Neuro #2 - Info For The Final

Front 1

a sudden explosive, disorderly discharge of cerebral neurons and is characterized by a sudden, transient alteration in brain function, usually involving motor, sensory, autonomic, or psychic clinical manifestations and an alteration in arousal

Back 1

seizure

Front 2

a general term for the primary condition that causes seizures

Back 2

epilepsy

Front 3

a seizure lasting more than 30 minutes

repeated seizures 1 right after the other prior to the person regaining consciousness

general from abruptly stopping seizure meds, untreated, or inadequately treated people

It is an emergency, because of the cerebral hypoxia that can result resulting in mental retardation, dementia, or even death.

Back 3

status epilepticus

Front 4

seizure that begins locally and is confined to one part or one group of muscles

Back 4

partial seizure/jacksonian seizure/focal motor

Front 5

seizure that affects both hemispheres of the brain

Back 5

generalized seizure

(grand mal, limited grand mal, or petit mal)

Front 6

Time period that follows a seizure.

People will sleep, and often do not remember the seizure. They will wake up frightened, wondering what has happened.

Length of time it lasts varies.

Back 6

postictal phase

Front 7

a state of muscle contraction in which there is excessive muscle tone

Back 7

tonic phase

Front 8

a state of alternating contraction and relaxation of muscles

Back 8

clonic phase

Front 9

the person is awake, but unresponsive to you

rapid eye movements, repeating of words

Back 9

focal gaze

(CM of partial/focal seizures)

Front 10

a partial seizure experienced as a peculiar sensation preceding the onset of generalized seizure that may take the form of gustatory, visual or auditory experience or a feeling of dizziness, numbness, or just a "funny feeling"

Back 10

aura

Front 11

early clinical manifestations, such as malaise, headache, or depression, that may occur hours to a few days before the onset of a seizure

Back 11

prodroma

Front 12

What is the treatment for a seizure?

Back 12

anti-epileptic drugs
diazepam
avoidance of triggers

Front 13

What are the nursing implications for a seizure?

Back 13

Teach the patient and family about the disorder, medications and importance of strict adherence, triggers, seizure precautions.

Driving and work restrictions: They must be stable on their medication and no seizure activity for 6 months to get their drivers license restored.

They should not work or drive heavy machinery, climb, use blades, etc

Front 14

a defect of pattern recognition--a failure to recognize the form and nature of objects

Back 14

agnosia

Front 15

impairment of comprehension or production of language

happens in people who have had a stroke

Back 15

dysphasia

Front 16

loss of the comprehension or production of language

happens in people who have had a stroke

Back 16

aphasia

Front 17

inability to write

Back 17

agraphia

Front 18

an acute state of confusion that results from cerebral dysfunction secondary to drug intoxication, metabolic disorders, or nervous system disease

Back 18

delirium

Front 19

What are the CM of delirium?

Back 19

difficulty in concentration
restlessness
irritability
tremulousness
insomnia
poor appetite

Front 20

What is the treatment for delirium?

Back 20

Treat the underlying cause.

Front 21

a chronic state of confusion caused by degeneration, compression, atherosclerosis, or trauma

Back 21

dementia

Front 22

What is the test used to evaluate a person for dementia?

Back 22

mini-mental exam

Front 23

A progressive degenerative disorder of the cerebral cortex

It accounts for more than ½ of all dementias.

Back 23

Alzheimer disease

Front 24

What is the last thing to go in an Alzheimer patient?

Back 24

long term memory

Front 25

What disease can only be confirmed after death?

Back 25

Alzheimers

Front 26

What are the nursing implications for Alzheimer disease?

Back 26

support, safety, medications, information, support groups for families, etc.

Front 27

What are the CM of Alzheimer disease?

Back 27

Initially, symptoms include forgetfulness, subtle memory loss, difficulty learning and retaining new info, inability to concentrate, and deterioration in personal hygiene and appearance.

Later, there is difficulty with judgment, communicating, restlessness, combativeness, nocturnal awakening, and disorientation.

Front 28

What is normal intracranial pressure (ICP)?

Back 28

5-15 mm Hg or 60-180 cm H20

Front 29

What are some diseases/disorders that can affect ICP?

Back 29

herniation
hemorrhagic stroke
tumor
hematoma
hydrocephalus
cerebral edema

Front 30

something used to evaluate a person neurologically

evaluates eye opening, verbal and motor responses

Back 30

Glasgow coma scale

Front 31

On the Glasgow coma scale, would a mild head injury or severe head injury have more points?

