week 6 diseases of the nervous system

Question 1

nervous system diseases (3)

Answer 1

1. inflammatory/degenerative
2. trauma
3. postmortem conditions

Question 2

inflammatory diseases of the nervous system (14)

Answer 2

1. meningitis
2. hydrocephalus
3. encephalitis
4. myelitis
5. neuritis
6. epilepsy
7. rabies
8. multiple sclerosis
9. parkinsons diseases
10. alzheimers disease
11. CJD
12. cerebral palsy
13. transient ischemic attack
14. cerebrovascular accident

Question 3

infection of the cerebrospinal fluid by a virus or bacteria

Answer 3

meningitis

Question 4

the buildup of fluid in the cavities (ventricles) deep within the brain.

• excess fluid increases the size of the ventricles and puts pressure on the brain
• normally flows through the ventricles and baths the brain and spinal column

Answer 4

hydrocephalus

Question 5

viral inflammation of the Brain
-only occurs in rare cases such as herpes, simplex viruses like cold sores and genital herps (most common cause), varicella zoster virus (which causes chickenpox and shingles

Answer 5

encephalitis

Question 6

inflammation of the spinal cord which can disrupt the normal responses from the brain to the rest of the body and from the rest of the body to the brain. inflammation in the spinal cord can cause the myelin and axon to be damaged resulting in symptoms such as paralysis and sensory loss

Answer 6

myelitis

Question 7

inflammation of nerve or nerves

• sensory nerves affect sensation, temp, pain, vibration, or touch from skin
• motor nerves that control muscle movement
• autonomic nerves that control functions such as blood pressure, heart rate, digestion and bladder

Answer 7

neuritis

Question 8

a chronic neurogenic disease marked by sudden alterations in consciousness and frequently by convulsions
2 sub categories partial and generalized

Answer 8

epilepsy

Question 9

seizures that begin from a particular areas in the brain. consciousness is sometimes intact, sometimes reduced, and sometimes completely absent.

• most common form
• occurs in up to 2/3s of patients

Answer 9

partial (local or focal) seizures

Question 10

both hemispheres are involved with brain (epilepsy)

• always a disturbance of consciousness
• approx. 6% of patients have this type

Answer 10

generalized seizures

Question 11

viral infection of the nervous system that results encephalitis

Answer 11

rabies

Question 12

inflammatory autoimmune disorder that degrades the myelin sheath of nerves

Answer 12

multiple sclerosis

Question 13

chronic disease characterized by slowly spreading tremor, muscle weakness, and marked gait

• 4 symptoms considered cardinal;
• bradyinesia, tremor rigidity, and postural instability

Answer 13

parkinsons disease

Question 14

progressive, irreversible decline in mental function, memory impairment, reasoning, judgement, abstract thought and comprehension

Answer 14

Alzheimers disease /dementia

Question 15

rare, degenerative disorder that destroys brain cells and results in brain atrophy

• a rare brain disease that affects one person per million population each year, and occurs when a normal brain protein spontaneously changes into an infectious abnormal form called “prion” and accumulates in brain cells.
• people with the disease experience a rapid onset of dementia, and a range of neurological symptoms including walking difficulties, sudden jerky movements, and sometimes visual disturbances.
• patients usually die within one year following the onset of symptoms.
• autopsy is only way to confirm presence of disease

Answer 15

creutzfeldt-jakob disease

Question 16

• not transmissible from person to person by normal contact or through environmental contamination.
• transmission can occur during invasive medical procedures involving the central nervous system due to exposure to contaminated brain tissue.
• can be inherited by mutation.
• average age of death is 68 in US.

Answer 16

creutzfeldt-jakob disease cont’d

Question 17

procedures and routines embalming solutions are ineffective against “prions”; however, studies show that chemical solutions and physical processes involving bleach, sodium hydroxide, or autoclaving can inactivate the prion.

-if bodies of CJD patients haven’t been autopsied, then transportation, prep, disinfection, and final disposition can be safely performed when standard precautions are strictly enforced.

