unit4 Flashcards
Frontal Lobe
Motor
Parietal Lobe
Sensory
Temporal Lobe
Hearing, Emotion, Memory
Cortex
inch gray matter
Occipital
Sight
Mid Brain,
Midbrain
Pons
Medulla
It contains 12 cranial nerves, and helps in the control of respiration, swallowing, wakefulness, and other activities
The central nervous system (CNS)
comprised of the brain and spinal cord
It communicates with the organs and body systems via the PNS
Its divisions include the cerebrum, cerebellum, and brain stem
spinal cord
runs from the brain through the vertebral column, stopping near the tailbone
The brain and spinal cord are covered in meninges, divided into the: Outer portion (dura mater) Middle layer (arachnoid) Inner layer (pia mater)
Cervical Cord section, Thoracic cord section, Cuada Equina section.
Ends at L2 (Lumbar 2)- Splits at cauda equina
peripheral nervous system (PNS)
comprised of the autonomic nervous system (ANS),
12 cranial nerves, and spinal nerves
It is divided into the:
Sympathetic nervous system – which controls changes in the body required to respond to stress (the “fight-or-flight” response)
Parasympathetic nervous system – which controls changes required to oppose stress (the “rest-and-digest” response)
spinal nerves
31 pairs: 8 cervical pairs 12 thoracic pairs 5 lumbar pairs 5 sacral pairs 1 coccygeal pair
Each spinal nerve sends sensory impulses from the body organs and skin surfaces to the brain, while motor impulses return impulses from the brain via the spinal cord
Nervous system disorders
Headache Nausea Vomiting Mood swings Fever Weakness
Disturbances in motor function include paralysis, seizures, and stiffness
Disturbances in sensory function include inability to speak, visual problems, and paralysis
cerebrospinal fluid (CSF)
obtained via lumbar puncture. Distinctive test for neuro.
Encephalitis
“inflammation of the brain tissue”
It may be commonly carried by mosquitos
It may cause fever, headache, and back or neck stiffness, leading to lethargy, mental confusion, and coma
It may be caused by bacteria, viruses, or other diseases such as chicken pox or measles
usually diagnosed by examining the CSF via lumbar puncture
Meds?
Meningitis
inflammation of the brain and the spinal cord meninges
usually a result of a bacterial infection
Such inflammation may involve all three meningeal membranes – the dura mater, arachnoid, and pia mater
Meningitis may cause:
High fever, Chills, Photophobia, Severe headache, Vomiting, Neck stiffness
This may lead to:
Drowsiness, Stupor, Seizures, Coma
It is usually caused by bacterial or viral agents, and is almost always a complication of bacteremia (bacteria in the blood).
diagnosed by a lumbar puncture, which shows: Cloudy or milky-white CSF Elevated CSF pressure Decreased glucose level High protein level
usually response well to appropriate IV antibiotics
Poliomyelitis
Seems to be increasing recently
caused by a virus entering the body via the gastrointestinal tract, and manifesting in the spinal cord and brain stem
Rabies
a form of encephalomyelitis that may be fatal
acute viral disease of the central nervous system, transmitted from animals to people through infected saliva
(Neuro toxin)
Once fully manifested (Incubation period), rabies causes delirium, severe encephalitis, muscular spasms, seizures, paralysis, coma, and death
Diagnosis: based on patient history and physical examination that checks for muscle spasms, pain, and stiffness
cauterized and injected with immune globulin
immunizations must be started immediately, involving a series of 5 IM (Intramuscular) injections
Shingles
acute infection caused by the varicella zoster virus (VZV)
Nearly ½ of shingles patients have experienced “chicken pox” previously (caused by the same virus)
Shingles causes an itching, painful, red-colored rash as well as vesicles that follow the path of one of the sensory nerves
Tetanus
acute, potentially fatal infection of the central nervous system
irritability, headache, fever, and painful spasms of the muscles resulting in “lockjaw” and laryngeal spasm
via (usually) puncture-type wounds
Cerebrovascular Accident (CVA)
Also known as a stroke or brain attack
usually occurs in people over age 50, and is a major cause of death in this age group
A CVA is a sudden impairment of cerebral circulation in one or more blood vessels
This interrupts or lessens oxygen supply, usually causing serious damage or necrosis in brain tissue
