chapter 17 alteration of neuro function

Question 1

traumatic brain injury

Answer 1

Alteration in brain function caused by an external force

Question 2

spinal cord injury

Answer 2

Primary:
Occurs with initial mechanical trauma and immediate tissue destruction

Secondary:
Pathophysiologic cascade of events that begins immediately after injury and continues for weeks

Question 3

mechanisms of spinal injury

Answer 3

1. fractures and dislocations
2. cervical spine injuries resulting from hyperextension and hyperflexion of the neck

Question 4

spinal shock

Answer 4

-Complete loss of reflex function below level of lesion
-Occurs in initial period after injury

Question 5

neurogenic shock

Answer 5

• Caused by absence of sympathetic activity and unopposed parasympathetic tone
• occur above T6

Question 6

autonomic dysreflexia

Answer 6

• Massive, uncompensated sympathetic discharge in SCI: T6 or above
• Often initiated by full bladder or rectum or other stimuli (pain)
• Sensory receptors below level of injury are stimulated
  immediate treatment is nessacary

Question 7

cerebrovascular accidents ( stroke)

Answer 7

An infarction (death) of brain tissue that results from lack of blood

Question 8

types of cerebrovascular accidents

Answer 8

1. ischemia: occlusion of blood vessels caused by thrombus or emboli
   - thrombus: is arterial occlusion of the brain and intracranial vessels
   - emboli: blood occlusion caused by fragments of thrombosis formed outside the brain ….usually from the heart
2. hemorrhage: is rupture of blood vessels in the brain
   - cerebral aneursym= weakening of the arterial wall
   - hypertension
   and worst headache
3. hypoperfusion: lack of blood flow to the brain

Question 9

meningitus

Answer 9

microorganism invasion of the brain vis blood vessels , tissues, and direct access

Question 10

microorganisms are

Answer 10

1. fungal
2. bacterial
3. virus …HPV type 2

Question 11

Inflammatory response initiated causing meninges

Answer 11

• cerebral edema & damage to brain tissue
• Inflammatory exudate thickens CSF → decreases normal CSF flow → hydrocephalus
• Meninges become edematous → increased ICP

Question 12

manifestations of meningitus

Answer 12

1. severe headache
2. Nuchal rigidity
3. Kerning sign ( knee can not be fully extended)
4. Brudzinski sign ( neck stiffness)

Question 13

Multiple sclerosis

Answer 13

• acquired autoimmune disorder where the myelin sheath is lost( demyelination)
• causes disruption in nerve conduction with subsequent death of neurons and brain athropy

Question 14

Manifestations of MS

Answer 14

Paresthesia, weakness
Impaired gait
Visual disturbances
Urinary incontinence

Question 15

Guillian-Barre syndrome

Answer 15

acute, acquired inflammatory disease causing demyelination of the peripheral nerves —-typically after respiration or GI infection

Question 16

Manifestation of Gullian Barre

Answer 16

Progressive muscle weakness & ascending flaccid paralysis
Lack of reflex response
Pain, general muscle aches
Vision and speech impairment
Life-threatening → respiratory failure

Question 17

Mysasthenia gravis

Answer 17

• Acquired, chronic autoimmune disease
• IgG antibody inhibits acetylcholine receptors → decreased transmission of nerve impulse across NM jxn and decreased muscle depolarization

Question 18

manifestation of myasthenia gravis

Answer 18

• weakness and fatigue of muscles of the eyes and the throat causing diplopia, difficulty chewing, dysarthria, dysphagia
• Myasthenic crisis → can lead to respiratory arrest.
• Cholinergic crisis: anticholinesterase drug toxicity leads to smooth muscle hyperactivity r/t accumulation of acetylcholine