Test 3 revision Flashcards

Question

What are special needs of the brain?

Answer 1

The brain does not store large amounts of glycogen or ATP. The brain cannot do anaerobic respiration. The brain must have a constant supply of blood to bringm oxygen and glucose or it will start to die very quickly. 15-20% of the blood from the left ventricle goes directly to the brain.

Answer 2

Glasgow Coma Score Mild TBI: 13-15 Moderate TBI: 9-12 Severe TBI: 3-8 Reflexes ◦ Pupils: PERRLA Equalization ◦ Equality of strength in left versus right arms and legs ◦ Drift: Can the arms stay up for a count of 10, legs for a count of 5? ◦ Ataxia: Finger to nose rapidly

Answer 3

◦ Head of the bed at least 30 degrees ◦ Corticosteroids to decrease oedema ◦ Administer mannitol (osmotic diuretic) or possibly hypertonic saline (3%) ◦ Cooling to lower brain and body metabolic requirements ◦ Induce hyperventilation to reduce CO2 level and induce vasoconstriction ◦ Keep blood pressure high enough for perfusion ◦ Seizure prophylaxis ◦ Monitor ICP and prepare for surgery or medically induced coma

Answer 4

Protection Sensation Metabolic Temperature regulation Absorption Excretion Blood reservoir

Answer 5

Cellulitis is a bacterial infection of the dermis and subcutaneous tissue that can easily, and rapidly spread. It more commonly occurs in older adults, though a particular type- periorbital cellulitis- occurs in children.

Answer 6

Most commonly "streptococcus pyogenes" or "staphylococcus aureus (staph infection)

Answer 7

Occurs when the skin barrier is broken and bacteria have access to the lower dermis and fatty tissue layers. Can be via cut, insect bite, burn, scrape, puncture wound, or patches of dry skin. Most commonly found on the legs

Answer 8

People with.. - Diabetes - Venous diseases - Lymphoedema - Leg ulcers - Oedema - IV drug use - Over weight - Have a weakened immune system - Other skin diseases (eczema or athletes foot) - Already have a swollen arm or leg - Have had cellulitis before

Answer 9

Red, swollen, painful, blisters, warmth. Sometimes there are blisters filled with yellow fluid. May develop fever if infection becomes symptomatic. Can cause sepsis if enters the blood stream, low blood pressure, high fever.

Answer 10

Treatment: Antibiotics (oral or IV), elevate legs, wound care and antibiotic creams, possibly compression stocking to reduce fluid

Answer 11

Bandage, keep skin wounds clean, antibiotic cream, heal exciting breaks in the skin. Diabetes or poor circulation: Examine feet every day, moisturize, avoid injury

Answer 12

“localized damage to skin and/or underlying tissue as a result of pressure or pressure in combination with shear”

Answer 13

Bones – skin, subcutaneous tissue, and muscle caught between bone and a hard surface are under great pressure Mechanical devices – oxygen tubing, canes, bed rails, catheters, nasogastric tubes Pressure occludes blood vessels, which causes ischemia Muscle may actually be affected first as it is less resistant than skin

Answer 14

Skin and subcutaneous tissue may stay in place due to friction against a surface When moved, or when sliding down in a chair, muscle and bone may move This shears the skin and subcutaneous tissue from the muscle

Answer 15

Stage 1, stage 2, stage 3, stage 4, unstageable and deep tissue injury

Answer 16

Skin remains intact with localized area of erythema or discolouration that is non-blanchable (Does NOT change color/lighten when pressure (e.g. finger-press) is applied) (Just red no skin breakage)

Answer 17

Partial-thickness skin loss. Dermis intact but exposed. No granulation tissue, slough, or necrosis Partial thickness injury that exposes the dermis; may appear blister-like. (Skin that appears when a blister pops)

Answer 18

- Full thickness loss of skin that exposes the hypodermis (Adipose tissue, granulation tissue visible). - Ulcer typically has rolled edges. - Eschar and slough may be visible at the edges but do not cover the wound - No exposure of muscle, fascia, bone, tendon, ligament, or cartilage

Answer 19

Full thickness loss of skin that exposes further underlying tissues such as fascia, tendon/muscle, ligament, bone, etc. Slough or eschar may be present but do not cover the wound

Answer 20

Full thickness loss of skin (stage 3 or 4) but slough, eschar and/or necrosis cover the wound so damage is unable to be confirmed

Answer 21

Injury in tissues deep to the skin which appears as a persistent, non-blanchable, deep red, maroon or purple discolouration or blood-filled blister (skin may or may not be intact).

