Diseases and disorders of Nervous system Flashcards

Question

how to diagnose and treat epilepsy?

Answer 1

diagnose - EEG, MRI and CT, cerebral angiography may identify vascular changes, skull radiography for fractur, blood serum treatment - anticonvulsant meds (no cure tho) (in rare cases, surgical intervention to excise identified lesion in brain, implanted vagus nerve stimulator (VNS) which sends impulses of elecetrical energy through vegus nerve to brain to prevent seizures)

Answer 2

aka cerebrovascular accident or brain attack sudden interruption of blood flow to part of the brain caused by a blood clot or a burst blood vessel within the brain (Lack of oxygen causes brain cells to die within minutes of a stroke’s onset) each yr stroke affects 800,000 and kills 130,000 ppl in the US vascular disease so stroke and heart disease have similar risk factors more strkoes r caused by a blood clot, r classified as ischemic stroke About 15% of strokes result from a burst blood vessel and are described as hemorrhagic strokes. These may be caused by a brain aneurysm

Answer 3

Focal: Simple focal - No loss of consciousness; minor sensory and motor disturbances; tingling and flashing lights, involuntary movements Dyscognitive focal seizure - Loss of awareness or consciousness; staring and purposeless movements Generalized seizures Absence seizure - Petit mal seizure: staring into space or “daydreaming” Tonic seizure - Stiffening of muscles Clonic seizure - Repeated jerking movements of muscles on both sides of the body Myoclonic seizure - Jerking or twitching the upper body, arms, or legs Atonic seizure - Loss of normal muscle tone Tonic-clonic seizure - Grand mal seizure: mixture of all symptoms

Answer 4

Controllable - high bp - atrial fibrillation - high cholesterol - diabetes - atherosclerosis - tobacco use and smoking - alcohol use - physical inactivity - obesity Uncontrollable risk factors - age - gender - family history - prior stroke or TIA - patent foramen ovale

Answer 5

- numbness - loss of vision - muscle weakness on one side of face or body - confusion - difficulty walking, speaking and understanding - sudden severe headache - sudden aphasia, dysphasia, difficulty understanding language - diplopia - sudden onset of dizziness, loss of balance, loss of coordination

Answer 6

diagnose - assessment of cognitive, motor and sensory function to determine the extent and location of stroke. CT, MRI and cerebral angiography, electroencephalography, to pinpoint location of strkoen and whether itś stroke is ischemic or hemorrhagic treat - ischemic stroke (treated with clot-busting drugs injected IV or directly into brainś bv near the blood clots using a catheter) hemorrhagic strokes (treated with medicine to reduce bp, control Intracranial pressure or counteract blood-thinning meds if pt was taking those) may need surgery to repair blood vessels in brain (intense rehabilitation may be needed for physical, speech, cognitive and emotional complications of a stroke)

Answer 7

mini-stroke a temproary interruption of blood flow to brain (cause is embolus formed by atheroscelrosis) less severe s/s (sudden weakness, numbness down 1 side of body, dizziness, dysphagia, confusion, difficulty seeing w/ one eye, loss of balance, suddenonset headache, recurring) but may require immediate medical attention bc it may be a precursor to stroke

Answer 8

may affect eyes, hearing, balanace and muscles of face or shoulder inflammation to the cranial nerves is commonly associated with facial or ocular palsy as well as facial pain etiology of cranial nerve inflammation is often idiopathic but may include viral or bacterial infections of stroke most common known cranial nerve disorders r trigeminal neuralgia and Bellś Palsy

Answer 9

severe chronic pain resulting from dysfunction of the 5th cranial nerve, known trigeminal nerve which transmits sensory info from face and jaw (one side) aka tic douloreux, rare, after 50 mostly pain may be triggered by touching face, chewing, drinking, or talking most painful medical condition etiology is uncertain, thought to be compression of nerve root by trumor or vascular lesion, sequeala of multiple sclerosis or herpes zoster, demyelination of trigeminal neurons

Answer 10

diagnose - physical exam and history (protect face and avoid temp extremes) treat - antiseizure med, antidepressants, muscle relaxants, and analgesics

Answer 11

paralysis of facial muscles caused by inflammation of the facial nerve. r isk factors include recent respiratory infections and pregnancy. A viral infection or immune disorder probably triggers the nerve inflammation (compression of the nerve in the bony canal) that causes Bell’s palsy.

Answer 12

inability to salivate, form tears, blink and move facial muscles which results in a drooping eyelid, lips and expressionless face

Answer 13

diagnose - physical exam of the face and a history to rule out stroke, Lyme disease, and tumors, CT or MRI to confirm and to view possible structural causes of inflammation treat - anti-inflammatory medication and antiviral meds if paralysis is related to a viral infection (most ppl recover within a few weeks) (warm moist heat, gentle massaage, facial exercise, analgesics, artifical tears and eye patch, electrotherapy)

Answer 14

acute inflammation of the first two meninges that cover the brain and spinal cord: the pia mater and the arachnoid mater most common r acute bacterial meningitis and viral meningitis in recent yrs bacterial meningitis has caused more than 4,000 causes and abt 500 deaths annually in US rare auses of meningitis include fungi and cancer

Answer 15

severe infectionthat requires immediate medical attention ot prevent serious complication or death

Answer 16

The most common bacterial cause is Streptococcus pneumoniae (the pneumococcus). Other bacterial causes include Group B streptococci, Neisseria meningitides (the meningococcus), Listeria monocytogenes, and Haemophilus influenzae type b (Hib). spread in respiratory droplets and secretion (usually during close contact as when kissing) (listeria monocytogenes is acquired through contaiminated food)

Answer 17

- positive Kernig sign (resistance to leg extension after flexing thighs on the body) - Brudzinski sign (neck flexion causing flexion of hips from supin poistion) - severe headache - stiff neck (nuchal rigidity) - high fever - chills - vomiting - confusion - sensitivity to light - increased DTR - irritability - hypersensitivity of skin In infants: - bulging fontanel - irritablity - poor reflexes Meningingococcal meningitis also causes a skin rash

