Chapter 11 Flashcards
(63 cards)
1
Q
Facial skeleton
A
- mandible
- 2 zygomatic
- 2 maxillary
- 2 nasal bones
2
Q
Cerebral cranium
A
- protects the brain and brainstem, and the anterior facial bony structure
- 8 bones
3
Q
Meninges
A
- lies just beneath the skull and provide 3 protective layers
- dura, arachnoid, pia
4
Q
Cerebrum
A
- two cerebral hemispheres are composed of neural tissue
- the two hemispheres are divided into four principal lobes: frontal, temporal, parietal and occipital
5
Q
Brainstem
A
- main conduit for information between the brain and the spinal cord by way of cerebellar peduncles
- ascending and descending tracts
- contains all cranial nerve nuclei and controls: respiration, CV system functions, level of consciousness, sleep, and alertness
6
Q
Autonomic nervous system
A
- innervates glands, smooth muscle, and cardiac muscle
- divided into parasympathetic and sympathetic nervous systems
7
Q
Cerebellum
A
- controls function in the higher level of coordination or voluntary movements and in the maintenance of balance, equilibrium, and muscle tone
8
Q
Broca’s area
A
- frontal lobe (primary mortar cortex)
- speech
9
Q
Wernickes area
A
- parietal lobe/ temporal
- speech comprehension
- located in the dominant hemisphere only
10
Q
Spinal Cord
A
- body’s communication system
- transmits nerve impulses
- white matter (myelinated) and grey matter (neurons or nerve cells)
11
Q
Spinal Nerves
A
- 31 pairs
- ventral or dorsal roots
12
Q
Warning signs of neurological diseases (positive)
A
- hypersensitivity
- seizures
- movement disorders that include tremor, spasm, and tics
- upper motor neuron signs: spasticity, hypertonicity, and hyperreflexia
13
Q
warning signs of neurological diseases (negative)
A
- represent loss of function
- paresis
- paralysis
- hyposensitivity
- dementia
- aphasia
- syncope
- neck stiffness
- gait dysfunction
14
Q
Red flags for urgent intervention
A
- alteration in level of consciousness
- fixed or abnormal pupils
- abnormal eye movements
- acute visual impairments
- focal neurological symptoms occurring after head trauma
- paralysis or progressive muscle weakness
- bowel or bladder incontinence
- acute severe headache, especially associated with nausea and vomiting or focal neurological deficits
- prolonged or recurrent generalized seizures
15
Q
Stroke
A
- cerebrovascular accident (CVA)
- caused by a lack of oxygen to the brain that may lead to reversible or irreversible paralysis, hemorrhagic, embolic
16
Q
Red flags for stroke
A
- numbness or weakness of the face, arm, or leg on one side of the body
- confusion, trouble speaking, or understanding
- vision difficulties in one or both eyes
- problem with speaking, slurred speech
- trouble walking, dizziness, loss of balance or coordination
- severe headache with no cause
17
Q
Stroke causes
A
- cardiac embolism
- hematological stroke
- lacunar stroke
- intracerebral hemorrhage: meth, cocaine, ecstasy
- younger population (15-45 years) accounts for 3% of strokes
18
Q
Stroke referral/diagnosis
A
- medical emergency
- diagnosis: hx, CT scan, MRI, EEG, doppler flow stuides
19
Q
Stroke Treatment & RTP
A
- antihypertensives
- anticoagulants
- anti platelet agents
- heparin ASA
- rehabilitation
- level of recovery
- residual impairment
- type of sport
20
Q
Guillain-Barre Syndrome
A
- acute, diffuse demyelinating disorder of the spinal roots and peripheral nerves
- either gender at any age but uncommon in early childhood
21
Q
Red flags for GB syndrome
A
- progressive weakness beginning distally and moving proximally
- areflexia
- afebrile state
- pain with slightest movement of affected area
- nocturnal muscular cramps
- patients with recent hx of URI or gastro illness
22
Q
GB syndrome S&S
A
- progressive distal muscle weakness
- loss of DTRs on both sides
- weakness evolves quickly over hours or days
- paresthesia & numbness
- may progress to respiratory paralysis
23
Q
GB syndrome treatment
A
- EMG
- CSF analysis
- elevated protein levels
- NCV
- supportive care
- rehabilitation
24
Q
GB prognosis & RTP
A
- 85% recovery completely or nearly completely
- 30% still have residual weakness after 3 years
- 3% have relapse
- > 5% mortality rate
- RTP depends on level of symptom resolution and release by medical provider
25
Headaches (vascular)
caused by spasms of the vessels surrounding the brain, and include migraines, fever-inducing toxic headaches, headaches as a result of high blood pressure
26
Headaches (contraction/tension)
result from muscular tension on the cervical spine and cranium
27
Headaches (traction/inflammatory)
result from other disorders that could include stroke or a sinus infection
28
Sinus headache
pain is usually behind the forehead or cheekbones
29
Cluster headaches
pain is in and around one eye
30
Tension headaches
pain is like a band squeezing the head
31
Migrane headaches
pain, nausea, and visual changes are typical of classic form
32
Medical evaluation of headaches
- new or unusual
- sudden onset of severe headache
