Outcome 10 Neurology Flashcards
Brain is damaged by a sudden disruption in the flow of blood to a part of the brain
Cerebrovascular Accident (CVA)
CVAs are also called _____ or _____
stroke or brain attack
3 types of vascular disorders causing CVA
- Occlusion by an atheroma
- Sudden obstruction by an embolus
- Cerebral bleed/hemorrhage
Symptoms of CVA
Severe headache, aphasia, dysplasia, sudden weakness, numbness or paralysis, confusion or impaired consciousness, drooping of one side of eyelid and mouth, vision difficulties, sudden dizziness, loss of balance and coordination
T or F. CVA needs immediate intervention to limit brain damage.
T
2 families of drugs to treat CVA
- Anticoagulants like Warfarin and Coumadin
2. Thrombolytic agents like aspirin or heparin (Iv)
Temporary episodes of impaired neurologic functioning caused by an inadequate flow of blood to a portion of the brain.
Transient Ischemic Attack (TIA)
TIAs are also called ____ or ____
“little strokes” or “mini strokes”
TIAs have a duration of less than ___ hours
24
TIAs are caused by a piece of plaque formed by ______
atherosclerosis
The plaque in TIA breaks away from a wall of an artery or heart valve and travels to the brain, which is known as an ____
emboli
Another cause for TIA are _______ from an arterial ulcer.
platelet fibrin emboli
Treatment for TIA depends on the _____ of the attack.
location
T or F. Anticoagulants are used during the episode to lessen the frequency or chance of TIA recurrences.
T
Chew _____ as symptoms appear in TIA
aspirin
Usually results in brain injury that can range from mild to life-threatening or fatal
head trauma
Collection or mass of blood forms between the skull and the dura mater
epidural hematoma
Epidural hematoma affects the area between the ____ and the ____, the outer most of the 3 meningeal layers
skull and the dura mater
In epidural hematoma, symptoms appear a few hours after ______
head trauma
Epidural hematoma symptoms include sudden headache, dilated pupils, nausea, vomiting, drowsiness and _____
hemiparesis
In epidural hematoma, blood from ______ seeps into and around the meningeal layers due to head trauma
ruptured vessels
In both subdural and epidural hematoma, sudden _____ and _____ causes brain to strike the skull
acceleration and deceleration
2 surgical interventions for subdural/epidural hematoma
- craniotomy
2. cranial trephination or burr hole
Craniotomy and trephination are procedures done to remove ______ and to cauterize ______ if increasing intracranial pressure becomes life threatening
accumulated blood; the bleeding vessel
The cause of epidural hematoma is typically a _____
blow to the head
The blood collects or pools between the dura mater and the arachnoid membrane
subdural hematoma
What areas of the brain are affected in a subdural hematoma?
the dura mater and the arachnoid membrane
The general cause of a subdural hematoma is ______
the head striking an immovable object
Symptoms of an epidural hematoma typically appear within _____ of a head trauma,
a few hours
Subdural hematomas have a _____, causing symptoms to appear later
delayed symptom onset
Epidural hematomas are usually caused by ______, while subdural hematomas are caused by ______
a blow to the head; the head striking an immovable object
Possible bruising of the cerebral tissue
cerebral concussion
Cerebral concussion is also called a ______
mild traumatic brain injury
In a cerebral concussion there is a disruption of the normal ______ in the brain, but the brain itself usually is not permanently injured
electrical activity
Cerebral concussions are caused by ______ movement of the head, as in an acceleration-deceleration insult
back and forth
Cerebral concussions are also caused by ____ trauma or falling
blunt force
Cerebral concussions are treated with quiet bed rest with observation for signs of _____
behavioral changes
Most severe concussion where the injury includes bruising of brain tissue along or just beneath the surface of the brain
cerebral contusion
Another name for cerebral contusion
contrecoup insult
Cerebral contusion is caused by a _____ or impacting against a _____ as occurs in a car accident.
blow to the head; hard surface
In cerebral contusion, a _____ force against ______ of the brain occurring when colliding with the _____ may damage structures deep in the brain.