Answer 18

diagnose - physical exam, history and analysis of cerebrospinal fluid obtained by lumbar puncture (splinal tap) for bacteria. in bacterial meningitis CSF has low glucose and elevated leukocytes and proteins + CT treat - IV antibiotics, anticonvulsive, glucocorticoids, aspirin or acetaminophen, corticosteriods to control swelling, immediate treatment is needed (even with treatment complicatations like hearing loss, cranial nerve damage, mental disabilites or paralysis can occur)

Answer 19

more common rhan bacterial meningitis enteroviruses r most cases of viral meningitis other causes r herpes simplex virus, HIV, West Nile virus, and mumps no specific treatment, s/s r treated with rest, analgesics and antiinflammatories

Answer 20

inflammation of brain, most often caused by viral infection rare in US, most cases r mild, if severe than v. dnagerous and brings serious compplications viral causes include arboviruses (transmitted by mosquitoes, enterovriuses, and viruses that cause herpes simplex, chickenpox and shignel) West Nile virus causes a type of encephaliytis only way to prevent is avoid mosquitoes

Answer 21

- headache - stiffness of neck and back - visual disturbances - lethargy - fever - muscle and joint aches - weakness Rarely, severe cases occur and include symptoms: - severe headache - confusion - perceptual changes - weakness - seizures

Answer 22

diagnose - lumbar puncture for analysis of CSF, blood may be drawn for analysis, CT or MRI for brain swelling, EEG treatment - no specific, s/s r treated with rest, analgesics and anti-inflammatories, antipyretic, anticonvulsants, antibiotics, antiviral for HSV encephalitis,

Answer 23

aka polio, crippling, potentially fatal viral infection of anteroir horm cells of gray matter of spinal cord, causing selective destruction of the motor neurons last case of polio in US occurred in 1979 risk factors for polio include lack of vaccination and travel to areas with endemic polio transmitted orally and infects motor neurons = muscles weaken, atrophy and may become paralyzed (Death floows respiratory and cardiac failure)

Answer 24

- fever - sore throat - malaise - flaccid paralysis - headahce - weakness - vomiting - stiff neck - back ache

Answer 25

viral infectio nof brain in wild mammals (mainly bats, raccoons, coyotes, foxes and skunks) can also unvaccinated domestic dogs and cats can be transmitted to humans through bite, scratch, saliva or urine of an infected animal affects abt 1 person a yr in US risk is highest for people who work with animals, such as veterinarians, animal control officers, and wildlife biologists following entry into human tissue, typically through bite or scratch the virus moves to spinal cord and brain (incubation is 1 motnh to yr based on location)

Answer 26

occur late in course of disease (days before death0 - fever - headache - agitiation - confusion - hallucination - difficulty swallowing - excess salivation - fear of water (hydrophobia) - insomnia - partial paralysis

Answer 27

begin as soon as exposure is suspected - immunoglobulin injectoins near wound (neutralize virus before it can move into nervous system) - series of five vaccination are given in arm to stimulate the body's immune system to fight the virus - prevented by vaccinating domestic dogs and cats

Answer 28

aka herpes zoster acute painful dermatomal inflammation of sensory neurons caused by reactivation of latent chickenpox virus (varicella zoster virus) affects nearly 1 M ppl mainly in ppl over 50 and those who are immunocompromised (risk is associated with prior chickenpox infection and with age) incubation is 7 to 21 days, onset to recovery is 10 days to 5 weeks, if all vesicles appear within 24 hours total duration is usally shorter, mostly skin overlyign thoracic dermatomes, can occur on face, neck and salp

Answer 29

painful, red, watery blisters around trunk, often on one side along the course of the peripheral nerves or dermatmes that r affected these may occur on face around eyes or other areas burning or tingling 2-3 days before appearance of lesions and sometinmes accompanied by fever in some cases pain continues after rash clears, a condition called postherpetic neuralgia

Answer 30

diagnose - characteristic pattern and painful viesicles, clutre of virus, blood sample for VZV antibodies treatment - no specific treatment, antiviral agents, ice, lotions and anti-inflammatories, analgesics, mild tranquilizers or sedatives, antipruritic steroids, drying agents prevented with chickenpox vaccine in children or shingles vaccine in adults

Answer 31

aka lockjaw acute muscle rigidity and paralysis caused by bacterial nerve toxin rare, affects 30 ppl yrly (1 M throughout world, mainly in underdeveloped nations w/o vaccination) caused by tetanus toxin, a nerve toxin produced by bacterium Clostridium tetani (binds with motor neurons, stimulates them and causes muscles to be continually stimulated to contract) 35% mortality rate

Answer 32

characteristic muscle rigidity painful muscle spasms difficulty swallowing (oisthotonos) respiratory failure rigid, flexed jaw called trismus extremely febrile (temp > 101F) irrritable sweats profusely face spans

Answer 33

bacteria live in animal and human intestines bc retanus bacteria r excreted in animal feces and can persist in soil bacterial is often found in manure or in soils fertilized with manure deep, penetrating wound containing contaminated soil can introduce bacteria into tissue bc tetanus bacteria is anaerobic (not required o2) they thrive in deep wounds that lack oxygen

Answer 34

diagnose - usin pt history (inadequate immunization, acutely ill) tetnus - can be cured, need to clean and disinfect wound, if person is unimmunized than immunoglobulin injections to neutralize toxins, if person last tetanus vaccination was 10+ yrs ago than immunization with inactive toxin is needed, sedatives, muscle relaxants for spasms and seizures, quire, dark environment for rest

Answer 35

condition of muscle weakness and paralysis caused by bacterial nerve toxin (rare in US, affects abt 145 ppl annually) occurs in 3 forms: Infant botulism (most common), foodborne and wound muscles become weak and paralyzed and r unable to contract (condition called flaccid paralysis)