Answer 22

Repositioning, using supportive surfaces that distribute or relieve pressure (e.g. certain types of mattresses), reducing exposure to sustained moisture (e.g. due to incontinence), reducing shear and friction forces, etc. Further management may include wound dressing/treatment, debridement, infection prevention/management, pain management and nutritional/hydration management.

Answer 23

Gastroenteritis is inflammation of the lining of the stomach and the intestines. It is usually caused by an infectious agent but can also be a reaction to medication or poisons. The pathophysiology of gastroenteritis is different for different kinds of infections.

Answer 24

Children have a greater percentage of water which increases their risk of dehydration. In addition children have immature kidneys (so cannot reabsorb water as well) and they have a great surface area to weight so can lose water easier

Answer 25

Rotavirus Norovirus

Answer 26

Transmitted faecal-orally Occurs when microorganisms from an infected stool of one person enter the mouth of another. Germs are transferred from hand to mouth because the hands have touched contaminated items and have not been well washed afterwards.

Answer 27

Viruses invade and take over the cells that line the stomach and the gut These are the cells that first absorb nutrients and water from the stomach and intestines Additionally, the viruses release toxins that cause the death of surrounding cells. Ultimately, the intestines cannot absorb nutrients and water well, and even lose some of the fluid that they do have in their tissue

Answer 28

Symptoms start with vomiting followed by watery diarrhoea Low fever is present, but high fever is typically not from a gastroenteritis virus.

Answer 29

Clostridium difficile (Cdiff) Campylobacter Shigella Salmonella

Answer 30

The spread of gastroenteric bacteria is usually through undercooked food (especially chicken or eggs) or unpasteurized milk. C. diff used to be thought of as a nosocomial infection (one obtained through the hospital) but it is now prevalent in the community

Answer 31

Release of a toxin – in some cases, the bacteria itself doesn’t even have to get into the body, but if the toxin made by the bacteria is taken in and is not killed by sufficient heat in cooking. The toxin causes the cells that line the gut to stop taking in water and nutrients and instead to dump fluid and electrolytes into the gut, causing diarrhoea. Invasion by the bacteria itself – Bacteria get into the mucosa. The immune system responds by causing inflammation, which can cause ulceration of the tissue of the intestines and bleeding.

Answer 32

Cramping and vomiting followed by diarrhoea Bacterial gastroenteritis is more likely (not always) to present with a high fever and bloody or mucous-filled diarrhoea.

Answer 33

Diarrhoea requires three or more loose stools in a day. Unless stools are loose and unless there are at least three stools in a day, diarrhoea is not generally diagnosed or treated. Dehydration/Hypovolemia (liquid portion of the blood (plasma) is too low): - Sunken fontanels in a baby; dry mucosal membranes, sunken eyes, decreased tears. - Weight loss – especially for a baby - Rapid thready pulse; decreased blood pressure; dizziness Hyponatremia - Less sodium = less nervous activity - Apathy, weakness - Depressed reflexes, twitches Hypokalaemia - Less potassium = less muscle - Muscle weakness that can lead to paralysis - Pulse may be bradycardic from lack of potassium or can be tachycardic from dehydration Metabolic acidosis - Rapid breathing to blow out the acid - As acidosis gets worse, especially with low potassium, may greatly increase bradycardia

Answer 34

Monitor diarrhoea, dehydration and electrolyte & acid-base imbalances. Treatment * Handwashing with soap, not just gel At home: * Oral rehydration therapy (ORT) * Usually prepackaged. * Rough guide: A litre of water, 6 teaspoons of sugar, and ½ teaspoon of salt. * If child will not drink, may need ondansetron to reduce nausea and to give ORT with a syringe. In hospital: * NG fluids, possibly with electrolytes * Possibly medication for diarrhoea; however, if diarrhoea is from an infectious cause, medication may not be given so that the body can wash the pathogen out of the body. * Feeding as soon as child will take in food.