Back 31

mild head injury

Front 32

decreased muscle tone

Back 32

hypotonia

Front 33

increased muscle tone

Back 33

hypertonia

Front 34

a gradual increase in muscle tone causing increased resistance until tone suddenly is reduced

a type of hypertonia

Back 34

spasticity

Front 35

type of hypertonia

muscle resistance to passive movement of a rigid limb that is uniform in both flexion and extension throughout the motion

Back 35

rigidity

Front 36

decreased movement

loss of voluntary movement despite preserved consciousness and normal peripheral nerve and muscle function

Back 36

hypokinesia

Front 37

partial paralysis with incomplete loss of muscle power

a type of hypokinesia

Back 37

paresis

Front 38

loss of motor function so that a muscle group is unable to overcome gravity

a type of hypokinesia

Back 38

paralysis

Front 39

excessive movement

Back 39

hyperkinesia

Front 40

abnormal, involuntary movement

Back 40

dyskinesia

Front 41

a decrease in associated and voluntary movements

caused by a deficiency in dopamine or a defect of the postsynaptic dopamine receptors

Back 41

akinesia

Front 42

slowness of voluntary movements

Back 42

bradykinesia

Front 43

an increase in the fluid content of brain tissue

occurs after brain insult from trauma, infection, hemorrhage, tumor, ischemia, infarct, or hypoxia

Back 43

cerebral edema

Front 44

involves the head striking a hard surface or a rapidly moving object striking the head

the dura remains intact, and brain tissues are not exposed to the environment

Back 44

closed (blunt) trauma

Front 45

occurs when a break in the dura results in exposure of the cranial contents to the environment

Back 45

open (penetrating) trauma

Front 46

an injury to parts of the brain located on the side opposite that of the primary injury, as when a blow to the back of the head forces the frontal and temporal lobes against the irregular bones of the anterior portion of the cranial vault

Back 46

contrecoup

Front 47

bruising and bleeding that occurs from the force of impact

impact causes small tears in blood vessels

Back 47

contusion

Front 48

a swelling comprising a mass of extravasated blood (usually clotted) confined to an organ, tissue, or space and caused by a break in a blood vessel

Back 48

hematoma

Front 49

What is usually the cause of a subdural hematoma?

Back 49

head injury/trauma

Front 50

What can a subdural hematoma lead to?

Back 50

increased ICP and herniation

Front 51

an injury resulting from impact with an object

partial or complete loss of function, as that resulting from a blow or fall

may or may not lose consciousness

Back 51

concussion

Front 52

What are the CM of postconcussive syndrome?

Back 52

headache
nervousness
anxiety
irritability
insomnia
depression
inability to concentrate
forgetfulness
fatigability

Front 53

injury to the cervical vertebrae and adjacent soft tissues produced by a sudden jerking or relative backward or forward acceleration of the head with respect to the vertebral column

Back 53

whiplash

Front 54

common in people 30 to 60 years of age and older

caused by biochemical and biomechanical alterations of the intervertebral disk tissue

Back 54

degenerative disk disease (DDD)

Front 55

disease marked by progressive cartilage deterioration in synovial joints and vertebrae

people complain of being stiff in the morning before exercise

Back 55

degenerative joint disease (DJD)

Front 56

structural defect involving the neural arch of the vertebra

affects lumbar spine most often

Back 56

spondylolysis

Front 57

occurs when a vertebra slides forward in relation to the vertebra below, commonly occurring at L5-S1

Back 57

spondylolisthesis

Front 58

a narrowing of the spinal canal caused by degenerative or traumatic changes at the level of the lumbar vertebrae

causes a lot of pain

Back 58

spinal stenosis

Front 59

degeneration of the sciatic nerve

causes pain in the back of the thigh

Back 59

sciatica

Front 60

a protrusion of part of the nucleus pulposus through a tear in the posterior rim of the annulus fibrosus

usually caused by trauma, DDD, or both

Back 60

herniated intervertebral disk

Front 61

any disease of a nerve root

Back 61

radiculopathy

Front 62

any disease of the nerve

causes numbness and tingling in the joints

Back 62

neuropathy

Front 63

Third leading cause of death and disability in the US, mainly occurring in older adults . Incidence is greater in blacks and women.

a sudden, nonconvulsive focal neurologic deficit

Back 63

cerebrovascular accident/CVA/stroke

Front 64

What are the risk factors for having a stroke?

Back 64

hypertension
smoking
diabetes
polycythemia
thrombocythemia
presence of lipoprotein-a
impaired cardiac function
atrial fibrillation

Front 65

occurs when the cerebral arteries are occluded by plaques. The plaques either occludes completely or breaks off and travels upstream.

Back 65

thrombotic stroke

Front 66

An artery that contains blockage may spasm, causing neuro deficits that resolve in 24 hours with no residual dysfunction.

a "mini-stroke"

Back 66

transient ischemic attack (TIA)

Front 67

the terminology used for thrombotic stroke because symptoms are slowly progressive over minutes to hours

Back 67

stroke-in-evolution (progressive stroke)

Front 68

a thrombotic stroke that has reached its maximum destructiveness

Back 68

completed stroke

Front 69

type of stroke that involves fragments that break from a thrombus formed outside the brain, in the heart, aorta, or common carotid

Back 69

embolic stroke

Front 70

What are the risk factors for an embolic stroke?