Answer 36

for infants: eating honey - consuming home-canned foods - injection drug use (esp heroin)

Answer 37

infants: - constipation - floppy babies (unable to hold up head and move muscles) - difficulty crying and swallowing - may drool and having difficulty sucking and feeding Food born botulism (Wound botulism resembles it) : - droppy facial and eye muscles - difficulty swallowing or speaking - nausea - double vision - vomiting and cramps - difficulty breathing

Answer 38

nerve toxin produced by the bacterium Clostridium botulinum that binds motor neurons and prevents them from sending signals to muscles for contraction thrive in anaerobic conditions, found in soil and can contaminate food and wounds infants may digest bacteria or their spores in soil to honey foodborne botulism is usually transmitted by eating improperly canned low-acid foods like green beans, beets, corn garlic-infused oil has been linked to botulism wound botulism follows a deep, contaminated wound that permits bacteria to grow in anaerobic conditions (mostly in heroin users)

Answer 39

diagnose - physical exam and pt history treat - infants can be treated with botulism immunoglobulin, foodborne botulism can be treated with meds to promote vomiting and bowel movement, botulism can also be treated with injected antitowxin, respiratory assitane ma be needed , restoration of nerve and muscle function may be slow and require phscial therapy

Answer 40

UNCOMMON BUT POTENTIALLY DISTABLING OR FATAL NEUROLOGICAL ILLNESS THAT OCCURS IN CHILDREN AFTER A VIRAL INFECTION infants who use aspirin during flu and chickepox infection r at risk for RS liver and brain inflimmation (persistant vomiting, rash, lethargy abt 1 wk after viral infection, serious cases = seizure)

Answer 41

diagnose - pt history, liver biopsy for defintive diagnosis (shows fatty changes in the microvasculature in liver tissue), blood tests may reveal elevated fatty acid treat - nonspecific, aims to lower intracranial pressire, many children recover but w/ intellectuall disability, seizure diorder, cranial nerve damage and motor nerve damage

Answer 42

most common form of dementia, result of progressive destruction of memory and nearly all other important brain function risk is linked with age (abt 1/2 of ppl over 85 have AD) causes r unknown: only 5% of cases r linked to known genes and considered heredity (bnormality found on chroosome 21) in AD connections btwn neurons die as do neurons themselves + tangles of protein called neuro-fibrillary tangles Death results from pneumonia, other infections, or injuries from falls and accidents.

Answer 43

often begin with memory loss and confusion loss of short-term memory, inabiltiy to concentrate, incapabicty to learn new info, impairement of reasoning, subtle changes in personality inherited forms may have an early onset (in the 40s or 50s) over time ppl lose memory, spatial and temporal orientation, become more confused and exhibit swings in emotion and personality changes

Answer 44

exam and history, neurological exam for sesory and motor deficiets, blood tests, CT and MRI, brain scans which reveal brain atrophy, widened sulci, enlarged cerebral ventricles (in later stages)

Answer 45

chronic, progressive, degenerative, autoimmune disorder of the CNS in which muelin sheath is attaacked = sclerosis that debilitates nerves affects 400,000 ppl in US with estimated 10,00 new cases annually risk is associated with age, mostly btwn 15 and 50, particularly 20-40 women r at greater risk several types, most forms have periods of remission and exacerabtion

Answer 46

numbness or weakness in 1 or more limbs optic neuritis fatigue double vision (diplopia) unsteady gait vertigo difficulty with urination = UTI facial numbness or pain speech problems dysphagia hearing loss impotence in men fatigue emotional disturbances depression irrritabilty short-tempered vision loss in 1 eye As disease progresses: = Loss of motor function, bladder and bowel control and cognitive decline

Answer 47

diagnose - history, neurological exam, MRI to visualize nerve tissue, characteristic cerebral or spinal plaque, CSF may show elevated Ig levels and oligoclonal bands on an MS panel treat - physical therapy, occupational therapy, antispasmodic to control muscle spasm, corticosteroids to control inflammation, antiseizure meds to suppress tingling and numbness and immune system modulators to suppress immune-mediated exacerabtions

Answer 48

aka Lou Gehrig's disease, progressive loss of motor functions affects abt 30,000 ppl in US risk is associated witha age (30+) and more in men a(could be genetic - autosomal inherite traits)

Answer 49

- fasciculations (small local involuntary muscular contraction) - atrophy - twitching - weakness in limbs - slurred speech with progression comes: - paralysis - inability to chew, swallow, speak and breath

Answer 50

diagnose - history of s/s, electromyogram to study muscle activity, muscle biopsy, nerve conduction study to meausre motor nerve function, MRI to visualize nervous system changes and damages no treatment, 1 med to slow progression of ALS by lowering level fo neurotransmitter glutamate, Riluzokle shows promise in slowig progression, tizanidne and baclofen r muscle relaxants other meds treat various symptoms

Answer 51

a degenerative disease characterized by progressive loss of control over muscle coordination and movement. affects about half a million people in the United States, but experts feel PD may be more prevalent because many cases remain undiagnosed. Early-onset PD, occurring before age 50, accounts for about 5% of PD cases. cause is related to reduced levels of neurotransmitters dopamine and nirepinephrine (caused by death of dopamine-producing neurons in substantia nigra)

Answer 52

Risk factors for PD include age and sex. The average age of onset is 60 and the risk increases with age. Men are at higher risk than women

Answer 53

dopamine - substantia nigra can't communicate with motor regions that produce smooth, coordingated muscle movement norepinephrine - loss is due to death of neuron endings responsible for its productions, affects heart rate, bp

Answer 54

fatigue; irregular heartbeat; low blood pressure; associated dizziness, especially upon standing - noticeable shaking in hand - rigid, masklike facial muscles progresses into: - tremors - stiffness - inabilty to initiate movement - uncoordinated, shiffling gait - loss of reflexes - problems swallowing and chewing - difficulty speaking, hunched posture - cognitive impairements - sexual dysfunction - depression

