Neurologic Disorders Flashcards
Congenital abnormality in the connection between arteries and veins without a developed capillary, resembling a “bag of worms”
arteriovenous malformation
Suspect intracranial AVM when a port-wine stain spans the cutaneous distribution of the trigeminal cranial nerve (CN V). True or False.
True
CN conveys impulses related to smell
olfactory CN I
CN conveys impulses related to sight; visual acuity
optic CN II
- CN supplies four extraocular muscles: the medial rectus, superior rectus, inferior rectus, and inferior oblique, which adduct, depress, and the elevate the eye
- Supplies the levator palpebrae superioris muscle, which controls the eye-lid opening
- Pupil constriction
oculomotor CN III
CN controls movement of the superior oblique muscle which intorts the eye
trochlear CN IV
CN
- three branches: maxillary, mandibular and ophthalmic
- controls chewing movements
- delivers impulses related to touch, pain, temperature in the facial area
- corneal reflex (with CN VII)
trigeminal CN V
CN supplies the lateral rectus muscle that abducts the eye
abducens CN VI
CN
- controls the muscles of facial expression including eye-lid closure
- sensation and taste of the anterior two third of the tongue
- controls the tear and salivary glands
- corneal reflex with CN V
facial CN VII
CN transmits impulses related to equilibrium and hearing
vestibulocochlear CN VIII
CN
- sensation and taste in the posterior one third of the tongue
- controls swallowing
- controls salivary glands
- controls viscera in the thorax and abdomen
glossopharyngeal CN IX
CN controls the skeletal muscle movements in the pharynx, larynx, and palate
Vagus CN X
CN controls swallowing and controls movement of the head
accessory CN XI
CN controls muscles involved in speech and swallowing
hypoglossal CN XII
What is the initial diagnostic tool for arteriovenous malformation?
CT
What is the radiologic study of choice or “gold standard” for diagnosing AVM?
cerebral angiography
Emergent medical management of ruptured AVM
- ABCs
- controlling increased ICP by positioning, hyperosmolar therapy, mild hyperventilation (PaCO2 33-35), temperature control, seizure control, sedation/analgesia, and pharmacologic paralysis
a progressive descending neurologic disorder caused by the Clostridium botulinum bacteria, which causes general muscle weakness that can result in respiratory failure
Botulism
What age group is most often affected by botulism?
infants < 6months of age
bacteria multiply, colonize the intestines, and produce toxin, which affects the neuromuscular junction, blocking the release of acetylcholine from nerve endings, resulting in paralysis
pathophysiology of botulism
- Constipation, poor feeding, lethargy, increasing weakness
- physical exam: hypotonia and symmetrical CN palsies
- infants have weak cry, expressionless face, ptosis, and sluggish pupillary responses; gag, suck, and swallow reflexes are diminished or may be absent
clinical presentation of botulism
how to diagnosis botulism
stool sample for botulinum toxin
how to treat botulism
human botulism immune globulin intravenous (BIG-IV)
Botulism Pearl
botulism should be suspected of any infant that presents with hypotonia and difficulty with sucking, feeding, swallowing, or weak cry
