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Med Surg 106 > Neuro/MSK #5 > Flashcards

Neuro/MSK #5 Flashcards

1
Q

This scar tissue is found in the areas of the brain where abnormal firing of neurons begin:

A

Gliosis
glee-oh-sis

Leads to cavitation.

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2
Q

Name some metabolic disturbances that may cause a seizure:

A
  • Acidosis
  • Electrolyte imbalance (Esp Na)
  • Dehydration or water intoxication (still Na)
  • HypOglycemia
  • Hypoxemia (decreased O2 in blood)
  • Alcohol or barbiturate withdrawal (malnurished)
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3
Q

What are the two categories of causes of seizures?

A
  1. Metabolic disturbances

2. Extracranial disorders

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4
Q

What are the 4 extracranial disorders that may cause a seizure?

A
  • HTN
  • Diabetes M can cause:
  • Sepsis
  • Systemic lupus erythematosus
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5
Q

This condition is due to spontaneous, recurring seizures caused by an underlying chronic condition:

A

Epilepsy.

  • approx 3 million ppl in US have.
  • increasing in older adults
  • increasing in African American and lower socio-eco
  • slightly more common in males
  • around 200,000 new cases/yr
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6
Q

What are the two classifications of seizures (types)?

A

These are determined by the site (focus) of electrical disturbance…

  1. Focal seizures: begin in specific REGION of brain
  2. Generalized: BOTH sides of brain
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7
Q

What are the 4 phases that a seizure may involve?

A
  1. Prodromal phase: a sensation. Pt may not experience or be aware of, we may not see.
  2. Aural phase: halucination/halo is seen (sensory).
  3. Ictal phase: the actual seizure activity.
  4. Postictal phase: rest and recovery.
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8
Q

This involves bilateral synchronous discharges:

A

General seizure.

There is no warning or aura.

Most of time pt loses consciousness for a few seconds to several minutes.

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9
Q

This type of general seizure is characterized by loss of consciousness and falling, the body stiffens with subsequent jerking of extremities:

A

Tonic-clonic seizures:

Body stiffening (tonic)
Jerking extremities (clonic)

May experience cyanosis, drooling, foaming, tongue/cheek biting, incontinence.

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10
Q

This type of general seizure is characterized by a staring spell with other manifestations such as clicking tongue or rapid blinking:

A

Atypical Absence seizure

Adults can get these.
Have a brief warning.
Experience confusion afterward.

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11
Q

This generalized seizure is characterized by sudden, excessive jerk of the body and extremities:

A

Myoclonic seizure

Myo- muscle

Like when you’re falling asleep and jerk awake.

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12
Q

This type of general seizure is also known as the “drop attack” and pts will often wear helmets:

A

Atonic seizure

tonic- tone

Loss of muscle tone. Begins suddenly and person falls. Consciousness returns by the time they hit the ground.

Can resume normal activity immediately.

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13
Q

Term used when no specific cause is known for a disease or condition:

A

Idiopathic

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14
Q

Etiology of Epilepsy. There are MANY causes but name the age ranges and their common causes:

A
  1. AGE of the person. The most common causes for the first 6 months of life is severe birth injury, congenital birth defects involving the CNS, infections, and inborn errors of metabolism.

Ages 2-20: birth injury, infection, trauma to the head, genetic factors

20-30: structural lesions/ tumor, head injury, vascular disease, drugs/alcohol (on the rise).

Over 50: Stroke, metastatic brain tumor

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15
Q

Another cause for epilepsy that accounts for 30% of seizures:

A

Idiopathic

Unknown cause!

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16
Q

The third major/most common cause for epilepsy?

A

Genetics.

Some types run in families. Some are predisposed with a lower threshold.

Some are related to syndromes from their childhood.

More than 500 genes could play a role.

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17
Q

Physiology of epilepsy:

A
  • Abnormal neurons spontaneously firing
  • Firing can spread to adjacent or distant areas of the brain.
  • Gliosis is found in areas of the brain where firing starts
  • Changes in astrocytes may be a cause of recurring seizures.
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18
Q

How do we divide focal seizures?

A

Into simple or complex, according to their clinical manifestations.

19
Q

This type of focal seizure involves a change or loss of consciousness, produces a dreamlike experience, displays strange behavior, no memory of before or during the seizure, and usually lasts just a few seconds:

A

Complex focal.

20
Q

These are strange behaviors exhibited during complex focal seizures:

A

Automatisms

Repetitive movements, lip smacking, pedaling, pearl-rolling, unbuttoning/rebuttoning shirt, etc.

21
Q

These focal seizures manifest with the patient remaining conscious, experiencing unusual feelings/ sensations that can take many forms:

A

Simple focal seizure.

May experience sudden unexplainable feelings of joy, anger, sadness, or nausea

May hear, smell, taste, see, or feel things that are not real.

22
Q

These begin in a specific region of the cortex and produce signs and symptoms related to the function of the area of the brain involved:

A

Focal (partial) seizures.

Caused by focal irritations.

