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Written PCE > Neuro Conditions > Flashcards

Neuro Conditions Flashcards

1
Q

List the non-modifiable and modifiable risk factors for stroke.

A 
Non = age, M>F, family hx, prev TIA/stroke
Mod = HTN, cardiac disease, DM, hypercholesterolemia, smoking, inc BMI, oral contraceptives, drug use
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2
Q

What are the 2 categories of stroke and their causes?

A 
Ischemic = thrombosis, embolism
Hemorrhagic = aneurysm, AVM, etc.
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3
Q

What are the 5 mechanisms of traumatic brain injury?

A

Coup - occurs at area hit/injured
Contracoup - occurs opposite to area injured
Diffuse Axonal Injury - shearing/tearing from rotational forces in areas of density change
Contusion
Anoxic injury

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4
Q

Describe the 4 types of hematomas

A

Epidural - outside the dura (usually from skull #); arterial
Subdural - below dura; venous bleed
Subarachnoid - between arachnoid and pia
Intracranial - within the brain (below pia)

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5
Q

What are the signs of a basal skull #?

A

Blood or CSF out the nose, raccoon eyes, battle sign

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6
Q

Describe the 2 types of abnormal posturing.

A

Decerebrate - indicates brain stem damage (below red nucleus), extension of UE + LE (worse prognosis)
Decorticate - damage to cerebrum, internal capsule or thalamus (could be midbrain as well but red nucleus not intact)

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7
Q

Describe spinal shock and its symptoms

A

Temporary suppression of all reflex activity below level of injury; can last weeks to months
Symptoms: areflexia, flaccid paralysis, loss of sensation

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8
Q

Describe neurogenic shock and its symptoms

A

Body’s reaction to sudden loss of sympathetic control; occurs with injuries above T6
Symptoms: decreased vasomotor tone (hypotension, hypothermia despite normal blood volume), bradycardia, can lead to metabolic issues

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9
Q

Describe the levels of the ASIA scale

A 
A = complete
B = sensory incomplete (sensory but not motor preserved below level)
C = motor incomplete (more than half of key muscles have less than grade 3)
D = motor incomplete (more than half of key muscles have grade 3 or more)
E = normal
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10
Q

What is zone of partial preservation?

A

Dermatomes below sensory level and myotomes below motor level that remain partially innervated (in complete injury)

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11
Q

Anterior cord syndrome

A

Caused by flexion injuries or vascular occlusion, loss of motor function, B/L loss of pain and temp below lesion, dorsal column spared

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12
Q

Posterior cord syndrome

A

Loss of fine touch, vibration, conscious proprio below lesion

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13
Q

Central cord syndrome

A

Generally in hyperextension injuries; upper motor and sensory function more impaired than LE; stiff trunk (invisible disability)

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14
Q

Brown Sequard

A

Hemi section of cord = ipsi loss of dorsal column and motor function; C/L loss of pain and temp below lesion

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15
Q

Cauda Equina

A

More LMN lesion; bowel and bladder signs, saddle parasthesia, B/L symptoms

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16
Q

Conus Medullaris

A

Can affect conus and root = varied picture

17
Q

What are some common health risks in SCI?

A

DVT/PE, heterotopic ossification, osteoporosis, post traumatic syringomyelia (formation of abnormal tubular cavity in spinal cord)

18
Q

What are 3 effects of Duchenne Muscular Dystrophy?

A
  • muscle cells replaced by fat and CT
  • progressive symmetrical wasting
  • in w/c by 10-12, death by 20
19
Q

What are 2 classic signs of DMD?

A

Gower’s sign - pushing on thighs to get off of floor

Calf pseudohypertrophy - well defined calves but with fat and CT

20
Q

Name the 4 classic signs of Parkinson’s and 5 other signs

A 
Classic = bradykinesia, resting tremor, rigidity, postural instability
Other = micrographia, loss of automatic movement, hypokinesia/akinesia, mask face, postural hypotension, sleep disturbance, fatigue
21
Q

Describe the 4 types of MS

A

Relapsing Remitting - new or old symptoms resurface or worsen; full or partial recovery between relapses; each flare up may cause more loss of function
Primary Progressive - gradual worsening of symptoms over time
Secondary Progressive - begins as relapsing remitting but steadily worsens
Progressive Relapsing - between relapses the disease slowly gets worse

22
Q

What are the 3 types of meningitis?