twisting and shearing; two hemispheres; cranial bones
Contusion is associated with _____
skull fracture
A break or fracture in one of the bones of the cranium, when depressed or torn loose, they are pushed below the normal surface of the skull
depressed skull fracture
Depressed skull fractures are caused by ______ in the skull with a ______ object
direct impact; blunt object
In depressed skull fracture, a fractured bone may cut an ____ or ____ causing hemorrhage in the brain
artery or vein
Treatment for depressed skull fracture includes relieving the _____
intracranial pressure
Surgical intervention for depressed skull fracture that elevates the bone back into place
craniotomy
____ is used in depressed skull fractures until they are partially healed
head protection
Injury of the spinal cord affect the innervation of any spinal nerves distal to the point of insult.
paraplegia and quadriplegia
In para/quadriplegia, the ____ and ____ often result in the failure of spinal nerve functioning.
extent of the injury and consequential edema
Loss of nerve function below the waist, resulting in paralysis of the lower trunk and legs
paraplegia
Loss of nerve function at the cervical region resulting in paralysis of the arms, hands, trunk and legs
quadriplegia
Para/quadriplegia are due to _____ or _____
vertebral fractures or dislocation
In para/quadriplegia, the ____ causes injury/trauma to the cord and the severity of the trauma.
site
In paraplegia there is trauma to ___ and below
T1
2 other causes for paraplegia
- vertical compression
2. hyperflexion
In quadriplegia, there is trauma to ___ and above
C5
Para/quadriplegia are treated with restoration of the normal ____ and ____ of the spine;
alignment and stability
4 other treatments for para/quadriplegia
- decompression of the spinal cord, nerves and vertebrae 2. early rehab.
- neck and spine stabilization.
- hypothermic state to injured area
In para/quadriplegia, ____ is used to prevent or slow edema
methylprednisone
Degeneration or deterioration of an intervertebral disc that may result in pain in the areas served by the spinal nerves of the involved disc space.
degenerative disk disease (DDD)
DDD is caused by age due to decreased ____ in the disc, or ____ wear and tear.
water; mechanical
Misalignment in DDD can cause ____ and ____, eventually involving the nerve roots causing scarring.
inflammation and disc destruction
2 key diagnostic indicators that accompany a depressed skull fracture
- battle’s sign (bruising behind the ears)
2. racoon eyes (bruising around and under the eyes
DDD sequela is _____
spinal stenosis
4 treatments for DDD
- be active
- analgesics and NSAIDs
- physical therapy
- spinal fusion and freeing of the nerve roots from entrapment
Rupture of the nucleus pulposus through the annular wall of the disc and into the spinal canal
herniated and bulging disk
Herniated and bulging disk is also called ____ or ____
ruptured or slipped disk
4 causes for herniated and bulging disk
- accumulated trauma
- sudden impact
- poor posture
- aging
Conservative treatment of herniated and bulging disk consists of using ____ and ____
hot and cold packs
Family of drugs to treat herniated and bulging disk
relaxants and analgesics
3 surgical interventions used for herniated and bulging disks where the herniated disc may be excised
- percutaneous discectomy
- microdiscectomy
- removal of the disk with laminectomy and fusion of the vertebrae
Pathologic condition brought about by trauma, degeneration or rupture of the nucleus pulposus
sciatic nerve injury or spinal stenosis
In sciatic nerve injury, rupture of the nucleus pulposus occur within intervertebral discs ___ through ___
L4, S3
In spinal stenosis, there is narrowing of the spinal canal or _____ because of compression on the spinal cord and spinal nerve roots
nerve root foramen (sciatica)
Trauma to sciatic nerve may result from a fall, gunshot or stab wounds, or poor ____
body mechanics
In spinal stenosis, ____ can lead to degeneration of the disc or the nucleus pulposus.
