neurological conditions Flashcards
1
Q
what is a ischemic stroke?
A
a blockage of a blood vessel causing hypoxic damage to an area of brain tissue
2
Q
what is a hemorrhagic stroke?
A
blood vessels in the brain rupture. This can cause bleeding into the surrounding brain tissue and can apply pressure to other areas of the brain
3
Q
what is a transient ischaemic attack?
A
A TIA is caused by the temporary disturbance of blood supply to a restricted area of the brain, resulting in brief neurological dysfunction that usually persists for less than 24 hours.
4
Q
what are the risk factors of a stroke?
A
hypertension,
heart disease,
diabetes,
smoking,
alcohol consumption,
high cholesterol,
illicit drug use
5
Q
what are clinical signs of a stroke?
A
Response – possible loss of consciousness
Airway – noise/loss of reflexes/vomiting
Breathing – stertorous (snoring or gasping)
Circulation – radial full and slow, patient flushed and warm, raised blood pressure
Disability – cerebral irritation, confusion, agitation & aggression, fits, incontinence and altered levels of consciousness
Pupils possibly unequal, slow to react
Hemiparalysis
Monoplegia
6
Q
what does FAST stand for?
A
facial drop,
arm weakness,
slurred speech,
time of onset.
7
Q
what does AVVV stand for?
A
ataxia or loss of coordination,
visual disturbance,
vertigo (room is spinning)
vomiting.
8
Q
how would you manage a stroke patient?
A
SMART approach
ACVPU
Airway – consider breathing
Breathing – consider oxygen as per JRCALC
Circulation – radial pulse, colour, temperature
Disability – FAST, mobility, pupils
Expose/Examine - any injuries?
Secondary survey – head to toe
History of events
Medical alert bracelet
Provide support for relatives
Patient may still be able to hear
Remember medication
Full set of observations
Consider the recovery position – sit back at 30°
9
Q
what is epilepsy?
A
the tendency to have recurrent seizures.
a sudden burst of excess electivity activity in the brain causing a temporary disruption in the normal passage between brain cells.
this distruption results in the messages being mixed up.
10
Q
what are causes of epilepsy?
A
cerebral damage from previous infection such as meningitis,
brain injury or lack of oxygen at birth,
brain trauma,
cerebral hemorrhage or tumor
cryptogenic (cause unknown)
Causes: traumatic brain injuries: strokes, tumours, lack of oxygen.
Infections- meningitis, HIV.
Genetic.
Low blood sugar levels.
Developmental conditions such as autism
Alcohol withdrawal- brain chemicals being umbalenceed due to the depressant factor in epilepsy.
Drug intoxication or withdrawal- sudden uncontrollable electrical surge in the brain.
11
Q
what does a general seizure mean?
A
both side of the brain are involved at the outset
12
Q
what does tonic clonic seizures mean?
A
violent muscle contractions
13
Q
what does tonic seizures mean?
A
rigid (/not flexiable)
14
Q
what does atonic seizures mean?
A
floppy and muscles react. pt falls forward
15
Q
what does absence seizures mean?
A
brief lapse of consciousness
16
Q
what does partial seizure mean?
A
the discharge starts in a localized area of the brain
17
Q
what does simple partial seizure mean?
A
can remember what happend
patient is consious, pins and needles, unusual smell and taste, localised jerking
18
Q
what does complex partial seizure mean
A
loss of consciousness, repetitive behaviour, walking round appearing drunk
19
Q
what does secondary generalised seizures mean?
A
previous symptoms leading to tonic clonic seizures.
20
Q
what is a tonic sezuire?
A
patient goes rigid (not flexible) and falls to the floor. stiffening of the muscles no convlsion (no irregular movement)
21
Q
what is a chronic sezuire?
A
start convulsing (contraction of the muscles) and labored breathing
22
Q
what is a atonic seziure?
A
sudden loss of muscle tone, person collapses to the ground. usually a quick recover.
23
Q
what is a absences seziure?
A
brief interruption of consciousness, blank staring, fluttering of the eyelids, nodding of the head.
24
Q
what is the epilepsy medication?
A
carbamazepine,
sodium valproate,
levetiracetam
25
how would you manage a seziure?
Dangers – clear space, do not restrain, loosen tight clothing
Response – ACVPU – continually reassess
Airway – do not forcibly open the airway
Breathing – high flow oxygen required
Circulation – radial pulse, colour, temperature of patient
Disability – pupils, sleep after seizure is normal, FAST test
Expose and examine – any injuries?