Answer 35

Rheumatic fever causes inflammation, of the heart, blood vessels and joints. Can be caused by inadequately treated strep throat or scarlet fever. Rheumatic fever is caused by Group A (Beta-haemolytic) streptococcus bacteria. There are over 100 strains of group A strep bacteria, but the one that causes rheumatic fever is often Strep pyogenes.

Answer 36

Our skin and respiratory tract are colonised with Group A strep bacteria, but they can cause cellulitis, gastroenteritis, and strep throat when uncontrolled. Group A strep is generally spread by droplets or direct contact. Rheumatic fever occurs after an infection of the throat with group A strep, called strep pharyngitis or strep throat. Cellulitis can also be caused by group A strep, but rheumatic fever is more closely linked to strep throat than to cellulitis.

Answer 37

When a child has strep throat, the immune system makes antibodies to the Strep bacteria. One of the major antigens on the group A Strep that the immune system attacks is called the “M protein”. Unfortunately, the group A strep’s M-protein looks very much like proteins found on the heart muscle, heart valves, synovial lining of the joints, the nerves, and skin/subcutaneous tissues. In acute rheumatic fever, the child’s immune system then starts attacking these other sites in the body. When the immune system attacks these sites, especially the heart, it forms Aschoff bodies (are nodules found in the hearts). T-cells and phagocytic cells travel through the blood to come to the cells with proteins that look like the strep M-protein. At these areas, the phagocytic immune cells attack the body cells and the proteins around them. Eventually, like in other areas with inflammation, they wall themselves off and create a nodule of collagen (scar tissue). This breakdown of the joints, heart, skin, and even nervous tissue causes the symptoms associated with acute rheumatic fever.

Answer 38

Occurs 2 to 4 weeks after strep throat Not everyone with acute rheumatic fever gets the same symptoms but will develop some of the following: - High fever - The Jones Criteria: Joint pain (migrating polyarthritis). The arthritis generally starts in the lower legs and “migrates” upward over time. - Carditis – chest pain and shortness of breath. Acute rheumatic fever typically affects the valves and the endocardium (inner lining).This causes the valves not to be able to close properly so that some blood flows the wrong way when the heart pumps (Mitral regurgitation, aortic regurgitation). - Skin nodules – from the collections of collagen under the skin. - Erythema marginata – a red, non-itchy rash. - Sydenham’s chorea – involuntary tics from the face or arms.

Answer 39

- Patient history that includes recent respiratory infection - Draw labs to assess for inflammation and for antibodies to Strep antigens - Auscultate for left sided heart murmur - Assess for heart failure, especially left sided symptoms - ECG for heart rhythm - Assess for joint pain and inflammation that is moving upward - Assess skin for new nodules (Especially hands) - Assess for new rashes, especially if non-itchy - Assess for tics or neurological changes

Answer 40

- Obtain throat culture of any school age child with sore and red throat - Provide antibiotics: penicillin (long term) - Provide anti-inflammatory medications: aspirin - Prednisone is given if there is pericarditis – inflammation of the sac around the heart - Provide medications for heart failure; Diuretics; ACE or ARB; Beta blocker; Possibly calcium channel blockers if atrial fib is present; Low sodium diet - Ensure adequate oxygenation - Emotional support for decreased function with chorea - Long term care; Prophylactic antibiotics; Heart valve replacement

Answer 41

A bacterial infection that causes red throat/ tonsils, fever, painful swallowing, body aches, and swollen lymph nodes.

