Neurological Flashcards
Multiple sclerosis
-A progressive auto immune disorder characterized by a combination of inflammation and degeneration of the Mylan of the brain is white matter, leading to decreased brain mass and obstructed transmission of nerve impulses
Patho: Gradual but I’m predictable progression with or without remissions. Symptom onset between 20 and 40 years of age.
Subjective: fatigue, urinary frequency urgency or hesitancy, sexual dysfunction, vertigo, weakness, numbness, blurred vision, diploplia, loss of vision, emotional changes. Relapse symptoms develop rapidly over hours or days, and symptoms take weeks to recede.
Objective: muscle weakness, ataxia, hyperactive deep tendon reflexes, paresthesias, sensory loss, loss of vibration sense, intention tremor, optic neuritis, cognitive changes,. MRI reveals brain lesions that are typically periventricular, and perpendicular to the ventricles.
Seizure disorder – epilepsy
-A chronic disorder characterized be re-current, unprovoked seizures secondary to an underlying brain abnormality.
Patho: Episodic abnormal electronic discharges of cerebral neurons may be caused by a central nervous system disorder, structural defect, or disorder that affects functioning of the CNS.
Subjective: history of prior seizure, premonition or aura, body is stiff and rigid, followed by rhythmic a jerking movements. Eyes roll upward, drooling, bladder or bowel control
Objective: tonic phase: reflection and characteristic cry with contraction of abdominal muscles, followed by generalize extension for 10 to 15 minutes. Loss of consciousness for 1 to 2 minutes, eyes deviated upward, and dilated peoples.
Clonic phase: contractions alternate with muscle relaxation.
Postictal:, followed by confusion and lethargy
Encephalitis
-Acute inflammation of the brain and spinal cord involving the meninges, often due to a virus
Patho: Virus
Subjective: Mild viral illness with fever. Recovery and quiet stage followed by onset of lethargy, restless, and mental confusion.
Objective: Altered mental status, confusion, stupor, coma, photophobia, stiff neck, muscle weakness, paralysis, ataxia.
Meningitis
-Inflammatory process and then meninges, the membrane around the brain and spinal cord
Patho: bacterial, viral, or fungal organisms from their upper respiratory tract invades the bloodstream, then crosses the blood brain barrier to infect the CSF
Subjective: Fever, chills, headache, Stiff neck, G, malaise, vomiting, irritability, seizures
Objective: AMS, confusion, nuchal rigidity, fever, petechia With meningococcal meningitis, brudinski and Kernig signs. LP and CSF cx confirm the diagnosis
Intracranial tumor
-And abnormal growth within the cranial cavity that may be a primary or metastatic cancer
Patho: Lesion causes displacement of tissue and pressure, affecting CSF fluid circulation. Function is threatened her compression and distraction of tissues. Incidence of primary brain tumors pics between 65 and 79 years old
Subjective: Persistent headache, mayo a patient from sleep. Nausea, early morning vomiting. Unsteady gait, impaired coordination. Memory loss and confusion. Reduced vision acuity or visual loss. Behavior or personality change. Seizure.
Objective: Signs Mayberry by location of tumor. Altered consciousness, confusion, papilledema, cranial nerve impairment, a facia, vision loss, nice stag mess, gait disturbances, ataxia. CT scan or MRI confirms diagnosis
pseudotumor cerebri
-Clinical syndrome of intracranial hypertension that mimics brain tumors
Patho: Unknown
Subjective: Severe daily headache, throbbing, may awaken patient. Pain behind the eye, vomiting, short episodes of blurred vision, double vision, wishing sound in ears.
Objective: Papilledema, inferior nasal vision field defect, decreased visual acuity, alert, unimpaired consciousness, absence of focal neurologic signs. CT scan or MRI reveals no cause of increased intracranial pressure
Stroke
-Interruption of blood supply to a part of the brain or the rapture of a blood vessel, spilling blood into spaces around brain cells
Patho:
Subjective: Sudden numbness or weakness, especially in one side of the body. Sudden confusion were trouble speaking more understanding speech. Seven trouble seeing in one or both eyes. Set in trouble with walking, dizziness, or loss in balance of coordination. Sudden severe headache with no known cause
Objective: very I part of the brain affected. Hypertension, AMS, difficulty managing secretions, weakness or paralysis of extremities are facial muscles, a facia, articulation impairment, impaired horizontal gaze
Myasthenia gravis
-and autoimmune disorder of neuromuscular junction involved with muscular activation. Auto antibodies directed against the acetylcholine receptors in the neuromuscular junction cause distraction and inflammatory changes in the post synaptic membrane’s that lead to muscle dysfunction
Patho: Acetylcholine receptor sites stop transmitting nerve impulses across the neuromuscular junction to direct muscle contraction. Confined to ocular muscles and 15% of cases
Subjective: Drooping eyelids, double vision, difficulty swallowing or speaking, fluctuating fatigue or weakness that improves with rest, and ability to work with arms raised above head, difficulty walking, symptoms are worse later in the day and improved with rest.