23
Q

This type of focal seizure is also called pseudoseizures and are psychiatric in origin:

A

Psychogenic seizures.

They resemble epileptic seizures but accurate diagnosis usually requires use of video-EEG monitoring to capture a typical episode.

From some kind of trauma. (abuse)

24
Q

The loss of full control of bodily movements; irregularity of muscular action:

A

Ataxia

Impaired coordination, balance, difficulty walking, etc.

Unsteadiness in standing and walking from a disorder of the control mechanisms in the brain, or from inadequate information input to the brain from the skin, muscles and joints.

25
Q

A neurological condition characterized by loss of the ability to perform activities that a person is physically able and willing to do:

A

Apraxia

Caused by brain damage.
Rare and many forms: tongue & mouth to speak (verbal apraxia), inability to copy, draw, or build simple figures (constructional apraxia), etc.

26
Q

Absence of sensibility to pain, particularly the relief of pain without loss of consciousness; absence of pain or noxious stimulation:

A

Analgesia

27
Q

What is a dermatome?

A

Area of skin supplied by a single spinal nerve.

28
Q

What does the cerebellum control?

A

Motor control.

(It may also be involved in some cognitive functions such as attention and language, and in regulating fear and pleasure responses, but its movement-related functions are the most solidly established)

Latin for “little brain.”

29
Q

Consisting of, containing, or discharging pus:

A

Purulent

30
Q

(Of a liquid) cloudy, opaque, or thick with suspended matter:

A

Turbid

31
Q

If this area of the frontal lobe is damaged you may see expressive aphasia:

A

Broca’s area.

With expressive aphasia, the person knows what he or she wants to say, yet has difficulty communicating it to others. It doesn’t matter whether the person is trying to say or write what he or she is trying to communicate.

Gma Vi BRO! or BROken speech.

32
Q

If this is damaged (in LT temporal lobe) you would see receptive aphasia aka “fluent aphasia”:

A

Wernicke’s area.

With receptive aphasia, the person can hear a voice or read the print, but may not understand the meaning of the message. Oftentimes, someone with receptive aphasia takes language literally. Their own speech may be disturbed because they do not understand their own language.

“Were Knee key air - ee a” disturbed sentence.

33
Q

This lobe of the brain controls executive functions such as planning for the future, judgment, decision-making skills, attention span, and inhibition:

A

Frontal lobe.

You use your frontal lobe nearly everyday. You use it to make decisions, such as what to eat or drink for breakfast in the morning, as well as for thinking or studying for a test. The frontal lobe is also where our personality is formed and where we can carry out higher mental processes such as planning. In addition, the frontal lobe is necessary to being able to speak fluently (without fault) and meaningfully. (Broca’s area)

34
Q

This lobe responsible for processing auditory information from the ears (hearing):

A

Temporal lobe.

The Temporal Lobe mainly revolves around hearing and selective listening. It receives sensory information such as sounds and speech from the ears. It is also key to being able to comprehend, or understand meaningful speech. In fact, we would not be able to understand someone talking to us, if it wasn’t for the temporal lobe. This lobe is special because it makes sense of the all the different sounds and pitches (different types of sound) being transmitted from the sensory receptors of the ears. (has wernicke’s area)

35
Q

This lobe is important to being able to correctly understand what your eyes are seeing:

A

Occipital lobe.

Similar to how the temporal lobe makes sense of auditory information, the occipital lobe makes sense of visual information so that we are able to understand it. If our occipital lobe was impaired, or injured we would not be able to correctly process visual signals, thus visual confusion would result.

36
Q

This lobe processes sensory information that has to do with taste, temperature, and touch:

A

Parietal

The parietal lobe is where information such as taste, temperature and touch are integrated, or processed. Humans would not be able to to feel sensations of touch, if the parietal lobe was damaged.

37
Q

What are the 3 pairs of arteries that feed the left and right hemispheres of the brain called?

A

Circle of Willis

38
Q

What do malignant hyperthermia and status epilepticus have in common?

A

Skeletal muscle rigidity, acid build up

39
Q

What are some side effects of the anti-seizure drug, Phenytoin (Dilantin)?

A

Hyperplasia of the gum tissue (gingiva).

If medication is abruptly discontinued, may precipitate seizures; must be compliant with consistent schedule.

40
Q

What sort of dietary restrictions are needed with the medication Carbamazepine (Tegretol)?

A

Must not take with grapefruit.

41
Q

What are some other therapies other than medication for seizures?

A

Surgery: anterior temporal lobe resection is the most common

Vagal nerve stimulation: Thought to interrupt synchronization of epileptic brain-wave activity and stop excessive discharge of neuron

Also diet: ketogenic
and Biofeedback.

42
Q

How do treat status epilepticus?

A

Initially, rapid-acting IV lorazepam (Ativan) or diazepam (Valium)

Followed by longer acting drugs.

43
Q

Term to describe neck stiffness as with meningitis:

A

Nuchal rigidity.

44
Q

Is bacterial or viral meningitis more dangerous?

A

Bacterial. Left untreated = death.

Med Surg 106 (8 decks)

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