Secondary survey -
- Head to toe
- Medical alert band
- Bracelet
- Provide support for relatives
- Patient may still be able to hear
- Remember medication
- Consider the recovery position
26
what is status epilepticus?
uncommon but potentially life threatening condition.
occurs when seizures or recurrent seizures continue for 30 minutes with no recovery imbetween.
can result in permanent neurological damage, respiratory failure, cardiac arrrest and death.
27
what is a febrile convulsions?
seizures brought on by a sudden rise in body temperature
28
what are causes of febrile convulsions?
illness/ infection.
to much clothing
over heated environment
common in children up to 3 years old
29
what are signs and symptoms of febrile convulsions?
Loss of consciousness
Twitching or jerking of arms and legs
Breathing difficulty
Foaming at the mouth
Going pale or bluish in skin color
raised body temperature
30
what is meningitis?
what is it caused by?
Meningitis is inflammation of the lining around your brain and spinal cord.
caused by bacteria, viral or fungal pathogens swelling to the meninges
31
what are symptoms of meningitis?
Non-disappearing rash
Headache
Nausea
Sudden fever
Light sensitivity
Confusion
Lethargy
32
what is cerebral palsy?
a group of disorders that affect a persons ability to move and maintain balance and posture.
33
what causes cerebal palsy?
an abnormal brain development or damage to the developing brain that affects a persons ability to control their muscles.
lack of oxygen to the brain during birth
34
what other conditions would a patient possibly have with cerebral palsy?
intellectual disability,
seizures,
problems with vision, hearing or speech,
changes in the spine such as scoliosis,
joint problems
35
what is Parkinson's disease?
a condition were there isnt enough chemical dopamine in the brain due to some of the nerve cells that have made it stop working
36
what are symptoms of parkinsons?
tremors, stiffness, changes in speech, voice and swallowing, slowness of movement, balence problems and trouble with handwriting.
37
what is the most common form of parkinsons disease?
idiopathic Parkinson's.
idiopathic means the cause is unknown.
38
what is vascular parkinsonism?
affects people whose blood supply to their brain is limited.
slow movements, tremor, difficulty with walking and balance, stiffness and rigidity) are produced by one or more small strokes, rather than by gradual loss of nerve cells
39
what are symptoms of vascular parkinsonism?
slowness of movement and stiffness.
usually affects your mobility. people can have problems walking which means they can be unsteady on their feet, walk with shuffling steps or have balence problems.
can also include bladder problems, communication problems, thinking and memory problems
40
how is vascular parkinsonism managed?
physiotherapy and occupational therapy- to reduce risks of falling
41
what is cauda equnia syndrome caused by?
when an injury or herniated disk compresses nerve roots at the bottom of the spinal cord.
the cauda equina nerves communicate with the legs and bladder it causes back pain, weakness and incontinenece.
42
what are the 2 types of cauda equina syndrome?
incomplete cauda equina syndrome:
causes you to lose urgency or sensation in your bladder and bowels. meaning you cant feel when you need the toilet- affects 40% of people.
complete cauda equina syndrome:
causes urinary and or bowel retention or incontience.
retention means that you cannot go to the toilet.
incontinence means you cannot stop yourself from going to the toilet.
it affects 60% of people.
43
what are symptoms of cauda equina syndrome?
lower back pain, or leg pain
leg weakness
numbness or sensations in the back of the legs, but, hip and inner thighs, urinary and fecal incontinence (cannot control bowel movements) ,
urinary retention (bladder doesnt empty)
44
what is multiple scerosis?
a condition that affects the nerves in the central nervous system. (brain and spinal cord)
in MS the myelin that protects your nerves there is damaged causing blurred vision and problems with how we move, think and feel.
45
what does myelin do?
helps messages travel quickly and smoothly from the brain, down the spinal cord and onto the rest of your body.
in MS the myelin is damaged stripping it off the nerve fibers. this damage disrupts messages travelling along nerve fibers.
slow it down, become distorted or not get through at all.
46
what are some common symptoms of MS that begin with?
fatigue
numbness and tingling
loss of balance and dizziness
stiffness or spasms
tremor
pain
bladder problems
bowel trouble
vision problems
problems with memory and thinking
47
what is delirium?
a change in a persons mental state that happens suddenly over 1-2 days. charicterised by confusion, anxiety, incoherent speech and hallucinations.
48
what are the symptoms of delirium?
be less alert and not respond to things happening around them
be easily distracted
be less aware of where they are, or what time it is (disorientation)
suddenly be less able to do something (for example, walking or eating)
speak less clearly or struggle to follow a conversation
have sudden swings in mood or behaviour
have hallucinations – see or hear things that aren’t real
have delusions or become paranoid – strongly believing things that are not true.