- change in pattern
- chronic headache with localized pain
- interrupts sleep or present in the morning
- associated with nausea or vomiting
- visual disturbance
- associated with numbness, paralysis or weakness
- head ache associated with stiff neck, fever, weight loss, neurological S&S
33
Seizure Disorder and Epilepsy
- caused by abnormal discharges of electrical activity in the brain, and may arise from a number of pathologies
- outward manifestation of seizure is altered awareness, involuntary movement, and/or convulstions
34
Seizure disorders intermittent tonic-clonic
- pre octal aura of smells or sounds
- tonic-clonic muscle contractions
- tongue biting
- incontinence (not always)
- postictal: confusion, disorientation, exhaustion & lethargy
35
Seizure disorders absence (focal) seisures
- brief episode (3-10) seconds
- loss of attention or awareness
- more pre or postictal states
- automatisms: chewing, lip smacking, swallowing, facial twitching
36
Treatment of seizure disorders
- anticonvulsant medications
- barbiturates: phenobarbital
- benzodiazepines: valium
- carboxamides: carbamazepine
- plus 14 other classes of drugs
37
Seizure RTA
- consideration of risk
- seizure free for 1 year on medication
- seizure free for 2 years without medication
- avoid high risk sports: gymnastics, high diving, sky diving, rock climbing, motor sports
- avoid some non contact sports as well
38
Multiple Sclerosis
- neurodegenerative, lifelong chronic disease diagnosed primarily in young adults, characterized by the gradual accumulation of focal plaques of demyelination in the brain
39
Forms of MS
- Relapsing remitting MS: cyclic episodes of worsening neurological function followed by complete remission. 85% of people diagnosed with MS
- Primary progressive: gradually worsening neurological function without remission. 10% of people diagnosed with MS
40
Other forms of MS
- secondary progressive
| - progressive relapsing
41
Treatment for MS
- no cure
- categories of treatment
- disease modifying: inferno beta - 1a/b
- symptom relieving: corticosteroids, muscle relaxants, immunosuppressants
- mild to moderate exercise
42
ALS (amyotrophic lateral sclerosis)
- lou gehrig's disease
- fatal, progressive, neurological disease that slowly attacks neurons responsible for voluntary muscular actions; there are no effective treatments to stop or reverse the progression
- prognosis: certain death 50% are dead within 3 years of diagnosis
43
Bell's Palsy
- disease that typically affects one nerve, the facial cranial nerve, resulting in unilateral or bilateral facial weakness or paralysis; it has a rapid onset and most always spontaneously resolves
- recovery completely within 1-8 weeks
44
Complex regional pain syndrome
- complex regional pain syndrome is a condition involving over activity of the sympathetic nervous system that can occur after minor injury, due to trauma to a nerve
- type 1: follows an injury to soft tissue or bone
- type 2: previously called causalgia follows documented injury to a nerve
45
CRPS S&S
- severe burning pain
- hyperhidrosis
- pain beyond what would be expected for an injury
- local edema
- pathological changes in skin
- radiographic changes to bone
- DD: raynauds, gout, myositis ossificans, compartment syndrome
46
CRPS treatment
- desensitization of the effected extremity
- joint mobilization and PROM/AROM
- pain reduction techniques
- tens, e-stim, hydrotherapy
- edema control
- restore strength and function
- medication for pain control
47
CRPS prognosis and RTP
- can be reversible in early stages (4-6)
- may become irreversible after 8-9 months
- RTP depends on severity of symptoms and level of recovery
48
Upper motor neuron
- brain or spinal cord
- damage presents as weakness, paralysis, increased muscle tone, hyperactive DTRs, babinskis reflex
- DO NOT regnerate
49
Lower Motor neuron
- relate to nerve cell bodies or axons or both
- located in the anterior horn and peripheral nerves
- damage presents as decreased muscle tone, diminished or absent DTRs, muscular twitching, progressive atrophy of the affected muscles
50
Parts of a neuron
- Dendrites
- Axon
- Myelin sheath
- schwann cell
- node of ranvier
- terminal branches
51
Chemical synapse
- presynaptic terminal
- terminal vesicles
- synaptic cleft
- neurotransmitters
- receptor proteins
- postsynaptic neuron
52
CN 1: olfactory
smell
| sensory
53
CN2: optic
vision (diplopia)
| sensory
54
CN 3: Oculomotor
opening/closing of eyelids
motor movements
parasympathetic - pupil constriction
both
55
CN 4: trochlear
down and inward movement of the eye
| motor
56
CN 5: trigeminal
muscle of mastication
| mixed
57
CN 6: abducens
lateral movement of eye
| motor
58
CN 7: facial
taste, facial muscles, open and close mouth
| - mixed
59
CN 8: vestibucochlear (acoustic)
snapping fingers
| sensory
60
CN 9: glossopharyneal
swallowing
| mixed
61
CN 10: vagus
swallowing
| mixed
62
CN 11: spinal
shrugging shoulders
SCM
motor
63
CN 12: hypoglossal
movement of tongue
| motor