A

Aseptic - fungus, virus, parasite
Tuberculosis - abscess or edema
Bacterial - in child or infant considered medical emergency

23
Q

What are 2 signs used to rule in meningitis?

A

Brudzinski’s sign - involuntary flexion of hips and knees when neck is passively flexed
Kernig’s sign - painful knee ext from position of 90 deg hip and knee flexion

24
Q

Creutzfeldt Jakob Disease

A

Caused by prions - movement disorder/dementia - rapidly progressive and fatal

25
Q

Post Polio Syndrome (initial effect and after years)

A

Attacks neurons in brainstem and ant horn
Initial - death of motor neurons for skeletal muscles (those that survive sprout new terminals to make up for loss = some movement recovery and enlarged motor units)
Years later - gradual deterioration of sprouted fibers due to metabolic stress from larger motor units = muscle weakness and paralysis

26
Q

Describe the 3 types of cerebellar lesions

A 
Archicerebellum/vestibulo = vestibular control of head and body position = gait and trunk ataxia (fall toward side of lesion)
Paleocerebellum/spino = synergy of agonists/antagonists/postural correction = hypotonia, trunk ataxia, ataxic gait - lose core activity, jerky movements
Neocerebellum/cerebro = coordination of fine skilled movements = intention tremor, dysdiadochokinesia, dysmetria
27
Q

Describe the 3 stages of complex regional pain syndrome

A

1 (0-3 months) - puffy, swelling, redness, warmth, stiffness, allodynia, positive bone scan
2 (3-6 months) - inc pain and stiffness, firm edema, cyanosis, atrophy, osteopenia
3 (6 months+) - tight, smooth, glossy, cool, pale skin - stiffness and contractures, nail and hair changes, severe osteopenia

28
Q

What are 6 risk factors for CP?

A
  • Prenatal (maternal infection, malnutrition, maternal seizures)
  • Perinatal (prematurity, obstetric complications)
  • Low birth weight
  • Low APGAR
  • Multiple births
  • Post natal infection, environmental toxins, anoxia, brain tumour, CVA
29
Q

Describe the 4 types of CP and their subtypes

A

Spastic:
Diplegia - affects legs more than arms (most walk independently or with gait aid and milestones delayed)
Hemiplegia - arm and leg of same side; leading cause is perinatal stroke; most walk independently
Quadriplegia - all 4 limbs; global damage; majority non ambulatory
Dyskinetic:
Athetosis - slow, continuous, involuntary writhing movement that prevents stable posture
Ataxia - intention tremor and poor coordination
Mixed:
- typically entire body affected and has spastic and dyskinetic characteristics

30
Q

What are the 4 types of spina bifida?

A

Occulta - no cord involvement - may have hair tuft
Cyctica - visible or open lesion
Meningocele - cyst includes CSF; cord intact
Myelomeningocele - cyst includes CSF and herniated cord

31
Q

Erb’s Palsy

A

C5/6 injury - arm usually at side, medially rotated, can’t bring arm away (no biceps, brachialis, delt)

32
Q

Klumpke’s Palsy

A

C7, C8, T1 injury - affects intrinsic hand muscles - have claw hand (flexed fingers)

33
Q

Median Nerve Palsy

A

C6-8, T1 - thenar muscles affected - ape hand (can’t bring thumb away from hand)

34
Q

What causes vascular cognitive dementia?

A

Secondary to poor blood flow = multiple small lesions (usually high BP, atherosclerosis)

35
Q

Describe the difference between spastic and flaccid bladder.

A

Spastic - injuries above conus - reflex arc still intact
- bladder can be trained to empty on its own (can manage with IC or Foley)
Flaccid - below T12 - messages don’t travel between cord and bladder because reflex arc not intact - loses ability to fill and must be catheterized

36
Q

Describe the difference between spastic and flaccid bowel.

A

Spastic - peristalsis and reflex propulsion still in tact - reflex contraction can lead to stool retention - need suppository or digital stim
Flaccid - peristalsis and reflex propulsion not intact - slow propulsion, risk of incontinence - need to balance consistency of stool usually go more solid

Written PCE (7 decks)

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