Neurological Flashcards
2 groups of seizures
Focal- affect one area of the brain
Generalised- affect multiple areas of the brain/ spread to all areas
Types of seizures
Focal (one area of the brain)
Generalised:
-absence
-tonic
-atonic
-clonic
-myoclonic
-tonic clonic
Absence seizures
Stare into space/ repetitive movements
Last 5-10s, can occur in clusters
Often occur in children
Tonic seizure
Stiff muscles (back,legs, arms)
May have LOC
Tonic seizure
Stiff muscles (back,legs, arms)
May have LOC
Atonic seizure
Loss of muscle control
Falls
Clonic seizure
Repeated Jerking movements
Myoclonic seizures
Sudden brief jerks
Often no LOC
Tonic clonic seizures
Most dramatic seizure
Stiffness of limbs followed by jerking
Sudden LOC
Bite tongue
Lose bladder control
Can start as focal and spread
Last for several minutes
When seizures require hospital conveyance?
Last longer than 5 mins
First seizure
3 or more seizures in an hour
Unresponsive to treatment (benzodiazepines- midazolam- diezapam)
Head injury/ injury from seizures that requires hospital
Stroke/ illness/ infection cause of seizure
Seizure definition
Sudden and uncontrolled burst of electrical activity in the brain
(Excessive neuronal activity)
Symptoms of seizures
Confusion
Loss of consciousness
Jerking/ stiff movements
Staring spells
Cognitive/ emotional changes
Symptoms of seizures
Confusion
Loss of consciousness
Jerking/ stiff movements
Staring spells
Cognitive/ emotional changes
Causes of seizures
Stroke/ head injury
Infection of the brain eg meningitis/ encephalitis
Epilepsy
Pyrexia
Hypoxia
Severe illness
Lack of sleep
Legal/ illegal drugs
Alcohol misuse (eg withdrawal/ extreme intoxication)
Low blood sodium
Hypoglycaemia
Questions to ask for seizures
First seizure?
How many seizures have you had?
How long have they lasted for? (>5 mins= medical emergency)
Any signs/symptoms that forewarn a seizure?
Epilepsy? History?
Medication taken?
Taken alcohol?
Characteristics of seizure?
Care plan/ treatment plan for seizures?
Treatment for seizures?
If seizing- place in comfortable/safe position, maintain ABC
Hypoxic- 15lpm o2, OPA/NPA
Benzodiazepines- midazolam, diazepam (if multiple seizures, seizures lasting longer than 5 mins)
Stages of seizures
Prodome- early warning of seizure, changes in behaviour/ aura/ feeling off
Ictal- middle part of seizure, spans from first symptom- end of seizure
Post ictal- recovery period, can last minutes/hours, length dependent on the area of the brain that was affected/type of seizure, feel sleepy/ trouble talking/ weakness
Branches of the nervous system
CNS (brain and spinal cord)
Peripheral NS (neurons in body)- Somatic NS (voluntary) + autonomic NS (involuntary)- parasympathetic NS (relax) + sympathetic NS (fight or flight)
How many cranial nerves/ spinal nerves
12 cranial
31 pairs spinal (C-8, T-12, L-5, S-5, C-4)
Neuron structure
Myelin sheath- conductor, insulator
Axon
Nodes of ranvier (impulses jump across)
Dendrites (connect to other neurons/cells)
Cell body
Nucleus
Cell bodies clustered in CNS?
Nuclei
Cell bodies clustered in peripheral CNS?
Ganglia
Sensory/ afferent neuron?
Receive impulses from receptors on sensory organs, transmit impulses to CNS
Motor/ efferent neuron
Receives impulse from sensory neuron, sends impulse to an effector (gland/muscle) that generates a response
Can be somatic/voluntary or autonomic/involuntary
Nerve?
Bundle of neurons outside of CNS, no cell body
Oligodendrocytes?
Form myelin sheaths around axons of CNS
Microglia
White blood cells that defend the CNS/brain and destroy foreign/degenerated material
Astrocytes
Regulate external environment of neurons eg maintenance of synapses
Supporting cell of peripheral nervous system
Schwann cells (form myelin sheaths around peripheral axons)
Supporting cells of CNS
Astrocytes
Oligodendrocytes
Microglia
Synapse
Connection/junction between neuron and neuron/ neuron and muscle
Action at a synapse
-Electrical impulse/action potential travels along presynaptic neuron
-activated voltage gated calcium ion channels, activating protein kinase
-protein kinase phosphorylates vesicles, causing them to fuse with presynaptic membrane
-neurotransmitters released by exocytosis into synaptic cleft, diffuse across
-bind to receptors on postsynaptic neuron, converted back into an electrical impulse
Cerebrum
Largest part of brain, higher mental functions
Right and left hemisphere joined by corpus callosum
Grey matter (neuronal cell bodies) and white matter (neuronal axons)
5 lobes- frontal, parietal, occipital, temporal, deep insula
Frontal lobe
Brocas area- speech production
Motor area- voluntary skeletal muscle movement
Parietal lobe
Somatosensory area- muscular/skin sensation, feeling
Temporal lobe
Auditory area
Wernickes area- speech comprehension
Occipital lobe
Visual area
What brain centres control emotion?