Answer 42

Heart Disease - Initially, rheumatic fever causes mitral and aortic regurgitation. - Blood flows backwards when the heart pumps. You can hear this by a murmur in a stethoscope? Heart disease symptoms: Dyspnoea, tripod positioning, possible jugular venous distention Over time, the valves can harden and narrow, causing stenosis The back up of blood from the valves stretches the heart. Also, the heart muscle is damaged from the immune system. These two changes lead to * Atrial fibrillation * Left sided heart failure Acute Glomerulonephritis Occurs 1to 3 weeks after Strep throat or Group A Strep skin infection Antibodies bind to antigens on the group A Strep bacteria. These antibody-antigen complexes float through the blood. They flow to the glomerulus of the kidneys, but are too big to filter into the urine. The body tries to clear out the antigen-antibody complexes with inflammation. The inflammation destroys the lining of the glomeruli and leaves it with a sort-of scar tissue. Scar tissue doesn’t filter well, so the kidneys end up not filtering, and the body goes into Acute Renal Failure Intrarenal – the glomeruli are inside the kidney

Answer 43

Osteoarthritis is an inflammatory condition associated with degeneration of joint tissues. There is degradation of the articular cartilage in joints, ultimately leading to damage to the bone surfaces and synovial membrane. The joint becomes painful and mobility is decreased due to stiffening of the joint. Hip joint wearing down = hip replacement

Answer 44

Age Inflammation Joint injury Mechanical stress and obesity Neurological disorders Genetics Medications

Answer 45

A bone fractures (breaks) when force is applied to the bone which exceeds the bones tensile or compressive strength. Bone fractures may occur as a result of trauma or pathological processes which have weakened the bone, and any bone in the body can be affected. Fractures tend to be more common in young males and the elderly (65+ years).

Answer 46

Bone broken all the way through (bone separated into at least 2 pieces)

Answer 47

Break does not go all the way through the bone (bone remains in one piece)

Answer 48

Bone penetrates the skin (skin is also broken)

Answer 49

Skin remains intact, bone does not penetrate

Answer 50

Bone is broken into more than two pieces

Answer 51

Break is not obvious or easily discernible

Answer 52

Fragment of bone at ligament/tendon attachment point breaks off

Answer 53

Break is parallel to the long axis of the bone

Answer 54

Break is horizontal through the bone

Answer 55

Break is at an oblique angle to the long axis of the bone

Answer 56

Break curves around the cortical (compact) bone

Answer 57

Broken bone ends are mis-aligned

Answer 58

Broken bone ends are pushed into each other

Answer 59

- tenderness and/or pain - unnatural alignment/deformity - swelling - muscle spasm - impaired sensation - decreased mobility/limb function

Answer 60

- Fat embolism (most commonly associated with long bones) (particles of fat get into your bloodstream and block blood flow) Long bones can have fat in them. When you break a bone, fat can move across the blood vessels and become a ebolise. - Hypovolemic shock: Because bones are rich in blood, If the break is severe enough and bleeding cannot be contained, could be a risk to HS from hemorrhage. - Bone necrosis if blood supply compromised - Infection (More likely if open fracture) - Delayed union of bone pieces (mal- union & non-union). Delayed healing process.

Answer 61

1) Hematoma - Blood accumulation around break 2) Soft callus - Fibrous CT and fibrocartilage replace hematoma + new blood vessel formation 3) Hard callus - Bone tissue replaces soft callus tissue 4) Remodeling - Bone remodeling to sculpt bone original shape (or as close as possible)

Answer 62

1) Immobilisation (e.g. via splint, plaster cast) 2) Reduction: realignment of displaced fractures 3) Traction: use of weight/steady pulling force to stretch muscles and surrounding tissue to allow realignment of bone fragments 4) External fixation: pins & screws driven into bone fragments and attached to external plate to hold bones in place 5) Open reduction & internal fixation: surgical procedure exposing fracture site to allow re-alignment and then pins, screws, plates and/or rods to maintain alignment

Answer 63

Parkinson's disease is a movement disorder of the nervous system. Loss of dopaminergic neurons within the substantia nigra of the brain. These are neurons that secrete dopamine into parts of the basal ganglia (Key part that controls your body's voluntary movements) and therefore play a role in somatic motor control (skeletal muscle movements).