Answer 17

standard disinfection for CJD

Question 18

funeral service workers can safely remove the body of a CJD patient room for mortuary procedures using appropriate standard infection control measures, which includes wearing personal protective gear.

• WHO recommends placing the body in a leak proof pouch prior to moving
• bag should be lined with absorbent material to prevent leakage of body fluids.
• with excess fluid, a double bag should be utilized.
• after use, all surfaces should be disinfected.

Answer 18

transportation of CJD

Question 19

• an autopsied or traumatized body of a suspected or confirmed CJD patient can be embalmed using the precautions outlined in the WHO CJD infection control guidelines.
• CJD who haven’t been autopsied or not traumatized can be embalmed using standard precautions.
• family members should be advised to avoid superficial contact with a patient who has been autopsied.
• deceased who have not been autopsied , such contact need not be discouraged.

Answer 19

prep and dressing for CJD

Question 20

• emblaming bodies that haven’t been autopsied can be performed using standard precautions.
• place body in waterproof bag/sheet to collect bodily fluids
• make sure to use disposable instruments
• incision sites be closed with super glue, wiped down with bleach and body washed

Answer 20

emblaming CJD deceased not autopsied

Question 21

• special precautions for CJD deceased should be taken including placing a plastic sheet with absorbent wadding and raised edges underneath head to ensure containment of fluids and to prevent any spillage.
• cranial cavity should be packed with absorbent material and soaked in bleach and tightly sutured.

Answer 21

-CJD deceased who have been autopsied

Question 22

• avoiding unnecessary manipulation of CJD deceased that would force purging and risk of opening of incision sites.
• casket should be lined with leak proof sheet
• viewing should not be prohibited
• if autopsy has been performed, should avoid superficial contact

Answer 22

viewing of CJD deceased

Question 23

• according to WHO all collected fluids should be disinfected by adding 40 grams of sodium hydroxide pellets per liter of fluid. then left alone for an hour
• after hour, can be disposed like other biohazard waste.
• plastic sheets and other disposable items should be incinerated.
• work surfaces should be disinfected by flooding with undiluted bleach

Answer 23

terminal disinfection and waste removal of CJD deceased

Question 24

• no special interment, entombment, inurnment or cremation requirements for patients with CJD.
• does not present risk of environment

Answer 24

final disposition of CJD deceased

Question 25

chronic disorder characterized by impairment of motor control skills and movement

• group of disorders that affect movement and muscle tone or posture.
• caused by damage that occurs to the immature brain as it develops, most often before birth
• signs and symptoms appear during infancy or preschool years

Answer 25

cerebral palsy

Question 26

brief interruption of blood supply due to occlusion of cerebral vessel (mini stroke)

Answer 26

transient ischemic attack (TIA)

Question 27

an ischemic (blockage) or hemorrhagic (rupture) in a cerebral blood vessel that causes a loss of blood supply to brain tissues

Answer 27

cerebrovascular accident or stroke

Question 28

trauma subcategories (3)

Answer 28

1. concussion
2. contusion
3. intracranial

Question 29

the immediate and temporary disturbance of brain function as the result of trauma

Answer 29

concussion

Question 30

a bruise often accompanied by swelling

Answer 30

contusion

Question 31

contusion vs concussion

Answer 31

1. temporary loss of neuro function with no apparent structural damage lasting seconds to minutes ; most severe injury in which the brain is bruised with possible surface hemorrhage
2. jarring of brain that causes it to stop functioning momentarily ; unconscious for more than seconds to minutes

Question 32

bleeding between the skull bone and the dura

Answer 32

epidural/extradural

Question 33

bleeding between arachnoid membrane and the Pia layer

Answer 33

subarachnoid

Question 34

1. brain purge
2. hemorrhage
3. diminished circulation
4. discoloration

Answer 34

1. clear to pink edematous fluid in the nose and ears
2. escape of blood from the vascular system
3. wasting, decreased in size of an organ or tissue
   4 bruising of eyes (bilateral ecchymosis)