Answer 55

Difficulty in swallowing headache visual degeneration masklike expression pill-rolling tremor joint rigidity loss of appetite leg cramps muscle weakness constipatio involuntarily hurried gate loss of libido, impoten ce aching back monotone speech

Answer 56

diagnose - physical exam, neurologic exam, and history. No blood tests can detect PD but urine can show decreased dopamine. Imaging tests do not usually help diagnosis because MRI or CT appear normal in PD. treat - main medical treatment for PD is levodopa (L-dopa (L-dopa can cross blood-brain barrier which dopamine can't cross and is converted into dopamine in brain), L-dopa levels can be prolonged by carbidopa, deep brain stimulation (DBS), counseling and meds

Answer 57

disorder characterized by shaking of hands and head, esp during voluntary movement 5+ million peopel have essential tremor risk facotr is relatied to age and genetics (over 40)

Answer 58

shaking hads and head in a yes, no pattern makes it hard to eat, drink, write and grasp

Answer 59

diagnose - history and physical exam. The ability to perform simple movements and draw are used to diagnose essential tremor. Blood tests and imaging tests may be used to rule out other diseases. treat - beta blockers, antiseizure meds, tranquizliers, botox to improve head and voice tremors, physical and occupational therapy, deep brain stimulation

Answer 60

aka huntington's chorea progressive degenerative disease of brain that affects motor and cognitive function chorea = involuntary, ceaselless, rapid and jerky movements affects abt 30,000 ppl in US chief risk factor is having parent with HD is caused by a defective gene on chromosome 4 resulting in death of specific neurons in brain

Answer 61

begin in 40s - motor functions degenerate - jerking, writhing movements - involuntary sustained muscle contractions - difficulty walking, speaking, swallowing and moving eyes - cognitive and mental degeneration - difficulty planning - loss of visual perception - inflexible thinking - impaired mumeory - loss of judgment - impulse control - angry outburst - personality changes high risk for depression and sucide, death 10-30 urs after onset

Answer 62

diagnose - history, pt intervuew, neurological exam, psychiatric exam (MRI normal early) (EEG can revela changes, genetic test can confirms presence of defective gene) treat - aimed at restoring muscle flexibility and movement and treating depression and related psychiatric and psychological conditions (drug therapy is SSRI antidepressants, antipsychotic), physical therapy, occupational therapy, speech therapy, psychoscoial support. There is no cure for Huntington’s chorea

Answer 63

- group of malformations of spine in which posteroir prtion of bony canal contaiing spinal cord (usually in lumbar region) is completely or partially absent - type of neural tube defect, a developmental structural abnormality in the formation of the vertebrae and spinal cord. - occurs during early weeks of gestation as spinal cord and bony canal develop (vertebrae fail to fuse correctly, producing a weak spot over the spinal cord or an opening that exposes the spinal cord, allwoing meninges and spinal cord to hernaite) - most common neural tube defect in the United States (occurs in about 1,500 of the 4 million babies born each year in the US)

Answer 64

- having previous child with spina bifida - folate deficienct (vitamin B9) - maternal obesity - diabetes - cause is unknown

Answer 65

motor weakness, paralysis, and loss of bowel and bladder control.

Answer 66

diagnose - exam, measuring maternal levels of apha-feto protei (presence of spina bifida), iltrasound, amniocentesis to visualize defect in fetus treatment - surgery for meningocele, meningomyelocele, myelcole, prenatal surgery,physical therapy, occupational therapy, counseling help children adapt and develop classroom, mobility and bathroom skills, folic acid supplementation before and during pregnanct

Answer 67

condition of the buildup of CSF around the brain = abn enlargement of head and pressure changes in brain (pediatric and adults) Hydrocephalus is among the most common birth defects, affecting about 1 in 500 births in the United States. Around 70–90% of children with spina bifida also have hydrocephalus. accumulation can be triggered by congenital defects in strucutre of brain's ventricles and vessels, inflammation, infection or trauma

Answer 68

having spina bifida, brain trauma, and infections such as meningitis, mumps, and rubella or syphilis during pregancy

Answer 69

in infants: - bulging fontanel - sutures of skull separate - scalp veins become distended - head circumference increases at faster rate than normal - high-pitched cry - irritable - large head - downward-facing eyes - projectile vomiting - seizures - abnormal muscle tone of legs - poor feeding - uncoordinated movements (can lead to permanent motor and cognitive impairments)

Answer 70

diagnose - physical exam, clinical picture, radiographic skull studies and imaging with MRI or CT treat - implanted shunt to help move and drain CSD into jugular vein or peritoneal cavity (shunt for life), some catheters empty into peritoneal cavity and others into right atrium of heart

Answer 71

congenital disorder characterized by impaired muscle movement, tone, and posture (involves cerebral nervous sustem function dealing w/ movement, learning, hearing, sight and thinking) CP is almost always present at birth and affects about 1 in 300 children (most common crippling condition in children) Cerebral palsy is usually apparent before 3 years of age. (congential, acquire, bilateral or unilateral in form of nonprogressive paralysis) more common in premature infants and in male babies cause remains unknown. CP is probably triggered by low oxygen supply to the brain during fetal develoment, birth process or early childhood up until 9 y/o, interruption of blood circulation to brain during labor, infection, hed trauma inflammation

Answer 72

preterm birth breech birth, low birth weight. Infant illnesses such as meningitis, encephalitis, and jaundice raise the risk for CP. Other risk factors include maternal infections such as rubella, chickenpox, cytomegalovirus, toxoplasmosis syphilis, and maternal exposure to toxins such as methyl mercury.