Back 70

atrial fibrillation
myocardial infarction
endocarditis
rheumatic heart disease
carotid artery plaques

Front 71

Why does a second stroke often follow an embolic stroke?

Back 71

because the source continues to exist

Front 72

type of stroke caused by the rupture of a cerebral artery or vein that results in blood loss into the ventricular system.

Sx are abrupt in onset, and loss of consciousness is common.

Back 72

hemorrhagic stroke (intracranial hemorrhage)

Front 73

What are the risk factors for a hemorrhagic stroke?

Back 73

long term elevation of systolic BP
aneurysms
bleeding into a tumor
head trauma
illicit drug use

Front 74

small area of infarct that occur in hypertension and diabetes, less than 1 cm in diameter

Back 74

lacunar stroke

Front 75

What are the CM of a stroke?

Back 75

Depend on the area of the brain involved.

Cerebral edema occurs and takes up to 2 weeks to resolve, so degree of disability is not easily determined initially.

Front 76

What are the CM of a hemorrhagic stroke?

Back 76

acute headache and sudden LOC

If the patient goes into a deep unconscious state, the person rarely survives.

Front 77

What is the treatment for a thrombotic stroke?

Back 77

TPA, an anticoagulant drug

Front 78

What is the treatment for a hemorrhagic stroke?

Back 78

surgery

Front 79

What are the nursing implications for a stroke patient?

Back 79

Always keep the patient’s head elevated to prevent cerebral edema and promote venous return.

Front 80

Generally benign reoccurring headache often triggered by stress, hunger, fatigue, red wine, nitrates, MSG, chocolate, cheese, hormonal fluctuation, medications.

Generally, unilateral.

Back 80

migraine

Front 81

What is the treatment for a migraine?

Back 81

medication
dark room
rest

Front 82

type of headache that occurs primarily in men

several attacks can occur during the day for several days, followed by none for weeks or months. It can occur without warning, and can be severe, unilateral tearing, burning periorbital pain lasting 30-120 mins.

Usually occurs at the same time of day, and on the same side

Back 82

cluster headache

Front 83

What are the CM of cluster headache?

Back 83

lacrimation
reddening of the eye
nasal stuffiness
eyelid ptosis
nausea
pain referred to the face and teeth.

Front 84

Most common type of headache

mild to moderate band like or pressure around the head without other associated symptoms

Back 84

tension-type headache

Front 85

What are the 2 types of cerebral tumors?

Back 85

primary intracerebral
primary extracerebral

Front 86

infection of the meninges

Back 86

meningitis

Front 87

What are some causes of meningitis?

Back 87

bacteria
viruses
fungi
tuberculosis (TB)

Front 88

What are the CM of meningitis?

Back 88

nuchal ridigity (inflexibility of neck movement)
Kernig sign
Brudzinski sign

Front 89

inability to extend the leg with the hip flexed at a right angle

CM of meningitis

Back 89

Kernig sign

Front 90

flexion of the legs and thighs with forceful flexion of the neck onto the chest

CM of meningitis

Back 90

Brudzinski sign

Front 91

How is meningitis treated?

Back 91

antibiotics

if it is viral, use supportive measures

Front 92

What are the nursing implications for meningitis?

Back 92

Neuro exam - looks for changes in LOC
Seizure precautions
Support patient and family

Front 93

localized collection of pus within in the parenchyma of the brain and spinal cord

often occur after trauma, neurosurgery, ear infection, or infection

Back 93

abscess

Front 94

What are the CM of an abscess?

Back 94

fever
changes in LOC
seizures
headache
N/V
nuchal rigidity
confusion

Front 95

What is the treatment for an abscess?

Back 95

treat cause
antibiotics
ventilation
nutrition
wound care
lumbar puncture
supportive therapy

Front 96

an acute febrile illness, usually of viral origin, with nervous system involvement

inflammation of the white and gray matter of the brain

causes increased intracranial pressure

Back 96

encephalitis

Front 97

What is the most common cause of encephalitis?

Back 97

virus

*can be caused by HIV

Front 98

What is the treatment for encephalitis?

Back 98

anti-viral drugs
lumbar puncture

Front 99

What can HIV cause?

Back 99

cerebral complications

Front 100

What carries Lyme disease?

Back 100

ticks

Front 101

disease that can cause encephalitis, meningitis, meningeal inflammation

Back 101

Lyme disease

Front 102

How is Lyme disease treated?

Back 102

antibiotics

Front 103

degenerative disorder involving the dopamine receptors, causing deficiency, otherwise etiology is unknown

thought caused by genetics, exposure to toxins (manganese dust, CO)

generally affects men aged 40 and up.

