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MBB > Review (part 2) > Flashcards

Review (part 2) Flashcards

1
Q

The ASIA (ISNCSCI) impairment score has 5 levels (A, B, C, D, and E). What is an A score? E score?

A

A = Complete injury

E = return of normal and sensory function

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2
Q

What motor abilities will a patient with a C1-4 injury have? What are the realistic activity of daily living (ADL) rehab goals?

A

Patients have limitied movement of head and neck meaning they are dependent on caregivers for everything

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3
Q

What motor abilities will a patient with a C5 injury have? What are the realistic activity of daily living (ADL) rehab goals?

A

Has elbow flexors (C5)

Goals include independent eating after cuff set up and assisting with upper body dressing/bathing (need help with lower body dressing/bathing)

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4
Q

What motor abilities will a patient with a C6 injury have? What are the realistic activity of daily living (ADL) rehab goals?

A

elbow flexors (C5) and wrist extensors (C6)

independent eating, upper body dressing/bathing (need help with lower body derssing/bathing)

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5
Q

What motor abilities will a patient with a C7 injury have? What are the realistic activity of daily living (ADL) rehab goals?

A

elbow flexors (C5), wrist extensors (C6), elbow extensors (C7)

independent upper body dressing/bathing and inependent/some help with lower body dressing/bathing

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6
Q

What motor abilities will a patient with a T1-S5 injury have? What are the realistic activity of daily living (ADL) rehab goals?

A

complete use of upper extremities

independent in all ADLs

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7
Q

With regards to a C1-3, C4, C5, C6, and C7-8 spinal injury, which patients will have a greater amount of mobility and independence?

A

greatest to least

C7-8 > C6 > C5 > C4 > C1-3

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8
Q

What is neurogenic shock? Describe how the symptoms occur

A

Definition:
Triad of hypotension, bradycardia and hypothermia due to disruption of ANS.

Lack of sympathetic input to vasculature, arteries dilate, blood pools in venous compartment.

Lack of sympathetic input to heart (T1-T4) results in unopposed vagal tone, causing bradycardia and reduced myocardial contractility.

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9
Q

What is spinal shock? Describe how the symptoms occur

A

loss of sensory, motor, and reflex function of the spinal cord below the lesion

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10
Q

What is autonomic dysreflexia (AD)? Who is at high risk for AD?

A

Disconnection of the sympathetic nervous system to the brain above the lesion can result in episodes of HTN (below the lesion), bradycardia, pounding headache (vasodilation of vessels above the lesion - especially in the brain), sweating above the lesion, and anxiety in response to a noxious stimulus

Patients with a lesion T6 or above are at high risk

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11
Q

What is cauda equina syndrome? Is this an UMN or LMN syndrome? What are the GI/GU symptoms? Is pain present?

A

injury to the “horse tail”

LMN

areflexic bowel, bladder, and lower extremities

pain is present

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12
Q

What is conus medullaris syndrome? Is this an UMN or LMN syndrome? What are the GI/GU symptoms? Is pain present?

A

injury to the cone at the end of the spinal cord

can be UMN, LMN, or mixed

variable degrees of bowel, bladder effects.

No pain but saddle anesthesia is common

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13
Q

Do patients with UMN damage to S2, 3, 4 have bowel reflexes?

A

yes

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14
Q

Do patients with LMN damage to S2, 3, 4 have bowel reflexes?

A

no

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15
Q

Is ALS a motor or sensory or mixed disease? Does it involve UMN or LMN? What is the tissue involvement (cell body-motor neuron/myelin/axon/NMJ/muscle)?

A

motor

UMN and LMN (will have both clinical symptoms)

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16
Q

What are the characteristics of Guillan-Barre? What is the tissue involvement (cell body-motor neuron/myelin/axon/NMJ/muscle)?

A

ascending paralysis

myelin

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17
Q

What can cause acquired neuropathy? What is an example of hereditary neuropathy? What is the tissue involvement (cell body-motor neuron/myelin/axon/NMJ/muscle)?