CVA may cause sudden unconsciousness, permanent neurologic disability, or death
Symptoms are based on the part of the brain affected and the severity of the CVA
Stroke typically results from cerebral embolism, thrombus, or hemorrhage
Risk factors include: hypertension and family history of stroke or transient ischemic attacks
Aneurysm/stroke
Left-side body system damage is indicative of right-side brain damage, and vice versa
transient ischemic attack (TIA)
an episode of cerebrovascular insufficiency
It is usually associated with partial occlusion of a cerebral artery by an atherosclerotic plaque or an embolus
Common symptoms include dizziness, limb weakness, numbness, slurred speech, and brief or mild loss of consciousness
are warning signs of an impending stroke
A common surgery to correct bloodflow for TIA is a carotid endarterectomy
Bell’s palsy
affects the 7th (VII) cranial nerve (facial nerve) to cause one-sided (unilateral) paralysis of the face
Signs and symptoms usually result from interference in motor function
It is of idiopathic origin, but may be caused by viruses, Lyme disease, hypertension, diabetes mellitus, hemorrhage, meningitis, tumor, local trauma, sacroidosis, and autoimmune disorders
Epilepsy
chronic brain disease caused by intermittent electrical activity
Incidence is highest during childhood and in the elderly, involving recurring seizures (“sudden attacks”) – not all seizures are characterized by convulsions
About ½ of all seizure disorder cases are idiopathic
treated with anticonvulsive medications
Headache
(cephalgia) is usually a symptom of another disease state
main fissures(2)?
The prime fissures are the longitudinal fissure
(separates L and R cerebrum) and lateral fissure
(separates the temporal lobe from the frontal & parietal
the (2) main sulci, their associated lobes & prime function
gyrus= in frontal lobe = motor function.
Post central gyrus= in parietal lobe = sensory function
Where is the gray matter in the cerebrum located generally (2)
grey matter of brain is located: in the cerebral cortex (outer 1 in) and Basal ganglia area (deep central cortex)
What structures comprise the diencephalon? And where are they located?
diencephalon includes the thalamus and hypothalamus. The diencephalon is located above the brainstem. The hypothalamus is anterior to thalamus
What are the (2) main functions of the cerebellum?
cerebellum controls fine movement and coordination
what is the function of the thalamus & hypothalamus?
Thalamus fx= relay of sensory/motor tracts Hypothalamus= temp, wakefulness, homeostasis
what (3) structures make up the brainstem?
Midbrain, pons, medulla oblongata
what are the general functions of the “brainstem”?
respiration, swallowing, wakefulness, cranial nerves originate
What brain structure contains arbor vitae?
found in the cerebellum
What is the structure that connects the cerebral hemispheres?
corpus collosum
What are the ventricle names that circulate the CSF (cerebral spinal fluid)?
Third x2, then cerebral acqueduct, then fourth ventricle.
What brain structure is referred to as the “little brain”
cerebellum
what are the names of the (3 meninges) that surround the brain and spinal cord?
Outer portion (dura mater) Middle layer (arachnoid) Inner layer (pia mater)
what is the name of the condensed spinal cord region at the L2 level called?
Conus Medullaris
what is the name given to the spinal cord fibers after L2 called?
Cauda equina
What type of matter is the butterfly-shaped inner region of the spinal cord versus the outer region matter?
gray matter
What type of matter do the ascending/descending tracts primarily utilize?
white matter, why? Because it’s myelinated= faster
How many pairs of spinal nerves are there?
31 pairs of spinal nerves
(Spinal Nerves) What are the divisions and # of each of the divisions?
8 cervical, 12 thoracic, 5 Lumbar, 5 Sacral, Coccygeal 1
Afferent means what in relation to spinal nerves?
Sensory-ingoing through dorsal root
Efferent means what in relation to spinal nerves
motor- outgoing through ventral root
What are the two divisions of the Peripheral Nervous System (PNS)?
Somatic and Autonomic Nervous system.
Somatic “voluntary” control r/t to skeletal muscles
Autonomic- “involuntary” control = sympathetic and parasympathetic divisions
Are the (12) cranial nerves and (31) spinal nerves part of the peripheral nervous system?