Answer 64

Tremor (resting) Rigidity or muscle stiffness Bradykinesia (Slowed movement) or akinesia (No movement (e.g. lack of initiating movement) The above signs can be associated with decreased facial movements/expression, postural & gait alterations and speech or swallowing alterations. Additional signs & symptoms develop due to the wider impact of dopamine loss in the brain and may include autonomic effects (e.g. drooling, constipation, urinary retention) and cognitive effects (e.g. depression, dementia).

Answer 65

No known cause It typically occurs after the age of 40 and is more common in males. Probably a specific genetic or environmental component.

Answer 66

No treatment to stop the disease are get neourns back. Levodopa (L-dopa): a dopamine precursor that is converted to dopamine by the remaining neurons in the substantia nigra (thus effectiveness reduces over time) Dopamine agonists: trigger dopamine receptors to stimulate the necessary neuronal signals Anticholinergics: dopamine-acetylcholine balance in the basal ganglia is important for proper signaling, as dopamine levels decrease, an imbalance develops, thus anticholinergics attempt to restore the balance Deep brain stimulation: electrical stimulation of certain brain regions to alleviate the symptoms associated with improper signaling Supportive care, e.g. physiotherapy, occupational therapy

Answer 67

State of increased muscle tone & rigidity

Answer 68

State of alternating muscle contraction & relaxation

Answer 69

A serious complication of epilepsy when seizure activity of tonic-clonic seizures (mostly) is sustained for longer than 5 minutes or there are recurrent seizures without recovery of consciousness in between. Status epilepticus is a medical emergency because seizure activity increases oxygen demand and ventilation is temporarily suspended during the seizure. Therefore is the seizure activity is sustained, the brain will quickly be deprived of oxygen. Cerebral hypoxia - neuronal death - respiratory failure. LIFE THREATENING

Answer 70

A disorder that affects a person's ability to think, feel and behave clearly. Psychosis "a severe form of mental disorder in which thinking is disconnected from external reality” Includes: - Sensory hallucinations - Delusions - Disorganized speech

Answer 71

Adding stuff thats not there Excess of normal experiences - Sensory hallucinations, delusions, disorganized speech and behaviour

Answer 72

MESOLIMBIC pathway in the brain – “reward pathway”. Pathway involved in addiction. Normally dopamine runs through this system and we get happy. Too much dopamine in this pathway is when schizophrenic symptoms arise. Dopamine is the chemical that attaches to receptors to trigger the feelings of reward. Reward causes an increase in dopamine in the mesolimbic system, but so does acute stress. It is thought that the purpose of this is to increase a feeling of reward to help get through a stressful situation. Chronic stress, however, will often decrease the amount of dopamine in the mesolimbic pathway. Additionally people with schizophrenia have more receptors so dopamine have more to bind to.

Answer 73

There are 5 kinds of dopamine receptors throughout the body. The D2-receptors are the main ones associated with schizophrenia. In patients with schizophrenia, there is noted to be an increase in D2-receptors in the mesolimbic pathway. Excessive activation of the D2 receptors in the mesolimbic pathway have been repeatedly related to the positive symptoms of schizophrenia.

Answer 74

Things we are taking away Reduction in normal function Apathy, lack of motivation, inability to initiate action, emotional blunting, poor concentration, decreased speech, decreased pleasure

Answer 75

Negative symptoms occur from TOO LITTLE dopamine through the MESOCORTICAL pathway. Starts at the same place as the reward pathway, but instead it runs to the front of the brain - Important in maintaining attention, working memory, and planning. - This pathway uses both dopamine and serotonin. - It is thought that by decreasing dopamine in this pathway that it comparatively increases serotonin, which leads to the negative symptoms.