A

Diebetes and EtOH

Charcot-Marie-Tooth type 1A

axon

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18
Q

What are clinical characteristics of Myesthenia Gravis? What is the tissue involvement (cell body-motor neuron/myelin/axon/NMJ/muscle)?

A

ocular symptoms (lots of NMJs there) - Ptosis, diplopia

fatigue increases with prolonged used

NMJ

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19
Q

What is muscular dystrophy? What is the tissue involvement (cell body-motor neuron/myelin/axon/NMJ/muscle)? What is the special test to identify this disease?

A

muscle weakness due to wasting

muscle

Gower’s sign

20
Q

Is glutamate an excitatory or inhibitory neurotransmitter? What is its precursor?

A

excitatory

glutamine

21
Q

What are the 3 ionotropic glutamate receptors? What ions do they conduct?

A

NMDA = Na+ and Ca2+

AMPA = Na+

Kainate = Na+

22
Q

What is so special about NMDA receptor channels?

A

it is blocked by Mg2+ until sufficient depolarization is reached

23
Q

What are the 2 metabotropic receptors? One is found on the presynaptic cleft and the other on the post synaptic cleft. Which one is excitatory? inhibitory? What G protein do they use?

A

presynaptic = inhibitory; Gi

Post synaptic = excitatory; Gs

24
Q

Is GABA an excitatory or inhibitory neurotransmitter? What is its precursor?

A

inhibitory

Glutamate

25
Q

What are the 2 GABA receptors? Are they ionotropic or metabotropic? What do they conduct?

A

GABA-A = ionotropic; conducts Cl-

GABA-B = metabotropic; decrease Ca2+ conductance and increase K+

26
Q

Is glycine excitatory or inhibitory? What is its precursor? What does its ionotropic channel conduct?

A

inhibitory

Serine

Cl- conductance

27
Q

Is acetylcholine excitatory or inhibitory? What is its precursor?

A

excitatory

choline + acetyl-CoA

28
Q

Where in the neuron is ACh made?

A

terminal end of axon (presynaptic bulb)

29
Q

What are the two types of ACh receptors? are they ionotropic or metabotropic?

A

nicotinic = ionotropic

muscarinic = metabotropic

30
Q

Is dopamine excitatory or inhibitory? What is its precursor?

A

excitatory

tyrosine

31
Q

Is dopamine released at varicosities?

A

yes

32
Q

Dopamine has 2 receptors. One is on the varicosity (presynaptic) and the other is postsynaptic. what do they do? Are they ionotropic or metabotropic?

A

presynaptic (varcosity) = inhibitory; metobotropic

postsynaptic = excitatory; metabotropic

33
Q

Is norepinephrine excitatory or inhibitory? What is its precursor?

A

excitatory

tyrosine

34
Q

what are the receptors for norepinephrine? are they metabotropic or ionotropic?

A

alpha and beta receptors

metabotropic

35
Q

How are monoamines (dopamine, norepinephrine) degraded?

A

they are reabsorbed via specific transporters

36
Q

Is serotonin excitatory or inhibitory? What is its precursor?

A

excitatory

tryptophan

37
Q

What are group of serotonin receptors called?

A

5-HT receptors

38
Q

What are the receptors for neuropeptides called? What do they conduct?

A

mu-opioid receptors

increase K+ conductance and decrease Ca2+ conductance

39
Q

What is serotonin syndrome?

A

increased HR

sweating

dilated pupils

hyperactive bowel sounds

hyperthermia

40
Q

How do you treat serotonin syndrome?

A

benzodiazepines

41
Q

Name 5 opioids that are strong agonists

A

morphine

methadone

fentanyl

oxycodone

heroin

42
Q

Name 2 partial agonist opioids

A

tramadol

tapentadol

43
Q

Name 1 mixed agonist-antagonist

A

buprenorphine

44
Q

name 2 opioids with high affinity but no efficacy

A

naloxone

naltrexone

45
Q

What is MAC? how does it relate to potency?

A

minimum alveolar concentration

potency = 1/MAC

46
Q
A

MBB (24 decks)

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