Answer 73

vary and depend on type and extent of damage (doesnt progress) - muscle problems like abnormal rigidty - floppiness of muscle - Muscle movement is jerky, stiff, and writhing w/ reduced voluntary movement - People with CP have trouble walking, grasping objects, and producing smooth, fine movements - Excessive drooling and difficulty swallowing, sucking and chewing occur - Other problems include hearing and visual - when infant is lifted from behind legs may be difficult to seperate and infant may cross their legs

Answer 74

diagnose - physical and neurological exam, CT, MRI, brain ultraosund treatment - depends on nautre and severity, anticonvulsant drugs to reduce seuzres, cast or braces to aid walking, muscle relaxants to relive spasms along with traction or surgery, physical therapy, occupational therapy, speech therapy CP is uncurable

Answer 75

abnormal masses of tissue growing in the brain. An estimated 23,000 new cases occur each year in the United States and about 14,000 people die from brain tumors annually cause is genetic damage

Answer 76

increasing age, race (mostly in caucasians), expousre to chemicals and radiation, family history

Answer 77

s vary and depend on the area of the brain affected. - More frequent and severe headaches - vision loss and double vision, - confusion - dizziness - unexplained vomiting - loss of coordination - Speech and hearing problems and personality changes can also occur. - cerebral edema - increased ICP - herniation - gocal or generalized seizures

Answer 78

diagnose - neurological exam, imaging via MRI and CT treatment - chemo, immunotherapy, surgery, radiation, after treatment pt may need rehabilitation, physical therapy, occupational therapy, and speech therapy

Answer 79

1. spastic CP - hyperactive reflexes or rapid contraction, older children hav scissor gait (walking on toes and crossing foot over other) (70% of pt w/ CP) 2. Athetoid CP - involuntary muscle movement, esp during times of stress and reduced muscle tone, difficulty speaking (20%) 3. Ataxic CP - lack of control over voluntary movements, poor balance and wide gait

Answer 80

- psoterior arches of verebrae, commonly in lumbosacral area, fail to fuse but no herniation - asymptomatic, only evidence is dimpling, tuft of hair or hemangioma - etiology is associated w/ ionizing radiation, reduced levels of vitamin A and folic acid, metabolic imbalance - maternal blood lvels of AFP may be measured to detect possible neral tube defects - diagnos w/ prenatal ultrasonography or w/ ostnala physical exam, detection of neurologic symptoms, visual inspection of spin and spinal ultrasonography - usually don't need intervetion, only if neurologic problems

Answer 81

- rare, protrusion of the meninges through a small opening in spinal column, thus forming a sac that becomes filled with cerebrospinal fluid (repaired surgically) - no nerve involvement so no neurologica problems - skin over area may be fragile so rupture of sac is potential problem - cause could be metabolic abnormality w/ reduced levels of vitamin A and folic acid - diganoed with visual exam of spinal area and verification of presence of sac + radiographic studies if spin - treat w/ surgical intervention in first 24 to 48 hours - paralysis usually doesn't occur

Answer 82

- aka spina bifida cystica - most common and srs defect in which opening exposes spinal cord - usually in lumbar region - maybe neurologic symptoms - musculoskeletal malformation, immobile joints, paralysis of lower extremities, bowel or bladder control may be affected - etiology is nerual tube fails to close during fetal development, allowing meninges, spinal nerves and spinal cord to herniate, may be genetic or related to excposure to agent orange - diagnose w/ physical exam and iamging findings, surgical exploration for severity - treat w/ suurgical interveiton in first 24 hrs of life - may need phyiscal therapy, leg braces, cruttches, ambulaton training, helps increase child's mobility, bladder and bowel

Answer 83

- large amt of CSF in brain's ventricles due to an imbalaance btwn CSF production and drainage - impairment of circulation of CSF in ventricular circulation may be caused by lesion, congenital strucutre defect, imapirement of flow of CSD in subarchnoid space prevents CSD from reaching areas where it normally would be reabsorbed by arachnoid villi = intracranial hemorrhage resulitng from ehad trauma, blood clot, prematurity or infeciton (meningitis)

Answer 84

- large amt of CSF in brain's ventricles due to an imbalaance btwn CSF production and drainage - impairment of circulation of CSF in ventricular circulation may be caused by lesion, congenital strucutre defect, imapirement of flow of CSD in subarchnoid space prevents CSD from reaching areas where it normally would be reabsorbed by arachnoid villi = intracranial hemorrhage resulitng from ehad trauma, blood clot, prematurity or infeciton (meningitis)

Answer 85

- common theory hold that unknown virus triggers immune system to turn against body and attack myelin (no virus have been conclusively implicated) - risk increases as one moves from S to N - greater risk in yt populaton - 2/3 of cases develop in ppl btwn 20 and 40 and rarely in ppl over 60

Answer 86

relapsing-remitting: relapses followed by recovery w/ no prgression of neurologic dysfunction btwn relapses primary-progressive: disease progression w/ no remissions secondary-progressiveL disease begisn as relapsing-remitting but later becomes progressive w/ few remissions progressive-relapsingL progressive disease from onset w/ relapses and siease progression during period btwn relapses

Answer 87

- interferon beta-1a (Avonex, Rebif), interferon beta-1b (betaseron), glatiramer (Copaxone) and mitoxantrone (Novantrone) - immunosuppresive tehrapies (radiation, steroids, immune globulin, cytotoxic drugs) - nuewer treatments r biolgoci meds such as natalizumab (Tysabri) - siponimod and cladribine for both secondary-progressive MS and relapsing-remitting MS (orally administratied)

Answer 88

1) occlusion of an artery caused by atheroma 2) sudden obstruction by an embolus, including cerebral thrombosis (clot), embolism (moving clot), other moving emobli 3) cerebral bleeding most often caused by atherosclerosis and hypertension as well as blood disorders, arrhythmias, systemic disease, hyperlipidemia, rheumatic heart disease, head trauma, high-fat diet, lack of exercise, cig smoking, obesity, fmily histroy of atherosclerotic disease CVA caused by embolus or hemorrhage often have sudden onset wherease strokes caused by thrombus may appear more gradually cerebral thrombosis occurs if one of the cerebral arteries become narrowed bc of plaque buildup from atherosclerotic thromus or clot can enlarge until it partially or completely blocks blood flow to artery