aging
An _____ may prompt more rapid degeneration of spinal stenosis
inflammatory autoimmune response
In spinal stenosis, aging and arthritic changes may also cause narrowing of the ____ and the ____
spinal canal and the foramen
3 treatment options for spinal stenosis
- oral prednisone
- physical therapy
- ultrasound diathermy with massage
Pain in the head that is not confined to any one specific nerve distribution area
headache
Another word for headache
cephalalgia
Causes of headaches
–
Family of drugs to treat headaches
NSAIDs
Periodic severe headaches that may be completely incapacitating and almost always are accompanied by other symptoms, such as nausea and vomiting, anorexia, intense hemi cranial or bilateral throbbing pain and visual signs and symptoms
migraine
Causes of migraine is unknown but may be biological with changes in the _____
cerebral blood flow
2 types of spinal cord injuries
paraplegia and quadriplegia
In migraines there is ______ followed by _____ of the cerebral and cranial arteries
vasoconstriction; vasodilation
Family of drugs to treat migraines
analgesics
Chronic brain disorder, characterized by sudden episodes of abnormal intense electrical activity in the brain which results in seizure activity
epilepsy/seizure disorder
Type of epilepsy with known abnormalities in the brain resulting from a pathologic process, genetic or acquired
symptomatic epilepsy
Pathologic conditions associated with seizures
- scar tissue on cerebral cortext from infection or trauma
- cortical neoplasm
- cerebral edema
- TIAs
- CVAs
Other possible causes of epilepsy
- birth trauma (cerebral palsy)
- drug toxicity
- diabetes
- hypoglycemia
- other conditions depriving the brain of oxygen
Family of drugs to treat epilepsy
anticonvulsants ex.phenytoin, carbamazepine, valporic acid, etc
Common slowly progressive neurologic disorder characterized by the onset of recognizable disturbances
Parkinson’s disease
4 recognizable disturbances in Parkinson’s disease
- “pill-rolling” tremor of the thumb and forefinger
- muscular rigidity
- slowness of movement
- postural instability
T or F. In Parkinson’s, the cause of the degeneration of nerves in the motor system is unknown.
T
In Parkinson’s, a deficiency of _____ has been clinically demonstrated in patients with this disease
dopamine
Parkinson’s can also occur after which three incidents?
- after ingestion of poison, 2. after encephalitis
3. after taking certain major tranquilizers and certain antihypertensive drugs
In Parkinson’s, degenerative disease of the brain involve ______ parts of the brain
preferentially various
T or F. There is no cure and no known way of preventing Parkinson’s
T
A hereditary degenerative disease of the cerebral cortex and basal ganglia where progressive atrophy of the brain occurs
Huntington’s chorea/disease
The exact cause of Huntington’s disease is uncertain but it is an _____ trait that can be inherited by either sex
autosomal dominant
General cause of spinal cord injuries (para/quadriplegia)?
vertebral fractures and/or dislocations
3 ways to classify spinal cord injuries in terms of injury mechanism
- compression
- hyperflexion
- hyperextension
In spinal cord injuries, damage occurring the ___ vertebral level is usually fatal
C3
Surgical treatment option for degenerative disk disease
spinal fusion and freeing of the nerve roots from entrapment
In ______ disk there is a rupture of the nucleus pulposus through the annular wall of the disk and into the spinal call
herniated disk
In _____ disk, the nucleus pulposus extends into the inner annulus only
bulging disk
Another name for spinal stenosis
sciatica
3 sciatic nerve injury/spinal stenosis surgical interventions
- discectomy or microdiscectomy
- spinal fusion
- chemonucleolysis and/or decompression
For Huntington’s disease, haloperidol lactate and fluphenazine are prescribed to reduce ____
agitation
Progressive destructive motor neuron disease that results in muscular atrophy
amyotrophic lateral sclerosis (ALS)
ALS is also called _____ disease
Lou Gehrig’s
ALS may be caused by ______ trait
autosomal inherited
A new drug that has shown promise in slowing progression and extending life of ALS patients
Riluzole
In ALS, tizanidine and baclofen are muscle relaxants to help relieve _____
muscle spasticity
Neurologic condition typified by an overwhelming urge to move the legs or body part is to stop an uncomfortable or odd sensation
restless legs syndrome (RLS)
Restless legs syndrome incidence appears to increase after the ages ___ and ___
40 and 50
2 things that may play a role in causing RLS
- anemia
2. stress
Family of drugs to alleviate or lessen symptoms in RLS
dopamine agonists
Frightening and anxiety provoking total loss of recent memory; learning process is completely blocked. Memory disturbances are involved
transient global amnesia
Transient global amnesia temporary duration is __ to __ hours
1 to 6 hours
5 precipitating events to transient global amnesia
- stress or emotional events
- swimming
- immersion in cold water
- driving a motor vehicle
- sexual intercourse.
