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20 Cards in this Set
- Front
- Back
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Medulla oblongata |
Involved with breathing, digestion, heart rate, blood pressure |
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Posturing |
Flexion of arms, wrist, and fingers with adduction in upper extremity Extension, internal rotation and plantar extension in lower extremity indicates severe brain injury unilateral-stroke or bilateral general brain injury Occurs with inter cranial pressure |
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Decorticate |
Arms flexed, hands clenched, legs extended and feet turned in Indicative of damage to cerebrum, thalamus, or midbrain |
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Thalamus |
Relay station of the brain, involved in sensory perceptions and regulation of motor function |
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Decerebrate |
Arms extended, head arched back, legs extended and rotated in, teeth clenched Damage to brainstem, midbrain, cerebellum, Worse prognosis, more extensive brain stem injury |
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S/S coma |
Absent: eye opening, following commands, verbalization, volitional behavior (ICU trauma patient, massive stroke patient) Glascow coma less than 15 |
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Possible outcomes of a coma |
Brain death Cerebral death Minimally conscious state Akinetic mutism Locked-in syndrome Persistent vegetative state |
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Ventral pons
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nuclei of pons relaysignals from forebrain to cerebellum; involved in sleep, respiration,swallowing, bladder control, hearing, equilibirium, taste, eye movement, facialexpressions, facial sensation, posture
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Seizures |
Disruptionin balance between neural excitation et inhibition
Changeleads to abnormal, excessive discharge of CNS neurons Suddenbrain function alterations Alteredlevel of awareness and arousal |
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Types of seizures |
Partial (focal) 60% are complex partial seizures (consciousness impaired) Generalized |
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Generalized Seizures |
Absence=brief lapses in consciousness with no postictal period Atonic=drop seizures, sudden brief loss of muscle tone Tonic-clonic=grand mal seizures Myoclonus= sudden uncontrollable jerking (may not lose consciousness |
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How seizures work |
High-frequency bursts of action potentials
Something getting in the way of inhibiting continual firing Relatively long-lasting depolarization Influx of Ca++opens Na+channels Na+influx → repetitive action potentials with some sort of impairment of inhibition Firingbecomes greater in frequency et amplitudelRecruitnearby neurons if inhibition fails Firingusually stops when malfunctioning neurons exhausted et become hyperpolarizedand can no longer form another action potential Usuallyself-limiting but can lead to chronic brain changes over time, should try toprevent |
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Prodroma phase |
hours to days before seizure Malaise HA depression |
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Aura |
partial SZ may priced minutes before Taste, hear, feel funny |
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Postictal |
Period after seizure Sleepy, confused, memory lose, |
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S/S dementia |
memoryloss, impaired learning, mood changes, hallucinations, sleep disruption(common), poor judgment, delusions, muscle rigidity
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Causes of delirium |
Causes:intoxication, metabolic disorders, nervous system disease, withdrawal fromETOH/sedatives, illness, head injury, anesthesia, postnatal, cerebral lesions,toxin, UTI in elderly (seen frequently in med psych unit with confused elderlyperson from nursing home and UTI) (once you treat with antibiotics, they returnto normal
Reversible |
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S/S delirium |
Early
Difficultyconcentrating, restlessness, irritability, insomnia, tremors, ↓appetite, SZ,disturbed dreams Later Inattention,altered perceptions (visual sensory auditory), hallucinations, delusions,distress, incoherence, agitation, violence, tachycardia, insomnia ETOHwithdrawal relatedl↑temp,HTN, sweating, tremors |
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When is it dementia and not delirium? |
Acute: UTI, Rx over dose or renal impairment |
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Terminology |
Altered Awareness
*Selective attention -Ability to focus on appropriate stimuli *Memory -Recording, retention, retrieval of information *Episodic memory- For events, personal history, experiences *Semantic memory- For facts et information *Implicit memory For actions, habits, skills, motor memory *Emotional memory How one feels about something *Dysmnesia/amnesia Loss of past memory et ability to form new memories Data Processing Deficits *Agnosia Loss of recognition thru one or more senses *Prosopagnosia Loss of ability to recognize faces *Anosognosia Decreased awareness of own disease *Dysphasia/aphasia Impaired comprehension or production of language *Expressive aphasia Ability to comprehend but not produce language *Receptive aphasia Ability to produce language but not comprehend speech |