Objective: The ptosis that develops within two minutes of upward gaze. Facial weakness when popping out cheeks. Hypophonia. Difficulty managing secretions. Respiratory compromise or failure. Weakness of skeletal muscles without reflex, sensory, or coordination abnormalities.
Guillain-Barré syndrome
-Postinfection disorder followed by nonspecific gastrointestinal a respiratory infection that causes an acute neuromuscular paralysis
Patho: Unusual immune response damages the peripheral nerves
Subjective: History of recent illness and recovery, progressive weakness, more in the legs in the arms, increased difficulty walking. Pier seizure, pain in the shoulder, back, or posterior thigh. Double vision
Objective: Distal weakness, usually bilateral and symmetric, and diminished reflexes and a sending pattern. Ataxia, progressing to flaccid paralysis. Facial nerve weakness bell palsy, type Ljubljana. Dysphasia, difficulty handling secretions. Respiratory distress. Lumbar puncture reveals increased protein in CSF
Trigeminal neuralgia
-Recurrent paroxysmal sharp pain that radiates into one or more branches of the fifth cranial nerve
Patho: Maybe caused by a small artery that chronically compresses the fifth cranial nerve and wears away the nerves Mylan or by Irritation of the nerves afferent portion.Usual age is 40 to 60 years. More in women
Subjective: Sharp pain episode on one side of the face that last seconds to minutes, pain may rarely be bilateral. Potential pain triggers are chewing, swallowing, talking, washing the face, brushing the teeth, exposure to cold, and even a breeze across the face. Episodes may occur several times a day to several times a month followed by a pain-free. Period
Objective: Normal neurologic findings. May have a slight sensory impairment of the regions of pain. Pain occurs in the distribution of one or more divisions of the facial
Bells palsy
-Temporary acute paralysis or weakness of one side of the face
Patho: Acute inflammation of the facial nerve
Subjective: Rapidly progressive muscle weakness on one side of the face. Numbness.
Objective: Fishel creases and nasolabial fold disappear on affected side. I lid will not close on affected side and lower lid sags, leading to I irritation. Food and 11 Maple and affected side of mouth. Facial sensation is intact
Peripheral neuropathy
A disorder of the peripheral nervous system that results in motor and sensory loss in the distribution of one or more nerves -
Patho: Impaired blood flow, basal constriction, and ischemic changes
Subjective: Gradual onset of numbness, tingling, burning, and cramping, most commonly in the hands and feet. Night pain in one or both feet. Early signs maybe unusual sensations of walking on cotton, floors feeling strange, or inability to distinguish between Queens by feel. Sensation of burning accompanied by hyperalgesia
Objective: reduced. Sensation in the foot with the monofilament, lots of pain or sharp touch sensation in the mid calf level. Distal pulses maybe present or diminished. Diminished or absent ankle and knee reflexes. Decreased or no vibration sensation below the knees and it temperature sensation maybe less impaired. Dissell muscle weakness, inability to stand on toes or heels. Skin alteration or injuries her extremities that the patient does not feel
Parkinson disease
-I slowly progressive, degenerative neurological disorder in which deficiency of the dopamine your transmitter results in poor communication between parts of the brain that coordinates and controlled movement and balance
Patho:
Subjective: tremors Occur initially at rest and with fatigue, disappearing with intended movement and sleep. Progression to pill – rolling movement of fingers bilaterally and trimmer of the head. Slowing of voluntary an automatic movements. Numbness, aching, tingling, and muscle soreness occurring many patients
Objective: Tremors, muscle rigidity, stooped posture, balance and stability, short, shuffling steps, freezing gate, difficulty swallowing, drooling, voice softening, slow slurred monotonous speech, impaired cognition, dementia
Normal pressure hydrocephalus
-I syndrome simulating degenerative diseases that is caused by not communicating hydrocephalus (dilated ventricles with intracranial pressure with an expected ranges)
Patho:
Subjective: Gate impairment is the first symptom. Unsteadiness and difficulty turning. Forgetfulness, cognitive impairment. Urinary frequency that progresses to urgency and incontinence overtime
Gate impairment, wide base stance, short, small steps, introduced floor clearance. No tremor. No sensory impairment. Cognitive impairment, executive function impaired. Impaired memory recall for recent events. CT scan and MRI of the brain reveal enlarged ventricles not attributable to brain atrophy or a congenital problem
Objective:
Post polio syndrome
-The reappearance of neurologic signs 10 or more years after survival of a cute poliomyelitis
Patho:
Subjective: History of paralytic or non-paralytic polio. New – onset muscle weakness, muscle cramps. Increased pain sensitivity. Fatigue. Cold intolerance. Difficulty with swallowing were speaking. Shortness of breath. Difficulty sleeping.
Objective: Vocal and asymmetric muscle weakness and atrophy. Fasciculations. Dysphasia, dysarthria. Sleep apnea, hypoventilation