Transient global amnesia patient may have experienced _____ on previous occasions, usually without nausea, vomiting or photosensitivity
migraine headaches
T or F. Transient globa amnesia is treatable
F
Degeneration of peripheral nerves
peripheral neuritis
Another name for peripheral neuritis
neuropathy
Peripheral neuritis is caused by toxicity of what 6 vthings
- chronic alcohol intoxication
- arsenic
- lead
- carbon disulfide
- benzene
- phosphorus
2 other causes for peripheral neuritis
- infections
- mumps
- pneumonia
- diphtheria - metabolic or inflammatory disorders
- diabetes
- rheumatoid arthritis
- gout
- systemic lupus erythematosus
2 physiologic causes of headache
- tension headache
2. vascular headache
Headache strain on facial, neck and scalp muscles
tension
Headache caused by edema within the blood vessels of the head resulting in change in arterial size
vascular
Type of preparation taken at the first sign of a migraine to help
Ergot preparation
Symptoms of migraine other than a headache
nausea
anorexia
visual symptoms
Seizure that arises from a localized area in the brain
partial seizure
Seizure where there is diffuse electrical abnormality within the brain
generalized seizure
Prolonged seizure activity – one seizure follows another with no recovery of consciousness between attacks
status epilepticus
Families of drugs to treat peripheral neuritis
anticonvulsants and tricylic antidepressants
Pain of the area innervated by the fifth cranial (trigeminal) nerve, the trigeminal nerve
trigeminal neuralgia
Another name for trigeminal neuralgia
tic doloureux
Trigeminal neuralgia may be related to compression of a _____ by a tumor or vascular lesion
nerve root
Trigeminal neuralgia is a sequela to _____ or _____
multiple sclerosis or herpes zoster
Families of drugs to treat trigeminal neuralgia
analgesics, anticonvulsants or muscle relaxants
Disorder of facial nerve that causes a sudden onset of weakness or paralysis
Bell’s palsy
Symptoms of Bell’s palsy result from blockage of impulses from the cranial nerve # __ caused by compression of the nerve in the bony canal
7th cranial (facial) nerve
_____ has been noted in a small percentage of people with Lyme disease
bilateral facial paralysis
T or F. Early treatment is critical in Bell’s palsy
T
Procedure to stimulate the nerve and prevent muscle atrophy in Bell’s palsy
electrotherapy
4 other treatments for Bell’s palsy
- warm moist heat
- gentle massage
- facial exercise to stimulate muscle tone
- prednisone
Inflammation of the meninges, the membranous coverings of the brain and spinal cord
meningitis
Meningitis can originate directly from which 3 areas?
