Peripheral Nervous System Flashcards
1
Q
MS (Multi. Sclerosis)
A
- myelin sheath destroyed permanently, impulses seeking “good sheath” cause jerky movement
- viral , autoimmune, hormones, heredity, mild - severe cases
- s/s: primary: visual issue, imbalance, ataxia, bowel/bladder dysfunction, paresthesia, 2ndary: dysarthria, kidney stones, pressure ulcers, intentional tremors from voluntary movement, tertiary: social isolation, unable to work, relationship issues
- dx: history, lumbar puncture, blood gMS for antibodies
2
Q
MS Treatments
A
- immunotherapies (imuran, cytoxan)
- steroids : ACTH, soul-medrol
- anti-seizure meds: Tegretol (carbamazepine), gabapentin (Neurotonin), baclofen for muscle spasms
- B&B dysfunction: Metamucil, fiber-con, pyridium/ stool softeners, colace, fleets
- antidepressants: Ritalin, Prozac, Zolofts, Paxil
- chemo: novantrone..s/e cardio toxicity
- goal is to avoid extreme heat/cold, physical trauma, and infections
3
Q
Plasmapheresis
A
To remove antibodies via plasma exchange, suppressing immune response/ inflammation
4
Q
Myasthenia gravis
A
- “grave muscle weakness “ caused by neuromuscular disease, autoimmune process, or a virus
- s/s: increased muscle weakness with activity and improving with rest, eye ptosis, mask-like expression dysphagia, stress/pregnancy/temp./trauma, vocal fading
- C/O: diaphragm & chewing muscles weaken, too many/too little anticholinergic meds= myasthenic or cholinergic Crisis
- tensilon test used to dx, along with s/s and EMG
5
Q
MG Tx
A
- cholinesterase inhibitors: Mestinon-longer action less s/e & Prostigmin- improvement in 10 mins but lasts 3-4 hrs
- pt must take meds same time daily
- cholinergic meds can cause cholinergic crisis (too much) or myasthenia crisis (too little)… give atropine for cholinergic crisis
- atropine blocks aCH effect: raises HR, lowers secretions & peristalsis …s/e dry mouth, thirst, raised pulse
- plasmapheresis, immunosuppressants and steroids (lowers inflammation & antibodies), removal of thymus gland
6
Q
ALS/Lou Gehrig’s disease
A
- neuro disease affecting motor neurons for voluntary movement, genetic, poor prognosis
- s/s vague..poor coordination/falls, fisculations (twitching), dysphagia/chewing issues, poor cough and gag, pseudobubular, one sided radiating pain
- dx may be late..based on s/s
7
Q
ALS Tx
A
- baclofen for muscle spasms
- Valium (diazepam) for seizures/spasms
- rilutek slows disease progress
- PT OT Massage
- repositioning, rehab, tube feedings
8
Q
Guillain Barre
A
- abrupt inflammatory disorder that progresses from weakness to paralysis
- only illness where remyelination & demyelination occur
- dx: CSF high, protein high
- 3 stages.. onset, plateau, recovery… weakness/paralysis, labile BP, cardiac dysfunction
- good prognosis…tx w/ support care & plasmapheresis
9
Q
Blood gases
A
- pH: <7.35-7.45>
- O2: <45-35>
- hCO3: 22-26
- monitor these with GB PTs
10
Q
Trigeminal Neuralgia
A
- cranial nerve disease of nerve V …usually affects mandibular & maxillary …only sensory (not motor) portion of nerve is affected
- s/s: irritation/chronic nerve compression starts onset s/s…intense, recurring pain, may last secs-mins. multiple times/day..pain is one-sided, triggered by touch/breeze/chewing/talking..rapid blinking/tearing in affected side
- tx: Treat Trigeminal with tegretol, phenytoin, carbamepazine, nerve block, rhizotomy
11
Q
Bells Palsy
A
- CN VII (facial) affected from inflammation/edema
- caused by herpes simplex & zoster, virus, autoimmune???
- s/s: loss of motor control on affected side, dry eyes, tingly lips, unable to close eye or mouth , loss of taste, speech difficulties
- dx: EMG, history
- tx: prednisone, analgesics, heat, gentle massage
12
Q
CV Disorder facts
A
- TIA, ischemic/embolic, and hemorrhage stroke are top common
- permissible HTN for perfusion
- usually caused by hi cholesterol, is preventable
- ischemic: occlusion on vessel wall, embolic: foreign object causes occlusion, hemorrhage: T.B.I.-related i.e. aneurysm … this is THE WORST ONE TO HAVE
13
Q
T.I.A.’s
A
- temp blockage of blood to brain..lasts mins.-hrs…not an actual stroke but a warning of a future one
- low O2 & glucose=irritated PT
- CV may show infarcted area
14
Q
CVA
A
- an actual stroke..some are preventable, causes 5 milli. deaths/yr..very common in southern states due to diet, smoking and drinking
- neuro deficits will depend on areas affected..this will cause infarction
- **maintain circulation to avoid further ischemia
- risk factors: arterio/atherosclerosis, hi cholesterol, smoking, obesity, diabetes
15
Q
B.E.F.A.S.T.
A
Breathing
Eyes
Facial
Arm Weakness
Speech
Time