Answer 89

- congenital, abn structures of bv in which arterial blood moves directly into veins, giving bv appearance of tangled mass of arteries and veins = tendency to hemorrhage - s/s r N&V, stiff neck, confusion, lethargy, generalzied weakness, visual problems, irritability, impaired pseech, muscle weakness, paralysis, ringing in ears, dizziness, syncope

Answer 90

diagnose - clincial signs, CT, MR treat - surigcal intervention, radiation therpay, emobolization of involved vessel

Answer 91

diagnose - phyiscla exam, history, cranial MRI, CT, carotid ultrasonography, EEG treat - anticoagulants, pt chew aspirin tablet

Answer 92

- collection or mass of blood that forms btwn skull and dura mater (outermost of the 3 meningeal layers covering brain) - subdural hematoma r when blood collects or pools btwn dura mater an arachnoid membrane (second meniungeal membrane) - head trauma is cause (blow to head = epidural or head striking immovable objects = subdural hematoma)

Answer 93

- within few hours of head trauma sudden headache dilated pupils n&v increased drowsiness hemiparesis unconsciousness coma death

Answer 94

- similar to epidural hematoma excpet onset is delayed bc of slower accumulatio nof blood (may mimic symtpoms of TIA, stroke, dementia), diplopia is common

Answer 95

diagnose - examination of pt, history of recent head trauma, cranial radiography, CT, cerebral arteriography, treat - craniotomy (cranial trephination - burr hole in skull w/ drill to relieve pressure by draining off blood that accumulates), remove accumulated blood, cauterize bleeding vessels

Answer 96

- more serious than concussion (involves brusing of tissue along or just beneath he surface of brain = may also be termed a contrecoup insult) - s/s range from temportary loss of consciousness to coma, severe headache, hemiparesis, droswy, letargic or hostile and combative - caused by blow to the head or by impact against a hard surface, as occurs in automobile accident (twisting or shearing force against the 2 hemisphere of brain that occurs when it collides w/ cranial bones)

Answer 97

diagnose - thorough neuroligc exam, CT, cranial radiography treat - need to be hospitalized so that their vital signs can be monitored and rapid medical intervention can be provided

Answer 98

- occurs with a break or fracture in one of the bones of the cranium - when the skull bones r depressed or torn loose they r pushed below the normal surface of the skull

Answer 99

bruising behind ears (Battle sign) raccoon eyes hemiplegia seizures bleeding from wound, ears, nose, around eyes changes in pupil clear or bloody drainage from the ear or the nose headache stiff neck nuchal rigidity N&V visual disturbances slurred speech confusion restlessness irritability difficulrty balancing drowsiness seizures loss of consciousness

Answer 100

diagnose -physcal exam, cranial radiography, CT treat - relieving intracranial pressure, craniotomy, elevate depressed bone, head protection

Answer 101

- injuries to spinal cord = effect on innervation of any spinal nerve distal to point of insult - extent of injury and consequential edema often results in faiulure of sponal nerve functioning w/ resulting loss of motor and senosry function - paraplegia = loss of nerve function in areas gleow waist and paralysis of lower trunk and legs - quadriplegia/tetraplegia is loss of nerve functions at cervical region resultign in paralysis of arms, hands, trunk, legs - caused by veretebral fractures or vertebral dislocation

Answer 102

paraplegia: loss of motor and sensory control of the trunk of the body and lwoer extremities, loss of bowel, bladder, sexual function quadriplegia: paralysis of lower extremities and usually trunk w/ either partial or total paralysis of upper limbs hypotension, hypothermia, bradycardia and respiratroy problems als o may be present

Answer 103

trauma to thoracic and lumbar regiosn of spina (T1 and below) = paraplegia Z(vertical compression and hyperflexcion of spin usually produces this injury) trauma to cerbical vertevra e (C5 or above) = quadriplegia injuries btwn C5 and C7 = paresis to shouler and arms damage above C3 is usually fatal (usual cause is hyperextension or flexion of tha portion of the spine)

Answer 104

diagnse - neurologic funciton, spinal radiography, MRI, CT treat - restoration of normal alignemnt, stabiltiy of spine, decompression of spinal cord, nerves, verebrae, surgery or using specialized meds and procedures, imediate spinal cord truama itnervention includes stabilization of neeck and spine, corticosteroids, hypothermic state to injured area

Answer 105

- DEGENERATION OR DETERIORATON OF AN INTERVETRTEBRAL disk may result in pain in the areas served by the sinal nerves exiting at or below that disk space

Answer 106

- when pain occurs it radiates down the nerve path (dermatome) - pain may be describes as burning, can become intractable ==- constant back pain and severe pain that radiates down one or both legs may be accompanied by loss of some motor mfuncitons in legs - numbness - tingling associated with weakenss - bowel or bladder issues (incontinence or constipation)

Answer 107

- natural part of aging (as person ages fluid in disk decreases, causing disease- could be mechanical and the result of ocnstant wearing on the disk, mislaignmnet of vertebrae causes continual rubbing on the disk involved, resulting n inflammation and gradual desrtuction of the disk - inflammation eventually involves the spinal nerve roos and may cause scarring, sequela is spinal stenosis, in which there is narrowing of the vertebral canal, nerve root canals (foramen), or intravertebra; fpra,oma. causing nerve root to become trapped in formane as they leave the spinal canal)

Answer 108

diagnose - clinical findings, histroy of previosu back injury, MRI, myelography with contrast to show disk status, CT, electromyography, neurologic examination treat - as active as possible, narctoci analgesics, NSAIDs, oral steroids, epidurals or selective nerve root blocks, physical therapy, Transcutaneous electrical nerve stimulation (TENS), bracing of spine, spinal fusion, freeing of the spinal nerve root, lidocain topical, ablation, pain pumps (last resort), implanation of a spinal cord stimulator (SCS), device that masks pain

