Pathologies

Question 0

What does MS do?

Answer 0

The demyelination occurs due to plaques forming throughout the cerebral hemispheres thought to be caused by an autoimmune response but we are still unsure of the cause

These plaques cause demyelination of nerve fibres which means that action potentials can’t be conducted as well and the function of the nerve effectively ceases.

Question 1

Types of ms

Answer 1

Relapse remitting
Primary progressive
Secondary progressive

Question 2

Relapse-remitting MS

Answer 2

Characterised by a course of recurrent discrete relapses interspaced by periods of remission where recovery is either complete or partial.

In relapse remitting MS remyelination occurs following an acute inflammatory demyelination episode. This is because the brain contains pre-curser oligodendrogalcytes

With each inflammatory attack there is increasing damage to the axons and axonal degeneration. Eventually leads to secondary progressive as the remitting periods stop and the disease progresses

Question 3

Primary progressive MS

Answer 3

Primary progressive MS is typified by progressive and cumulative neurological deficit without remission or evidence of exacerbation

Question 4

Secondary progressive MS

Answer 4

Typified by having begun with relapses and remissions before entering a phase of progressive deterioration where disability increases

Question 5

Stroke

Answer 5

An accident with rapidly increasing clinical signs of focal or global disturbance of cerebral function. Can either be ischemic or haemorrogic

Question 6

Ischemic stroke

Answer 6

Stroke where the blood supply is occluded to an area of the brain

Question 7

Haemorrogic stroke

Answer 7

Bleeding causes increased pressure in the brain and on brain tissue

Question 8

Parkinson’s disease

Answer 8

Chronic progressive neurodegenerative disorder. The loss of neurones that produce dopamine in the substantia nigra in the mid brain. There are changes in the substantia nigra due to the lack of dopamine and this causes parkinsonian changes and symptoms

Question 9

Falls can be caused by

Answer 9

Nutritional status, environmental hazards, lack of exercise, medication + age and medical condition

Question 10

Guillain-Barré syndrome

Answer 10

Peaks at 4 weeks

Starts in LLs first and then spreads to ULs but ULs regain function first.

Acute inflammatory demyelination which results in a slowing or block of nerve conduction. Serious cases present with trunkal weakness as well as proximal and distal weakness

Weakness, sensory loss and persistent fatigue are the main components of the disease

Question 11

Radial nerve palsy (neurotmesis)

Answer 11

Neurotmesis is the most severe nerve injury and involves complete nerve division (division of the axon, myelin sheath and connective tissue)

Question 12

Wallerian degeneration

Answer 12

Once a peripheral nerve is transacted the distal axons start the process of wallerian degeneration where macrophages enter the area and remove the myelin and axonal debris. The basement membrane and Schwann cells remain intact. Schwann cells move to the basement membrane and secrete nerve growth factor which attracts axonal sprouts from the terminal of the proximal axon. These provide paths for the regenerating axons to follow

Question 13

Hemiparesis

Answer 13

Weakness on one side of the body

Question 14

Pusher syndrome

Answer 14

Patients with hemiparesis actively push their weight away from the non-hemiparetic side to the hemiparetic side. Doesn’t happen in stroke but happens in other brain injury, rehab takes longer in these patients

Question 15

3 types of head injury

Answer 15

Direct impact on the skull
Penetration through the skull
Collision between brain substance and the internal skull structure

Question 16

Open and closed head injuries

Answer 16

Open is when a skull fracture occurs which complicates recovery due to bone fragments and the skull needing to heal

Closed is injury without any skull disruption

Question 17

Subarachnoid haemorrhage

Answer 17

Bleeding into the subarachnoid space. Caused by hypertension, trauma, bleeding disorders, drug use and vascular malformation

Question 18

Surgery to repair aneurysm for subarachnoid haemmorage

Answer 18

Clipping of right anterior communicating artery. Anterior communicating arteries are most common to get aneurysms usually develop on branching points due to the constant pressure of the blood flow

Question 19

Hemianopia

Answer 19

Visual field loss on either side of the vertical midline

Question 20

Neglect

Answer 20

Act as if one side of space doesn’t exist
For instance will only draw one side of a clock
Only will be able to attend to events happening on one side

Question 21

Paraplegia

Answer 21

Impairment in motor and/or sensory function of the lower extremities

Question 22

Spinal cord lesion

Answer 22

Below T8 some loss of trunk and abdominal muscles

grade A injury - complete lesion as paraplegia + trunk symptoms