Answer 76

Bipolar disorder is considered a mood disorder. Bipolar is noted to have both periods of mania and then later periods of depression

Answer 77

Bipolar symptoms are not due to a single neurotransmitter; however, there are changes in the balance of neurotransmitters in the brain during manic and depressive episodes. Manic Symptoms - Excessive excitement, agitation and energy (usually euphoria) - Risk taking behaviour (gambling, business investments) - Racing thoughts - Grandiosity with feelings of well-being and self confidence - Rapid, pressured speech (often tangential or with flight of ideas) - Highly distractible - Rapid heart rate, elevated blood pressure - Impulsivity; increased risk of suicide Bipolar Depression Symptoms - Anhedonia - Slowed movement/behaviour - Low mood or sadness - Fatigue - Guilt/worthlessness - Difficulty concentrating

Answer 78

In manic episodes, there is an increase in glutamate, noradrenaline, and dopamine. Glutamate causes an increase in excitability of the neurons, so more neurons are firing more frequently. It is extremely important in neuroplasticity and making new neural connections and learning. Glutamate levels are higher when awake – and manic episodes are often preceded by difficulty sleeping. However, too much glutamate over a long period leads to the death of neurons. Noradrenaline Normally released from the adrenal glands during acute stress. It is also a neurotransmitter for the sympathetic nervous system. Dopamine – may contribute to psychosis often (not always) found in acute mania During the depressive phase of bipolar, there is a decrease of noradrenaline

Answer 79

Block dopamine receptors so that the neurotransmitter dopamine cannot excite the next neuron in the pathway to signal

Answer 80

Haloperidol (Haldol) Zuclopenthixol (Accuphase) (There are 5 different dopamine receptors. Antipsychotics are antagonists to the D2 receptor – Blocking the D2 receptor reduces the positive symptoms of schizophrenia)

Answer 81

Sedation Extrapyramidal Side Effects: Movement dysfunction such as - Dystonia (continuous spasms and muscle contractions) - Akathisia (may manifest as motor restlessness), etc) - Rigidity (Cogwheel) Dopamine is one of the neurotransmitters that helps the basal ganglia maintain this fluidity.

Answer 82

Benztropine (Cogentin)

Answer 83

Block D2 receptors but also block Serotonin (5HT) receptors Blocking both receptors allows for a better balance between dopamine and serotonin Because 2nd Gen anti-psychotics do a better job balancing the dopamine and serotonin in this pathway, they do better at managing negative symptoms.

Answer 84

- Olanzapine - Risperidone - Quetiapine - Clozapine

Answer 85

Two important things to remember for 2nd Gen Antipsychotics Doesn't have (as much) - Extrapyramidal Side Effects; Tardive Dyskinesia; Sometimes sedation But has a is more associated with - Rapid weight gain (especially olanzapine) - Hypotension (they also block some receptors in the Sympathetic Nervous System) Risperidone: Hyperprolactinemia Quetiapine: Sedation

Answer 86

Clozapine is the most effective antipsychotic. However, it cannot be tried until the client has failed 2 other anti-psychotics. T his is because of the severity of the side effects: – Agranulocytosis (requires repeated blood tests) – Anticholinergic side effects – to the point of intestinal obstruction and hypersalivation – More extreme hypotension and sedation than the other 2nd generation

Answer 87

Narrow therapeutic range ■ There is a very small range between when lithium becomes effective and when it becomes toxic ■ Requires repeated blood tests to make sure client is in effective range The effects of sodium regulation ■ Because lithium is replacing sodium through the channels in the cell, changing the amount of sodium in the body can dramatically affect the lithium level. ■ Lithium is increased by anything that causes hyponatremia. What gets rid of sodium? – Vomiting, sweating, exercise, low sodium diets, high fever Medications that interfere with lithium ■ SSRIs and other anti-depressants – can cause serotonin syndrome ■ NSAIDS and other medications that affect the kidney, because the kidney excretes excess lithium Renal tubular damage may occur with prolonged therapy so monitoring of renal function is essential in patients on lithium therapy

