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DH 2 > Neurologic Disorders Exam 6 > Flashcards

Neurologic Disorders Exam 6 Flashcards

1
Q

What are the different disorders and conditions when it comes to the neurologic disorders.

A

Neurological- epilepsy/seizures and cerebrobascular accident
Developmental- Autism
Genetic- Down syndrome
Degenerative- MS, Alzheimers disease, Parkinsons disease

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2
Q

What is cerebrovascular accident (stroke) ?

A
  • Sudden interruption of oxygenated blood to the brain causing tissue necrosis
  • Can comes to CVD
  • Affects motor, speech and some cognitive disfunction
  • Severe- death can occur within minutes
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3
Q

What are the predisposing factors for cerebrovascular accident (stroke) ?

A
  • Hypertension- greatest risk factor
  • Atherosclerosis
  • Hypercholesterolemia, hypertriglyceridemia
  • Tobacco use
  • Cardiovascular disease
  • Diabetes mellitus
  • Oral contraceptive use
  • Drug abuse
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4
Q

What are the etiological factors for cerebrovascular accident (stroke) ?

A

Thrombosis
Intracerebral
Ischemia
Cerebral Hemorrhage

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5
Q

What are stroke symptoms ?

A

B - balance
E - Eyes
F - Face
A- Arms
S- Speech
T-Time

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6
Q

What are the signs and symptoms Cerebrovascular Accident?

A
  • Residual and Chronic effect- memory, speech, sensation and motion tem and perm loss.
  • Right Hemiplegia- more difficult with verbal communication, cautious, anxious or disorganized
  • Left Hemiplegia- more difficult with physical coordination, overconfidence.
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7
Q

What are the after symptoms after stroke ?

A
  • Physical paralysis
  • Articulation- aphasia
  • Salivation and swallowing difficulty
  • Increase pain, touch sensitivity
  • Visual impairment
  • Mental dysfunction possible
  • Personlity changes
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8
Q

What are the medical management for a stroke (CVA)

A

Drugs- anticoagulant, antihypertensive, thrombolytic, vasodilator, steroid, antiepileptic
Surgical correction of aneurysm, clots, malformations, removal of small clots, graftling to bypass bloacked vessel.
Therapy physical therapy, occupational therapy, speech therapy.

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9
Q

What are the dental management for a stroke (CVA)?

A
  • Timing- how long since stroke?
  • Med-mgmt- control/ prevention
  • Identify risk factors
  • DONT NOT recommend aspirin for pain management
  • Local anesthesia with epinephrine- modifications
  • Appointment procedures- four handed, short appointmet
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10
Q

What are the oral manifestations of CVA?

A
  • Facial paralysis- decrease tongue movement, decrease self cleaning.
  • Lack of sensation of biofilm collection= inflammation
  • May detect carotid calcifications on panoramic
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11
Q

What is autism spectrum disorders?

A
  • neurobiological disorders affecting how a person interacts communicates, relates, plays, imagines and learns
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12
Q

What are the unknown cause for autism?

A

possibe: pyschogenic, genetic, biochemical, neurophysiologic

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13
Q
A
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14
Q

What does autism include:

A

Autistic disorder
Aspergers syndrome
Rett syndrome
Childhood disintegrative disorder
Pervasive developmental disorder not otherwise specified

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15
Q

What are th clinical presentations for autism ?

A

delayed/abnormal; social interaction, Language, imaginative play
Social communication deficits
Restricted interests
Repetitive behaviors
Signs shown before 3
Male more likely to have it

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16
Q

What are the medical management for autism?

A
  • psychotherapy
  • dietary intervention
  • speech and language therapy
  • auditory therapy
  • educational intervention
  • behavorial therapy
  • music therapy
  • medications: Stimulants (Ritalin), Tranquilizers (Diphenhydramine), Anticonvulsants (Phenytoin), and Antipsychotic (Risperidone)
17
Q

What are the dental management for autism?

A
  • Before- rehearse verbiage
  • limit wait time before seated
  • quiet dental environment
  • appointments short and organized
  • use tell- show-do to alleviate fear
  • provide short, clear commands
  • positive reinforcement/praise
  • carregiver encouragement
18
Q

What are the oral manifestations of autism ?

A
  • increased caries risk
  • increased inflammation risk
  • medication side effects
19
Q

What is down syndrome: trisomy 21?