49
what are the 3 types of delirium?
hyperactive (too active), hypoactive (not active enough) and mixed, where a person may change from one type to another during the course of a day. Among older people, including those with dementia, hypoactive and mixed delirium are most common.
50
how would you diagnose delirium?
4A
alertness- are they drowsy or agitated?
awareness- their age or date of birth. where are they?
attention? the ability to stay focused on a mental task
acute change? if the symptoms seem to come and go
51
what are the risk factors of delirium?
having dementia – this is the biggest single risk factor for delirium
being older than 65
being frail or having multiple medical conditions
poor hearing or vision
being in an unfamiliar or disorientating environment
being sleep deprived
not being able to sit up or move around
taking certain medications, particularly those that cause drowsiness
having already had delirium in the past.
52
what is a episodic headache?
may occur occasionally but no more than 15 days in 1 month.
can last anywhere from half an hour to several hours
53
what is a chronic headache?
more consistent, can occur 15 days a month. pain management is necessary
54
what are the symptoms of a tension headache?
a dull, aching sensation all around the head.
tenderness or sensitivity around the neck, forehead, scalp or shoulders
stress may trigger them
55
what are cluster headaches?
severe burning and piercing pain.
occur around or behind one eye or one side of the face at a time.
56
what are symptoms of a cluster headache?
swelling, redness, flushing, and sweating on the side that’s affected by the headache
nasal congestion and eye tearing on the same side as the headache
57
how often do people with a cluster headache experience them?
one every other day to eight for day. around the same time
58
what type of pain does a migraine give? what are the symptoms?
pulsing pain deep within the head..
throbbing pain, usually on one side of the head
light sensitivity
sound sensitivity
nausea and vomiting
59
what are the triggers of migranes?
sleep disruption
dehydration
skipped meals
some foods
hormone fluctuations
exposure to chemicals
60
what is a hemicrania continua headache?
a moderate headache on one side of your head that last continuously for 3 months. periods of intensity a few times per day.
61
what are symptoms of hemicrania continua?
tearing or eye redness
nasal congestion or runny nose
eyelid drooping
forehead sweating
miosis or excessive shrinking of the pupil
restlessness or agitation
62
what is a ice pink headache?
short, intense stabbing pains in your head lasting only a few seconds.
These headaches can occur a few times daily and come on without warning. Ice pick headaches could feel like a single stab or multiple stabs in succession.
move to different parts of the head
63
what is a thunderclap headache?
a severe headache that comes on rapidly, reaching peak intensity under a minute.
64
what could thunderclap headaches be a indication of?
blood vessel tears, ruptures, or blockages
stroke
brain injury
reversible cerebral vasoconstriction syndrome (RCVS)
vasculitis (inflammation of blood vessels)
pituitary apoplexy (bleeding into or loss of blood from an organ)
65
what is motor neuron disease?
a condition which progressively damages parts of the nervous system, leading to muscle weakness.
the nerves stop working and die
66
what are the early symptoms of motor neurone disease?
limb onset disease- a weakened grip which can cause problems picking up or holding objects.
weakness at the shoulder, cannot lift the arm
tripping up over your foot due to weakness at the ankle or hip.
bulbar onset disease- increased slurred speech. may be difficult to swallow.
respiratory onset disease- starts by affecting the lungs, rather than affecting them at the end of the condition. breathing difficulties and shortness of breath. headaches and a lack of sleep due to not getting rid of co2
67
what is spacasticity?
when muscles contract, become stiff or spasm involuntarily its called spasticity.
68
what causes spasticity?
when nerve impluses that control muscle movement are interrupted or damaged.
a variety of conditions can cause this including:
spinal cord injury,
brain injury,
amyotrophic lateral sclerosis
multiple sclerosis.
69
what are symptoms of spasticty?
muscle tightness,
joint stiffness,
involuntary jerky movements,
exaggeration of reflexes,
unusual postures,
bnormal positioning of fingers, wrists, arms, or shoulders
muscle spasms
involuntary crossing of the legs, which is called “scissoring” because the legs cross like the tip of a pair of scissors
difficulty controlling the muscles used to speak
muscle contraction that limits your range of motion or prevents your joints from extending all the way
pain in the affected muscles and joints
back pain
difficulty moving
70
what is transient loss of consciousness?
loss of consciousness with complete recovery. like a blackout.
71
what are causes of transient loss of consciousness?
uncomplicated faint or situational syncope;
orthostatic hypotension;
dysfunction of the nervous system (epilepsy);
dysfunction of the cardiovascular system (syncope); or
dysfunction of the psyche (psychogenic attacks).