Yes
the first six cranial nerves in order?
olfactory, optic, oculomotor, trochlear, trigeminal, abducens
the last six cranial nerves in order?
facial, vestibular cochlear, glossopharyngeal, vagus(x), spinal accessory, hypoglossal,
What cranial nerve is noted for most parasympathetic effects?
Oculomotor
Which cranial nerve provides taste, facial movements, and saliva?
Facial
which cranial nerve provides trapezius shrugging and head turning?
Accessory
Olfactory (I)
Smell
Optic (II)
Sight
Oculomotor (III)
Eyelid, pupil, eyelid movement
Trochlear (IV) and Abducens (VI)
Eyeball movement
Trigeminal (V)
face and mouth pain, temperature, and touch; chewing
Facial (VII)
taste, facial movement, saliva secretion
Auditory (VIII)
hearing, balance
Glossopharyngeal (IX)
swallowing, saliva secretion, taste, sensation in mouth and pharynx
Vagus (X)
pharyngeal, laryngeal, chest, and gastrointestinal system movement and sensation
Accessory (XI)
head and shoulder movement
Hypoglossal (XII)
tongue movement
What is the most important neurologic laboratory test
analyzing the cerebrospinal fluid (CSF), obtained via lumbar puncture
Are neurological infections more common in the young?
yes
Encephalitis is defined as? & common mode of transmission
“inflammation of the brain tissue”, common mode of transmission= mosquitoes
What are the S/S of Encephalitis?
It may cause fever, headache, and back or neck stiffness, leading to lethargy, mental confusion, and coma
What are the cause/s of Encephalitis?
It may be caused by bacteria, viruses, or other diseases such as chicken pox or measles
How is Encephalitis Dx’d?
CSF culture, electroencephalogram, CT , MRI, & radionuclide scans
How is Encephalitis Tx’d?
antiviral medication with varying degrees of effectiveness
What is Meningitis?
inflammation of the brain and the spinal cord meninges
What type of microorganism is the typical cause of the Meningitis infection?
Bacterial most common
S/S of Meningitis may cause? (6)
High fever, Chills, Photophobia, Severe headache, Vomiting, Neck stiffness
may lead to:
Drowsiness, Stupor, Seizures, Coma
A complication is often related to what condition?
complication of bacteremia
Poliomyelitis: Is the incidence less or greater than in the past?
Incidence is less than in past
Poliomyelitis: What is the microorganism, mode of entry, AND what nervous system structures does it affect?
Caused by a virus entering the body via the gastrointestinal tract, and manifesting in the spinal cord and brain stem
What is the term to describe the effects of those who have had polio that may experience later progressive effects?
progressive muscle decline later in life= (“postpolio syndrome”)
What potentially fatal (condition) or form is Rabies known as?
encephalomyelitis
Rabies
a) What microorganism is the cause
b) what part of the nervous system does it affect
c) AND how is it transmitted?
a) Acute viral disease
b) of the central nervous system
c) transmitted from animals to people through infected saliva
Rabies: What are the S/S?
delirium, severe encephalitis, muscular spasms, seizures, paralysis, coma, and death
Rabies: Dx’d?
exam (spasm, pain, stiffness), animal biopsy, & physical
Rabies: Tx’d?
Immunoglobulin + 5 series IM immunizations
Shingles: What is the microorganism cause & name?
an acute infection caused by the varicella virus (VZV), which mainly affects older adults
What % of those dx’d with Shingles, had a hx of chicken pox?
50% have had h/o of chicken pox
Shingles: S/S?
itching, painful, red-colored rash as well as vesicles that follow the path of one of the sensory nerves
Shingles: DX?
lesions, blood test for HZVirus
Shingles: TX?
depends on severity: antivirals, antipruritics(anti-itch), and analgesics
What year was vaccination for shingles 1st used and for what age?
2006 vaccination for > 60
Tetanus: What is the a) microorganism and b)mode of transmission?
a) bacterial- neurotoxin, affects CNS
b) puncture wound
Tetanus: Could this condition be fatal?
yes
Tetanus: Is the DPT immunization as a child enough if you reach adulthood?
No, typically need a booster every 5-10yr to be immune as immunology cannot be conferred.