Answer 88

lithium is a mood Stabiliser to treat bipolar disorder. Lithium is an element in the same row of the periodic table as sodium and potassium meaning it can flow through the same channels as sodium, but it doesn’t move out of cells as easily as sodium. Since the action potential to create and pass on signals from neurons is all based on the polarization of the cell due to moving sodium ions across it, lithium reduces the excitability of the neurons so that they can chill This causes a balance in the levels of neurotransmitters in the brain. Amazingly, lithium does not change the neurotransmission of people not affected by bipolar, so it stops excessive excitability without hindering appropriate excitability

Answer 89

1 to 3 weeks for a response from lithium. Goal range for acute phase: 0.8 1.2mmol/L Goal maintenance range: 0.6-0.8mmol/L Mild toxicity symptoms start at 1.5mmol/L

Answer 90

Early symptoms of lithium toxicity: Confusion, vomiting, tremor, slurred speech, increased sleep Late symptoms of lithium toxicity: Blurred vision, visual colour changes, ataxia, dysrhythmia, trembling, convulsions, increased urine

Answer 91

Gastric lavage; diuresis; hemodialysis

Answer 92

Nausea, anorexia, vomiting, diarrhoea Thirst and polyuria Tremor, weakness Hypothyroidism (due to interference with iodination) Mental confusion Teratogenesis Oedema and weight gain Nephrogenic diabetes insipidus

Answer 93

An unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage

Answer 94

Pain starts with stimulating primary nociceptors (first order neurons) (Sensory). Run from the perheery into the dorsal horn spinal cord/brain stem. - Neurotransmitter crosses over the synapse and causes action potential in second order neuron. SOD ends and transmit signals to thalamus, within the ascending spinothalamic tract of the spinal cord and brainstem. - Tertiary sensory neurons then transmit signals from the thalamus to other brain regions, including the: primary somatosensory cortex limbic system prefrontal cortex

Answer 95

The pain sensory nerves going to the brain or the spinal cord are damaged. Brain doesn't realise that the pain is coming from the nerve It localises the pain as coming from the place where the receptor is located. Presents as burning, numbness or electric shock

Answer 96

Diabetic neuropathy Neuralgias Complex regional pain syndromes

Answer 97

Unmyelinated axons are directly affected by hyperglycemia and ischemia by diabetes. The longer the axons the greater the risk for neurophy

Answer 98

The perception of pain occurs once nociceptive signals reach specific areas of the brain via tertiary sensory neurons.

Answer 99

Opioid analgesic Gold standard for potency, therapeutic effect, and side effects Obtained by opium poppies Morphine is not highly protein-bound (35%) and is relatively hydrophilic so crosses only slowly into the CNS

Answer 100

Opioid antagonists are medications that block the activation of opioid receptors in your central or peripheral nervous systems. In other words, these medications block the effects of opioids. They're key to treating opioid overdose, opioid use disorder and other conditions. respiratory depression

Answer 101

Naloxone and Naltrexone

Answer 102

A chemical that works by binding to opioid receptors. Receptors found in the CNS, PNS and the gi tract. Used to treat acute and chronic pain. Can alleviate severe delbitaibg pain

Answer 103

Tissue similar to the ones that grow in your uterus grow in other parts of your body. Ectopic endometrium called lesions respond to hormones, grow with blood supply, and break down/ shed- irritation & of the surrounding tissue - inflammation- scarring adhesion - It is not known what causes endometriosis; there are a few theories (e.g. retrograde menstruation, embryological tissue origin) and growing evidence that an improper immune response may be involved.

Answer 104

Hormonal therapy- Contreceptive pill Surgery to remove scaring/ lesions, hysterectomy, oophorectomy

Answer 105

Primary breast cancer is usually described as non-invasive or invasive and classified according to where the abnormal cell proliferation begins. Breast cancer is the most common cancer in females, but it can also occur in males (although is very rare).