72
what history taking questions would you ask someone with trainset loss of consciousness?
person's posture immediately before TLoC;
presence or absence of any prodromal symptoms (such as sweating or feeling warm/hot) and movement during event (for example, jerking of the limbs and duration);
appearance (for example, whether eyes were open or shut) and colour of the person during the event;
any biting of the tongue (record whether the side or the tip of the tongue was bitten);
injury occurring during the event (record site and severity);
duration of the event (onset to regaining consciousness);
presence or absence during the recovery period of confusion or weakness down one side; and
current medication that may have contributed to TLoC (for example, diuretics).
73
what ECG problems should you look for when loss of consciousness happens?
conduction abnormality (for example, complete right- or left-bundle branch block or any degree of heart block);
evidence of delayed atrioventricular conduction, including bundle branch block;
evidence of a long or short QT interval; or
any ST segment or T wave abnormalities.
74
what are causes of urinary incontinece?
Stress incontinence: Leakage when sneezing, exercising, or coughing
Side effects of medications
Certain foods
Weakened pelvic floor muscles
Pregnancy & child birth
Aging
Severe constipation
Changes in the body from childbirth or surgery
75
whats the difference between a sezuire and epilepsy?
A seizure is a single occurrence, whereas epilepsy is a neurological condition characterized by two or more unprovoked seizures.
Epilepsy is a brain disorder that causes recurring, unprovoked seizures. Your doctor may diagnose you with epilepsy if you have two unprovoked seizures or one unprovoked seizure with a high risk of more.
Seizures are sudden surges of abnormal and excessive electrical activity in your brain and can affect how you appear or act. Where and how the seizure presents itself can have profound effects.
76
what is multiple sclerosis?
A chronic autoimmune disease that affects the central nervous system. Causes inflammation and damage to the myelin sheath (the protective covering around the nerve fibres)
This can disrupt the communication between the brain and rest of the body.
77
what are symptoms of multiple sclerosis?
Fatigue, difficultly walking, vision problems such as blurred vision, problems controlling the bladder, numbness or tinging in different parts, muscle stiffness and spasms, problems with balance and co-ordination, problems with learning and planning.
78
what are risk factors of MS
Genetics, vitamin D deficiency, cigarette smoking, diet and obesity in early life, woman 2x as likely, latitude (increases in the northern latitudes), Epstein bar virus ( EBV is a type of herpesvirus called herpesvirus 4)
79
what is amneisa?
Problem with part of the brain which is responsible for memory formation.
Amnesia refers to the loss of memories, including facts, information and experiences
2 types:
Retrograde- cant remember memories from your past.
Anterograde- brain cant form new memories from what your experiencing now.
80
what are causes of amnesia?
Traumatic Brain Injury
Neurosurgery
Hypoxia or Anoxia
Ischemia
Viral Infections
Stroke
Seizures
Brain Tumors
81
what is the management of amnesia?
The aid of digital devices to set reminders
Journaling
Exercise
Cognitive behavioural therapy
Psychotherapy
82
what is the treatment for epilepsy?
Oxygen, buccal midazolam
IV access- diazepam. (treats anxiety, seizures, muscle spasms or twitches. It can also reduce the symptoms of alcohol withdrawal. It works by helping your nervous system calm down.)
83
what is grand mal epilepsy?
A tonic-clonic seizure, previously known as a grand mal seizure, causes a loss of consciousness and violent muscle contractions. It's the type of seizure most people picture when they think about seizures.
84
what is petit mal epilepsy?
Absence seizures involve brief, sudden lapses of consciousness
85
what is focal epilepsy?
focal epilepsy is a neurological condition in which the predominant symptom is recurring seizures that affect one hemisphere (half) of the brain.
86
what are the stages of a sezuire?
aura stage- halluciation, confusion, dizzy, numbness
tonic stage- back arched, stiff body, incontinence,
clonic stage- jerky movement, blinking eyes
postrical stage- weak limbs, exhaustion, sleepy
87
what is alzheimers disease caused by?
Caused by a loss or damage to the synapses in the brain, which in turn causes neural atrophy within the brain.
The damage occurs to a build up of proteins (amyloid plaques) which causes delays in the transmission of electrical signals within the brain
The build up of prrotein tau causes neural pathways to become tangled or clumped further accelerating neural atrophy.
Over time this causes certain parts of the brain mostly the hippocampus and temporal lobes to shrink which causes the symptoms of alzheimers.
88
what are the symptoms of alzhimers?
M
Symptoms:
Confusion, disorientation and getting lost in familiar places
Difficulty planning or making decisions
Problems with speech and language
Problems performing daily activities without assistance and performing self-care tasks
Personality changes such as becoming aggressive, demanding or becoming suspicious of other people
Hallucinations and delusions
Low mood or anxiety
