
Q

postpolio syndrome objective

A

focal and asymmetric muscle weakness and atrophy
fasciculations
dysphagia, dysarthria
sleep apnea, hypoventilation

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