Answer 106

Ductal carcinoma in-situ originates within the epithelial cells lining the ducts of the breast and the growing mass remains within the duct. This type carries the risk of becoming invasive ductal carcinoma. Lobular carcinoma in-situ is not really a breast cancer, as it is not invasive or potentially invasive. It is localized cell growth within the lobules.

Answer 107

Invasive ductal carcinoma is the most common type of breast cancer. It develops from cells lining the ducts of the breast that then spread to the surrounding tissue. There are a number of rarer, sub-types of invasive ductal cancer. Invasive lobular carcinoma is the second most common type of breast cancer. It originates with epithelial cells in the lobules that then spread to surrounding tissues.

Answer 108

early age of menarche and late age of menopause nulliparity or late 1st pregnancy genetics (e.g. BRAC genes) and family history environmental factors (e.g. poor diet, smoking, lack of physical activity, increased weight after menopause, alcohol use)

Answer 109

This is a twisting of the spermatic cord which disrupts blood supply to the testis. This can occur spontaneously, or as a result of physical exertion or trauma, most commonly in younger aged males around the time of puberty. Vascular engorgement and ischemia occur, which can eventually lead to testicular necrosis and loss of function.

Answer 110

There is typically a rapid onset of scrotal swelling and pain. Other signs & symptoms may include nausea/vomiting, fever, loss of the cremaster reflex and a horizontally positioned testis. Emergency management is required as irreversible changes can occur within 4-6 hours. It is treated with detorsion (manual untwisting), possibly followed by surgery.

Answer 111

Benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland. Common in men over 50. Often considered a normal part of aging.

Answer 112

Weak inconsistent stream of urine Have to strain when urinating Pain during urination Trouble initiating urination

Answer 113

- relieving obstruction & allowing urine to flow normally. Finasteride shrinks prostate gland by inhibiting conversion of testosterone

Answer 114

Spinal cord injury involves damage to the spinal cord that results in some alteration to normal function. The impact of the injury can range from temporary disruption of function to permanent loss of function. Spinal cord injury may be a result of trauma or disease processes that cause damage. Most commonly, spinal cord injury occurs due to trauma of the vertebral column associated with: motor vehicle accidents falls violence sporting injuries, e.g. diving

Answer 115

Total loss of sensory and motor functions below the lesion/level of injury.

Answer 116

Some level of function remains below the lesion/level of injury.

Answer 117

Temporary disruption of cord function.

Answer 118

Bruising of neural tissue with temporary loss of cord function.

Answer 119

Tearing of neural tissues with loss of cord function. Return of function may be possible with very minor damage, otherwise likely to be permanent loss.

Answer 120

Severing of spinal cord causing permanent loss of function.

Answer 121

Spinal cord injury involves the initial damage to the spinal cord (primary injury) The primary injury produces mechanical disruption to the vertebral column (e.g. vertebral fracture or dislocation), causing cord contusion, compression, laceration or transection. This focal damage of the spinal cord injures neurons and oligodendrocytes and disrupts vasculature and the blood-spinal cord barrier.

Answer 122

Secondary injury involves the cascade of events that result from the primary injury. These include microscopic hemorrhaging within the spinal cord and/or surrounding meninges and the infiltration of inflammatory chemicals and cells into the spinal cord. These subsequently cause swelling of the spinal cord which leads to functional impairment and vascular impairment. These factors then lead to further damage to the spinal cord (i.e. cellular dysfunction & death) via increased pressure and cord compression and ischemic injury.

Answer 123

Immediately following the primary injury, spinal shock occurs. Spinal shock involves the loss of spinal cord activity at and below the level of injury, including: loss of all reflexes (somatic & autonomic) paralysis of skeletal muscles decreased or no sensation pinal shock also results in an inability to activate thermoregulatory mechanisms (e.g. vasoactivity, sweating) and thus the individual's body temperature is determined by the external temperature. Spinal shock can last a few days to a few months and can make it difficult to determine the actual extent of injury and functional loss.