- brain
- spinal cord
- sinuses
3 bacteria most responsible for meningitis
- Haemophilus influenza
- Neisseria Meningitidis
- Streptococcus pneumoniae
4 treatment options for meningitis
- aggressive IV antibiotic therapy
- anticonvulsants to control seizure
- glucocorticoids to reduce cerebral inflammation and edema
- aspirin and acetaminophen are used for headaches
Inflammation of brain tissue
encephalitis
3 types of encephalomyelitis
- Eastern equine
- Western equine
- Venezuelan equine
Non-endemic encephalitis
West Nile viral encephalitis
Encephalitis is caused by viruses or the toxins from ____ or ____ from mosquito bites
chickenpox measles or mumps
Antiviral agents are effective against only ____ encephalitis
herpes simplex
4 encephalitis treatments
- mild analgesics for pain,
- antipyretic for elevated temperatures,
- anticonvulsants for seizure activity
- antibiotic for any intercurrent infection
4 recognizable disturbances associated with Parkinson’s disease
- pill rolling tremor
- muscular rigidity
- slowness of movement (shuffling gait)
- postural instability
Acute rapidly progressive disease of the spinal nerves
Guillain-Barré syndrome
Guillain-Barré syndrome is on ____ but has more of a ____ process
autoimmune; infectious
Surgical treatment option for Parkinson’s disease
deep brain stimulation
Guillain-Barre syndrome has been known to follow a _____ or gastroenteritis after 10-21 days
respiratory infection; gastroenteritis
Guillain-Barré syndrome is associated with _____ of the nerves
demyelination
To treat Guillain-Barré syndrome, _____ washes the plasma to remove antibodies, thereby shortening the time required for recovery
plasmapheresis
IV ____ may be beneficial in treating Guillain-Barré syndrome
immunoglobulin
Collection of pus can occur anywhere in the brain tissue
brain abscess
CNS abscesses may be the result of _____ or _____ infections elsewhere in the body
local or secondary
3 common causative organisms for brain abscess
- Staphylococci
- Streptococci
- Pneumococci
Brain abscess can be caused by ______ including head trauma and a craniotomy wound, or a port of entry for microorganism
breaches in the integrity of CNS
2 drugs to treat brain abscess
- IV antibiotics to resolve infection
2. Mannitol or steroids are to reduce cerebral edema
Drainage of the brain abscess may be necessary to relieve _____ and to _____ the offending organism
intracranial pressure; culture
Viral infection of the anterior horn cells of the gray matter of the spinal cord and causes a selective destruction of the motor neurons
poliomyelitis
Another name for poliomyelitis
Postpolio syndrome
In poliomyelitis, ____ enters the body through the nose and throat and crosses into the gastrointestinal tract
poliovirus
In poliomyelitis, poliovirus reproduces in the ____ and travels in the ____
lymphoid tissue; bloodstream
In poliomyelitis, poliovirus travels to CNS where the virus assaults the ____ of the ____
motor neurons of the spinal cord
Poliomyelitis is transmitted from person to person by ____ or ____
infected oropharyngeal secretion or feces that contain the virus
2 types of polio vaccines
- inactivated polio vaccine (IPV)
2. oral poliovirus vaccine (OPV)
3 different serotypes of polio virus
Type1
Type2
Type 3
_____ vaccine and ____ vaccine afford immunity from all 3 forms of poliomyelitis
sabin trivalent oral vaccine; salk vaccine
Ceaseless, uncontrolled, involuntary movements (Huntington’s)
chorea
T or F. Huntington’s chorea causes personality changes
T
T or F. Mind functioning is affected in ALS
F; the main result of ALS is muscular atrophy
Peripheral neuritis typically affects the ____ of the ____
distal muscles of the extremities
Peripheral neuritis leads to muscle ____ and sensory ____
weakness; loss
Surgical treatment for trigeminal neuralgia to alleviate pain
dissection of nerve root
T or F. Bell’s palsy is usually bilateral
F; usually unilateral
What must be ruled out before treating Bell’s palsy
CVA
Key symptom of meningitis
stiff neck
Stiffness of the neck that resists any sideways or flexion-extension movement
nuchal rigidity
2 diagnostic signs of meningitis
- Kernig’s sign
2. Brudzinski’s sign
2 types of meningitis
- bacterial
2. viral (less serious)
Type of causative pathogen for encephalitis
virus, but can be caused by toxins from chickenpox, measles, or mumps
In Guillain-Barre Syndrome, symptoms start at ___ and ___
feet and hands
In Guillain-Barre Syndrome, progressive muscle weakness and paralysis follows in ___ to ___ hours
24 to 72 hours
Guillain-Barre is on an autoimmune basis but can also follow a ____ or ____
respiratory infection; gastroenteritis
A lumbar puncture contraindicates when diagnosing a brain access because the increased ICP can cause the ____ to ____, causing death
brainstem to herniate
Type of neurons selectively destroyed in poliomyelitis
motor neurons
Postpolio syndrome typically appears ___ years or more after the original infection in a person who has had polio
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