A
  • Etiology- chromosmal abnormality; extra chromosome
  • Clinical Presentation- short neck, flatten facial profile, slanted eyes with epicanthic fold covering inner eye corner
20
Q

What are the cognitive and behavioral characteristics for down syndrome?

A
  • short attention span
  • impulsive
  • show learning, delayed developmental milestones
21
Q

What are the dental management for down syndrome?

A
  • involve caregiver
  • Communicatin techniques
  • consider cognitive abilities
  • minimize background noise
  • more frequent recare
22
Q

What are the oral manifestations for down syndrome?

A
  • macroglossia
  • macrosomia
  • narrow vaulted palate
  • Mouth breathing
  • periodontal infections
  • xerostomia
23
Q

What is parkinsons disease?

A
  • neurodegenerative disorder caused by deficiency of dopamine
  • occur in middle ages and older persons, higher incidences in males
24
Q

What are the medical management for parkinsons?

A
  • Therapy- physical occupational
  • Symptomatic control- replenish dopamine shortage with levodopa
  • Surgical relief of symptoms- deep brain stimulation, ablation
25
Q

What are the dental management for parkinsons?

A
  • consider efffects of condition on patients ability to maintain oral health at home
  • recommend alternative or modified oral aids
  • anesthesia with epine
  • help patient into and out of chair and assist with going to and from reception room
  • raise chair slowly
  • use techniques for effective communication
26
Q

What are the oral complications for parkinsons?

A
  • Excess saliva and drooling
  • Decreased swallowing
  • expression fixed, masklike,diminished blinking
  • tremor in lips tongue, neck ,dysphagia
  • Drugs side effects: xerostomia, nausea, tardive dyskinesia
27
Q

What is multiple sclerosis?

A
  • Autoimmune disease, unknow cause
  • Chronic demyelinating disease
  • Myeline sheath destroyed with white matter of CNS- MS plaques
  • Occurs on: onset 20-40 years
  • 2:1 ration; female to male
  • Caucasion females more frequently affected
28
Q

What are some characteristics of multiple sclerosis ?

A
  • Visual impairment, diplopia, fatigue weakness
  • Musclar coordination
  • Transient tingling
  • involuntary eye motion
  • speech disorders
  • Relapses and remission
  • almost normal life span <50% non- ambulatory
29
Q

What are the medical management for MS?

A
  • Prompt diagnosis and early treatment within 6 months crucial to deter nurological damage
  • prevent relapses and progression
  • Treat exacerbations
  • Symptom relef to improve function
  • psychological therapy and support
  • adequate nutrition rest, avoid stress/stain, prevent infections and injury, non-strenous excersie and activity encouraged
30
Q

What are the medications for MS?

A
  • IV corticosteroids
  • Interferon injections
  • Muscle relaxers
  • Antidepressants
31
Q

What are the Dental management?

A
  • Delay treatment during relapsing episode; care during remission
  • Address medication side effects- burning and dry mouth (saliva sub), pilocarpine prescription
  • Examine for opportunistic infections from immunosuppressants
32
Q

What are the oral complications for MS?

A
  • Dysarthria (difficulty speaking)
  • Paresthesia, facial numbness, trigeminal neuralgia
  • decreases: motor, sensory, cognitive functions
  • increase: medications
33
Q

What is dementia: alzeimers disease

A
  • Dementia- progressive intellectual decline
  • Slow chronic inability to remeber, reason, learn and imagine
  • Results in loss of independence
  • Occurance: older than 65 years old increasing 85 plus
  • Risk factors: Family history , age, genetics , down syndrome, periodontitis
    • 8 years duration from symptoms to death
34
Q

What are the medical management for dementia?

A
  • slow disease progression
  • Cholinesterase inhibitors- boost acetylcholine for cognition
  • Memantine (namenda)- regulates glutamate, chemical messenger
  • Manage symptoms
35
Q

What are the dental management for dementia?

A
  • Thorough medical history
  • Include patient when speaking to caregiver
  • use nonverbal communication
  • Mild to moderate disease
  • review medications and oral side effects
  • short appointments and clam environment
36
Q

What are the oral manifestions and complications for MS?

A
  • Side effects of medication: xerostomia
  • Caries
  • Lesions
  • Candidiasis
  • Hard and Soft deposits
  • Periodontal disease
  • Caries
  • Injuries from falls: broken teeth, ulceration

DH 2 (21 decks)

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