Answer 109

aka ruptured or slipped disk - rupture of nucleus pulposus through annular wall of the disk and into spinal canal =- usually result from accumulated trauma (eg improper body mechanics when lifting) or sudden impact, poor posture and aging process

Answer 110

- intervertebral disk r soft pads of cartilage and gelatinous material located btwn each of the vertebrae that make up the spine (acts as shock absorber and gives back flexibilty for movement) - each disk has gelatunous center called the nucleus pulosa which is surrounded with an annulus (circular wall-like) - bulging is less severe (rupture can cause sevre back pain and even disabiltiy if it presses against or pinches the spinal nerves) - sudden, sharp pain that worsens with movement or in certain positions may radiate from the back to the butt, thighs, legs foollowing the course of the impinged nerve, causing pain, paresthesia, muscle weakness in the leg in a dermatomal pattern - when this pain results from pinching of nerve roots that form sciatic nerve, it is known as sciatica - herniation of disk occurs in the lower back, btwn 4th and 5th lumbar vertebrae or btwn 5th lumar and first sacral, ruptured disk in the cerbical region = pain and weakness in the arms and neck - pain is either unilater or bilateral

Answer 111

diagnose - thorough history of the back pain, physical exam of back, diagnosis of lumbar disk hernitiont can be consideered if the pt has sciatic pain when physicican peforms straight leg raise test, MRI, CT, myelography treat - hot or cold packs, muscles relaxants, analgesics, epidural injections and physical therapy, surgical excision of herniated disk (percutaneous diskectomy - needle into intraverebral splaceand aspirate bulging prat, microdiskectomy - small surgical incision, allowing material t be aspiration, diskectomy - lasar ablation and evaporation of disk, removal of disk w/ laminectomy w/ fusion of vertebrae)

Answer 112

- sciatic nerve injury is pathologic condition caused by trauma, degeneration, rupture of nuclues pulposus within Intervertebral disk - spinal stenosis, narrowing of spinal canal or nerve root foramen is often termed sciatica bc of the compression the spinal cord and spinal nerve roots - trauma to sciatic nerve from fall, poor body mechanics, gunshot, stab wounds, aging process, inflammatory autoimmune response, osteophytes on forame, congenital

Answer 113

- causes pressure directly on sicatic nerve or on other closely positioned spinal nerves, sending impulses down the nerves - severe, sharp pain radiating from sciatic nerve down leg and foot (continous or intermittent) - rupture of nucleus pulposus posteriorly toward nerual canal, pressure on nerve root causing sciatic symtpoms or affects sciatic nerve, causing low back pain and leg pain (anterior and later ruptures may or may not porduce symtopoms)

Answer 114

- pain in the back - radiating down the legs - pain in the butt, thighs, calves - pain increases with standing, walking or exercise - numbness in areas that become worse when standing, wlaking or exercisitng - weakness in legs - relfex in lower extremities often r asymmetric

Answer 115

diagnose - medical history, physical exam, spinal radiography (degenerative changes and narrowed spinal canal) , MRI, CT, myelography, blood serum, vascular integriy s assessed and insufficieny is ruled out, EMG (neurologicla changes) treat - oral corticosteroids, physical therapy, ultrasound diathermy with massage or acupuncture, exercise to strenghten back and abd, analgesics, muscle relaxants, antiinflammaotry meds, heat and cold or gentle massage (myofascial release), corticosteroids epidural injections, leaning forward or sitting often helps relieve back pain, diskectomy or microdiskectomy, spinal fusion, chemical dissolving with an enzyme of the nucleus pulposus (chemonucleolysis), decompression of the spinal nerve f oramen q

Answer 116

- cephaglia is pain in the head that is not confinedto nay one specific nerve distribution area - cause is stress, too little or too mch sleep, overeating or overdrinking, stuffy or noisy environment, heavy physical labor, caffein withdrawal, sensitivty to scents, strain on facial, neck and scalp resulting from tension (tension ehadahche), edema within blood vessels of head (vascualr headache)

Answer 117

- acute or chornic and located in the frontal, temportal and/ or occipital region - may be confined to only one side of head or may be located above one or both eyes - type of [ain may vary from dull and aching ot almost unbearable - intense intermittent painm throbbing pain, pressure pain or penttrating pain - sensitivity area exists in only meninges, skin, muscles covering skull, numerous nerves that travel from the brain to the head and face - usually self-limiting and underlying symptoms

Answer 118

- sinus infection or congestion, temporomandibular joint syndrome, hypertension, stroke, brain tumor, encehalitis, mostly r symtpms of fatigue or tension

Answer 119

- severe pain developing around or behind one eye, having abrupt onset and cessation - affected eye may tear - usually occur at night, continue occuring for several weeks or months and them disappear for some time, even years - more common in men and r associated w/ nasal congestion and partial Horner syndrome

Answer 120

diagnose - medical history, physical exam, neurologic testing, cranial and spinal radiography, EEG, cranial CT treat - treat underlying cause, analgesics, muscle relaxants, minor tranquilizers, muscle massages, relaxation w/ warm bath

Answer 121

- periodic severe headaches that may be completely incapacittating and almost always r accompanied by other symptoms such as nausea and vomiting, sensitivity to light, anorexia, intense hemicranial or bilater throbbing pain, visual signs and symtoms

Answer 122

- visual auras (flashing lights, zigzaggin lines, areas of total darkness) - photophiba - usually warming period during which the person feels abn fatigued and irritable -occassional symtpoms r numbess or tingling in one arm or one side, dizziness, temporary mental confusion

Answer 123

- etiology s iodiopathic, certain factors: inherited or genetic aspect, certain foods - biologic cause may be changes in cerebral blood flow, attributable to vasocontrisctionfollowed by vasodilation of the cerebral and cranial

Answer 124

idangose - recrring, severe headaches, preceed by any combination by s/s, EEG, CT, MRI to rule out other conditions treat - bed rest in quiet, darkened room, analgesics, vasoconstrictors, antiemetics, biofeedback, calcitonin gene-related peptide (CGRP) inhibitors (CGRP causes nerve cells more sensitive to painful stimuli)