Tetanus: S/S characteristics?
irritability, headache, fever, and painful spasms of the muscles resulting in “lockjaw” and laryngeal spasm
Cerebrovascular Accident (CVA): is a major cause of death for those over 50 y/o?
True
What is the cause of a CVA?
a sudden impairment of cerebral circulation in one or more blood vessels
This interrupts or lessens oxygen supply, usually causing serious damage or necrosis in brain tissue
What is the most common cerebral artery that supplies the parietal and temporal lobes?
Middle cerebral Artery
what cerebral artery supplies the frontal lobe?
Anterior cerebral Artery
What are the three types of causes/types of CVA?
cerebral embolism, thrombus, or hemorrhage
CVA: What are two risk factors?
Family hx of CVA/TIA, HTN (HYPERTENSION)
What type of CVA would occur related to opening of an aneurysm?
hemorrhage
CVA: DX’d
EEG, CT, or MRI
A left Cerebral infarct would affect which side of the body?
Right body presentation/dysfunction due to L CVA
CVA: Tx’d
Anticoagulant, HTN meds
Transient Ischemic Attack (TIA) is an episode of cerebrovascular _______
cerebrovascular insufficiency. Temporary
Transient Ischemic Attack (TIA) is usually associated with __________ occlusion of a cerebral artery by an atherosclerotic plaque or an embolus
partial occlusion of a cerebral artery by an atherosclerotic plaque or an embolus
Transient Ischemic Attack (TIA): S/S
dizziness, limb weakness, numbness, slurred speech, and brief or mild loss of consciousness
Transient Ischemic Attack (TIA): Dx test
Arteriogram
A common surgery to correct bloodflow for TIA is a?
carotid endarterectomy procedure may be used to correct TIA artery blockage
Bell’s palsy affects the _______( #, name)cranial nerve?
Facial nerve #7 (VII)
Bell’s palsy: S/S and is it unilateral or bilateral? It is of idiopathic origin, but may be caused by viruses, Lyme disease, hypertension, diabetes mellitus, hemorrhage, meningitis, tumor, local trauma, sacroidosis, and autoimmune disorders
unilateral facial droop (usually result from interference in motor function)
Bell’s palsy: TX meds: (2)
Analgesics and anti-inflammatory medications (corticosteroids) and other measures may include warm, moist heat; massage; and/or electrotherapy
Epilepsy definition?
chronic brain disease caused by intermittent electrical activity
Epilepsy: what % is idiopathic cause?
50%
Epilepsy: characterized by seizures, but not all seizures are characterized as: _____________
convulsions
Epilepsy: Dx tests (3)
by more than 1 seizure via EEG, CT, or skull x-rays
Epilepsy: Med Tx?
anticonvulsants
what is another name for Headache (HA)?
(cephalgia)- is usually a symptom of another disease state
what are the two types of physiological causes of HA’s? (2)
physiologic cause: by tense facial, scalp, and neck muscles, as well as dilation or constriction of the vessels inside the head (muscular or vascular). Also be head trauma, insomnia, substance abuse,
Headache (HA): They may be acute or chronic, and caused/triggered by (6)
Allergies, Noise, Stress, Lack of sleep, Toxic fumes, Consumption of alcohol
Headache (HA): DX tests used
skull x-rays, EEG, CT, MRI, cranial nerve testing, arteriogram, lumbar puncture, and CSF testing
Headache (HA): general TX
different medications, diet, exercise, and adequate sleep
Parkinson’s: What sex & age is the condition more prevalent?
Prevalent in men >50’s
Parkinson’s: Definition?
slow progressive brain disorder involving the basal ganglia/substantia nigra region with brain cells that have deficient dopamine
Parkinson’s: It characteristically produces? (3) S/S:
Progressive muscle rigidity, Akinesia, involuntary tremor
Parkinson’s: common physical manifestations (6)
Rigid, immobile hands, Slow speech, Fine tremor- “pill-rolling” motion of the fingers, Infrequent blinking, An expressionless face, Flexed arms, “bent-forward” posture, walking gait with short, quick steps
Parkinson’s: is it curable? What med tx is given?
not curable- but dopamamine med (L-dopa)
Dementia definition?
a loss of mental ability because of loss of brain cells or neurons
what are the types of dementia?
a) senile (old) cells degenerate naturally
b) Vascular dementia is considered a form of senile dementia because it usually occurs in older adult
c) head trauma
d) substance abuse
dementia: tx meds
vascular (HA) hippuric acid including cholinesterase inhibitors and memantine
Alzheimer’s disease is a degenerative disorder of the __________, especially the frontal lobe
cerebral cortex esp frontal lobe deterioration of cells
Alzheimer’s: how many years could the condition develop to late stage?
