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64 Cards in this Set
- Front
- Back
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Vascular Neurological disorder
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Stroke
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Infectious Neurological disorder
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Meningitis
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Degenerataive Neurological disorder
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Alzheimer and Parkinson
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Inflammatory Neurological disorder
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MS & MG
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#1 indicator of neurological problems
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LOC – level of consiousness
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Sympathetic nervous system
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Fight or flight
Increases HR, Force of contraction, bronchodilation, pupil dilation Decreases peristalsis |
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Parasympathetic
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Conserves and restores energy
Decreases rate and contractility, causes bronchoconstriction and pupil constriction Increase peristalisis and relaxes spincter |
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Basal ganglia
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Cluster of cells at the base of the brain
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Hypothalamus
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Regulates endocrine functions
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Cerebellum
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Contains basal ganglia and coordinates movements
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Stroke
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Loss of brain function due to an interruption in the blood supply to the brain
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Modifiable factors contributing to stroke
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Smoking and high cholestrol
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Cardinal manifestation of stroke
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Facial drooping, unable to elevate arms evenly
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#1 cause of disability
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Stroke
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Which age group is most vulnerable to a stroke
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Men over the age of 65
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Thrombus
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A stationary clot
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Embolus
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A traveling clot
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Most common location of embolus orientation
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Left atrium due to atrial fibrillation
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Warfarin
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Thins blood in pt with atrial fibrillation to prevent stroke
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Most common cause of stroke
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Thrombus in arteries that deliver blood through the brain tissue
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Ishemic stroke
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Cerebral thrombus or embolus
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Cerebral hemorrage
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Brain bleed
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Causes of Stroke
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HTN
Smoking (esp bad with the pill) High plts and RBC Poorly working heart A-fib Diabetes |
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Risk factors for stroke
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Dehydration
Low fluid volume |
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Causes of cerebral thrombosis
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Atherosclerosis
Inflammation and Increased coagulation |
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TIA
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Transcient Ischemic Attack
Symptoms resolve in 24 hours Warning sign of stroke TIA:Stroke as Angina:MI |
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S/Sx of TIA
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Muscle weakness, visual disturbances, paresthesia
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Thrombic stroke
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Caused by arterial occlusion by atheroma which becomes inflamed and breaks off forming clots
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Embolic Stroke
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Stroke caused by embolus
Pts. likely to have a-fib, endocarditis, be post MI or have valve disease |
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Hemmorrahagic stroke -
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Caused by hypertension or aneurysm
- wide spread and severe as bleeding causes a dramatic rise in intercranial pressure |
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Aphasia
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Pts can talk but can not link words to meaning
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Receptive aphasia
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Inability to decode the spoken word
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Dysphagia
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Inability to swallow
- high risk for aspiration |
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Stroke acronymn
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F – Facial Droop
A – Arm Drift S – Slurrred speech T- Timely response |
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Treatment for Thrombic stroke
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TPA – Tissue Plasminogen Ativator
- increased risk of bleeding |
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Treatment for hemmoragic stroke
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Craniotomy to suction out the collected blood and clamp the bleeding artery
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Meningitis
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Inflammation of protectie membranes convering the central nervous system (meninges)
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Dura Mater
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Tough fibrous outer layer of meninges
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Arachnoid Mater
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Lose web like layer of meninges
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Pia Mater
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Inner layer of meninges filled with small vessels that cling around the brain and spinal cord
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Where does CSF circultate
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Between the arachnoid and pia maters
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Least threatening type of menegitis
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Viral
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Most threatening type of menegitis
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Bacterial
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Who develops fungal menegitis
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Immuno-compromised
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Chroid plexus
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Group of cells at the base of the brain which make CSF
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Bacterial meningitis
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Medicl emergency
WBC 10-100,000/uL with neutrophil predominance Protein >4.5 mg/dL Gram stain : positive in 60% Culture positive in >80% Cloudy CSF |
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Which infections are dangerous
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Gram negative
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Where is CSF drawn from
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Subarachnoid space in lumbar region
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Rx for viral meningitis
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Antiemitic (anti nausea drug)
Fluids – dehdration is a risk de to nausea Isolation and advanced universal precautions |
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Signs of meningitis
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Nuccal rigidity (stiff neck)
Kernig sign (pt can’t straigten leg after flexing hip) Brdzinski sign – when flexing neck, knees flex at the same time |
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Alzheimer disease
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Possibly caused by loss of neurotransmitter
Protein in neurons becomes twisted Plaques form Accounts for half of all dementia cases |
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Manifestations of Alzheimers
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Memory loss
Disorientation x 2 (time and place) Wandering Impaired judgment Inability to communicate Incontinence |
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Dyspraxia
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Pt has something in mind, but can not put thoughts into action
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Aricept
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Inhibits cholinesterase which normally breaks down acetycholine
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Parkinson disease -
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Characterized by lack of dopamine
- Degenerative disorder of basal ganglia - to much acetylcholine |
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Acetylcholine
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Excitatory neurotransmitter that brings messages from nerves to muscles
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Dopamine
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CNS neurotransmitter that is essential to control of motion
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Manifestations of Parkinsons
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muscle rigidity
balance problems tremor bradykinesia (slow movement) Parkinson shuffle – hunched posture and microsteps |
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Treatment of Parkinsons
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Dopaminergic drugs – control not cure of s/sx
Anticholinergics |
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Multiple sclerosis
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Destruction of myelin sheath
Autoimmune process where a previous viral assult has occurred in a genetically susceptible pt |
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Clinical manifestations of MS
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Onset between ages of 20-40
Predominatntly women Preceded by event such as infection trauma or pregnancy Numbness Double vision Nystagmus (rhythmic movement of eyes Tremors Dysphagia Uncoordinated movements |
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Treatments of MS
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Glucocorticoids and interferon
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Myasthenia gravis (MG)
Clinical manifestations |
Diplopia – double vision
Ptosis – drooping eyelids Masklike face |
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Myasthenia gravis (MG)
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Tends to affect synapse in chest and head
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