Hypothalamus, Limbic system
Brain centre responsible for feeling fear/memory of fears?
Amygdala
What centres are responsible for memory
Temporal lobe- hippocampus, amygdala
Medulla oblongata
Control of breathing/cardiovascular system
Cerebellum
Motor learning, co ordinating movement of different joints, balance
2 corticospinal tracts of spinal cord
Ascending- carry sensory information
Descending- carry motor information
Cranial nerves
Olfactory nerve
Oculomotor
Optic
Trochlear
Trigeminal
Abducens
Facial nerve
Vestibulocochlear
Glossipharyngeal
Vagus nerve
Accessory nerve
Hypoglossal nerve
Reflex arc
Stimulus- receptor- action potential- sensory neuron- CNS (spinal cord)- relay/interneuron- motor neuron- effector (muscle/gland)-
Involuntary
Autonomic nervous system
Involuntary functi n
Sympathetic NS (fight/flight)
Parasympathetic NS (relax/regulate changes made back to normal)
Acts of parasympathetic ns
Constricts pupils
Lowers heart rate
Increases saliva production
Dilates blood vessels
Constricts bronchi
Decreases blood flow to skeletal muscles
Increases stomach and intestine mobility
Contracts bladder
Acts of sympathetic ns
Dilated pupils to enhance vision
Decreases saliva production
Increases heart rate
Constricts blood vessels, increases blood pressure
Dilates bronchi to allow more air into the lungs
Increases blood flow to skeletal muscles
Reduced stomach motility, diverts blood flow from GI tract
Liver Release glucose to increase blood sugar
Stimulate adrenal glands to secrete stress hormones
Relaxes bladder
Multiple sclerosis
Chronic autoimmune disease affecting CNS, damages myelin sheathe of neurons (sclerosis= hardening)
Disrupts communication between brain and body
Symptoms of multiple sclerosis
Fatigue, difficulty walking, vision problems, poor bladder control, numbness/ tingling in parts of body, muscle stiffness/spasm, balance/coordination problems, problems with thinking/learning/planning
Risk factors of multiple sclerosis
Age
Genetics
Smoking
Diet/obesity
Gender (female more likely)
Vitamin D deficiency
Parkinson’s (+symptoms)
Degenerative condition, dopamine deficiency due to dysfunctional brain cells
Dopamine involved in motor movement and emotion regulation
Not enough dopamine released into synapse
Symptoms- bradykinesia (slow movement), tremor, postural instability, rigidity
Cauda equina syndrome
Injury compresses nerve bundle at base of spinal cord (cauda equina) / sensory nerves of pelvis.
Cauda equina controls bladder/bowel function
Symptoms of Cauda equina
Incontinence
Urinary retention
Sciatica
Weakness/numbness in legs/genitals/anus, sexual dysfunction
Amnesia - 2 types
Retrograde- unable to retrieve old memories
Anterograde- unable to form new memories
Causes of amnesia
Trauma/head injury
Seizures
Stroke
Brain tumours
Neurosurgery
Hypoxia
Ischarnia
Viral infection
Epilepsy
Uncontrolled/excessive neuronal activity in part of/ all of CNS, causing sudden alteration in behaviour
Types of epilepsy (severity)
Grand map (tonic clonic)
Petit mal (absence)
Focal (specific lobe/part of the brain)
Causes of epilepsy
Traumatic brain injury (stroke, tumour,hypoxia,injury), genetic, brain infections, low blood sugar, alcohol withdrawal, drug intoxication
Treatment of epilepsy
Buccal midazolam, IV diazepam, oxygen.
Alzheimer’s
Type of dementia
Loss/damage to synapses, causes loss of neuronal connections)
Over time affected parts of brain shrink eg hippocampus/temporal lobe, causing symptoms of Alzheimer’s
Symptoms of Alzheimer’s
Confusion
Disorientation
Getting lost
Difficult decision making
Speech/language problems
Personality changes eg aggression
Low mood/anxiety
Meningitis
Bacterial/viral Infection of meninges (layers of brain and spinal cord), causes inflammation
Symptoms of meningitis
Non blanching rash
Photophobia
Neck stiffness
Muscle pain
Fever
Drowsiness
Nausea/vomiting
Seizures