10 years could take to progress to late stage
Alzheimer’s: what is the cause? Is there a cure?
no known cause, but has been linked to heredity, autoimmunity, toxicities- mercury eg, and viruses. NO CURE- some meds slow progression
Alzheimer’s: Dx tests?
MRI,CT to see plaques
Definition of apnea # of periods ____ lasting for ____sec during every ___ hour of sleep.
10 secs during every 1 hour
Brain Tumor manifestations result from increased ________ pressure
increased intracranial pressure
Brain Tumor Tx
chemotherapy, radiation, and surgery, dependent on the type and location of the tumor
Traumatic brain injury (TBI)
is a complex injury with many symptoms and disabilities
concussion
head trauma that does not physically bruise the brain tissue
contusion
more serious than concussion, and is defined as a physical bruising of the brain tissue
main symptom of both a concussion and a contusion
unconsciousness, and there may also be amnesia following the event
epidural hematoma
“a collection of blood between the skull and dura mater”
subdural hematoma
“collection of blood between the dura mater layer and the arachnoid layer”
S/S of a hematoma
dilated pupils, headache, nausea, vomiting, dizziness, increased intracranial pressure, loss of consciousness, hemiparesis, and convulsions
Tx hematoma
reduce ICP, and may include craniotomy and cauterizing of tissue
Spinal Cord Injury: what is the term to describe the lower body that has been affected?
paraplegia
Spinal Cord Injury: what is the term to describe when UE/LE are all affected?
quadriplegia
Spinal cord injury often causes loss of feeling and movement (_______) the area of injury
below the level
When the C1-C3 area of the spinal cord is injured, it is often fatal, due to?
the breathing centers in the medulla being affected when C1-3 levels are involved
what is the condition called whereby damage to ½ of the spinal cord is affected?
Brown Sequard syndrome
Amyotrophic Lateral Sclerosis (ALS) Definition? And also known by what name?
a degenerative disease that affects the upper and lower motor neurons, and is commonly called “Lou Gehrig’s disease”
(ALS) Possible prognosis in years?
debilitating progressive- could fatal in 1 year
(ALS) Age range of onset? And gender?
age range 40-70, Men 3x more common
Guillain-Barre Syndrome: Definition
lastGuillain-Barre syndrome is an acute, progressive spinal nerve disease of unknown origin
Guillain-Barre Syndrome: S/S
It causes fever, malaise, nausea, muscle weakness, paresthesia, and paralysis
Guillain-Barre Syndrome: how long do the symptoms progress and recovery can last?
Symptoms can progress to several weeks, and recovery can take up to one year
Huntington’s Chorea: Definition
This genetic disease affects half of children in families in which one parent has the dominant gene
Huntington’s Chorea: age appear?
It does not appear until middle age
Huntington’s Chorea: s/s key (3)
progressive brain deterioration, loss of muscle control, and chorea
Huntington’s Chorea: is there a cure?
There is no cure, and treatment is supportive
Multiple Sclerosis (MS): definition?
a chronic inflammatory disease involving demyelinization of the white matter of the brain and spinal cord
Multiple Sclerosis (MS): S/S (6ish)
lack of coordination, muscle weakness or numbness, unsteady gait, paresthesia, vertigo, difficulty speaking, etc.
Multiple Sclerosis (MS): Med tx Acute attacks vs Chronic?
a) Acute attacks are treated with corticosteroids
b) Chronic forms are treated with interferons, immune modulators
Myasthenia Gravis: definition?
Myasthenia gravis is a chronic and progressive neuromuscular disease that appears to develop from the presence of autoantibodies to the acetylcholine receptor (affects the NMJ)
Myasthenia Gravis: symptom presentation
causes severe muscular weakness and progressive fatigue
Myasthenia Gravis: Does this condition cause muscle atrophy?
not cause muscular atrophy