Back 103

Parkinson disease

Front 104

What are the CM of Parkinson disease?

Back 104

muscle rigidity
tremors
akinesia (gait and movement disturbances)
mask-like facial expression
drooling
higher pitched voice
impaired speech
difficulty swallowing

Front 105

What is the treatment for Parkinson disease?

Back 105

drug therapy to treat symptoms

Front 106

What are the nursing implications for Parkinson disease?

Back 106

psychosocial support
education
physical therapy

Front 107

Primary demyelinating disorder leading to widespread neurologic dysfunction (forms hard yellow plaques of scar tissue)

It does not affect the PNS.

Generally affects people age 20-50, and twice as many women as men.

Back 107

Multiple sclerosis (MS)

Front 108

What are the CM of multiple sclerosis?

Back 108

Initially vision problems and sensory impairment such as parathesias that can be transient.

Later, blurred vision, diplopia, poorly articulated speech, muscle weakness and spasticity, hyperreflexia, urinary problems, tremor, gait ataxia.

Front 109

What is the treatment for multiple sclerosis?

Back 109

steroids
muscle relaxants
meds for urinary retention
physical therapy
supportive measures

Front 110

What are the nursing implications for multiple sclerosis?

Back 110

exercises to improve urinary retention
assistive devices
exercises
psycho/social supportive measures
support groups

Front 111

degenerative disorder diffusely involving lower and upper motor neurons resulting in progressive muscle weakness

Back 111

amyotrophic lateral sclerosis (ALS)

Front 112

What are the CM of ALS?

Back 112

impaired speech/chewing/swallowing/choking
excessive drooling
difficulty breathing
depression and crying spells
inappropriate laughing
absent abdominal or cremasteric reflexes
absent Babinski sign
EMG changes
thinning of the skin
thickening of the nails
loss of body hair
decreased perspiration

Front 113

What does ALS lead to that can cause death?

Back 113

respiratory failure

Front 114

What is the treatment for ALS?

Back 114

drugs (Rilutek)
muscle relaxants for spasticity

Front 115

What are the nursing implications for ALS?

Back 115

supportive care
hospice

Front 116

Acquired inflammatory disease (humoral and cell mediated immunologic) that results in demyelination of the peripheral nerves, generally preceeded by a campylobactor jejuni infection

The humoral component blocks conduction of nerve impulses to muscles and results in paralysis.

Back 116

Guillain-Barre syndrome

Front 117

What are the CM of Guillain-Barre syndrome?

Back 117

: May vary from paresis of the legs to complete quadriplegia, respiratory insufficiency, and ANS instability. There may be burning, tingling pain… Generally, an ascending paralysis that usually plateaus and improves in 4 weeks. May take days to months to return to baseline, if it does.

Front 118

What is the treatment for Guillain-Barre syndrome?

Back 118

IV immune globin, respiratory support if needed, aggressive physical therapy. Plasmapheresis to reduce circulating antibodies.

Front 119

What are the nursing implications for Guillain-Barre syndrome?

Back 119

Ventilator management, ROM (range of motion exercises), nutrition, support, turn q2h, etc.

Front 120

A chronic autoimmune disease mediated by antiacetylcholine receptor antibodies that act at the neuromuscular junction.

These antibodies attach to the acetylcholine receptor sites, blocking, destroying, and weakening these sites, leaving them insensitive to acetylcholine, thereby blocking neuromuscular transmission.

Often associated with other autoimmune disorders: rheumatiod arthritis, lupus, and thyroid disease.

Strong association with thymus gland hyperplasia (.8)

Back 120

Myasthenia gravis

Front 121

What are the CM of myasthenia gravis?

Back 121

Symptoms of fatigue, weakness that worsens with activity, recurring URI. The muscles of the eyes, face, mouth, throat, neck are generally affected first. The EOMI muscles and levator muscles are most affected. Diplopia, ptosis, and ocular palsies.

Front 122

occurs when severe muscle weakness causes extreme quadriparesis or quadriplegia, respiratory insufficiency with SOB, and extreme difficulty swallowing

puts person in danger of respiratory arrest

generally occurs 3-4 hours after person takes medication

Back 122

myasthenic crisis

Front 123

similar to myasthenic crisis but arises from anticholinesterase drug toxicity and occurs 30-60 minutes after taking medication

Back 123

cholinergic crisis

Front 124

What is the treatment for myasthenia gravis?

Back 124

anticholinesterase drugs to counteract fatigue and restore about 80% of muscle function. Corticosteriods. Plasmapheresis to remove acetylcholine receptor antibodies.

Front 125

What are the nursing implications for myasthenia gravis?

Back 125

Supportive, respiratory support, plasmaphoresis, support groups, etc.