Answer 125

- dont involve entire brain but arise from localized area in brain - effects may involve hand or face w/ motor signs, such as a rhythmic twitching of a group of muscles or compulsive lip smacking or picking at clothing, behavioral, psychic and sensory manifestations (auras) can occur, amnesia

Answer 126

- diffuse electrical abnormality within the brain and include absnece (petit mal) and tonic-clonic (grand mal) attack

Answer 127

- one seizure follows another with no recovery of consciousness btwn attacks - medical emergency hat requires immediate anticonvulsant therapy to prevent cerebral anoxia, hyperpyrexia, vascular collapse and even death

Answer 128

- pathologic conditions such as scar tissu on cerebral cortex frmo ifnection or trauma, cortical neoplasms, cerebral edema, TIAs, CVAs, birth trauma (cerebral palsy), drug toxicit, diabetes, hypoglycemia, other conditions that depreive brain of oxygen

Answer 129

- neurologic condition characterized by an overwheliming urge to move the legs (is to stop an uncomfortable or odd sensation) - feelings r itching, burning, jittery, creepy-crawly, pulling, tugging and/or painful sensation (usually in leggs, ocassional in arms, hips or face), inabilty to sit for extended periods, walking or moving legs = relieve symptoms - exact cause is unknown, increases after 40 or 50, maybe anemia

Answer 130

diagnose - medical history, physical exam, mostly in evening or at night, moving legs = temp relief, daily diary of symtpoms, blood tests treat - no cure, treat w/ underlying cause, levodoa, dopamine agonists, ropinirole, opiods, benzodiazepine, regular exercise, cold or hot application

Answer 131

(irone deficiency, varicose veins, folate, magnesium deficiencies, sleep apnea, uremia, diaetes, peripheral neuroathy, Parkinson disease, thyroid disease, certai autoimmune idsorders)

Answer 132

- temproary amnesia abt entire moemory of current events for 1-6 (up to 12) hrs - s/s r repetitive asking of questions, memory loss for preceding 3 t 5 yr and sepcific events, normal neurologic signs, PERLA, no recall of period of amnesic experience after memory is recovered - caused by stress or emotional events, migraine headaches

Answer 133

diagnose - observing s/s on neurologic exam, TIA, CVA, seizure activity treat - supportive

Answer 134

- degeneration of the peripheral nerves - causes r chronic alcohol intoxication, toxicit yfrom arsenic, lead, carbon disulfide, benzene, phosphours, infectious disease includign mumps, pneumonia, diphtheria, metabolic or inflammatory disorders, diabetes, RA, gout, SLE, certain nutritional deficicency diseases

Answer 135

- s/s r clumsiness and loss of sensation in hands and feet followed by flaccid paralysis and wasting of muscles in those areas, DTR is diminished, tenderness in atrophied muscles, skin may take glossy, red appearance, sweat is decreased, foot drop, pain

Answer 136

diagnsoe -history, clinical findings characteristic of motor and sensory involvement, motor and sensory nerve impairment usually detected by EMG, nerve conduction study (NCS) treat - remove toxic substances, correct vitamin and nutritional deficits, treat underlying disease processes, avoid alc, anticonvulsants, tricyclic antidepressants and getting rest and physical therapy

Answer 137

- caused by viruses or the toxins from chickenpox, measles, mumps, result f a bite from an infected mosquito (Eastern equine, Western equine, Venezuelan equine encephalomyelitis, St. Louis encephalitis)

Answer 138

- acute, rapidly progressive disease of PNS - numbness and tingling of feet and hands, increasing muscle pain and tenderness, usually starts in lower extremities, move up body in 24 to 72 hours, respiratory insufficency, difficulty swallowing - though to be autoimmune, known to follow respiraotry infection or gastroenteritis, demyelination of nerves occurs

Answer 139

diagnsoe - elevated protein level in CSF, normal leukocytes as is CSF pressure treat - hospitalization, supportive treatmetn, plasmapheresis washes plasma to remove antibodies, IVIG

Answer 140

- collection of pus, can occur anywhere in brain tissue - main symtpoms is headache, increased ICP, N&V, visual disturbances, unequal pupil size, seizures, eye look to area of insult, nuchal rigidity - caused by local infection, secondary to infections elsewhere in body (staphylococci, streptococci, pneumococci, head trauma, craniotomy)

Answer 141

diagnose - history of infeciton or isult to CNS, charqcteristic clincal features, increased ICP, EEG, CT (no lumbar puncture), blood cultures treat - IV antibiotics, mannitol or steroids, surgical drainage

Answer 142

diagnose - clincal symtpoms, history of possible exposure, isolate poliovrisu from throat washing or feces, positive CSF cultrues treat - supportive, analgesics, moist heat applications, bed rest, physical therapy, respiratory support w/ mechanical ventilation,

Answer 143

- occur later in life in person who ahve previosly experienced the disease - functional deterioration of muscles is accompanied by loss of strength - progressive weakness begins 30 yrs or more after initial attack and involves already affected muscles - fasciculations and muscular atrphy

Answer 144

- gliomas (tumors derived from glial cells) - meningiomas (tumors arising from the arachnoid membrane) - embryonal tumors (neoplasms that arise in children) - all 3 = 75% of all cancerous primary brain tumrsors - gliomas and mengingiomas increase after 45 - among children udner age 15 brain tumors r most common slid malignancy

Answer 145

- no cure - drug therap to allievate cognitive symtpoms: cholinesterase inhibitors, rivastigmine (thought to prevent breakdwon of acetylcholine), N-methyl-Dasoartate (NMDA) inhiitor, antipsychotic or neuroleptic agents, SSRI antidepressants, risperidone and olanzapine for those who start to have delusion symtpms, mood stabilizers, trazodone for undowning general management of fluuid intake, adequate nutrition, personal hygeine

Diseases and disorders of Nervous system Flashcards

(169 cards)